Affiliations: [a] Instituto Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal
| [b] School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| [c] ACeS Algarve I Central, ARS Algarve, Faro, Portugal
| [d] Universidade do Algarve, Faro, Portugal
| [e] Centro de Investigação Interdisciplinar em Saúde-Porto, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal
| [f]
Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
Correspondence:
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Address for correspondence: Joana Pereira Sousa, School of Health Sciences, Polytechnic of Leiria, Rua General Norton de Matos, Apartado 4133, 2411-901 Leiria, Portugal. Tel.: +351244830010; E-mail: jomorango@gmail.com.
Abstract: BACKGROUND:Patients with heart failure often have difficulty recognizing signs and symptoms of the disease, which delays seeking help, and therefore interferes with patient engagement and self-care management. Early detection of these symptoms could lead to care-seeking and avoid hospitalizations. OBJECTIVE:The purpose of this study was to design a complex intervention through a systematic literature review and qualitative study. METHODS:Our design followed the Medical Research Council’s recommendations. To design a complex intervention, we combined a systematic literature review on education, symptom recognition, and self-care management in patients with heart failure, and semi-structured interviews with cardiology healthcare providers and patients with heart failure admitted to a cardiology ward. RESULTS:The systematic literature review identified 582 studies published between 2005 and 2014, of which four were included in the final review. These suggested that patient education focused on symptom recognition, combined with reinforcements, led to better self-care behaviors. Additionally, content analysis of semi-structured interviews revealed three themes: health management, behavior management, and support received. CONCLUSIONS:Combining the findings of the literature review and the themes that emerged from the semi-structured interviews, we proposed the development and implementation of a complex intervention on symptom perception and fluid management.
