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Kleman C, Turrise S, Winslow H, Alzaghari O, Lutz BJ. Individual and systems-related factors associated with heart failure self-care: a systematic review. BMC Nurs 2024; 23:110. [PMID: 38336711 PMCID: PMC10854154 DOI: 10.1186/s12912-023-01689-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/25/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a prevalent condition worldwide. HF self-care is a set of behaviors necessary for improving patient outcomes. This study aims to review and summarize the individual and system-related factors associated with HF self-care published in the last seven years (Jan 2015 - Dec 2021) using the Socioecological Model as a review framework. METHODS An experienced nursing librarian assisted authors in literature searches of CINAHL Plus with Full Text, Ovid Nursing, PsychINFO, and PubMed databases for peer-reviewed descriptive studies. Inclusion criteria were HF sample with self-care as the outcome variable, and a quantitative descriptive design describing individual and/or system-level factors associated with self-care. Exclusion criteria were interventional or qualitative studies, reviews, published before 2015, non-English, and only one self-care behavior as the outcome variable. The search yielded 1,649 articles. Duplicates were removed, 710 articles were screened, and 90 were included in the full-text review. RESULTS A subset of 52 articles met inclusion and exclusion criteria. Study quality was evaluated using modified STROBE criteria. Study findings were quantitated and displayed based on socioecological levels. Self-care confidence, HF knowledge, education level, health literacy, social support, age, depressive symptoms, and cognitive dysfunction were the most frequently cited variables associated with self-care. Most factors measured were at the individual level of the Socioecological Model. There were some factors measured at the microsystem level and none measured at the exosystem or macrosystem level. CONCLUSION Researchers need to balance the investigation of individual behaviors that are associated with HF self-care with system-level factors that may be associated with self-care to better address health disparities and inequity.
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Affiliation(s)
- Carolyn Kleman
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA.
| | - Stephanie Turrise
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
| | - Heidi Winslow
- Manager of Nurse Residencies, Novant New Hanover Regional Medical Center, 2131 S. 17th Street, Wilmington, NC, 28401, USA
| | - Omar Alzaghari
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
| | - Barbara J Lutz
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
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Wang Z, Tocchi C, Chyun D, Kim K, Cong X, Starkweather A. The association between psychological factors and self-care in patients with heart failure: an integrative review. Eur J Cardiovasc Nurs 2023; 22:553-561. [PMID: 36351041 DOI: 10.1093/eurjcn/zvac106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 09/06/2023]
Abstract
AIMS This integrative review aims to describe the current evidence concerning the relationship between a broad range of psychological factors (depression, depressive symptoms, anxiety, stress, and type-D personality) and self-care in patients with heart failure. METHODS AND RESULTS Six electronic databases were searched and keywords were used to identify potential eligible studies published within the last 10 years. To be eligible, individuals with heart failure aged 18 years or older and who were included in any type of observational study that examined the association between psychological factors and self-care were considered. Twenty articles were included, and 16 of them reported that depression/depressive symptoms were associated with poorer self-care, after controlling for age, sex, education level, cardiac history, or comorbidities. Five studies found that self-care confidence/self-efficacy mediates the relationship between depression/depressive symptoms and self-care. The association between depression/depressive symptoms and self-care varied in assessment methods and statistical approaches. Seven studies showed an inverse association between anxiety and self-care. Four studies found a stronger association between self-care and depression compared with the relationship between self-care and other psychological factors. Stress and type-D personality were both associated with self-care in four studies. CONCLUSION Depression/depressive symptoms and anxiety were found to be inversely associated with self-care in patients with heart failure. Depression exhibited a stronger impact on self-care than other psychological factors. Limited studies assessed stress and type-D personality; the results should be considered with caution. Further studies are warranted on different psychological factors and their underlying mechanisms in individuals with heart failure.
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Affiliation(s)
- Zequan Wang
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA
- Center for Advancement in Managing Pain, School of Nursing, University of Connecticut, 231 Glenbrook Rd, Storrs, CT 06269, USA
| | - Christine Tocchi
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA
- Center for Advancement in Managing Pain, School of Nursing, University of Connecticut, 231 Glenbrook Rd, Storrs, CT 06269, USA
| | - Deborah Chyun
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA
| | - Kyounghae Kim
- College of Nursing, Korea University, 145 Anam-ro, Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
- Institute of Nursing Research, Korea University, 145 Anam-ro, Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, 145 Anamro, Seongbuk-gu, Seoul 02841, South Korea
| | - Xiaomei Cong
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA
- Center for Advancement in Managing Pain, School of Nursing, University of Connecticut, 231 Glenbrook Rd, Storrs, CT 06269, USA
| | - Angela Starkweather
- College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA
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Tan H. The mediating role of anxiety in feelings of stigma and quality of life of post-epidemic hemiplegic patients with cerebral hemorrhage. J Clin Neurosci 2023; 112:12-19. [PMID: 37028216 DOI: 10.1016/j.jocn.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To analyze factors influencing the sense of shame, anxiety and quality of life of hemiplegic patients after cerebral hemorrhage and to verify the intermediary role of anxiety in the post-epidemic period. METHODS 240 hemiplegic patients with cerebral hemorrhage were enrolled from a third class a hospital in Hubei Province and interrogated by questionnaire and convenience sampling method. RESULTS Some ICH patients demonstrated problems related to sense of shame, anxiety, and poor quality of life. Sense of shame was positively related to anxiety and shame and anxiety were negatively related to the quality of life. Multivariate regression analysis indicated that age, educational level, occupational status, per capita monthly income, medical payment method, disease duration, sense of shame and anxiety influenced quality of life and together explained 55.8% of the variability. Anxiety mediated prediction of illness and shame on quality of life and the mediating effect accounted for 55.6% of the total effect. CONCLUSION The current study examined correlations between anxiety, stigma and quality of life while testing the hypothesis that anxiety mediated the quality of life. Anxiety was related to quality of life. As such, treatment of anxiety may present an opportunity to improve quality of life after ICH.
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Affiliation(s)
- Hui Tan
- Yanbian University, School of Nursing, YanJi 133000, China.
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Clark LA, Reed R, Corazzini KN, Zhu S, Renn C, Jennifer Klinedinst N. COPD-Related Fatigue: A Scoping Review. Clin Nurs Res 2022; 32:914-928. [PMID: 36540028 DOI: 10.1177/10547738221141224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Millions of people worldwide have chronic obstructive pulmonary disease (COPD), and one of the most common and troublesome symptoms that must be managed is fatigue. While there are existing interventions to address COPD-related fatigue, not all patients experience benefit. A better understanding of the factors associated with COPD-fatigue could elucidate new approaches to address COPD-related fatigue, thereby offering relief to a greater number of patients. The purpose of this review was to identify the physiologic, psychologic, and situational factors associated with COPD-related fatigue. A total of four databases, PubMed, CINAHL, Scopus, and Google Scholar, were searched. Those that were peer reviewed, in English, and published between 2000 and 2021, were included in the review. A total of 25 articles were included in this scoping review. The following factors were related to fatigue in COPD: dyspnea, pain, anxiety, depression, and sleep. Fatigue is a debilitating symptom with factors influential to the symptom and outcomes. Research is indicated to explore targeted and personalized interventions addressing the factors related to fatigue to mitigate this widespread symptom.
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Affiliation(s)
- Lindsey A. Clark
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Robert Reed
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Cynthia Renn
- University of Maryland School of Nursing, Baltimore, Maryland, USA
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Effects of a multidisciplinary management program on symptom burden and medication adherence in heart failure patients with comorbidities: A randomized controlled trial. BMC Nurs 2022; 21:346. [PMID: 36476375 PMCID: PMC9727875 DOI: 10.1186/s12912-022-01130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Comorbidities in heart failure (HF) are a complex clinical challenge. There is little data on the benefits of multidisciplinary postdischarge management programs in such patients. This study aimed to examine the effects of a multidisciplinary management program (MMP) on symptom burden and medication adherence in HF patients with comorbidities. METHODS In this clinical trial study, 94 HF patients with comorbidities were assigned to intervention (n = 47) and control (n = 47) groups by the stratified-random method. The intervention group underwent MMP supervised by a nurse for two months after discharge, including multi-professional visits, telephone follow-ups, and an educational booklet. Medication adherence and symptom burden were assessed using Morisky Medication Adherence Scale (MMAS) and Edmonton Symptom Assessment Scale (ESAS), respectively, on three occasions: Before discharge, six weeks, and eight weeks after discharge. RESULTS Both groups almost matched at the baseline, and the most frequent comorbidities included myocardial infarction (MI), hypertension, peptic ulcer, and depression, respectively. The interactive effect of time in groups showed that mean changes in total scores of symptom burden and medication adherence were significantly different (P < 0.001) at other time points. A significant increase in medication adherence (P < 0.001) and a significant reduction in the burden of all symptoms were observed in the intervention group compared to the control group from Time 1 to Time 3. CONCLUSIONS The MMP (targeting comorbidity) is a promising strategy for managing symptoms and medication adherence in HF patients with comorbidities.
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Kim J, Kim KH, Lim YH, Heo S, Moon K, Oh MS, An M. Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index v7.2. Clin Nurs Res 2022; 31:1296-1307. [PMID: 35726492 DOI: 10.1177/10547738221106590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The psychometric properties of the Korean version of the revised Self-Care of Heart Failure Index (SCHFI) remain undetermined; therefore, we aimed to evaluate the construct and convergent validity and reliability of the Korean version of the SCHFI in Korean patients with heart failure (HF). Using a cross-sectional design, 207 patients with HF provided data on self-care and self-efficacy in self-care for this psychometric testing. The confirmatory factor analysis supported the construct validity of the Korean version with a three-factor structure: Self-Care Maintenance, Symptom Perception, and Self-Care Management. Convergent validity was supported by the significant relationships between self-efficacy and each scale of the Korean version of the SCHFI (r = .425-.549, p < .001). The reliability estimates were marginally adequate, with a Cronbach's alpha of .655 to .776, McDonald's omega of .710 to .836, and composite reliability coefficients of .704 to .834. The SCHFI was supported as a valid and reliable measure of self-care for Koreans with HF. However, the marginal levels of the Cronbach's alpha coefficients still require validation in a larger sample.
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Affiliation(s)
| | - Kye Hun Kim
- Chonnam National University, Gwangju, South Korea
| | | | | | - Keumyi Moon
- Chonnam National University Hospital, Gwangju, South Korea
| | - Mi Sook Oh
- Chonnam National University Hospital, Gwangju, South Korea
| | - Minjeong An
- Chonnam National University, Gwangju, South Korea
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The Situation-Specific Theory of Heart Failure Self-care: An Update on the Problem, Person, and Environmental Factors Influencing Heart Failure Self-care. J Cardiovasc Nurs 2022; 37:515-529. [PMID: 35482335 PMCID: PMC9561231 DOI: 10.1097/jcn.0000000000000919] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care.
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Srivastava SP, Sinha AP, Sharma KK, Malik PS. Severity, Risk Factors and Quality of Life of Patients associated with Chemotherapy-Induced Peripheral Neuropathy. Clin Nurs Res 2022; 31:1080-1090. [PMID: 35362333 DOI: 10.1177/10547738221085613] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) refers to numbness, tingling, and burning sensation caused by chemotherapy that can cause impairment in Quality of Life (QoL) of the patients. Study assesses severity, risk factors, and quality of life of patients associated with CIPN. A cross sectional descriptive study was conducted at day care ward, tertiary care hospital India. Total of 98 patients receiving paclitaxel for ≥4 months were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, CIPN severity, risk factors, and QoL were collected by structured questionnaires. Study revealed that median score of autonomic symptoms was higher than sensory and motor symptoms. Mean score of FACT/GOG-Ntx sub-domain was 99.05 ± 20.87on a scale of 0 to 152. ECOG Performance status, current exercise behavior, and fruit and vegetable intake was found to be significantly (at p < .05) associated with sensory, motor, and autonomic symptom score. Therefore, CIPN was found to have debilitating effect on QoL.
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Afonso BQ, Ferreira NDC, Butcher RDCGES. Content validation of the symptom control outcome for heart failure patients in palliative care. ACTA ACUST UNITED AC 2020; 41:e20190427. [PMID: 33111762 DOI: 10.1590/1983-1447.2020.20190427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To estimate the content validity of the Symptom Control nursing outcome for heart failure patients in palliative care and to analyze the influence of experts' experience in the judgment of the relevance of indicators. METHODS A methodological study conducted in São Paulo in 2018, with an adaptation of Fehring's validation model. The relevance of the 11 outcome indicators was assessed by 19 experts by means of an electronically submitted survey. The influence of the experts' experience on judgment was analyzed by the Wilcoxon-Mann-Whitney test and by Kendall's Tau correlation. RESULTS The indicators were considered pertinent; with 54.5% classified as critical. There was no association between the weighted means of the indicators and the experts' experience. CONCLUSIONS The indicators analyzed are relevant for the evaluation of the Symptom Control outcome in this group of patients. The experts' judgment was not influenced by their area of clinical experience or by their experience with the Nursing Outcomes Classification (NOC).
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Affiliation(s)
- Beatriz Quirino Afonso
- Universidade de São Paulo (USP), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto. São Paulo, São Paulo, Brasil.,Instituto do Coração da Faculdade de Medicina da USP. São Paulo, São Paulo, Brasil
| | - Natany da Costa Ferreira
- Universidade de São Paulo (USP), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto. São Paulo, São Paulo, Brasil.,College of Nursing, University of Iowa, Iowa City, Iwoa, United States of America
| | - Rita de Cassia Gengo E Silva Butcher
- Universidade de São Paulo (USP), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto. São Paulo, São Paulo, Brasil.,NANDA International-Boston College, The Marjory Gordon Program for Clinical Reasoning and Knowledge Development, Boston, Massachusetts, United States of America
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Wang B, Xia L, Yu J, Feng Y, Hong J, Wang W. The multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with heart failure. Heart Lung 2020; 49:842-847. [PMID: 33011463 DOI: 10.1016/j.hrtlng.2020.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous researchers have found that depression can influence self-care behaviors of patients with heart failure (HF). However, the specific path of depression on self-care behaviors remains unclear. OBJECTIVES To determine the multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with HF. METHODS A cross sectional study on HF patients (n = 310) was conducted at a tertiary hospital in China. The Chinese versions of the Hospital Anxiety and Depression Scale (HADS-D), Health Literacy Scale for Patients with Chronic Disease and Self-care of Heart Failure Index (C-SCHFI) were used to assess depression, health literacy, self-care confidence and self-care behaviors of the HF patients respectively. RESULTS Depression had significant negative correlations with health literacy (r = -0.40, P < 0.01), self-care confidence (r = -0.41, P < 0.01), self-care maintenance (r = -0.18, P < 0.01) and management (r = -0.19, P < 0.01). After controlling for covariates, mediation modeling analysis showed that health literacy and self-care confidence were mediating variables between depression and self-care management and all the three paths were significant. A higher level of depression debilitated health literacy (β = -0.23, P < 0.001), and a higher degree of health literacy was associated with better self-care confidence (β = 0.31, P < 0.001) which contributed to better self-care management (β = 0.43, P < 0.001). Total mediation effect was -0.1940 with 95% CI from -0.2702 to -0.1266. However, self-care confidence did not mediate between depression and self-care maintenance. CONCLUSION Health literacy and self-care confidence exert a multiple mediating effect on the relationship between depression and self-care management. The relationship between variables should be considered when developing the tailored interventions for patients with HF to enhance their self-care behaviors.
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Affiliation(s)
| | - Lili Xia
- School of Nursing, Anhui Medical University, China
| | - Jia Yu
- School of Nursing, Anhui Medical University, China
| | - Yuan Feng
- School of Nursing, Anhui Medical University, China
| | | | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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