PMID- 25776041
OWN - NLM
STAT- MEDLINE
DCOM- 20151116
LR  - 20220331
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 5
IP  - 3
DP  - 2015 Mar 16
TI  - 'Engage me in taking care of my heart': a grounded theory study on 
      patient-cardiologist relationship in the hospital management of heart failure.
PG  - e005582
LID - 10.1136/bmjopen-2014-005582 [doi]
LID - e005582
AB  - OBJECTIVE: In approaching the study and practice of heart failure (HF) 
      management, authors recognise that the patient-doctor relationship has a central 
      role in engaging patients in their care. This study aims at identifying the 
      features and the levers of HF patient engagement and suggestions for orienting 
      clinical encounters. DESIGN: Using a grounded theory approach, we conducted 22 
      in-depth interviews (13 patients with HF, 5 physicians and 4 caregivers). Data 
      were collected and analysed using open, axial and selective coding procedures 
      according to the grounded theory principles. SETTINGS: All interviews were 
      conducted in an office in a university hospital located in a metropolitan area of 
      Milan, Italy. PARTICIPANTS: The data comprised a total of 22 patient, hospital 
      cardiologist and caregiver interviews. Patients aged >/=18 years with New York 
      Heart Association (NYHA) Functional Class of II or III were eligible to take 
      part. Patients were recruited primarily through their referral cardiologist. 
      RESULTS: The HF patient engagement process develops in four main phases that are 
      characterised by different patients' emotional, cognitive and behavioural 
      dynamics that contribute to shape the process of a patient's meaning making 
      towards health and illness regarding their care. The emerging model illustrates 
      that HF patient engagement entails a meaning-making process enacted by the 
      patient after the critical event. This implies patients' ability to give sense to 
      their care experience and to their disease, symptomatology and treatments, and 
      their changes along their illness course. Doctors are recognised as crucial in 
      fostering patients' engagement along all the phases of the process as they 
      contribute to providing patients with self-continuity and give new meaning to 
      their illness experience. CONCLUSIONS: This study identifies the core 
      experiential domains and the main levers involved in driving patients with HF to 
      effectively engage in their disease management. The model emerging from this 
      study may help clinicians think in a fresh way about encounters with patients and 
      their role in fostering their patients' health engagement.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Barello, Serena
AU  - Barello S
AD  - Faculty of Psychology, Universita Cattolica del Sacro Cuore, Milan, Italy.
FAU - Graffigna, Guendalina
AU  - Graffigna G
AD  - Faculty of Psychology, Universita Cattolica del Sacro Cuore, Milan, Italy.
FAU - Vegni, Elena
AU  - Vegni E
AD  - Department of Health Sciences, Universita degli Studi di Milano, Milan, Italy.
FAU - Savarese, Mariarosaria
AU  - Savarese M
AD  - Faculty of Psychology, Universita Cattolica del Sacro Cuore, Milan, Italy.
FAU - Lombardi, Federico
AU  - Lombardi F
AD  - Department of Clinical Sciences and Community Health, Universita degli Studi di 
      Milano, Milan, Italy.
FAU - Bosio, A Claudio
AU  - Bosio AC
AD  - Faculty of Psychology, Universita Cattolica del Sacro Cuore, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20150316
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Attitude to Health
MH  - Cardiology
MH  - Caregivers
MH  - *Disease Management
MH  - Female
MH  - Grounded Theory
MH  - *Heart
MH  - Heart Failure/*therapy
MH  - Hospitals
MH  - Humans
MH  - Interviews as Topic
MH  - Italy
MH  - Male
MH  - Medical Staff, Hospital
MH  - Middle Aged
MH  - *Patient Participation
MH  - *Physician-Patient Relations
MH  - Physicians
PMC - PMC4369000
OTO - NOTNLM
OT  - QUALITATIVE RESEARCH
OT  - patient engagement
EDAT- 2015/03/18 06:00
MHDA- 2015/11/17 06:00
PMCR- 2015/03/16
CRDT- 2015/03/18 06:00
PHST- 2015/03/18 06:00 [entrez]
PHST- 2015/03/18 06:00 [pubmed]
PHST- 2015/11/17 06:00 [medline]
PHST- 2015/03/16 00:00 [pmc-release]
AID - bmjopen-2014-005582 [pii]
AID - 10.1136/bmjopen-2014-005582 [doi]
PST - epublish
SO  - BMJ Open. 2015 Mar 16;5(3):e005582. doi: 10.1136/bmjopen-2014-005582.