Factors influencing adherence to a prescribed health regimen for individuals with heart failure.

摘要

Heart Failure (HF) is a source of substantial morbidity and mortality as well as a financial burden to both the health care system and individual patients. The complex process of HF requires multifaceted treatment. Despite advances in pharmacology and health care delivery processes, the problem of repeated hospitalization for HF remains significant. Non-adherence to prescribed health regimens has been identified as the most common cause of hospital readmission for individuals with HF. However, little work has been done to clarify the causes of non-adherence for this population. This study used a phenomenological methodology to identify factors that influence individuals to adhere to the prescribed regimen of care. Because of the nature of the research question, the interviews included rich information about the participants' experiences of the disease process and symptom management of HF. Themes emerging from this data were: failure to recognize symptoms, failure to respond to symptoms, making a decision to seek help, and lack of knowledge. Sub-themes of wait and see, helplessness and duty and devotion emerged within the theme of failure to respond appropriately to symptoms. In addition, the experience of adherence within the larger picture of receiving a diagnosis of HF and the subsequent management of the disease was described in detail. This yielded themes of acceptance, integration, adaptation and adherence. Sub-themes of loss and depression emerged within the theme of integration. The themes that emerged that described the factors influencing adherence were: availability of resources, convenience, personal perceptions, and support. Establishing a routine, planning, and identifying a focal point were sub-themee that promote a positive effect from the influencing factors. The data generated from this study can be used to better serve this population though more thorough and individualized assessment and treatment plans.