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Sethares KA, Westlake C, Viveiros JD, Elliott K. Correlation of health literacy and learning style preference in persons with heart failure. PATIENT EDUCATION AND COUNSELING 2024; 127:108367. [PMID: 38981405 DOI: 10.1016/j.pec.2024.108367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/13/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVE The purpose of the study was to describe demographic and health literacy correlates of learning style in older adults with heart failure (HF). METHODS Cross sectional data on learning styles (VARK Questionnaire, 16 items) and health literacy (S-TOFHLA, 36 items) were collected. Preferred learning style was determined and correlated to health literacy and demographic measures. RESULTS 116 participants with heart failure (M age = 75.1 (SD 12.5) years, M health literacy of 19 (SD 11.5). Most identified as male (59 %); with inadequate health literacy (67 %). Thirty percent reported a multimodal learning style preference with a kinesthetic (r = .33, p = .03) and not a visual preference (r = -.49, p < .001). Among unimodal learning styles, the most frequent was kinesthetic (26.7 %). Those with lower literacy levels were older (r = -.44, p = <.001), had less education (r = .48, p < .001) and reported a kinesthetic learning preference (r = .37, p = .001). CONCLUSION Older individuals identifying as male, with low health literacy, preferred a kinesthetic approach to HF education. Future research should consider the linkage between education tailored to learning style, health literacy and outcomes. PRACTICE IMPLICATIONS Assessment of learning style should be completed prior to an educational encounter.
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Affiliation(s)
- Kristen A Sethares
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA.
| | - Cheryl Westlake
- Memorial Care, 17360 Brookhurst Street, Fountain Valley, CA 92708, USA; Azusa Pacific University, 606 E Huntington Drive, Monrovia, CA 91016, USA
| | - Jennifer D Viveiros
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA
| | - Kathleen Elliott
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA
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Nozawa M, Hotta S, Tanaka M. Actual status of pre-discharge knowledge of hospitalised patients with heart failure and measurement tools to assess said knowledge: A scoping review. Heart Lung 2024; 64:46-54. [PMID: 38042096 DOI: 10.1016/j.hrtlng.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Heart failure (HF) patients have high readmission rates and require continuous adherence to HF self-care. Lack of knowledge about HF has been identified as a factor that contributes to poor adherence. OBJECTIVES To clarify and organise existing data about measurement tools used to assess pre-discharge knowledge of hospitalised HF patients, the content and level of pre-discharge knowledge, factors associated with the level of knowledge, and the effect of knowledge levels on patients' outcomes. METHODS Four electronic databases were searched for articles that described the content and level of knowledge of pre-discharge HF patients. RESULTS Thirty-three studies were included in this review. Twenty-two measurement tools were identified used for pre-discharge knowledge assessment. 'Heart failure pathophysiology and treatment' and 'salt and fluid management' were the most common knowledge content measured. The level of knowledge of 'the nature, definition, and causes of symptoms of heart failure' and 'fluid and medication management' tended to be low. High levels of knowledge were found for 'higher educational background', 'previous heart failure hospitalisation', and 'previous heart failure education', while low levels were found for: 'high number of medications' and 'first heart failure hospitalisation'. The level of HF knowledge implies an impact on compliance and self-care. CONCLUSION HF patients have low level of knowledge of the nature and causes of HF and fluid management prior to hospital discharge. Some of the variables that influenced the level of patient knowledge were educational background, number of medications taken, and disease duration.
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Affiliation(s)
- Mina Nozawa
- Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 Japan.
| | - Soichiro Hotta
- Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 Japan
| | - Makoto Tanaka
- Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 Japan
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da Silva CG, de Araújo SS, da Silva JI, Lira ALBDC, Lopes MVDO, Lopes CT, Frazão CMFDQ. Analysis of the content of the nursing diagnosis deficient knowledge in individuals with heart failure. Int J Nurs Knowl 2022; 34:116-125. [PMID: 35794806 DOI: 10.1111/2047-3095.12386] [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: 05/06/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze the content of the nursing diagnosis deficient knowledge in individuals with heart failure. METHODS Methodological study to validate the content of a nursing diagnosis based on the predictive model of diversity, carried out through the organization of the phenomenon of interest and analysis by judges using the collective wisdom model. The NANDA-I Knowledge Deficient diagnosis was evaluated by 48 judges and considered valid when it presented a median content validity index ≥ 0.8 in the confidence intervals. RESULTS Note that 66.6% of the judges indicated that the new definition proposed was more adequate than the definition adopted by NANDA-I. After the experts' analysis, the following defining characteristics were considered valid: inaccurate statements about the disease and/or therapy, inadequate performance in the management of intercurrences, increase in hospital readmissions, worsened quality of life, deficit in self-care performance, and follow-up of inadequate instruction; related factors are as follows: inadequate guidance offered by health professionals, nonparticipation of the patient in the planning of their health care, weakened relationship between professional and individual; populations at risk-elderly and low level of education of the individual and/or caregiver and the associated condition, mild cognitive impairment. Anxiety, depression, and impaired social interaction were elements considered not relevant to the content domain. CONCLUSION The validation of the content of the aforementioned diagnosis in patients with heart failure, through the analysis of judges with different degrees of expertise, made it possible to improve the definition and expansion of new diagnostic indicators. IMPLICATIONS FOR NURSING PRACTICE Updated diagnostic elements for the nursing diagnosis deficient knowledge in individuals with heart failure will facilitate accurate clinical judgment and the establishment of a therapeutic plan aimed at etiological factors modifiable by nurses.
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Affiliation(s)
| | | | | | - Ana Luísa Brandão de Carvalho Lira
- Nurse, Permanent Professor of the Graduate Program in Nursing, Federal University of Rio Grande do Norte, Doctor in Nursing, Natal, Brazil
| | | | - Camila Takáo Lopes
- Nurse, Adjunct Professor at Escola Paulista de Enfermagem (EPE), Federal University of São Paulo. Doctor in Nursing, São Paulo, Brazil
| | - Cecília Maria Farias de Queiroz Frazão
- Nurse, Adjunct Professor of the undergraduate and graduate courses of the Department of Nursing, Federal University of Pernambuco, Doctor in Nursing, Recife, Brazil
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Hunter EG, Rhodus E. Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review. Am J Occup Ther 2022; 76:23140. [PMID: 34990510 DOI: 10.5014/ajot.2022.047589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care. OBJECTIVE To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings. DATA SOURCES Articles published from January 1995 through 2019 identified through searches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice. FINDINGS Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; implementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission. CONCLUSIONS AND RELEVANCE The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury.
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Affiliation(s)
- Elizabeth G Hunter
- Elizabeth G. Hunter, PhD, OTR/L, is Assistant Professor, Graduate Center for Gerontology, College of Public Health, University of Kentucky, Lexington;
| | - Elizabeth Rhodus
- Elizabeth Rhodus, PhD, OTR, is Postdoctoral Fellow, Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington
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Tavakkoli Oskuei M, Barzanjeh Atri S, Davoodi A, Van Son C, Asghari-Jafarabadi M, Hosseinzadeh M. Evaluation of a self-care education program for older adults in Iran using a lifestyle improvement model. Int J Older People Nurs 2021; 17:e12419. [PMID: 34435738 DOI: 10.1111/opn.12419] [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: 09/26/2020] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender's Health Promotion Model and its influence on health-focused behaviour changes among older Iranians. METHOD This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire. RESULTS The mean difference and confidence limits of the older adults' health behaviours pre- and post-intervention scores were 2.228 (-5.450 - 9.916) and - 35.820 (-32.051 - 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth. CONCLUSION The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.
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Affiliation(s)
- Mehrnaz Tavakkoli Oskuei
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Barzanjeh Atri
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arefeh Davoodi
- Department of Medical-surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Asghari-Jafarabadi
- Department of Bio-statistics and Epidemiology, School of medicine, Zanjan University of medical science, Zanjan, Iran.,Center for the Development of Interdisciplinary Research in Islamic Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Runyan C, Marshall C, Aronow H, Vongkavivathanakul S, Daniels L, Currey J, Coleman B. Evaluation of Team-Based Learning to Increase Nurses' Knowledge of the Ventricular Assist Device. J Contin Educ Nurs 2021; 52:13-20. [PMID: 33373002 DOI: 10.3928/00220124-20201215-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 06/17/2020] [Indexed: 11/20/2022]
Abstract
Ventricular assist devices (VAD) are used to extend life expectancy for patients with advanced heart failure. Approximately 102 hospitals nationwide have a VAD program, but the majority implant only a small number of devices each year. This low-volume and high-acuity patient population can create concerns for maintaining nursing knowledge skill levels. Nursing staff from a step-down telemetry floor in a large urban hospital completed an Individual Readiness Assessment Test to assess their knowledge and accuracy in the care of mechanical circulatory support patients using the Immediate Feedback Assessment Technique. The nurses were then assigned to small groups and worked as a team to complete the same test known as the Group Readiness Assessment Test. Study results suggest that team-based learning was effective in increasing knowledge of mechanical circulatory support. [J Contin Educ Nurs. 2021;52(1):13-20.].
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Sousa JP, Oliveira C, Pais-Vieira M. Symptom perception management education improves self-care in patients with heart failure. Work 2021; 69:465-473. [PMID: 34120927 DOI: 10.3233/wor-213491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with heart failure often have difficulty recognizing signs and symptoms of the disease, which delays seeking help, and therefore interferes with patient engagement and self-care management. Early detection of these symptoms could lead to care-seeking and avoid hospitalizations. OBJECTIVE The purpose of this study was to design a complex intervention through a systematic literature review and qualitative study. METHODS Our design followed the Medical Research Council's recommendations. To design a complex intervention, we combined a systematic literature review on education, symptom recognition, and self-care management in patients with heart failure, and semi-structured interviews with cardiology healthcare providers and patients with heart failure admitted to a cardiology ward. RESULTS The systematic literature review identified 582 studies published between 2005 and 2014, of which four were included in the final review. These suggested that patient education focused on symptom recognition, combined with reinforcements, led to better self-care behaviors. Additionally, content analysis of semi-structured interviews revealed three themes: health management, behavior management, and support received. CONCLUSIONS Combining the findings of the literature review and the themes that emerged from the semi-structured interviews, we proposed the development and implementation of a complex intervention on symptom perception and fluid management.
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Affiliation(s)
- Joana Pereira Sousa
- Instituto Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal.,School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Cláudia Oliveira
- ACeS Algarve I Central, ARS Algarve, Faro, Portugal.,Universidade do Algarve, Faro, Portugal
| | - Miguel Pais-Vieira
- Centro de Investigação Interdisciplinar em Saúde-Porto, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal.,Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
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Pereira Sousa J, Neves H, Pais-Vieira M. Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial. NURSING REPORTS 2021; 11:418-429. [PMID: 34968218 PMCID: PMC8608136 DOI: 10.3390/nursrep11020040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022] Open
Abstract
Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).
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Affiliation(s)
- Joana Pereira Sousa
- Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
- School of Health Sciences, Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Correspondence:
| | - Hugo Neves
- Health Sciences Research Unit: Nursing—UICISA:E, Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal;
- Center for Innovative Care and Health Technology—CiTechCare, 2411-901 Leiria, Portugal
| | - Miguel Pais-Vieira
- Institute of Biomedicine—iBiMED, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
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Juárez-Vela R, Sarabia-Cobo C, Antón-Solanas I, Vellone E, Durante A, Gea-Caballero V, Pérez-Calvo J. Investigating self-care in a sample of patients with decompensated heart failure: A cross-sectional study. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2019.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Son YJ, Lee YM, Kim EY. How do patients develop self-care behaviors to live well with heart failure?: A focus group interview study. Collegian 2019. [DOI: 10.1016/j.colegn.2018.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Juárez-Vela R, Sarabia-Cobo CM, Antón-Solanas I, Vellone E, Durante A, Gea-Caballero V, Pérez-Calvo JI. Investigating self-care in a sample of patients with decompensated heart failure: A cross-sectional study. Rev Clin Esp 2019; 219:351-359. [PMID: 30850119 DOI: 10.1016/j.rce.2018.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND There is scarce evidence relating to self-care of heart failure (HF) in Spain. In particular, there is a need to establish patients' level of understanding of HF, as well as their ability to recognise signs and symptoms of decompensation. PATIENTS AND METHODS Cross-sectional study to determine the level of self-care in a population of Spanish patients admitted to hospital with a primary diagnosis of decompensated HF. A convenience sample of 108 patients (50 women and 58 men) aged 83±8 were recruited to participate in this study. RESULTS The Self-Care of Heart Failure Index version 6.2 was used to quantify self-care in our sample. Mean and standard deviation from the Self-Care of Heart Failure Index self-care maintenance subscale were: a) "exercise for 30 minutes", 1±1; b) "forget to take one of your medicines", 2±2; c) "ask for low-salt items when eating out or visiting others", 2±1. A percentage of 67.6 had experienced shortness of breath or ankle swelling in the past month. However, the vast majority of our patients were unlikely to independently implement a remedy: a) reduce salt, 2±1; b) reduce fluid intake, 1±1; c) take an extra diuretic, 1±1. Over 50% of our sample felt confident or very confident at following professional advice (3±1), keeping themselves free of symptoms (3±1), recognizing changes in their condition (3±1) and evaluating the significance of such changes (3±1). CONCLUSIONS HF patients have a significantly low level of self-care when compared with HF patients from other countries, especially when it comes to managing their condition. Self-care promotion should be a priority for all healthcare professionals involved in the care and management of HF patients.
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Affiliation(s)
- R Juárez-Vela
- Grupo de Investigación en Insuficiencia Cardiaca e Insuficiencia Fisiopatológica de la Interacción Cardiorrenal (IFICaR), Escuela de Enfermería, Instituto de Investigación Sanitaria de Aragón-ISS, Universidad de La Rioja, Logroño, La Rioja, España
| | - C M Sarabia-Cobo
- Facultad de Enfermería, Universidad de Cantabria, Santander, España
| | - I Antón-Solanas
- Facultad de Ciencias de la Salud, Universidad San Jorge, Zaragoza, España
| | - E Vellone
- Departamento de Biomedicina y Prevención, Universidad de Roma Tor Vergata, Roma, Italia
| | - A Durante
- Departamento de Biomedicina y Prevención, Universidad de Roma Tor Vergata, Roma, Italia
| | - V Gea-Caballero
- Grupo de Investigación Emergente Acreditado en Arte y Ciencia del Cuidado GREIACC, Escuela de Enfermería La Fe (Valencia), IIS La Fe, Valencia, España.
| | - J I Pérez-Calvo
- Grupo de Investigación en Insuficiencia Cardiaca e Insuficiencia Fisiopatológica de la Interacción Cardiorrenal (IFICaR), Servicio de Medicina Interna, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón-ISS, Zaragoza, España
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