title: "They diagnosed bad heart": a qualitative exploration of patients' knowledge about and experiences with heart failure.
abstract: BACKGROUND
  Patient education is central to the management of individuals with heart failure; therefore, it is important to know what these patients understand and experience both clinically and personally.
  
  
  OBJECTIVE
  This study qualitatively explored patients' knowledge regarding a heart failure diagnosis, their understanding of their cardiac care providers' treatment recommendations, and their views concerning the impact of heart failure on their daily lives and prognosis.
  
  
  METHODS
  A qualitative study was conducted whereby data were collected through 25 telephone interviews with adults being followed for heart failure at a Veterans Affairs medical center. Subjects were interviewed using semistructured open-ended questions. Audiotaped responses were analyzed using grounded theory methods.
  
  
  RESULTS
  The majority of participants were elderly, male, and white, and had New York Heart Association class II disease. Participants without angina typically experienced a lengthy and difficult diagnostic delay, with symptoms misattributed to comorbid diseases. Most understood the importance of self-monitoring and adhering to physician recommendations, and their discussions of life-changing effects typically focused on loss of physical functioning and decreased quality of life. Although participants wanted to know their prognosis, most had not received information about it or about advance care planning.
  
  
  CONCLUSIONS
  Patients require opportunities for enhanced communication with physicians and health care team members during the challenging diagnostic period and subsequently need more information about their medical condition and prognosis.
authors.affiliation: Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15206, USA.
authors.forename: Keri L
authors.initials: KL
authors.lastname: Rodriguez
authors.forename: Cathleen J
authors.initials: CJ
authors.lastname: Appelt
authors.forename: Galen E
authors.initials: GE
authors.lastname: Switzer
authors.forename: Ali F
authors.initials: AF
authors.lastname: Sonel
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life; D012923:Social Class; D014481:United States; D014493:United States Department of Veterans Affairs