Abstract
Purpose. The purpose of this study was to describe the Anchorage, Alaska Cardiac Resynchronization Therapy patient perspectives on the barriers and enablers encountered as they strive for disease management. This information was gathered to address the research question, "What are the barriers and enablers identified by the Cardiac Resynchronization Therapy patients concerning management of their heart failure?" Methodology. Data were collected and transcribed for analysis from participants' medical records and semistructured interviews with participants and health-care practitioners. Findings. Persons in end-stage heart failure with Cardiac Resynchronization Therapy can emit an upbeat and positive presence. Support of family and friends is an important enabler in management of heart failure and moderating its effect. Also, the staff and environment of a heart failure clinic can be powerful enablers, encouraging patients to engage in health-promoting behaviors. Conclusions. Findings indicated that a workable framework for management of heart failure may be possible with a combination of family and friend support and a heart failure clinic that is reality based but maintains a positive environment. Recommendations. Future studies are needed to identify barriers and enablers from the patient and clinician perspective that contribute to patient adherence of treatment plans in this chronically ill population. Additional studies should be conducted to explore care in clinic settings to evaluate whether HF patients' lack of awareness or education constitutes a barrier to compliance with prescribed treatment plans and the reduction of the rate of hospitalization, as well as reduction in cost due to shortened lengths of hospital stay and less required emergency room visits.