Heart failure at home—patients’ experiences of participation in structured home care

Introduction: Acute hospital settings do not provide the ideal care environment for older patients with heart failure (HF). An option is to provide advanced HF care in the patient’s home. A European integrated home-care model has been developed with the goals that patients will experience participation, safety and have knowledge about their disease and treatment. Participation in care has shown to have positive effects on self-care activities. Aim: To describe the meaning of participation in care of HF patients who receive home-care. Methods: Patients receiving home-care at four different settings were included in the study. Strategic sampling was used to reach a variation regarding severity of HF, different needs of home-care, age and gender. A total of 18 open ended interviews have been conducted. The interviews were analyzed with qualitative content analysis, where categories were developed inductively. A preliminary analysis based on nine out of 18 interviews has been initiated. Five preliminary categories that describe patient participation have been identified: caring communication, accessibility, individual activity, trust and prerequisites for making decisions. Each category consists of different subcategories. Significance of the study: Participation in care is regulated in health-care legalizations and is important from the individual’s perspective. Home-care is becoming more common in patients with HF. Therefore it is important to describe HF patient’s experiences of participation within home-care.