A case for consideration of cultural diversity in heart failure management: Part 1: Rationale for the DISCOVER Study
Patricia M Davidson
Centre of Cardiovascular and Chronic Care, School of Nursing and Midwifery, University of Technology Sydney, Sydney NSW; Curtin University, Perth WA
Peter Macdonald
Associate Professor, St Vincents Hospital and University of New South Wales, Sydney NSW
Esther Ang
Diversity Health, South East Health, Sydney NSW
Glenn Paull
Diversity Health, South East Health, Sydney NSW
Sam Choucair
Diversity Health, South East Health, Sydney NSW
John Daly
Faculty of Nursing, Midwifery and Health; WHO Collaborating Centre for Nursing, Midwifery and Health Development, University of Technology Sydney, Sydney NSW
Debra K Moser
Professor and Gill Chair of Nursing, University of Kentucky, Lexington; St George Hospital Cardiology Department, Sydney NSW
Kathleen Dracup
University of California, San Francisco CA, United States of America (on behalf of the DISCOVER Investigators)
PP: 204 - 210
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 HF. 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.
Keywords
cultural diversity; heart failure; DISCOVER Study; study design
References
Australian Bureau of Statistics (2003): Overseas Arrivals and Departures, Australia (ABS Catalogue No. 3401.0). Accessed at www.abs.gov.au 23 December 2003.
Australian Institute of Health and Welfare (2004): Heart, stroke and vascular diseases. Canberra AIHW Cat. No. CVD 27.
Brookes K, Davidson PM, Daly J, Hancock K (2004): Community health nursing in Australia: a critical literature review and implications for professional development. Contemporary Nurse 16(3): 195-107.
Cameron-Traub E. (2000): Meeting health care needs in Australia's diverse society in J Daly, S Speedy & D Jackson (eds). Contexts of Nursing. Sydney: Macmillan & Petty.
Davidson P, Stewart S, Elliot D, Daly J, Sindone A, Cockburn J (2001): Addressing the burden of heart failure in Australia: the scope for home-based interventions. Journal of Cardiovascular Nursing 16(1): 56-68.
Davidson P, Macdonald Paull G, Rees D, Howes L, Cockburn J, Brown M (2003a): Diuretic therapy in chronic heart failure: implications for heart failure nurse specialists. Australian Critical Care 16(2): 59-69.
Davidson PM, Daly J, Meleis AM, Douglas M (2003b): Globalization as we enter the 21st Century: reflections and directions for nursing research, science and practice. Contemporary Nurse 15 (3): 161-174.
Daly J, Jackson D, Davidson P, Wade V, Chin C , Brimelow V (1998): Illuminating the experiences of female spouses of survivors of acute myocardial infarction (AMI) : a pilot study of Lebanese-born women in South Western Sydney Australia. Journal of Advanced Nursing 28: 1199-1206.
Dracup K, Walden JA, Stevenson LW, Brecht ML (1992): Quality of life in patients with advanced heart failure. Journal Heart Lung Transplant 11: 273-9.
Grady KL, Dracup K, Kennedy G, et al. (2000): Team management of patients with heart failure: a statement for healthcare professionals from The Cardiovascular Nursing Council of the American Heart Association. Circulation 102: 2443-2456.
Hamadeh GN. Adib SM (1998): Cancer truth disclosure by Lebanese doctors. Social Science & Medicine 47(9): 1289-94.
Jaarsma T, Halfens R, Huijer Abu-Saad H, Dracup K, Gorgels T, van Ree J, et al (1999a): Effects of education and support on self-care and resource utilization in patients with heart failure. European Heart Journal 20: 673-82.
Jaarsma T, Halfens R, Huijer Abu-Saad H, Dracup K, Stappers J, van Ree J (1999b): Quality of life in older patients with systolic and diastolic heart failure. European Journal of Heart Failure 1: 151-60.
Jackson D, Daly J, Chang E (2002):Approaches in Qualitative Research. In Z Schneider, D Elliott , G
Lo-Biondo-Wood, J Haber: Nursing Research (2nd Ed). Sydney: Mosby.
Kelly DT (1997): Our future society: a global challenge. Circulation 95: 2459-64.
Lipson JG, Steiger NJ (1996): Self-care nursing in a multicultural context. Sage: Thousand Oaks.
McAlister FA, Lawson FME, Teo KK, Armstrong PW (2001): A systematic review of randomized trials of disease management programs in congestive heart failure. American Journal of Medicine 110: 378-384.
McMurray JJ, Stewart S (2000): Epidemiology, aetiology, and prognosis of heart failure. Heart 83: 596-602.
Meleis AI (1996): Culturally competent scholarship: substance and rigor ... based on a keynote speech given at the 11th research conference 'Toward Culturally Competent Health Care,' Rutgers State University. Advances in Nursing Science 19(2): 1-16.
Meleis AI (1999): Culturally competent care ... commentaries: defining transcultural nursing. Journal of Transcultural Nursing 10(1): 12.
Meleis A, Lipson J (2003): Cross-cultural health and strategies to lead development of nursing practice. In J Daly, S Speedy & D Jackson Nursing Leadership. Sydney: Churchill Livingstone.
Moser DK, Worster PL (2000): Effect of Psychological Factors in Physiologic Outcomes. Journal of Cardiovascular Nursing 14: 106-115.
Pria M (2003): Health and cultural diversity among the migrant population: another challenge of globalisation. Journal of Transcultural Nursing 14(3): 177-9.
Rich MW (2001): Heart failure in the 21st century: a cardiogeriatric syndrome. Review. Journals of Gerontology Series A - Biological Sciences & Medical Sciences. 56(2): M88-96.
Rockwell JM, Riegel B (2001): Predictors of self-care in persons with heart failure. Heart & Lung: Journal of Acute & Critical Care 30(1): 18-25.
Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ (2001): More 'malignant' than cancer? Five-year survival following a first admission for heart failure. European Journal of Heart Failure 3: 315-322.
Stewart S, McMurray JJ (2002): Palliative care for heart failure. British Medical Journal 325: 915-916.
Stewart S et al. (2003): Uncovering a hidden epidemic: A study of the current burden of heart failure in Australia. Centre for Innovation in Health Research, Division of Health Sciences. University of South Australia.
Taylor A & Box M (1999): Multicultural Palliative Care Guidelines. Palliative Care Australia. ISBN 0-646- 38432-5.
Thurmond VA (2001): The point of triangulation. Journal of Nursing Scholarship. 33(3): 253-8.
Webster RA. Thompson DR, Davidson PM (2003): The first 12 weeks following discharge from hospital: the experience of Gujarati South Asians survivors of acute myocardial infarction and their families. Contemporary Nurse 15(3): 288-299.
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