Naturalistic Decision Making by Older Adults with Chronic Heart Failure: An Exploratory Study Using the Critical Incident Technique

Abstract

Older adults with chronic heart failure (CHF) make daily decisions to manage their disease, with some of these decisions resulting in major health outcomes such as acute decompensation, hospitalization, and death. To understand how older adults with CHF make these decisions in their natural sociotechnical system context, we analyzed data from critical incident technique interviews with 12 older adults with CHF and 6 (family or friend) support persons. We identified key decision-making barriers, strategies, and distributed activity in stages of monitoring information or data, interpreting the information, and acting as a result. Our findings contribute to the broader research literature on CHF self-care as a naturalistic phenomenon and can aid in the exploration of design requirements for the development of technologies and interventions to assist in heart failure self-management.