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A Case for Consideration of Cultural Diversity in Heart Failure Management: Part 1: Rationale for the DISCOVER Study
Patricia M Davidson
Professor of Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University of Technology, Sydney Campus, NSW
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
Dean, Faculty of Nursing Midwifery and Health, 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
Dean and Professor, University of California, San Francisco CA, United States of America (on behalf of the DISCOVER Investigators)
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 management, DISCOVER Study, study design
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