Advance care planning experiences of patients with heart failure and their families: a qualitative systematic review protocol.

OBJECTIVE: This review aims to synthesize advance care planning experiences of patients with heart failure at stage C or D, and the experiences of their families. INTRODUCTION: The high incidence rates worldwide and the health burdens associated with heart failure indicate a need to implement end-of-life care for people with cardiovascular disease. Advance care planning is a core process in effective end-of-life cardiovascular care. Since the trajectory of heart failure is unique, it is necessary to establish patient-specific interventions focusing on their experiences, and develop effective advance care planning interventions. However, no previously published systematic reviews have integrated knowledge of the patient's or the family's experience. Therefore, more comprehensive analyses of the experiences of patients with heart failure and their families are required to conduct better interventions. INCLUSION CRITERIA: This review will consider qualitative studies on the experiences of adult patients with stage C or D heart failure who participated in advance care planning, and the experiences of their families. Studies conducted in all settings that accommodate patients with heart failure will be considered. METHODS: PubMed, CINAHL, Web of Science, Science Direct, Cochrane Central Register of Controlled Trials, PsycINFO, ProQuest Dissertations and Theses Global, Google Scholar, and gray literature will be searched for articles that meet the inclusion criteria. Studies published in English from the inception of the database to the present will be considered. Eligible studies will be critically appraised using standardized JBI tools for qualitative synthesis. The findings will be pooled using a meta-aggregation approach. The final synthesized findings will be assessed according to the ConQual approach to establish confidence in qualitative research synthesis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021229096.

Patient Perspectives of a Non-Invasive Telemonitoring Tool for Patients with Heart Failure.

AIM: Advancements in telemonitoring (TM) for patients with heart failure (HF) are incongruous because of the effect of TM intervention and various types of TM. This study aimed to clarify patients' experiences in using the TM tool. METHODS: This was a qualitative study. Data were evaluated using qualitative content analysis. Nine patients with heart failure → HF participated and completed the 1-month study period. RESULTS: The experience of this TM tool was determined using semi-structured interviews followed by qualitative content analysis. Finally, five themes emerged: habituation of self-care behaviour, no burden for use, a feeling of security, additional functions and advice rather than guidance. CONCLUSION: This TM tool is easy to use and has the potential to promote self-management in patients with HF. Based on the aforementioned findings, we revised this tool and added some functions and will perform additional tests.

Development of a Home-Based Nursing Intervention Model for Patients With Heart Failure: A Qualitative Feasibility Study.

AIM: To develop and verify the feasibility of a personalized home-based heart failure (HF) nursing intervention model to support HF patients, promote self-management, and avoid HF exacerbation and re-hospitalization. METHODS: Based on processes established in previous studies, literature reviews, and evidence-based guidelines and theories, we developed the nursing intervention model for patients with HF. The goal of this model is to harmonize symptom deterioration prevention behavior and individual lifestyle. After intervention, we conducted semi-structured interviews with participants, and data were transcribed verbatim, after which qualitative content analysis was employed. The contents of visiting nursing practice, opinions on this nursing model, and self-management in patients with HF were analyzed qualitatively and inductively from the viewpoint of practicality and acceptability. RESULTS: Five nurses who provided interventions, as well as five patients with HF, participated in this study. Accordingly, our findings showed that the framework, assessment, and nursing intervention contents of this model can be practical for everyday home nursing visitations. CONCLUSIONS: The content has been revised so that more visiting nurses can use them, including those who have less cardiovascular nursing experience.

Self-management of congestive heart failure among elderly men in Japan.

The purpose of this study was to explore the process of self-management in elderly male patients with congestive heart failure among those who have had not needed re-hospitalization for more than 2 years. Semi-structured interviews were conducted with 10 male congestive heart failure patients. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the modified grounded theory approach. As a result of the analysis, the core concept identified was a process of living life such that symptoms do not worsen, while balancing good choices and preferences. By trial and error, the men tried to find the limits of physical capacity and dietary choices that would lead to the worsening of symptoms, while also trying to maintain quality of life to the extent possible.

MRI reveals fetus in fetu in the mediastinum.

Fetus in fetu is an extremely rare condition in which a fetiform calcified mass is contained within the newborn or infant, often in the retroperitoneal cavity. We report a case of a fetus in fetu in the posterior mediastinum of a newborn. The prospective diagnosis was made by fetal US and MRI and confirmed by postnatal plain radiograph, CT and MRI.