Barriers and facilitators to thirst symptom management for patients with heart failure: A qualitative study

Abstract

Abstract Background: Thirst in patients with heart failure is commonly overlooked by health providers despite its high prevalence and great detriment. The aim of this study was to explore the barriers and facilitators to thirst symptom management for patients with heart failure from the perspectives of nurses. Methods: Semi-structured, in-depth interviews with nurses working in cardiology department and cardiac care unit were conducted in a tertiary hospital between March 2023 and May 2023. A content analysis was used to analyze data. The Consolidated criteria for reporting qualitative research (COREQ) guidelines were followed. Results: A total of 11 nurses participated in this study. Six main themes were identified: positive attitude (beneficial for recovery, improve treatment compliance, improve quality of care, establish mutual trust), negative attitude (increase workload, insufficient awareness, insufficient available interventions), supportive beliefs (beginning to gain attention from leaders), unsupportive beliefs (lack of standardized procedures, stress from coworkers, stress from patients), facilitators (systematic training，evidence-based nursing，adequate staffing, support of the leaders, establish systematic daily work pattern，severe thirst) and barriers (patients' distrust and low cooperation, heavy clinical workload, lack of human resources, lack of training). Conclusions: This study provides an understanding of barriers and facilitators to the delivery of thirst symptom care. Training sessions and standardized procedures are required to enable nurses for thirst symptom management. Tailored education is also critical because most HF patients do not understand why they are restricted from drinking water due to lack of associated knowledge.