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Clarke ST, Le Grande M, Murphy BM, Hester R, Jackson AC. Protocol for the development and validation of a clinical measurement tool for fear of disease progression and recurrence in cardiac patients. Chronic Dis Transl Med 2024; 10:195-204. [PMID: 39027197 PMCID: PMC11252435 DOI: 10.1002/cdt3.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 07/20/2024] Open
Abstract
Introduction One in two cardiac patients fear having another heart event or their heart condition getting worse. Research in other chronic illnesses demonstrates that screening for fear of progression and recurrence is vital for adequately addressing such concerns in clinical care. The current project aims to develop and validate a measure for fear of progression and recurrence in cardiac patients. Methods The Fear of Cardiac Recurrence and Progression Scale (FCRP) will be developed through a multistep process. An initial item pool will be generated through a review of the literature and existing measures and consultation with and feedback from key informants. The item pool will be tested in a sample of over 250 adults who have ever had an acute coronary event, undergone cardiac surgery, or a chronic cardiac condition. Exploratory factor analysis will be used to identify the underlying factors, and Rasch analysis will be used to reduce the number of items. A short form version of the FCRP will be developed for use as a brief screening tool, informed by clinical relevance and Rasch psychometric indices. Discussion While many cardiac patients experience fears related to the progression or recurrence of their illness, there remains the need for a validated tool with which these concerns can be identified and measured. It is expected that the design and validation of the FCRP will aid identification of cardiac patients suffering from clinically significant levels of fear of progression and recurrence and facilitate the design of tailored psychological interventions to target these fears.
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Affiliation(s)
- Sarah T. Clarke
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Michael Le Grande
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Barbara M. Murphy
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
| | - Robert Hester
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Alun C. Jackson
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Australian Centre for Heart HealthMelbourneVictoriaAustralia
- Centre on Behavioral HealthUniversity of Hong KongPokfulamHong KongChina
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Hayashi K, Okada A, Jurgens CY, Ito S, Tsuchihashi-Makaya M. Psychometric Analysis of the Heart Failure Somatic Perception Scale in Japanese Patients With Heart Failure. J Cardiovasc Nurs 2024:00005082-990000000-00205. [PMID: 39007756 DOI: 10.1097/jcn.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
BACKGROUND Patients with heart failure (HF) experience a wide variety of symptoms. Appropriate recognition of symptoms is important in HF care. The Heart Failure Somatic Perception Scale (HFSPS) measures the presence of HF symptoms and the degree to which physical symptoms are bothersome. OBJECTIVE The aim of this study was to assess the validity and reliability of the Japanese version of the HFSPS. METHODS Confirmatory factor analysis was used to assess structural validity. Construct validity was assessed using Spearman's rank correlation coefficient to evaluate the association between HFSPS total and subscale scores and global physical health on the Patient-Reported Outcomes Measurement Information System. Internal consistency was assessed using the model-based internal consistency for the HFSPS as a whole and Cronbach α for the subscales. RESULTS Participants were 315 Japanese outpatients (72.1% male), with a mean age of 72.9 ± 12.9 years. The result of confirmatory factor analysis was an adequate model fit by adding error correlations. Construct validity was significant for the correlation with global physical health of the Patient-Reported Outcomes Measurement Information System. The model-based internal consistency was 0.95. Cronbach αs for each subscale were 0.88 for dyspnea, 0.60 for chest discomfort, 0.77 for early and subtle symptoms, and 0.77 for edema. CONCLUSIONS The findings support the use of the HFSPS in a more diverse population, suggesting that it is a reliable and valid instrument in Japanese patients with HF. The HFSPS may provide an accurate assessment of the symptoms experienced by patients with HF in daily life in future educational intervention studies to improve symptom perception and coping behaviors.
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Wang Z, Conley S, Redeker NS, Tocchi C. An Evolutionary Concept Analysis in People With Heart Failure-Symptom Clusters or Symptom Cluster Profiles? ANS Adv Nurs Sci 2024; 47:166-187. [PMID: 37185222 DOI: 10.1097/ans.0000000000000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The concept of symptom clusters in heart failure (HF) has been defined and measured inconsistently. We used Rodgers' evolutionary method to review related concepts in the HF literature. Symptom clusters and symptom cluster profiles are characterized by multiple symptoms, a synergistic relationship, and result in a myriad of poor outcomes. Researchers should carefully consider the conceptual differences underpinning symptom clusters and symptom cluster profiles and choose the appropriate concept aligned with their research questions, empirical methods, and target HF population.
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Affiliation(s)
- Zequan Wang
- Author Affiliations University of Connecticut School of Nursing, Storrs (Ms Wang and Drs Redeker and Tocchi); and The Mayo Clinic, Rochester, Minnesota (Dr Conley)
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Antonio-Oriola R, Juárez-Vela R, Czapla M, Durante A, Di Nitto M, Benavent-Cervera JV, Saus-Ortega C, Navas-Echazarreta N, Cobos-Rincón A, Tejada-Garrido CI, Santolalla-Arnedo I, Gea-Caballero V. Spanish version of the Heart Failure Somatic Perception Scale (HFSPS v.3) - psychometric properties. Front Cardiovasc Med 2023; 10:1242057. [PMID: 38107264 PMCID: PMC10722411 DOI: 10.3389/fcvm.2023.1242057] [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: 06/21/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background The Heart Failure Somatic Perception Scale (HFSPS) is an instrument that examine the existence and gravity of physical signs and symptoms in patients with heart failure, as well as early and subtle symptoms of HF that have clinical value, we aimed to translate and adapt the HFSPS from English to Spanish and evaluate the psychometric properties. Method HFSPS translation and back translation were carried out according to the method established by of Beaton et al. A confirmatory factor analysis (CFA) was performed to test the factor structures. To assess criterion-related validity, HFSPS factor scores were correlated with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using the Spearman correlation method. The reliability of the internal consistency of the HFSPS was determined by calculating the Cronbach's alpha coefficient and the factor score determination coefficient. Results Data from 173 patients with a mean age of 80.7 years (SD 9.1), women (51.1%), were analyzed. The majority (74.7%) were NYHA class II/III. The confirmatory factor analysis of four factors after eliminating one item showed fit indices close to the recommended indices: χ2 = 169.237, p < 0.001, CFI = 0.920, TLI = 0.901, RMSEA = 0.057 and SRMR = 0.061. Regarding the validity related to the criterion, all the scores of the HFSPS dimensions were correlated with all the scores of the KCCQ dimensions and were statistically significant. The reliability of the HFSPS factors of the coefficient of determination obtained scores of 0.73 for the dyspnea factor and early and subtle and lower for edema and chest discomfort with fewer items. Cronbach's alpha was acceptable for three of the scales >0.71 and poor 0.52 for chest discomfort with two items. The internal consistency index based on the model was 0.850. Conclusion The Spanish version of the HFSPS is a valid and reliable instrument that that would be feasible to use in clinical and research setting to evaluate in the perception of symptoms in patients with heart failure.
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Affiliation(s)
- Rosa Antonio-Oriola
- Doctorate Program in Clinical and Community Nursing, University of Valencia, Valencia, Spain
| | - Raúl Juárez-Vela
- Faculty ofHealth Sciences, GRUPAC Care Research Group, University of La Rioja, Logroño, Spain
| | - Michal Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Angela Durante
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italia
| | - Marco Di Nitto
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - José Vicente Benavent-Cervera
- Faculty of Health Science, Research Group Community Health and Care, Valencia International University, Valencia, Spain
| | - Carlos Saus-Ortega
- Research Group in Art and Science in Care, Institute for Health Research La Fe (IISLAFE), University School of Nursing La Fe, València, Spain
| | | | - Ana Cobos-Rincón
- Faculty ofHealth Sciences, GRUPAC Care Research Group, University of La Rioja, Logroño, Spain
| | | | - Ivan Santolalla-Arnedo
- Faculty ofHealth Sciences, GRUPAC Care Research Group, University of La Rioja, Logroño, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Science, Research Group Community Health and Care, Valencia International University, Valencia, Spain
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Khanipour-Kencha A, Ghiyasvandian S, Mohammadi S, Khabazkhoob M, Mirshahi A, Wells R, Zakerimoghadam M. Effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission of patients with heart failure: protocol for a randomised controlled trial. BMJ Open 2023; 13:e074256. [PMID: 37558436 PMCID: PMC10414091 DOI: 10.1136/bmjopen-2023-074256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Heart failure (HF) as a long-term clinical syndrome is associated with inadequate self-care behaviours, a feeling of uncertainty and frequent hospitalisation. In recent years, empowerment has evolved for improving chronic disease management. Nevertheless, there is a lack of studies investigating remote care interventions such as a tele-empowerment programme in patients with HF. Therefore, this protocol proposes a randomised controlled trial which aims to evaluate the effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission in patients with HF. METHODS AND ANALYSIS The study is a double-arm and parallel-group randomised controlled trial in which a 10-week intervention, including 6 weeks of a comprehensive tele-empowerment programme and 4 weeks of follow-up, will be compared with usual care. A total of 96 eligible patients with HF will be recruited and randomly assigned to the intervention or control group. The patients in the intervention group will join virtual groups and receive the five-step tele-empowerment programme through the internet. The primary outcomes include self-care behaviours and uncertainty which will be measured with valid instruments at baseline and 10th week. The secondary outcome is the number of patients' hospital readmissions and will be assessed at the end of the study. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests including two-sample t-tests, Χ2, analysis of covariance or linear regression will be performed. In addition, standardised intervention effect sizes will be calculated for each outcome. ETHICS AND DISSEMINATION The trial has been approved by the Research Ethics Committee of School of Nursing and Midwifery & Rehabilitation at Tehran University of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER Iranian Registry of Clinical Trials (IRCT20100725004443N30).
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Affiliation(s)
- Ali Khanipour-Kencha
- Department of Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran
- USERN Care (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Ghiyasvandian
- Department of Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Mohammadi
- Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arvin Mirshahi
- Department of Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran
- USERN Care (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Rachel Wells
- School of Nursing, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Okada A, Tsuchihashi-Makaya M, Nagao N, Ochiai R. Somatic Changes Perceived by Patients With Heart Failure During Acute Exacerbation: A Qualitative Study Using Text Mining. J Cardiovasc Nurs 2023; 38:23-32. [PMID: 35467568 DOI: 10.1097/jcn.0000000000000915] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with heart failure (HF) often inadequately perceive their symptoms. This may be because the medical terms do not match the somatic changes experienced by patients. To improve symptom perception, healthcare professionals must understand the somatic changes as perceived by patients. OBJECTIVE This study aims to analyze patients' narratives about somatic changes in patients with HF by text mining and to clarify the overall description of somatic changes using patients' expressions. METHODS Semistructured interviews were conducted on 21 patients hospitalized for acute exacerbation of HF. Qualitative data obtained from the interviews were analyzed by content analysis through text mining. RESULTS Among the 21 patients, 76.2% were men. The mean (SD) age was 71.3 (13.7) years. The most frequently used terms were "breath," "distressed," "feet," and " ha-ha (gasping sound)" (46, 40, 29, and 28 times, respectively). The somatic changes noticed by patients could be categorized into medical jargon such as "dyspnea on exertion," "exercise intolerance," "fatigue," "paroxysmal nocturnal dyspnea," "frequent urination," "increased sputum," "weight gain," "feet and face edema," "abdominal edema," and "ankle edema." However, the expressions of somatic changes used by the patients were diverse. CONCLUSIONS The findings of patient-specific expressions of symptoms suggest that there is a need to assess symptoms not only using medical jargon but also by focusing on patient-specific expressions.
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Yang H, Tian J, Li J, Han L, Han G, Zhao J, Han Q, Zhang Y. Social and therapeutic decline earlier than physical and psychological domains after discharge in heart failure patients: A patient-reported outcome measurements of latent transition analysis. Front Cardiovasc Med 2022; 9:965201. [PMID: 36204569 PMCID: PMC9530707 DOI: 10.3389/fcvm.2022.965201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background Among patients with chronic heart failure (CHF), response shifts are common in assessing treatment effects. However, few studies focused on potential response shifts in these patients. Materials and methods Data of CHF patient-reported outcome measures (PROMs) were obtained from three hospitals in Shanxi, China, from 2017 to 2019. A total of 497 patients were enrolled and followed up at 1 month and 6 months after discharge. Latent transition analysis (LTA) was employed to determine the longitudinal transition trajectories of latent subtypes in CHF patients in the physiological, psychological, social, and therapeutic domains. Results The patients were divided into high- and low-level groups in the four domains according to the LTA. One month after discharge, the physiological and psychological domains improved, while the social and therapeutic domains remained unchanged. Six months after discharge, the former remained stable, but the latter deteriorated. The factors affecting the state transition in four domains were as follows. The influencing factor of the physiological domains are gender, age, tea consumption, smoking, alcohol consumption, physical activity, and light diet; those of the psychological domain are gender, occupation, smoking, alcohol consumption, and physical activity; those of the social domains are age; those of the therapeutic domains are education and income. Conclusion The disease status of CHF patients has shifted over time. Risk factors accelerate the deterioration of patients' condition. Furthermore, the risk factors of social and therapeutic domains deteriorate patients' condition faster than those of physiological and psychological domains. Therefore, individualized intervention programs should be given for CHF patients who may be transferred to the low-level groups to maintain the treatment effect and improve the prognosis.
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Affiliation(s)
- Hong Yang
- Department of Health Statistics, Shanxi Medical University, Taiyuan, China
| | - Jing Tian
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jing Li
- Department of Health Statistics, Shanxi Medical University, Taiyuan, China
| | - Linai Han
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Gangfei Han
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinghua Zhao
- Department of Health Statistics, Shanxi Medical University, Taiyuan, China
| | - Qinghua Han
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanbo Zhang
- Department of Health Statistics, Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Taiyuan, China
- School of Health Services and Management, Shanxi University of Chinese Medicine, Taiyuan, China
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Sun J, Guo H, Wang W, Wang X, Ding J, He K, Guan X. Identifying novel subgroups in heart failure patients with unsupervised machine learning: A scoping review. Front Cardiovasc Med 2022; 9:895836. [PMID: 35935639 PMCID: PMC9353556 DOI: 10.3389/fcvm.2022.895836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Heart failure is currently divided into three main forms, HFrEF, HFpEF, and HFmrEF, but its etiology is diverse and highly heterogeneous. Many studies reported a variety of novel subgroups in heart failure patients, with unsupervised machine learning methods. The aim of this scoping review is to provide insights into how these techniques can diagnose and manage HF faster and better, thus providing direction for future research and facilitating its routine use in clinical practice. Methods The review was performed following PRISMA-SCR guideline. We searched the PubMed database for eligible publications. Studies were included if they defined new subgroups in HF patients using clustering analysis methods, and excluded if they are (1) Reviews, commentary, or editorials, (2) Studies not about defining new sub-types, or (3) Studies not using unsupervised algorithms. All study screening and data extraction were conducted independently by two investigators and narrative integration of data extracted from included studies was performed. Results Of the 498 studies identified, 47 were included in the analysis. Most studies (61.7%) were published in 2020 and later. The largest number of studies (46.8%) coming from the United States, and most of the studies were authored and included in the same country. The most commonly used machine learning method was hierarchical cluster analysis (46.8%), the most commonly used cluster variable type was comorbidity (61.7%), and the least used cluster variable type was genomics (12.8%). Most of the studies used data sets of less than 500 patients (48.9%), and the sample size had negative correlation with the number of clustering variables. The majority of studies (85.1%) assessed the association between cluster grouping and at least one outcomes, with death and hospitalization being the most commonly used outcome measures. Conclusion This scoping review provides an overview of recent studies proposing novel HF subgroups based on clustering analysis. Differences were found in study design, study population, clustering methods and variables, and outcomes of interests, and we provided insights into how these studies were conducted and identify the knowledge gaps to guide future research.
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Affiliation(s)
- Jin Sun
- Medical School of Chinese PLA, Beijing, China
| | - Hua Guo
- Medical School of Chinese PLA, Beijing, China
| | - Wenjun Wang
- Key Laboratory of Ministry of Industry and Information Technology of Biomedical Engineering and Translational Medicine, Chinese PLA General Hospital, Beijing, China
- Medical Big Data Center, Chinese PLA General Hospital, Beijing, China
| | - Xiao Wang
- Key Laboratory of Ministry of Industry and Information Technology of Biomedical Engineering and Translational Medicine, Chinese PLA General Hospital, Beijing, China
- Medical Big Data Center, Chinese PLA General Hospital, Beijing, China
| | - Junyu Ding
- Medical School of Chinese PLA, Beijing, China
| | - Kunlun He
- Key Laboratory of Ministry of Industry and Information Technology of Biomedical Engineering and Translational Medicine, Chinese PLA General Hospital, Beijing, China
- Medical Big Data Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Xizhou Guan,
| | - Xizhou Guan
- Department of Pulmonary and Critical Care Medicine, The Eighth Medical Center, Chinese PLA General Hospital, Beijing, China
- Kunlun He,
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