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Lived Experiences of Patients Hospitalized With Acute Decompensated Heart Failure and Kidney Dysfunction
Gwen M Bernacki1,2,3,4, Ann M O'Hare1,2,3,5,6, Mahlet Assefa1,5
1Department of Medicine, University of Washington, Seattle.
JAMA Network Open
|January 17, 2025
Summary
Patients with acute decompensated heart failure and kidney dysfunction experience significant challenges. Improving communication and education is crucial for enhancing their care and engagement.
Area of Science:
- Cardiology
- Nephrology
- Patient Experience
Background:
- Kidney dysfunction complicates acute decompensated heart failure (ADHF) prognosis and treatment.
- Lived experiences of ADHF patients with kidney dysfunction are under-researched.
Purpose of the Study:
- To explore the illness and care experiences of hospitalized ADHF patients with kidney dysfunction.
- To identify areas for care improvement in this vulnerable population.
Main Methods:
- Qualitative study involving 40 interviews with 28 patients hospitalized with ADHF and kidney dysfunction.
- Interviews conducted during hospitalization and 3 months post-discharge.
- Inductive thematic analysis of transcribed interviews.
Main Results:
- Four themes emerged: functional limitations, adapting goals, interpreting clinical information, and decision-making roles.
- Patients struggled to understand kidney dysfunction's significance and connect it to symptoms.
- Participants often deferred decision-making to clinicians, feeling unequipped.
Conclusions:
- Improving education, communication, and patient engagement is vital for ADHF patients with kidney dysfunction.
- Addressing patient understanding and empowerment can enhance care for this group.
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