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Patient perspectives on decision making in heart failure
Dan D Matlock1, Carolyn T Nowels, David B Bekelman
1University of Colorado Denver School of Medicine, Division of General Internal Medicine, Academic Office 1, 12631 E. 17th Avenue, Campus Box B-180, Aurora, CO 80045, USA. daniel.matlock@ucdenver.edu
Journal of Cardiac Failure
|October 12, 2010
Summary
Patients with heart failure (HF) make difficult medical decisions using either active or passive styles. Understanding these decision-making approaches is crucial for personalized patient care.
Area of Science:
- Cardiology
- Medical Sociology
- Qualitative Health Research
Background:
- Heart failure (HF) presents patients with complex treatment choices.
- Effective decision-making is vital for managing HF.
- Patient perspectives on these decisions are not fully understood.
Purpose of the Study:
- To explore patients' perceptions of difficult decisions in heart failure.
- To identify factors influencing these patient decisions.
Main Methods:
- Qualitative study using in-depth, semistructured interviews.
- 22 patients with symptomatic heart failure were interviewed.
- Descriptive theme analysis was employed.
Main Results:
- Two decision-making styles identified: active (55%) and passive (45%).
- Active decision-makers focused on interventions like ICDs, medications, and transplants, weighing side effects, family, and quality of life.
- Passive decision-makers deferred choices to trust in God or physicians, often not identifying specific difficult decisions.
Conclusions:
- Heart failure patients exhibit distinct active and passive decision-making styles.
- Further research needed on communication strategies for passive decision-makers to ensure value-concordant care.
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