Using vignettes to understand heart failure self-care.
Jiayun Xu, Sofia Arruda, Joseph J Gallo and 6 others
PMID 29943481WHAT IT FOUND
Heart failure patients recognized breathlessness as urgent, but were less certain about weight gain and leg swelling.
Written scenarios showed gaps in applying self-care advice.
Key findings
01In the urgent vignette, 35% said they would go to the ER or call 911, and 35% said they would contact a health care provider.
02In the physician and increased self-care vignette, 75% recognized the need to contact a physician or increase self-care, but 80% did not identify the need to monitor weight more carefully.
03In the usual self-care vignette, no participants reported weight monitoring.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The responses were to written hypothetical situations, so patients may act differently during real symptom worsening. The participants' own worsening symptoms may have differed from the vignettes. Social desirability bias may have affected responses. The study did not measure what heart failure education participants had received. Only 20 patients were interviewed, and the paper notes the sample was mostly older, urban, male and African American, so findings may not apply to the wider heart failure population.
Declared interests
No conflicts of interest were reported; no funder is named in the supplied text.
The easy way to misread this
Do not conclude that vignettes improve heart failure self-care or patient outcomes. This study only asked patients how they would respond to written scenarios, and the authors state the vignettes have not been tested as an educational tool.