Understanding of illness Assignment PDF

Part one
Im, J., Mak, S., Upshur, R., Steinberg, L., & Kuluski, K. (2019). 'The Future is
Probably Now': Understanding of illness, uncertainty and end‐of‐life
discussions in older adults with heart failure and family caregivers. Health
Expectations, 22(6), 1331-1340. https://doi.org/10.1111/hex.12980
An interpretive description qualitative study of adults with heart failure (HF)
and their family caregivers. The aim of the study was to investigate patients’ and their
caregivers’ understanding of HF, their moments of uncertainty, and their knowledge,
understanding, and experiences with end-of-life discussions. 12 patients and seven
family caregivers were selected from an outpatient clinic in Canada, the selection
criteria included; patients who were older than 65 years with advanced HF or older
than 80 years and were being treated by the HF clinic, not awaiting a transplant, not
under specialist palliative care, English speaking, and able to provide informed
consent. The lead author conducted hour long interviews with the participants where
they were asked open-ended question on the following categories: goals of care, end-
of-life discussion, and understanding of illness. The transcripts from the interview
were reviewed and the answers to the questions were categorised. The study found
that the participants’ understanding of HF was shaped by their experiences with the
illness, symptoms, self-care routines, and hospitalisations, as well as their ability to
adapt to challenges cause by HF. Majority of participants were knowledgeable
regarding management of their disease, yet restricted in their comprehension of the
potential consequences of HF. Majority of participants had not yet participated in end-
of-life discussions, with an inability to connect the manifestations of HF with the
progression of illness leading towards the end-of-life. The study was limited by the
fact that the sample size for carers was small, as well as the fact that the data was

gained by only what the participants chose to share. Given the sensitivity of the topics
covered, some information may have been withheld. Overall, majority of participants
had not engaged in end-of-life discussions and further research is needed to determine
the impact of early end-of-life care discussions for patients’ with HF and their
caregivers.
Jiang, Y., Shorey, S., Seah, B., Chan, W. X., Tam, W. W. S., & Wang, W. (2018).
The effectiveness of psychological interventions on self-care, psychological
and health outcomes in patients with chronic heart failure—A systematic
review and meta-analysis. International Journal of Nursing Studies, 78, 16-25.
https://doi.org/https://doi.org/10.1016/j.ijnurstu.2017.08.006
A systematic review and meta-analysis with the aim of evaluating the
effectiveness of randomised control trials that use psychological theory or methods on
anxiety and depression levels, self-care behaviours, physical function, and health
related quality of life (HRQoL). The interventions used to assess the effectiveness
included; psychotherapy, stress management, motivational interviewing, and/or
therapeutic or nondirective supportive counselling. A thorough literature search of
English studies conducted between January 2006 and December 2016 was preformed
using CINAHL, Cochrane Library, EMBASE, PubMed, PsycINFO, Scopus, Web of
Science, and ProQuest Dissertations and Theses. The trials were reviewed by the
primary author in order to determine eligibility and were then critically appraised
based on the Cochrane Collaboration Tool. 29 articles were included in this systemic
review, comprising of 25 studies with 3837 participants. The outcome measures of
this review include self-care behaviours, anxiety and depression levels, HRQoL, and
physical function. The review found that psychological interventions improve HRQoL
at three months post follow-up. There was no significant effect on the participants’

anxiety level and physical function. Cognitive behavioural therapy (CBT) did show to
improve depression levels and a positive, but short term, effect was shown on self-
care. The review was limited by the fact that only English studies were included and
the sample size of some of the studies were relatively small. Overall, psychological
interventions on self-care and HRQoL in HF patients without clinical depression and
cognitive impairment, produces a beneficial effect.
Miller, S., Mandrusiak, A., & Adsett, J. (2018). Getting to the Heart of the Matter:
What is the Landscape of Exercise Rehabilitation for People With Heart
Failure in Australia? Heart, Lung & Circulation, 27(11), 1350-1356.
https://doi.org/10.1016/j.hlc.2017.08.016
A cross-sectional survey of public, private and community health services
across Australia, examining the quantity and features of services that provide exercise
rehabilitation for people with HF. The study aims to provide an update to information
regarding exercise rehabilitation services for people with HF in Australia and identify
perceived barriers for organisations to provide these services. In order to locate
eligible participants, researchers used the Cardiac Rehabilitation Program Directory.
457 services were then contacted for participation, of those, 334 responded. The
online program, Survey Monkey, was used to conduct the survey and gather
responses. The survey comprised of 24 questions, including the following sections;
service descriptors, perceived barriers, program characteristics, and exercise training
characteristics. An Excel spreadsheet was used in order to store the responses. The
principal researcher then summarised and analysed the responses to the questions.
Further qualitative data was provided by the thematic analysis of free text comments.
Out of the 334 respondents, 251 reported to provide a group-based supervised
exercise rehabilitation program for people with HF. Services that were unable to