Understanding frailty: a qualitative study of older heart failure patients' frail experience and perceptions of healthcare professionals with frailty

Background: Although frailty is highly prevalent in hospitalized older heart failure (HF) patients, its management is often delayed. Understanding the unique experiences of frail elderly HF patients and the perceptions of healthcare professionals (HPs) regarding frailty can facilitate the integration of frailty prevention and intervention into clinical practice. This study aimed to use a descriptive qualitative approach to obtain the experiences of frailty in older HF patients and the perceptions of HPs concerning frailty.

Methods: Qualitative interviews were conducted with 16 frail elderly HF patients and 13 healthcare providers. Data were analyzed using thematic analysis.

Results: The interviews yielded several themes with associated subthemes: "a state of predicament," "hope is gone and social isolation," "daily adjustment and attempts to do something," "thoughts on factors contributing to frailty," "the need for transformation of stakeholders' mindset regarding frailty," "management is imperative, but there is still a way to go".

Conclusions: Both elderly patients with HF and HPs described frailty as a state of predicament, involving being caught in life difficulties and falling into a treatment dilemma. Due to the overlap of symptoms and evaluating indicators between frailty and HF, it's essential to thoroughly understand modifiable risk factors that could worsen frailty and develop a specific frailty assessment tool for HF patients. Adequate social support, multidisciplinary collaboration, and a frailty education program for patients, caregivers, and HPs are essential to facilitate frailty management and improvement.