Perceptions of patients with heart failure before and after CRT implantation regarding their self-care

Abstract

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): ESC Nursing Training Grant Background Cardiac Resynchronization Therapy (CRT) is increasingly used to improve ventricular contraction and physical performance in patients with heart failure (HF). Although implantation of a CRT is associated with improved health status, not all patients benefit from a CRT implantation. Physical activity is an important self- care behaviour but some patients struggle with physical activity and experience lack of improvement of their physical condition and symptoms of HF. To optimise support to improve self-care of patients after a CRT implantation, information is needed on their expectations of the CRT and their needs and preferences towards self-care support. Purpose To explore perceptions of patients before and after CRT implantation regarding their expectations and explore factors that influence their physical activity, HF symptom monitoring and management and their needs and preferences towards self-care support. Methods An explorative generic qualitative study with semi-structured interviews is currently performed. A total of 18 adult patients were interviewed: 8 patients <3 months prior to the CRT implantation and 10 patients 5 to 24 months after CRT implantation. Patients varied in age and gender. Interviews were audio-recorded and thematically analysed according to Braun & Clarke. Results Prior to the CRT implantation, patients expected to feel more energetic and experience less dyspnea to resume activities they could not perform due to their poor cardiac condition. Remote monitoring of the CRT made them feel safe. Patients trusted the professional opinion of the healthcare providers. Few patients experienced support in their self-care from a HF nurse. Patients felt the need to easily contact their healthcare provider when experiencing symptoms or having HF–related questions. Informal caregivers play a key role in supporting patients in being physically active and monitoring and managing HF symptoms. Conclusion Before implantation patients have high expectations of the effects of CRT implantation. It is important to consider patients’ need for support to improve physical activity, symptom monitoring and thoughtfully responding to symptoms and engaging assistance of informal caregivers in their health.