Thirst in Patients With Advanced Chronic Heart Failure Waiting for a Heart Transplantation: A Mixed Methods Study of Patients' and Nurses' Experiences

Background Hospitalised patients with advanced chronic heart failure (CHF) waiting for transplantation may experience increased thirst due to their critical illness and therapy‐related requirements. The perspective of patients and nurses is important for developing a nurse‐based counselling intervention to reduce thirst. Aims To identify patients' and nurses' experiences and perceptions of thirst, as well as their information needs and preferences on information dissemination. Study Design This convergent mixed methods study used semi‐structured interviews with patients, focus groups and a survey with nurses in Germany. We analysed the qualitative data using content analysis and the quantitative data descriptively. We compared the results of both methodological approaches and summarized the data as meta‐inferences. Results & Findings We conducted 10 interviews with patients on intensive care units, intermediate care units and general wards during their waiting time for transplantation, two focus groups with, respectively, five nurses and a survey with 59 nurses caring for these patients. Analyses resulted in five common categories: experiences of thirst, factors that influence thirst, assessment of thirst, dealing with thirst and information about thirst. Patients' experiences with thirst differ markedly, ranging from mild to severe thirst, and they use various strategies to deal with thirst. Nurses consider thirst relevant for patients and nursing care. Strategies used in practice for assessment of thirst are very heterogeneous. In the survey, less than half of the nurses claimed to regularly assess patients' thirst. Nurses and patients wish to receive individual information and counselling. Conclusions Thirst in hospitalised patients with advanced CHF waiting for transplantation can be severe and is experienced differently. Standardised procedures for assessing and managing thirst on the ward seem essential to address patients' needs and preferences. Relevance to Clinical Practice Patients and nurses express a need for professional counselling on managing thirst in clinical practice.