Determinants of rheumatic heart disease: findings from qualitative research approach
Abstract
Background Rheumatic heart disease (RHD) is an autoimmune heart disease following unresolved or untreated Acute Rheumatic Fever (ARF), which results in irreversible valve damage and heart failure. Strategies for managing RHD could be planned to understand the disease determinants in local settings.
Objective To explore the determinants of RHD among the family with an RHD case.
Methods The study was a qualitative design using a grounded theory approach after in-depth interviews with respondents from families with RHD patients. Analysis was conducted after the scripts were finalized. Initial, intermediate, and advanced codings were performed. Ten respondents agreed to participate and completed the qualitative data collection process.
Results The analysis yielded two theme categories of what could have led to RHD among respondents due to internal and external causes. Internal causes were considered factors that could be managed or manipulated to improve an individual and family’s capacity. In contrast, external causes were considered factors that could not be managed or manipulated to improve an individual’s capacity or family. Therefore, these factors were considered beyond their control.
Conclusion This study explored RHD determinants according to the patients’ and their families’ perspectives. A holistic approach can be applied to managing RHD by considering these factors.
References
2. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. New England Journal of Medicine. 2017;377:713-22. DOI: https://doi.org/10.1056/NEJMoa1603693.
3. Liang-choo H. A Review of acute rheumatic fever and rheumatic heart disease research in Malaysia. Med J Malaysia. 2016;71:79-86. PMID: 27801390.
4. Sharma N, Toor D. Impact of socio-economic factors on increased risk and progression of rheumatic heart disease in developing nations. Curr Infect Dis Rep. 2019;21:21. DOI: https://doi.org/10.1007/s11908-019-0677-6.
5. Coffey PM, Ralph AP, Krause VL. The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: A systematic review. PLoS Negl Trop Dis. 2018;12:e0006577. DOI: https://doi.org/10.1371/journal.pntd.0006577
6. Zühlke L, Karthikeyan G, Engel Mark E, Rangarajan S, Mackie P, Mauff BC, et al. Clinical outcomes in 3343 children and adults with rheumatic heart disease from 14 low- and middle-income countries. Two-year follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY Study). Circulation. 2016;134:1456-66. DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.024769
7. Yilgwan CS. Socioeconomic status, benzathine penicillin prophylaxis, and clinical outcomes in patients with rheumatic heart disease [dissertation]. [Minneapolis (MN)]: Walden University; 2020.
8. Vuuren JJV. Six critical global issues: What are the world’s biggest problems and how can I help? Global Vision International. [cited 2022 May 30]. Available from: https://www.gvi.co.uk/blog/6-critical-global-issues-what-are-the-worlds-biggest-problems-and-how-i-can-help/.
9. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-357. DOI: https://doi.org/10.1093/intqhc/mzm042
10. Charmaz K. Constructing grounded theory - A practical guide through qualitative analysis. London: SAGE Publications Ltd; 2006.
11. Birks M, Mills J. Grounded theory: a practical guide. Second ed. Los Angeles: SAGE; 2015.
12. Tie YC, Birks M, Francis K. Grounded theory research: A design framework for novice researchers. SAGE Open Med. 2019;7:2050312118822927. DOI: https://doi.org/10.1177/2050312118822927
13. Kyngäs H, Kääriäinen M, Elo S. The trustworthiness of content analysis. In: Kyngäs H, Mikkonen K, Kääriäinen M, eds. The application of content analysis in nursing science research. Cham: Springer International Publishing; 2020:41-48.
14. Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation. 1986;1986:73-84. DOI: https://doi.org/https://doi.org/10.1002/ev.1427
15. Forero R, Nahidi S, De Costa J, et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC Health Services Research. 2018;18:120. DOI: https://doi.org/10.1186/s12913-018-2915-2
16. Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 4. ed. Los Angeles, Calif.: SAGE; 2014.
17. Tomljenovi? A. Effects of internal and external environment on health and well-being: from cell to society. Coll Antropol. 2014;38:367-72. PMID: 24851644.
18. Muntaner C, Mahabir DF, Gunn V. Social determinants of health. Oxford University Press. [cited 2022 May 30]. Available from: https://www.oxfordbibliographies.com/display/document/obo-9780199756797/obo-9780199756797-0150.xml.
19. Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Reports. 2014;129:19-31.https://doi.org/10.1177/00333549141291s206
20. World Health Organization. Social determinants of health. World Health Organization. [cited 2022 May 30]. Available from: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1.
21. World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health: final report of the commission on social determinants of health: World Health Organization; 2008. [cited 2022 June 30]. Available from: https://www.who.int/social_determinants/thecommission/finalreport/en/.
22. Cole GE, Holtgrave DR, Ríos NM. Internal and external factors that encourage or discourage health-relevant behaviors. USA: National Center for Prevention Services; 2021. [cited 2022 May 30]. Available from: https://dokumen.tips/documents/1-internal-and-external-factors-that-encourage-or-.html?page=3.
23. Leigh D. SWOT analysis. In: Silber KH, Foshay WR, Watkins R, Leigh D, Moseley JL, Dessinger JC, eds. Handbook of improving performance in the workplace. Volumes 1-3. Hoboken: John Wiley & Sons, Inc.; 2010. p.115-40.
24. Namugenyi C, Nimmagadda SL, Reiners T. Design of a SWOT analysis model and its evaluation in diverse digital business ecosystem contexts. Procedia Computer Science. 2019 2019;159:1145-54. DOI: https://doi.org/10.1016/j.procs.2019.09.283.
25. Potempa KM, Redman RW, Landstrom G. Human resources in nursing education: A worldwide crisis. Collegian. 2009;16:19-23.https://doi.org/https://doi.org/10.1016/j.colegn.2008.12.003
26. Zakaria RB, Musta’ama AHB. Rapport building in qualitative research. 2014. [cited 2022 May 30]. Available from: https://api.semanticscholar.org/CorpusID:148657033.
Copyright (c) 2023 Md Mizanur Rahman, Rudy Ngau Ajeng, Asri Bin Said, Abg Safuan Bin Adenan, Mohamed Ameenudeen, Greta Miranda Goh Kim Choo, Muhammad Siddiq, Mohd Faiz Gahamat
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Accepted 2023-12-12
Published 2023-12-12
