Self-Care and Pathophysiological Function in Patients with Chronic Heart Failure

Relación entre sobrecarga del cuidador y agencia de autocuidado del paciente de cirugía cardiaca en Cúcuta – Colombia

Introducción: Durante el posoperatorio de cirugía cardiaca surgen problemas físicos, psicológicos y sociales, que afectan la capacidad de agencia de autocuidado del paciente, lo cual trae consigo la necesidad de un cuidador durante su recuperación. Objetivo: Determinar la relación entre el nivel de sobrecarga del cuidador principal y la agencia de autocuidado del paciente de cirugía cardiaca. Materiales y Métodos: Se planteó un diseño descriptivo de corte transversal, analítico correlacional, participaron pacientes (n=86) y cuidadores (n=86) del programa de cirugía cardiaca, en una institución de alta complejidad en Cúcuta – Colombia, seleccionados con muestreo no probabilístico por cuotas, se aplicó la escala de valoración de agencia de autocuidado ASA y la escala de sobrecarga del cuidador de Zarit. Resultados: En cuidadores con una sobrecarga intensa, el 83,33% tenían a su cargo pacientes con baja capacidad de autocuidado. En el grupo de cuidadores con sobrecarga leve, el 63% los pacientes tenían capacidad de agencia de autocuidado media, mientras que, los cuidadores sin sobrecarga, la mayoría de sus pacientes (71, 01%) tenía una capacidad de agencia de autocuidado media, pero un 20,29% exhibió una alta capacidad de autocuidado. Discusión: La capacidad de agencia de autocuidado reduce el nivel de sobrecarga del cuidador, cuando el paciente logra adaptarse a las actividades que contribuyen al cuidado, disminuye el nivel de dependencia. Conclusiones: La investigación demostró la relación entre estas dos variables, se debe abordar a pacientes y cuidadores para alcanzar el empoderamiento del autocuidado.

Frailty Affects Self-Care Behavior in Congestive Heart Failure

To explore the association between frailty and self-care in older adults with congestive heart failure and analyze their influencing factors. The cross-sectional study was conducted at the department of cardiology of a hospital in China from March 2018 to November 2018. A total of 165 participants were recruited. Frailty and self-care were measured by the Tilburg Frailty Indicator, and the Self-care of Heart Failure Index (V6). The physical, psychological, and social frailty exerted a significant negative association with self-care. Exercise, income, comorbidities, and times of congestive heart failure-related hospitalizations were independent risk factors for frailty; surgical treatment, comorbidities, and income were independent risk factors for self-care. These findings help to fill the need for new approaches to identify the high risk of frailty individuals in the acute care setting for targeted intervention and tailored transitions in care to promote optimal patient quality care and biopsychosocial well-being.

Self-care education program improves quality of life in patients with chronic heart failure: A randomized controlled study protocol

OBJECTIVE

The objective of our research is to explore the efficiency of self-care education on the life quality in chronic heart failure (CHF) patients.

METHODS

The experiment will be implemented from July 2021 to July 2022 and was granted through the Research Ethics Committee of Shengjing Hospital of China Medical University (423507-037). Eighty patients are included in the study. The recruitment criteria of patients includes: the patients have been diagnosed with CHF by physician on the basis of echocardiography; being stabilized in the acute disease state; in accordance with medical record, the patients have no sensory-cognitive problems. Any reason for not participating in education course (such as not wishing to continue taking part in our experiment or discharge from hospital) is regarded as the exclusion criterion. The primary outcome is the patients' life quality, which is evaluated with Iranian heart failure quality of life questionnaire. Other outcomes include the incidence of hospitalization and total medical cost.

RESULTS

Table 1 suggests the comparison of patients' life quality between control group and study group after receiving the education of self-care.

CONCLUSION

The program of self-care education can be regarded as the proper method to improve the life quality in CHF patients.

TRIAL REGISTRATION

The protocol was registered in Research Registry (researchregistry6225).

Development of Cognitive and Physical Exercise Systems, Clinical Recordings, Large-Scale Data Analytics, and Virtual Coaching for Heart Failure Patients: Protocol for the BioTechCOACH-ForALL Project

Background

Heart failure is a chronic disease affecting patient morbidity and mortality. Current guidelines for heart failure patient treatment are focused on improving their clinical status, functional capacity, and quality of life. However, these guidelines implement numerous instructions including medical treatment adherence, physical activity, and self-care management. The complexity of the therapeutic instructions makes them difficult to follow especially by older adults.

Objective

The challenge of this project is to (1) measure real-life adherence to a regular physical exercise program and (2) attempt to influence older adult patients with heart failure toward embracing a more physically active self-care lifestyle.

Methods

This research consists of two studies, including a lab experiment and a pragmatic evaluation of technology at patients’ homes. The lab experiment aims at exploring in an objective way (measuring neurophysiological responses to stimuli) patient engagement with different characteristics of virtual agents, while the home study is a 3-phase prospective study where the developed technology platform is tested by heart failure patients in their own home environments. Patients undergo evaluation of their physical activity and cognitive status using standard evaluation methods (6-minute walk test, questionnaires) and receive wearable devices to accurately measure everyday life activity levels (home study phases 1-3). During home study phases 2 and 3, exergames (serious games for physical exercise) to provide a physical exercise plan as a joyful activity are delivered to patients’ private households and e-coaching techniques are implemented in the final phase (home study phase 3) of the protocol, to influence patient attitudes toward a more healthy and recommended lifestyle.

Results

The trial is still ongoing. Recruitment is ongoing, and the project has progressed for some participants through phase 2 of the home study. The sample size for both studies is 28 participants; 10 have already been included in the study, and both baseline clinical and patient-reported outcome data are retrieved. Phases 2 and 3 of the home pilot study are expected to be completed within 6 months.

Conclusions

The main challenge of the project is the change of attitude of older age heart failure patients through an e-coaching system. Given the adoption of a cocreation and living lab approach and the main objective for real-life evaluation, the project is ready to react to any collected feedback, even during the implementation of the research plan. Clinical assessment and objective evaluation are expected to provide all required information for reliable findings.

Trial Registration

ClinicalTrials.gov NCT03877328; https://clinicaltrials.gov/ct2/show/NCT03877328

International Registered Report Identifier (IRRID)

DERR1-10.2196/17714