title: A case for consideration of cultural diversity in heart failure management--Part 1: Rationale for the DISCOVER Study.
abstract: Heart failure is a condition increasing in prevalence and responsible for high health care utilization, morbidity and mortality. Randomised controlled trials of nurse-coordinated interventions have determined self-care and the incorporation of the patient and their family in care planning as critical elements of service delivery. Coping with a chronic illness, such as heart failure, forces the individual to adjust to changed physical, social and emotional functioning and to modify their lifestyle accordingly. Clinicians increasingly use models of care that focus care delivery on the community setting. In order to develop strategies to assist patients and their families with self-care it is important that clinicians understand the health-care seeking behaviours of all individuals targeted in the community. Australia is a culturally diverse nation, yet evaluations of models of care have been undertaken largely in individuals from predominately Anglo-Celtic origins. The end result of this approach is failure to understand the full range of diverse perspectives that individuals hold that can have an impact on self-care behaviours. Consideration of cultural diversity should extend beyond language to a broader appreciation of cultural values, health seeking beliefs and engagement of culturally unique communities. The 'Understanding the cultural experiences of individuals with chronic heart failure (CHF) in South East Health (DISCOVER) Study' seeks to uncover information on the health patterns, information needs and the adjustment process for overseas-born individuals with heart failure. Such information will assist clinicians to tailor health care service delivery and ensure the delivery of appropriate, quality care. This manuscript provides the background, rationale and methods for this study.
authors.affiliation: School of Nursing, Family and Community Health, University of Western Sydney and Western Sydney Area Health Service, Australia.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Peter
authors.initials: P
authors.lastname: Macdonald
authors.forename: Esther
authors.initials: E
authors.lastname: Ang
authors.forename: Glenn
authors.initials: G
authors.lastname: Paull
authors.forename: Sam
authors.initials: S
authors.lastname: Choucair
authors.forename: John
authors.initials: J
authors.lastname: Daly
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
mesh_terms: D000223:Adaptation, Psychological; D018864:Cultural Diversity; D003625:Data Collection / Q000379:methods; D003695:Delivery of Health Care / Q000458:organization & administration; D005544:Forecasting; D006333:Heart Failure / Q000208:ethnology / Q000451:nursing; D006801:Humans; D008019:Life Style; D016294:Models, Nursing; D008960:Models, Psychological; D020380:Needs Assessment / Q000458:organization & administration*; D009517:New South Wales / Q000453:epidemiology; D024802:Nurse's Role; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010353:Patient Education as Topic / Q000592:standards*; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D016746:Transcultural Nursing / Q000458:organization & administration