. Author manuscript; available in PMC: 2009 Feb 1.

Published in final edited form as: Patient Educ Couns. 2008 Feb;70(2):281–291. doi: 10.1016/j.pec.2007.10.015

Table 3.

Themes of heart failure social support and barriers to heart failure care and their representative quotes extracted from 4 focus groups with Native Hawaiians and Samoans

Domains and Themes	Representative quotes
Heart Failure Social Support Informational supports • Family’s knowledge of illness and medications • Training of caregivers Tangible-Instrumental support • Family offering and sharing in care giving responsibility • Respite for caregivers in the family	Patient: • “I was a little bit afraid of everything but then my kids and the husband was so helpful so...educate your own family about [heart failure]...cause they know what’s going on and help me with the food, with the exercise...I think its better.” • “[We] need somebody to help explain the medical jargon and...what’s happening in the body.” • “We need to have our kids involved too. Like my daughter...I took her [to the] doctor with me and she never thought that I had all these problems.... Today, she treating me.” Caregiver: • “[Heart failure care] gotta have cooperation, [from] the family, yeah.” • “So, the caretaker needs a lot of support from the person they taking care of.” • “My experience with my sister was I didn’t know what heart failure was”
Barriers to Heart Failure Management • Lack of heart failure knowledge • Poor doctor-patient communication • Lack of trust for physicians (Hawaiians only) • Financial burdens • Making needed diet changes • Competing demands on time	Patient: • “I think most Hawaiians no understand what the causes are [for] heart failure...” • “I would really love...education, education, like for all of us around here we do not know the difference between heart attack and heart failure.” • “You don’t just sit across a desk and say well, how is the heart today? You have to look them in the eye when you’re talking to ‘em. And you have to appear to them to be very interested.” • “I no really care for the doctor because you ask them something, they hiding something from you. They don’t come out with everything.... I said, what’s this drug for? He [the doctor] said this is the best drug for you, he never answer my question.” • “One of the challenges is money.” • “Samoan’s [sic] love to eat the fat.” Caregiver: • “Time is always an issue and uh, you know family responsibilities like you get kids.”

Domains and Themes

Representative quotes

Heart Failure Social Support
Informational supports
• Family’s knowledge of illness and medications
• Training of caregivers
Tangible-Instrumental support
• Family offering and sharing in care giving responsibility
• Respite for caregivers in the family

Patient:
• “I was a little bit afraid of everything but then my kids and the husband was so helpful so...educate your own family about [heart failure]...cause they know what’s going on and help me with the food, with the exercise...I think its better.”
• “[We] need somebody to help explain the medical jargon and...what’s happening in the body.”
• “We need to have our kids involved too. Like my daughter...I took her [to the] doctor with me and she never thought that I had all these problems.... Today, she treating me.”
Caregiver:
• “[Heart failure care] gotta have cooperation, [from] the family, yeah.”
• “So, the caretaker needs a lot of support from the person they taking care of.”
• “My experience with my sister was I didn’t know what heart failure was”

Barriers to Heart Failure Management
• Lack of heart failure knowledge
• Poor doctor-patient communication
• Lack of trust for physicians (Hawaiians only)
• Financial burdens
• Making needed diet changes
• Competing demands on time

Patient:
• “I think most Hawaiians no understand what the causes are [for] heart failure...”
• “I would really love...education, education, like for all of us around here we do not know the difference between heart attack and heart failure.”
• “You don’t just sit across a desk and say well, how is the heart today? You have to look them in the eye when you’re talking to ‘em. And you have to appear to them to be very interested.”
• “I no really care for the doctor because you ask them something, they hiding something from you. They don’t come out with everything.... I said, what’s this drug for? He [the doctor] said this is the best drug for you, he never answer my question.”
• “One of the challenges is money.”
• “Samoan’s [sic] love to eat the fat.”
Caregiver:
• “Time is always an issue and uh, you know family responsibilities like you get kids.”

Note. The key themes presented here are summarized or aggregated concepts and phrases of participants’ actual responses and the representative quotes are listed by type of participant - heart failure patient and caregiver.