Navigating the Patient with Heart Failure through the Health-care System – The Perspective of Hospital Nurses


  • Tamara Štemberger-Kolnik Research Institute, Faculty of Health Sciences in Celje, Celje, Slovenia
  • Bojana Filej Research Institute, Faculty of Health Sciences in Celje, Celje, Slovenia
  • Silva Nemeš Prevention and Promotion Programmes Management Centre, National Institute of Public Health, Ljubljana, Slovenia
  • Andreja Ljubič Research Institute, Faculty of Health Sciences in Celje, Celje, Slovenia; Department of Public Health, Ministry of Health, Ljubljana, Slovenia



healthcare systems, heart failure, health literacy, navigation, patient journey


BACKGROUND: Navigating the complex health-care system requires the patients to have comprehensive knowledge, active participation, and self-efficacy in health management to effectively engage in planned activities that include diagnosis, treatment, and rehabilitation, to ensure a high quality of life and successfully prevent disease-related complications.

AIM: This study aims to investigate which activities nurses in hospital settings perform to support patients with heart failure to increase health literacy and navigate effectively through the health-care system.

METHODS: Based on qualitative research, the data were collected through semi-structured interviews with 11 nurses from hospitals where patients with heart failure are treated. After reviewing and analyzing the transcribed interviews, a qualitative content analysis of the text followed.

RESULTS: Based on an inductive approach, we first identified coding units, which were grouped into 10 subcategories, and these into five categories: General health literacy, digital literacy, communication health literacy, interprofessional collaboration, and navigation through the health-care system. We found that the treatment of patients with heart failure varies in Slovenian hospitals.

CONCLUSION: Inequality in the treatment of patients between different hospitals highlights the need for a coordinated approach in the Slovenian health-care system. It is crucial to establish uniform national guidelines that would define treatment standards, ensure evidence-based patient care, and thus reduce the disparity in the quality of treatment between different medical institutions.


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Štemberger-Kolnik T, Filej B, Nemeš S, Ljubič A. Navigating the Patient with Heart Failure through the Health-care System – The Perspective of Hospital Nurses. Open Access Maced J Med Sci [Internet]. 2024 Apr. 15 [cited 2024 May 26];12:1-7. Available from:



Nursing in Internal Medicine