Experiences with cross-sectional healthcare and treatment in heart failure patients: implications for medical education.

Objectives: to explore how cross-sectional healthcare and treatment is experienced a) by patients with advanced heart failure and multimorbidity and b) by hospital-employed healthcare professionals.

Methods: Individual telephone interviews with 18 patients and close relatives were conducted. Furthermore, a focus group session was conducted with four specialised hospital-employed healthcare professionals. Purposeful sampling was used and interviews were semi-structured. Data were analysed using qualitative inductive content analysis.

Results: Three main themes emerged from the interviews with patients and close relatives. These included: 1) A need for improved coordination to ensure continuity of care; 2) a plea for patient-centred care; and 3) recognition of the need to care for close relatives. Analysis of the interviews with hospital-employed healthcare professionals also produced three themes. These concerned: 1) recognition of the role and needs of close relatives; 2) limited resources for and difficulties in meeting these needs; and 3) agreement on the need for patient-centred care. Furthermore, we learned that perceived challenges are rooted in time constraints and the need for an adequate level of medical knowledge of chronic conditions and complex treatment strategies.

Conclusions: This study indicates that cross-sectional healthcare and treatment of patients with advanced heart failure and multimorbidity lacked coordination, was insufficiently patient-centred and did not cater for close relatives' needs. The study identifies patient-centredness and coordination of healthcare services targeting patients and close relatives alike as critical to proper care, medical curriculum development and continued medical training courses.