Cumulative complexity: a qualitative analysis of patients' experiences of living with heart failure with preserved ejection fraction



Forsyth, Faye, Blakeman, Thomas, Burt, Jenni, Chew-Graham, Carolyn A, Hossain, Muhammad, Mant, Jonathan, Sharpley, John, Sowden, Emma ORCID: 0000-0002-3538-8725 and Deaton, Christi
(2023) Cumulative complexity: a qualitative analysis of patients' experiences of living with heart failure with preserved ejection fraction. EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, 22 (5). pp. 529-536.

Access the full-text of this item by clicking on the Open Access link.

Abstract

<h4>Aims</h4>To investigate how heart failure with preserved ejection fraction (HFpEF), within the context of limited clinical services, impacts patients' lives.<h4>Methods and results</h4>Secondary thematic analysis informed by the cumulative complexity model (CCM), of interview transcripts from 77 people diagnosed with HFpEF and their carers. Four themes corresponding to the core concepts of workload, capacity, access, and outcome described in the CCM were generated. Theme 1: Shouldering a heavy workload described the many tasks expected of people living with HFpEF. Theme 2: The multiple threats to capacity described how patients and carers strived to engage with this work, but were often faced with multiple threats such as symptoms and mobility limitations. Deficient illness identity (Theme 3) reflects how HFpEF either was not recognized or was perceived as a more benign form of HF and therefore afforded less importance or priority. These themes contributed to a range of negative physical, social, and psychological outcomes and the perception of loss of control described in Theme 4: Spiraling complexity.<h4>Conclusions</h4>The constellation of HFpEF, multi-morbidity, and ageing creates many demands that people with HFpEF are expected to manage. Concurrently, the same syndromes threaten their ability to physically enact this work. Patients' recollections of their interactions with health professionals suggest that there is a widespread misunderstanding of HFpEF, which can prohibit access to care that could potentially reduce or prevent deterioration.

Item Type: Article
Uncontrolled Keywords: Heart Failure, HFpEF, Older adults, Self-care, Health inequality
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 30 Jan 2023 17:28
Last Modified: 09 Aug 2023 06:00
DOI: 10.1093/eurjcn/zvac081
Open Access URL: https://doi.org/10.1093/eurjcn/zvac081
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3167972