caa a22 4500 605478759 CHVBK 20210128100407.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s10741-015-9511-x doi (NATIONALLICENCE)springer-10.1007/s10741-015-9511-x Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis [Elektronische Daten] [S. Ivynian, M. DiGiacomo, P. Newton] Over 50% of heart failure (HF) patients delay seeking help for worsening symptoms until these reach acute levels and require emergency hospitalisation. This metasynthesis aimed to identify and explore factors influencing timely care-seeking in patients with HF. Electronic databases searched were MEDLINE, Embase, and CINAHL. Studies were included if they were peer-reviewed journal articles, written in English, and reported perspectives of HF patients following qualitative data collection and analysis. Forty articles underwent analysis following the approach of Thomas and Harden. Leventhal's self-regulatory model (SRM) was used to organise the literature. Much of the literature fits within the SRM; however, this model did not account for all factors that influence patients' care-seeking for worsening symptoms. Factors not accounted for included patients' appraisals of previous care-seeking experiences, perceived system and provider barriers to accessing care, and the influence of external appraisals. When added to factors already represented in the model, such as misattribution of symptoms, not identifying with HF diagnosis, cognitive status, lack of understanding information provided, adaptation to symptoms, and emotional responses, a more comprehensive account of patients' decision-making was revealed. This metasynthesis identified factors, as yet unaccounted for, in a prominent model, and has suggested a more comprehensive framework for addressing care-seeking in HF patients. This information can be used to tailor education, communication, and service initiatives to improve HF patients' responses to worsening symptoms and target those most at risk of delay. Springer Science+Business Media New York, 2015 Metasynthesis nationallicence Qualitative review nationallicence Care-seeking nationallicence Symptoms nationallicence Ivynian S. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut DiGiacomo M. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut Newton P. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut Heart Failure Reviews Springer US; http://www.springer-ny.com 20/6(2015-11-01), 655-671 1382-4147 20:6<655 2015 20 10741 https://doi.org/10.1007/s10741-015-9511-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10741-015-9511-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ivynian S. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut NATIONALLICENCE 700 1- DiGiacomo M. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut NATIONALLICENCE 700 1- Newton P. Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, 2007, Ultimo, NSW, Australia aut NATIONALLICENCE 773 0- Heart Failure Reviews Springer US; http://www.springer-ny.com 20/6(2015-11-01), 655-671 1382-4147 20:6<655 2015 20 10741