The experiences of heart failure patients following their participation in self-management patient education programmes: a systematic review.

Background Heart failure patients benefit from self-management educational programmes. Most research reports tend to adopt a quantitative approach and report on outcome measures such as quality of life and symptom management. Objectives The objective of this review was to synthesise the evidence on the experiences of heart failure patients who participated in the self-management patient education programmes and the impact upon their subsequent health maintenance. Inclusion criteria Types of participants The participants were adult patients (18 years and older) with heart failure taking part in self-care management educational programmes. Phenomena of interest The review considered studies that explored heart failure patients' experiences of self-care management programmes. Types of outcomes The review focused on the subjective accounts of patients experiences of participation in self-care management programmes and ability to manage their condition confidently. Types of studies The review considered interpretive and critical qualitative studies and studies of mixed methods designs (only the qualitative data). Search strategy The search of the literature focused on finding published studies and other publications in the English language, from 2000 to 2011. Methodological quality Each study was assessed for methodological quality, independently by two reviewers, using the Joanna Briggs Institute's critical appraisal tools. Data extraction Data was extracted from qualitative studies and the qualitative elements of mixed methods studies using the Joanna Briggs Institute's data extraction tools. Data synthesis Using JBI-QARI, data were pooled in a meta-synthesis. Categories were formed based on an aggregation of findings with similar meaning. The categories were analysed to identify three synthesised findings that were presented as declamatory and generalisable statements to guide and inform practice. Results Eight studies were included in the review. Forty-seven findings were extracted and grouped into seven categories which were synthesised into two synthesised findings relating to motivation to attend self-care programmes and adopt health behaviours, and experience of greater confidence and control over heart failure through participation in group programmes and supportive healthcare professionals. Conclusion Self-management programmes were useful in building patients' confidence to manage heart failure. Patient self-management was enhanced when programmes were provided by supportive staff, augmenting patients' understanding and motivation to change their eating habits, take regular exercise and manage and monitor their symptoms including medication for health maintenance. Implications for practice Patients' experiences of self-management education programmes suggest that they are instrumental in motivating heart failure patients to take responsibility for their illness and when provided in a supportive, group environment these can offer patients confidence to manage their care. Hence, healthcare professionals should provide programmes which enable patients to take responsibility for changing health behaviours. Implications for research Further research exploring the negative experiences of patients need to be conducted to gain a clearer understanding of those patient experiences which hinder continued self-care.