Sheila is worried about her increasing breathlessness and manages to find a neighbour to keep her husband company while she visits her GP.
Her GP practice uses the SWIFT Check Up tool with patients. This tool allows healthcare professionals to “build up a picture of a person’s key relationships, how they are coping, how things are going at work and at home” (NHS Education for Scotland: Emotion Matters ).
| SWIFT | |
|---|---|
| Stress/Coping (Stress/Coping/Special support) |
Stress
Coping
Specific support needed? **Check mood if any concerns |
| Work/Home |
|
| Illness/LT Condition |
|
| Friends and family |
|
| Things I like to do |
|
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When the GP meets with Sheila, she bases her conversation around the SWIFT questions.
Scene 1:
GP: Hello, Sheila. I”ve not seen you for a while – I notice you”ve missed a couple of appointments. How are you feeling?
Sheila: Not particularly good, I”m afraid. Everything is becoming a bit of a struggle. I”m a bit fed up, to be honest. I can”t do the shopping, I can”t go to my choir and meet my friends. I feel that I”m stuck in the house all day, having to look after my husband, with nobody to really talk to about things. Not that I have anything very interesting to talk about…
Scene 2:
GP: How long have you been feeling like this?
Sheila: For a few months now. Even my husband has said that I”m not myself and he doesn”t usually notice these things.
Scene 3:
GP: How have you been keeping physically?
Sheila: I”m breathless even going up the stairs to our flat, so I don”t go shopping or out to meet friends any more. Even though I feel tired, I can”t seem to get to sleep at night. I used to read the paper every day and loved watching the soaps on TV but I can”t even be bothered doing that these days.
Scene 4:
GP: Have you got anyone who can help you out a bit at home and with the shopping?
Sheila: Well, my daughter works full time, so she can only help out at weekends. She pops round every Saturday but she usually has something on with her children and can’t stay very long. My husband doesn’t keep well, so I have to help him, rather than the other way round.
Scene 5:
GP: You sound a bit down. Could you fill in this questionnaire for me? It might help us think about how we can work on improving things.
Pulse point
We know that depression is prevalent in heart failure patients. It is important to try to differentiate between signs of physical ill health and depression in a person with heart failure, as symptoms can be similar, for example, fatigue and poor concentration. If you think that the person might be feeling low in mood it is important to assess risk. You can do this by either using a validated tool (see introduction to module) or by talking with the person about their feelings. Important questions to ask are around whether the person feels that they are at risk of suicide, or of harming themselves or someone else? Staff often avoid asking these difficult questions because they do not feel equipped to deal with the answers that people might give. Formal training exists for staff to help build their confidence and skills, so that they feel able to ask these difficult questions and deal with any answers. If you feel such training might be useful, it may be worthwhile finding out what kind of training your health board offers.
A useful resource is:
Page last reviewed: 25 Sep 2020
