Objective:This study aims to reveal the reasons for the healthcare selection bias in patients with chronic heart failure using a health ecology model(HEM)as a framework,providing reference for the effective implementation of the hierarchical medical treatment system and the improvement of patients'healthcare experience.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with 15 patients with chronic heart failure based on the HEM,and the interview data were analyzed using the directed content analysis method using the five dimensions of the HEM model,the individual trait level,the individual behavioral level,the interpersonal relationship level,the work and living conditions level,and the macro-policy level as a framework.Results:Based on the results of the interviewers,a total of 5 themes and 12 sub-themes were summarized,medical cognitive limitations(solidified hospital functions,alert to cardiac risks),single response to illness(risk-averse mentality,seeking psychological support,passive medical decision-making),behavioral norms impediments(intergenerational family influences,social recommendation convergence),imbalance in medical resources(differences in the drug catalogue,disparities in medical personnel,gaps in continuity of care)and policy understanding bias(low awareness of grading,lack of medical trust,questioning the purpose of the policy),respectively.Conclusion:Healthcare professionals need to strengthen the health education of patients with chronic heart failure,explore patients' coping resources and construct a multidimensional strategy for choosing medical institutions,and focus on policy-driven hierarchical health management of chronic heart failure,so as to improve the complete process chain of chronic heart failure management.
health ecologyhealthcare selection biaschronic heart failurehierarchical medical systemqualitative study
NETL
NSTL
万方数据
