Understanding the Lived Experience of Patients With Heart Failure During the COVID-19 Pandemic

BACKGROUND: Patients with heart failure face multifaceted challenges, including emotional, social, and psychological burdens, while managing their condition. The COVID-19 pandemic exacerbated these difficulties, amplifying fear, uncertainty, and healthcare complexities, further complicating their experiences. OBJECTIVE: The objective of this study was to identify and analyze the challenges faced by patients with heart failure during the pandemic. METHODS: A systematic review and meta-synthesis were conducted to analyze data from qualitative studies. Data were sourced from EMBASE, PubMed, and SCOPUS, spanning from March 11, 2020, when the WHO declared COVID-19 a pandemic, to May 5, 2023, marking the end of COVID-19 as a global public health emergency. RESULTS: A systematic review and meta-synthesis were conducted, identifying 676 articles through database searches: CINAHL-Complete (n = 130), PubMed (n = 313), SCOPUS (n = 210), hand search (n = 22), and Thai journal online (ThaiJO) (n = 1). After screening and quality assessment using the Critical Appraisal Skills Programme, 17 full-text articles of sufficient quality involving 277 participants with heart failure from East Asia (Taiwan, Japan), Southeast Asia (Thailand, Indonesia), Europe (Denmark, UK, Spain, Italy, Sweden), North America (United States), and the Middle East (Iran) were included in the synthesis. Six primary themes emerged: (1) Emotional Impact-patients reported increased anxiety, fear of disease progression, and heightened feelings of isolation, (2) Limited Physical and Social Activities-restrictions during the pandemic significantly disrupted daily routines, (3) Cultivating Resilience and Meaningful Living-many adapted by finding new coping mechanisms and purpose, (4) Divergent Perspectives on Care Delivery Innovation-although telehealth offered convenience for some, others faced challenges because of the lack of in-person care, (5) Social Support from Family and Friends-family support was critical but often limited by quarantine measures, and (6) Trust in Healthcare Providers-trust emerged as a key factor in managing heart failure during the crisis. Using the GRADE-CERQual approach, the certainty of evidence was evaluated and ranged from moderate to high. CONCLUSIONS: The findings underscore the urgent need for targeted interventions that address the emotional and practical needs of patients with heart failure during crises. By promoting well-being and enhancing healthcare delivery, these insights can inform healthcare providers and policymakers in developing tailored support strategies aimed at improving patient outcomes and quality of lifePROSPERO registration number: CRD42024526561.