Cargando…

‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda

BACKGROUND: Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illne...

Descripción completa

Detalles Bibliográficos
Autores principales: Namukwaya, Elizabeth, Murray, Scott A., Downing, Julia, Leng, Mhoira, Grant, Liz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5619713/
https://www.ncbi.nlm.nih.gov/pubmed/28957338
http://dx.doi.org/10.1371/journal.pone.0182876
_version_ 1783267450688634880
author Namukwaya, Elizabeth
Murray, Scott A.
Downing, Julia
Leng, Mhoira
Grant, Liz
author_facet Namukwaya, Elizabeth
Murray, Scott A.
Downing, Julia
Leng, Mhoira
Grant, Liz
author_sort Namukwaya, Elizabeth
collection PubMed
description BACKGROUND: Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. METHODS: Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. RESULTS: A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. CONCLUSION: There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information.
format Online
Article
Text
id pubmed-5619713
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-56197132017-10-17 ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda Namukwaya, Elizabeth Murray, Scott A. Downing, Julia Leng, Mhoira Grant, Liz PLoS One Research Article BACKGROUND: Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. METHODS: Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. RESULTS: A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. CONCLUSION: There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information. Public Library of Science 2017-09-28 /pmc/articles/PMC5619713/ /pubmed/28957338 http://dx.doi.org/10.1371/journal.pone.0182876 Text en © 2017 Namukwaya et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Namukwaya, Elizabeth
Murray, Scott A.
Downing, Julia
Leng, Mhoira
Grant, Liz
‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title_full ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title_fullStr ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title_full_unstemmed ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title_short ‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda
title_sort ‘i think my body has become addicted to those tablets’. chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: a qualitative longitudinal study from uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5619713/
https://www.ncbi.nlm.nih.gov/pubmed/28957338
http://dx.doi.org/10.1371/journal.pone.0182876
work_keys_str_mv AT namukwayaelizabeth ithinkmybodyhasbecomeaddictedtothosetabletschronicheartfailurepatientsunderstandingofandbeliefsabouttheirillnessanditstreatmentaqualitativelongitudinalstudyfromuganda
AT murrayscotta ithinkmybodyhasbecomeaddictedtothosetabletschronicheartfailurepatientsunderstandingofandbeliefsabouttheirillnessanditstreatmentaqualitativelongitudinalstudyfromuganda
AT downingjulia ithinkmybodyhasbecomeaddictedtothosetabletschronicheartfailurepatientsunderstandingofandbeliefsabouttheirillnessanditstreatmentaqualitativelongitudinalstudyfromuganda
AT lengmhoira ithinkmybodyhasbecomeaddictedtothosetabletschronicheartfailurepatientsunderstandingofandbeliefsabouttheirillnessanditstreatmentaqualitativelongitudinalstudyfromuganda
AT grantliz ithinkmybodyhasbecomeaddictedtothosetabletschronicheartfailurepatientsunderstandingofandbeliefsabouttheirillnessanditstreatmentaqualitativelongitudinalstudyfromuganda