"Being in good hands": next of kin's perceptions of continuity of care in patients with heart failure

BMC Geriatr. 2019 Dec 26;19(1):375. doi: 10.1186/s12877-019-1390-x.

Abstract

Background: Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF.

Methods: This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n = 15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon.

Results: The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities.

Conclusions: Next of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of "being in good hands" sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin.

Keywords: Continuity of care; Heart failure; Next of kin; Phenomenography; Qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Caregivers / standards*
  • Continuity of Patient Care / standards*
  • Family / psychology*
  • Female
  • Health Personnel / psychology
  • Health Personnel / standards
  • Heart Failure / diagnosis
  • Heart Failure / psychology*
  • Heart Failure / therapy*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Primary Health Care / standards
  • Qualitative Research