Abstract
Heart failure is a complex clinical syndrome with typical symptoms and signs that generally occur on exertion, but can also occur at rest. It is secondary to an abnormality of cardiac structure or function that impairs the ability of the heart to fill with blood at normal pressure or eject blood sufficient to fulfil the needs of the metabolising organs (Atherton et al., 2018). Heart failure (HF) is estimated to effect over 64 million people globally and accounts for 1–2% of all hospital admissions worldwide. In severe HF, the 1-year mortality is 50–60%; therefore, any examination into this topic is both timely and important (Al-Omary et al., 2022).
Managing symptoms of HF as guided by nursing and multidisciplinary teams has demonstrated significant benefits in improving both quality of life and morbidity and mortality (Wu et al., 2024). Monitoring the symptoms of HF is also imperative in preventing further deterioration and if caught early can circumvent a hospital admission. The use of tools such as the KCCQ12 and various other clinical indicators to highlight patient deterioration may assist in the early detection of an HF exacerbation (Spertus et al., 2020). Using these tools in the appropriate setting may increase both quality of life and hospital readmissions. We commend the authors for this clinically important examination.
This paper is the first to examine the translation of an important assessment tool for Thai populations. As such it provides important data to guide the urgent improvements required to address clinical assessment tools for all populations. This paper provides important and much needed data in guiding accurate and culturally appropriate assessment tools. These data represent an ideal opportunity to address any cultural barriers that exist in providing care, with a focus on culturally appropriate clinical assessment and quality of care for all populations
An overarching theme that one could take out of this paper is the importance of patient-centred care, which lies at the heart of nursing practice. Why is patient-centred care important? There is Level 1 evidence, ethical imperatives, legal obligations, consensus guidelines continually define the need for it and also it is the right thing to do. Therefore, providing culturally appropriate assessment tools is of great importance to nursing. Whilst the treatment of patients with HF has no doubt improved, resulting in improved survival rates, the symptom burden of patients with HF remains significant. This paper provided preliminary data examining thirst. Whilst we invest in new and innovative ways to manage HF, the symptom burden remains challenging for patients and represents an important aspect of nursing care.
Thirst represents an important issue for patients, In fact, one-quarter of all patients with HF experience thirst (van der Wal et al., 2022). It has long been established that thirst significantly decreases quality of life and causes patients distress (Allida et al., 2015; Eng et al., 2021; Waldréus et al., 2011). To ensure we provide optimal patient-centred care an important step is ensuring that patients are assessed in a culturally appropriate way, using as an evidence-based tool. We applaud the authors for their willingness to investigate this important topic, the implications for other specialities and languages globally are significant.
HF guidelines and consensus statements define the need for education about self-management and ongoing clinical management. Importantly, this is a continual, dynamic process beginning at diagnosis which needs to be person-centred, culturally appropriate and tailored to the individual’s health literacy (McDonagh et al., 2021). This paper, therefore, represents an important contribution to the literature on patient-centred care.
Reading this paper, you are struck by the pragmatic clinical design of this work which could take place in any hospital or clinic around the world. No doubt nurses reading this work will examine their clinical work through the lens of cultural appropriateness – and how to best provide care for all populations. This is so important for our profession and may prompt all nurses to undertake research.
The authors outline appropriate limitations of this small pilot study, with some limitations on sample size which should guide over interpretations of the results. The study populations, disease severity, co-morbidities or current clinical status were not defined, which at present, make the widespread adoption of this research to all populations challenging at present. However, the potential widespread positive clinical implications, the potential for other study in other specialities and the potential for additional larger multi-site trials means this study is a valuable addition to the literature.
This work provides an important step in patient-centred care, by ensuring this important factor for patients is examined. Whilst only a small study, this work demonstrates the importance of nurses attempting to provide culturally specific assessment tools for all populations, and this remains of the upmost importance to nurses globally.