Hearing the Veteranʼs Voice in Congestive Heart Failure Readmissions

摘要: Purpose/objective Our purpose was to examine congestive heart failure (CHF) readmissions from the veterans' perspective. The use of health care provider interventions, such as standardized education materials, home telehealth, and a CHF clinic, able reduce rates 35% 23%. objective input veterans fine-tune our efforts achieve readmission for patients with below national average 21%. We wanted identify factors that result in readmissions, including disease education, self-care management, barriers self-care. This study directed toward answering two questions: 1. What is veteran’s explanation readmission? 2. According veteran, what are following their treatment regimen? Primary practice setting It rural 84-bed Veterans Health Administration hospital Western United States. Findings Before this study, were one-sided, all professionals' viewpoint. hear veteran had say; so, we interviewed 25 veterans. Four excluded due issues consents. Ninety percent (n = 19/21) responded they knew worse by change breathing (shortness breath). They identified 48 signs/symptoms indicated worsening CHF. Weight gain noted an indication symptoms 6/48) 12.5% responses. Twenty-five 12/48) stated recognized early Thirty-eight 8/21) CHF, but only them contacted doctor. interesting note 29% 6/21) weight sign these listed other (such shortness breath) along gain. Weighing on daily basis practiced 30% group 7/21); no problems weighing themselves. More than 71% diet or taking medications. half did not need help meals, transportation, grooming/dressing/toileting. Conclusions concerned about evident delays seeking medical All who activities living, medications, needs met through support systems. perceive any care. However, there remain many unanswered questions. Does patient understand discharge know how information weights recognition symptoms, indicate urgent emergency interventions? Or it problem sufficient? Is question burden multiple comorbid conditions too medications? Do social drive readmissions? These questions further explored second which data analysis stage. Implications case management There three key findings study. think terms increase impact life. relationship between controlling clear 3. Hospital instructions should clearly associate associated