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Sugebo ES, Kassie TW, Gobena T, Tibore TK, Sebro SF, Ermolo TL. Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia. BMC Cardiovasc Disord 2024; 24:238. [PMID: 38714943 PMCID: PMC11075198 DOI: 10.1186/s12872-024-03901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Heart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area. METHODOLOGY Institutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test. RESULTS From the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior. CONCLUSION In this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior.
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Affiliation(s)
- Ermias Sigebo Sugebo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia.
| | - Teshager Worku Kassie
- Department of Nursing, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Public Health, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Temesgen Kechine Tibore
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Sisay Foga Sebro
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Tadesse Lelago Ermolo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
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Okada A, Hayashi K, Ichikura K, Kato NP, Wakabayashi R, Nagao N, Tsuchihashi-Makaya M. Psychometric properties of the Japanese version of the Self-Care of Heart Failure Index version 7.2. Eur J Cardiovasc Nurs 2024; 23:305-312. [PMID: 37474312 DOI: 10.1093/eurjcn/zvad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/22/2023]
Abstract
AIMS It is more important for patients with heart failure (HF) to objectively identify their self-care status. The Self-Care of Heart Failure Index (SCHFI) version 7.2 is a reliable and valid instrument comprising three scales: self-care maintenance, symptom perception, and self-care management. We aimed to translate the SCHFI v.7.2 into Japanese and test its validity and reliability. METHODS AND RESULTS This was a cross-sectional study. Two translators performed forward and backward translations between English and Japanese. To assess structural validity, confirmatory factor analyses were performed using the structure of the original version. To assess convergent validity, the associations between each scale and self-care self-efficacy were evaluated. To assess internal consistency, model-based internal consistency coefficients were calculated. Participants were 314 Japanese outpatients with HF (mean age: 72.8 ± 12.8 years). Regarding structural validity, all scales showed adequate model fit indices, supporting a two-factor structure with items similar to those in the original version. However, to improve the model fit indices, it was necessary to add error correlations for the self-care maintenance and symptom perception scales. Regarding convergent validity, all scales showed significant associations with self-care self-efficacy. Regarding internal consistency, the model-based internal consistency coefficients were sufficient for all scales (0.739, 0.908, and 0.783 for the self-care maintenance, symptom perception, and self-care management scales, respectively). CONCLUSION The Japanese version of the SCHFI v.7.2 had adequate validity and reliability. This instrument is useful for assessing self-care in Japanese HF patients. However, factors influencing self-care should be considered when interpreting results.
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Affiliation(s)
- Akiko Okada
- School of Nursing, Kitasato University, 2-1-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0329, Japan
| | - Kanako Hayashi
- Department of Nursing, The Cardiovascular Institute, 3-2-19 Nishiazabu, Minato-ku, Tokyo, Japan
| | - Kanako Ichikura
- Department of Health Science, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Naoko P Kato
- Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health, Linköping University, Linköping SE-581 83, Sweden
| | - Rumi Wakabayashi
- Department of Nursing, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinzyuku-ku, Tokyo, Japan
| | - Noriko Nagao
- School of Nursing, Kitasato University, 2-1-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0329, Japan
| | - Miyuki Tsuchihashi-Makaya
- School of Nursing, Kitasato University, 2-1-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0329, Japan
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Jiang Y, Zhang C, Hong J, Tam WWS, Ramachandran HJ, Wang W. Relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-confidence among patients with heart failure: Cross-sectional analysis of structural equation modelling. Int J Nurs Stud 2023; 147:104590. [PMID: 37741260 DOI: 10.1016/j.ijnurstu.2023.104590] [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: 11/23/2022] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Promoting self-care behaviours in heart failure management is an important goal and challenge for healthcare systems worldwide. Using the situation-specific theory of heart failure self-care, this study examined the relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-care confidence in these relationships. METHOD We analysed the baseline data from a previous randomised controlled trial study involving 213 patients with heart failure. Structural equation modelling was used to test our hypothesised model that included age, income, education, depression, anxiety, number of comorbidities, social support, self-care confidence, and self-care behaviours. Depression and anxiety were measured by the Hospital Anxiety and Depression Scale. Social support was measured by the Short Form of the Social Support Questionnaire satisfaction subscale. The Self-Care of Heart Failure Index (version 6.2) was used to assess self-care confidence and self-care behaviours (i.e., self-care maintenance and self-care management). RESULT The final model included age, depression, social support, and self-care confidence as independent variables. Age had a direct relationship with self-care maintenance (β = 0.235, p < 0.001) but not self-care management (β = 0.067, p = 0.179); better social support was directly associated with higher levels of self-care confidence (β = 0.267, p < 0.001); and higher levels of self-care confidence were associated with better self-care maintenance (β = 0.573, p < 0.001) and self-care management (β = 0.683, p < 0.001). The result showed an indirect relationship between social support and self-care maintenance through the mediator of self-care confidence (β = 0.153, p < 0.001), as well as an indirect relationship between social support and self-care management through self-care confidence (β = 0.182, p < 0.001). CONCLUSION Satisfactory social support can increase self-care confidence, thereby increasing self-care maintenance and management. The findings of this study also implied that self-care maintenance can increase with increasing age. Future interventions directly targeting assessment and management of self-care confidence, available social support, and the age of patients may help enhance their heart failure self-care behaviours.
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Affiliation(s)
- Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Bekele F, Tafese L, Demsash AW, Tesfaye H, Labata BG, Fekadu G. Adherence to self-care practices and associated factors among heart failure patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0288824. [PMID: 37611019 PMCID: PMC10446213 DOI: 10.1371/journal.pone.0288824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/04/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Heart failure is the leading cause of hospital stays, medical expenses, and fatalities, and it is a severe problem for worldwide public health. Successful heart failure therapy requires a high level of self-care as well as devotion to different elements of the treatment plan. Despite the positive effects of heart failure self-care on health outcomes, many heart failure patients engage in insufficient self-care behaviors. Additionally, conflicting information has been found regarding the prevalence and predictors of self-care behaviors in Ethiopia. As a result, this review's objective is to provide an overview of the most recent studies on Ethiopian heart failure patients' self-care practices. METHODS We have used four databases such as PubMed, Science Direct, Scopus and Google Scholar. Eventually, the final systematic review and meta-analysis contained eleven papers that matched the eligibility requirements. A systematic data extraction check list was used to extract the data, and STATA version 14 was used for the analysis. Heterogeneity was evaluated using the I2 tests and the Cochrane Q test statistic. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test were utilized. RESULT The pooled magnitude of adherence to self-care was 35.25% (95%CI: 27.36-43.14). The predictors of good adherence to self-care behavior includes heart failure knowledge (odds ratio = 5.26; 95% CI, 3.20-8.65), absence of depressive symptoms (odds ratio = 3.20;95% CI,1.18-8.70), higher level of education (AOR = 3.09;95%CI,1.45-6.61), advanced New York Heart Association (NYHA) class (odds ratio = 2.66; 95% CI, 1.39-5.07), absence of comorbidity(odds ratio = 2.92; 95% CI,1.69-5.06) and duration of heart failure symptoms(odds ratio = 0.37; 95% CI, 0.24-0.58). CONCLUSION The extent of self-care behavior adherence is shown to be low among heart failure patients. This study showed a positive relationship between self-care behavior and factors such as proper understanding of heart failure, the absence of co-morbidity, depression, higher levels of education, a longer duration of heart failure symptoms, and advanced classes of heart failure disease. Therefore, a continuous health education should be given for patients to enhance their understanding of heart failure. Besides, special attention should be given for patients having co-morbidity and depressive symptom.
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Affiliation(s)
- Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Lalise Tafese
- Department of Health Informatics, College of Health Science, Mattu University, Mattu, Ethiopia
| | | | - Hana Tesfaye
- Department of Midwifery, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Busha Gamachu Labata
- Department of Pharmacy, College of Health Science, Wallaga University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, College of Health Science, Wallaga University, Nekemte, Ethiopia
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China
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Hosseini SA, Karampourian A, Shamsizadeh M, Mohammadi Y. Application of Haddon strategy training on self-care behavior and disease consequences in heart failure. JOURNAL OF VASCULAR NURSING 2023. [DOI: 10.1016/j.jvn.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Getachew A, Assefa T, Negash W. Self-care behavior and associated factors among patients with heart failure in public hospitals of Southeast Ethiopia. J Int Med Res 2022; 50:3000605221119367. [PMID: 36002989 PMCID: PMC9421238 DOI: 10.1177/03000605221119367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study was performed to assess self-care behavior and associated factors
among patients with heart failure attending public hospitals in Southeast
Ethiopia in 2021. Methods An institutional-based cross-sectional study was conducted among 420 patients
with heart failure from 15 May to 30 June 2021 using a simple random
sampling technique. A multivariable binary logistic model was used to
identify factors associated with self-care behavior. Statistical
significance was declared at p < 0.05. Results The magnitude of good self-care behavior among patients with heart failure
was 53.6% [95% confidence interval (CI), 48.9–58.3]. Factors associated with
self-care behavior were treatment with a beta blocker [adjusted odds ratio
(AOR), 0.49; 95% CI, 0.27–0.89], treatment with digitalis (AOR, 0.11; 95%
CI, 0.05–0.24), the level of social support (AOR, 0.07; 95% CI, 0.03–0.15),
and the presence of depressive symptoms (AOR, 0.21; 95% CI, 2.70–8.33). Conclusion Slightly more than half of the respondents had good self-care behavior.
Attention should be given to enhancing good self-care practice through
integration of health education as routine care.
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Affiliation(s)
- Almaz Getachew
- Nursing Department, Madda Walabu University Goba Referral Hospital
| | - Tesfaye Assefa
- Nursing Department, School of Health Science, Madda Walabu University Goba Referral Hospital
| | - Wogene Negash
- Nursing Department, School of Health Science, Madda Walabu University Goba Referral Hospital
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Mulugeta T, Duguna D, Bekele A, Umeta B. Adherence to Self-Care Behaviors and Associated Factors among Adult Heart Failure Patients Attending Chronic Follow-Up Care at Jimma University Medical Center, Southwest Ethiopia. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2205110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Optimal outcomes and quality of life in patients with heart failure (HF) depend on effective self-care activities. However, patients may experience difficulties, and their performance may be inconsistent.
Aim:
To determine the level of adherence to self-care behaviors and associated factors among adult HF patients attending chronic follow-up care at Jimma University Medical Center (JUMC).
Methods:
A cross-sectional study was conducted between August and September 2021. Data were collected through face-to-face interviews and by reviewing patients’ medical records. The collected data were analyzed using SPSS version 25 and the findings were presented in frequency, percentage, mean (SD), and median (IQR). Multivariate logistic regression was performed to determine factors associated with adherence to self-care behaviors. Odds ratios with 95% confidence intervals and p-values were used to report the findings.
Results:
Out of 266 HF patients, 50.0% had good adherence towards self-care behavior recommendations. The highest following recommendation was taking medication as prescribed (75.5%), followed by a dietary recommendation of a low-salt diet (45.2%). Participants who could not read and write (adjusted odds ratio (AOR) = 0.30 (95% confidence interval (CI) 0.13, 0.71), P = 0.006), had an illness duration greater than or equal to ten years (AOR = 0.31 (95% CI 0.12, 0.82), P = 0.02), in the NYHA class II HF (AOR = 0.33 (95% CI 0.15, 0.73), P = 0.007) were negatively associated with good adherence to self-care behavior recommendations.
Conclusion:
In this study, only half of the respondents had good adherence to self-care behaviors. Lower educational level, longer illness duration, and NYHA class II HF were predictors of poor adherence to self-care. Therefore, nurses should devise strategies to counsel or educate the HF patients on self-care practice recommendations, particularly patients with a lower education level and who lived longer with HF.
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Editorial for the Paper Titled "Hospitalization for Heart Failure in the USA, UK, Taiwan and Japan: An International Comparison of Administrative Health Records on 417,385 Individual Patients. J Card Fail 2021; 28:367-369. [PMID: 34973871 DOI: 10.1016/j.cardfail.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/20/2022]
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Hailu Gebru T, Kidanu Berhe K, Tilahun Tsehaye W, Hagos Mekonen H, Gemechu Kiros K, Gebreslassie Gebrehiwot T, Teklebrhan Gebrehiwot G, Hailesilassie Teka Y, Maeruf Mohammed H. Self-Care Behavior and Associated Factors among Heart Failure Patients in Tigray, Ethiopia: A Cross-Sectional Study. Clin Nurs Res 2020; 30:636-643. [PMID: 33016105 DOI: 10.1177/1054773820961243] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to assess the prevalence of self-care behavior and associated factors among heart failure patients. This institutional-based cross-sectional study design was done in Tigray region, Ethiopia. The data collection process was made between February and April 2018. An interviewer assisted structured questionnaire and medical chart review was used to collect the data. Data was entered and analyzed using Statistical Package for the Social Science (SPSS) version 22. Bivariate and multivariable logistic regression were conducted to identify the predictors (p < .05). In this study, a total of 408 study subjects was included. The mean age of the participants was 45.4 (±19). The overall prevalence of good self-care behavior was 45.8% (95% CI: 40.9-50.5). Regression analysis revealed that age, educational level, co-morbidity, knowledge about heart failure, and social support were significantly associated with self-care behavior. Healthcare providers should strengthen patient education to improve self-care behavior.
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Affiliation(s)
- Tsegu Hailu Gebru
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Tigray, Ethiopia
| | - Kalayou Kidanu Berhe
- School of Nursing, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | | | - Haftea Hagos Mekonen
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Tigray, Ethiopia
| | - Kbrom Gemechu Kiros
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Tigray, Ethiopia
| | | | | | - Yared Hailesilassie Teka
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Tigray, Ethiopia
| | - Hayat Maeruf Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Tigray, Ethiopia
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Heo JM, Kim CG. The mediating effect of resilience on the relationship between Type D personality and self-care behavior in patients with heart failure. Jpn J Nurs Sci 2020; 17:e12359. [PMID: 32812696 DOI: 10.1111/jjns.12359] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/05/2020] [Accepted: 06/10/2020] [Indexed: 02/03/2023]
Abstract
AIM There have been few studies done looking at the relationship between resilience, Type D personality, and self-care behavior in patients with heart failure. The purpose of this study was to identify the mediating effect of resilience on the relationship between Type D personality and self-care behavior in patients with heart failure. METHODS The subjects consisted of a sample of 90 heart failure patients aged ≥20 years who visited the cardiology outpatient clinic in the Chungbuk area of South Korea. RESULTS Among 90 patients, 49 subjects (54.0%) were classified as Type D personality, who exhibited statistically significant differences in resilience and self-care behavior (p < .001). A statistically significant correlation was also observed between self-care behavior score and resilience score (p < .01). The resilience had full mediation effects on the relationship between Type D personality and self-care behavior. In other words, the higher their resilience, the better their self-care behavior. CONCLUSIONS The study showed that resilience and Type D personality have important effects on self-care behavior.
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Affiliation(s)
- Ji Min Heo
- Management & Welfare Division, Settlement Support Center for North Korea Refugees (Hanawon), Anseong-si, Gyeonggi-do, South Korea
| | - Chul-Gyu Kim
- Department of Nursing, Chungbuk National University, Cheongju, Chungbuk, South Korea
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Lee H, Park G, Lee KS, Jin H, Chun KJ, Kim JH. Knowledge, Adherence to Lifestyle Recommendations, and Quality of Life Among Koreans With Heart Failure. J Cardiovasc Pharmacol Ther 2020; 25:324-331. [PMID: 32233801 DOI: 10.1177/1074248420916324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess heart failure (HF) knowledge, adherence to lifestyle recommendations, and quality of life (QOL) among Koreans with HF and identify factors influencing QOL. METHODS A cross-sectional and correlational design was used and a total of 142 Koreans with HF were recruited between April 2012 and September 2013. Data were analyzed using multiple logistic regression with SPSS version 21.0. RESULTS The mean age of participants was 64.1 ± 7.4 years. A higher proportion of participants were male, married, unemployed, had a high education level, and class I New York Heart Association (NYHA) functional status. A higher proportion of participants had ≥2 comorbidities and the most prevalent comorbidity was diabetes. The mean score of HF knowledge was 6.9 (possible range 0-15) and the most frequent incorrect items were "proper actions to reduce thirst" and "causes of leg swelling" in both better and worse QOL groups. Among the recommended lifestyle, pneumococcal vaccination had the least adherence in both groups. Multiple logistic regression showed that patients in NYHA class I, with a higher left ventricular ejection fraction, who had knowledge of "amount of fluid intake a day" and consumed more than moderate alcohol tended to have better QOL. Conclusion: More active interventions targeting HF knowledge in proper actions to reduce thirst, causes of leg swelling, and the amount of fluid intake per day are required. Patients with HF in more serious condition need special attention regarding the risk of worse QOL. The role of alcohol consumption in QOL among HF patients in Korea needs further exploration.
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Affiliation(s)
- Haejung Lee
- College of Nursing, Pusan National University, Yangsan-si, South Korea
| | - Gaeun Park
- Department of Nursing, Pusan National University Yangsan Hospital, Yangsan-si, South Korea
| | - Kyoung Suk Lee
- College of Nursing, Seoul National University, Gwanak-gu, Seoul, Korea
| | - HyeKyung Jin
- College of Nursing, Kaya University, Gimhae-si, South Korea
| | - Kook-Jin Chun
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, South Korea
| | - Jong Hyun Kim
- Department of Internal Medicine, BHC Hanseo Hospital, Busan, South Korea
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12
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Johansson M, Athilingam P. Structured Telephone Support Intervention: Improved Heart Failure Outcomes. JMIR Aging 2020; 3:e13513. [PMID: 32039813 PMCID: PMC7055840 DOI: 10.2196/13513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/26/2019] [Accepted: 06/24/2019] [Indexed: 12/21/2022] Open
Abstract
Background Presently, 6.5 million Americans are living with heart failure (HF). These patients are expected to follow a complex self-management regimen at home. Several demographic and psychosocial factors limit patients with HF in following the prescribed self-management recommendations at home. Poor self-care is associated with increased hospital readmissions. Under the Affordable Care Act, there are financial implications related to hospital readmissions for hospitals and programs such as the Program of All-Inclusive Care for the Elderly (PACE) in Pinellas County, Florida. Previous studies and systematic reviews demonstrated improvement in self-management and quality of life (QoL) in patients with HF with structured telephone support (STS) and SMS text messaging. Objective This study aimed to evaluate the effects of STS and SMS on self-care, knowledge, medication adherence, and QoL of patients with HF. Methods A prospective quality improvement project using a pre-post design was implemented. Data were collected at baseline, 30 days, and 3 months from 51 patients with HF who were enrolled in PACE in Pinellas County, Florida. All participants received STS and SMS for 30 days. The feasibility and sustained benefit of using STS and SMS was assessed at a 3-month follow-up. Results A paired t test was used to compare the mean difference in HF outcomes at the baseline and 30-day follow-up, which demonstrated improved HF self-care maintenance (t49=0.66; P=.01), HF knowledge (t49=0.71; P=.01), medication adherence (t49=0.92; P=.01), and physical and mental health measured using Short-Form-12 (SF-12; t49=0.81; P=.01). The results also demonstrated the sustained benefit with improved HF self-care maintenance, self-care management, self-care confidence, knowledge, medication adherence, and physical and mental health (SF-12) at 3 months with P<.05 for all outcomes. Living status and social support had a strong correlation with HF outcomes. Younger participants (aged less than 65 years) performed extremely well compared with older adults. Conclusions STS and SMS were feasible to use among PACE participants with sustained benefits at 3 months. Implementing STS and SMS may serve as viable options to improve HF outcomes. Improving outcomes with HF affects hospital systems and the agencies that monitor and provide care for outpatients and those in independent or assisted-living facilities. Investigating viable options and support for implementation will improve outcomes.
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Affiliation(s)
- Marcia Johansson
- College of Nursing, University of South Florida, Tampa, FL, United States
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Self-care in Chinese heart failure patients: Gender-specific correlates. Heart Lung 2019; 48:496-501. [DOI: 10.1016/j.hrtlng.2019.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/27/2019] [Accepted: 05/02/2019] [Indexed: 11/23/2022]
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Tsutsui H, Isobe M, Ito H, Ito H, Okumura K, Ono M, Kitakaze M, Kinugawa K, Kihara Y, Goto Y, Komuro I, Saiki Y, Saito Y, Sakata Y, Sato N, Sawa Y, Shiose A, Shimizu W, Shimokawa H, Seino Y, Node K, Higo T, Hirayama A, Makaya M, Masuyama T, Murohara T, Momomura SI, Yano M, Yamazaki K, Yamamoto K, Yoshikawa T, Yoshimura M, Akiyama M, Anzai T, Ishihara S, Inomata T, Imamura T, Iwasaki YK, Ohtani T, Onishi K, Kasai T, Kato M, Kawai M, Kinugasa Y, Kinugawa S, Kuratani T, Kobayashi S, Sakata Y, Tanaka A, Toda K, Noda T, Nochioka K, Hatano M, Hidaka T, Fujino T, Makita S, Yamaguchi O, Ikeda U, Kimura T, Kohsaka S, Kosuge M, Yamagishi M, Yamashina A. JCS 2017/JHFS 2017 Guideline on Diagnosis and Treatment of Acute and Chronic Heart Failure - Digest Version. Circ J 2019; 83:2084-2184. [PMID: 31511439 DOI: 10.1253/circj.cj-19-0342] [Citation(s) in RCA: 409] [Impact Index Per Article: 81.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Affiliation(s)
- Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | | | - Hiroshi Ito
- Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Division of Biophysiological Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Ken Okumura
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Masafumi Kitakaze
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | | | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Yoshihiko Saito
- Department of Cardiovascular Medicine, Nara Medical University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Naoki Sato
- Department of Cardiovascular Medicine, Kawaguchi Cardiovascular and Respiratory Hospital
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Akira Shiose
- Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Atsushi Hirayama
- The Division of Cardiology, Department of Medicine, Nihon University Graduate School of Medicine
| | | | - Tohru Masuyama
- Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | | | - Masafumi Yano
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Kenji Yamazaki
- Department of Cardiology Surgery, Tokyo Women's Medical University
| | - Kazuhiro Yamamoto
- Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University
| | | | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
| | - Masatoshi Akiyama
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Shiro Ishihara
- Department of Cardiology, Nippon Medical School Musashi-Kosugi Hospital
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital
| | | | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Tomohito Ohtani
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | - Takatoshi Kasai
- Cardiovascular Respiratory Sleep Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine
| | - Mahoto Kato
- Department of Cardiovascular Medicine, Nihon University Graduate School of Medicine
| | - Makoto Kawai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
| | | | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Toru Kuratani
- Department of Minimally Invasive Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Shigeki Kobayashi
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | | - Koichi Toda
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Masaru Hatano
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | | | - Takeo Fujino
- Department of Advanced Cardiopulmonary Failure, Kyushu University Graduate School of Medical Sciences
| | - Shigeru Makita
- Department of Cardiac Rehabilitation, Saitama Medical University International Medical Center
| | - Osamu Yamaguchi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
| | - Masakazu Yamagishi
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Akira Yamashina
- Medical Education Promotion Center, Tokyo Medical University
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Factors Associated with Depression among Heart Failure Patients at Cardiac Follow-Up Clinics in Northwest Ethiopia, 2017: A Cross-Sectional Study. PSYCHIATRY JOURNAL 2019; 2019:6892623. [PMID: 31428624 PMCID: PMC6679871 DOI: 10.1155/2019/6892623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 07/08/2019] [Indexed: 11/22/2022]
Abstract
Background Depression is a comorbid disorder in patients with heart failure and it is a major public health problem worldwide. Little is known about the depression among heart failure patients in low-income countries, while, in Ethiopia, none was studied. Objective This study is to assess the prevalence of depression and associated factors among heart failure patients at cardiac follow-up clinics at Amhara Region Referral Hospitals, Northwest Ethiopia, 2017. Methods A hospital based cross-sectional study was conducted between March 30, 2017, and May 15, 2017, G.C., by using a systematic random sampling technique to select 422 of 1395 HF patients. Structured interviewer-administered questionnaires and patient card review with a checklist that incorporates the PHQ-9 tool for depression measurement were used. The collected data were checked, coded, and entered into Epi-info version 7 and exported to SPSS version 20. Bivariate logistic regression at p-value <0.2 was exported to multivariate logistic regressions and p-value <0.05 was considered statistically significant. Results A total of 403 were included with a response rate of 95.5%. Among the participants, 51.1% had depressive symptoms. Factors associated with depressive symptoms were poor self-care behavior 1.60 [AOR (95% CI=1.01, 2.55)], poor social support 1.90 [AOR (95% CI=1.16, 3.12)], being female 2.70 [AOR (95% CI=1.44, 5.07)], current smoking history 4.96 [AOR (95% CI=1.54, 15.98)], and duration of heart failure (>1 year) 1.64 [AOR (95% CI=1.04, 2.59)]. Conclusions Around half of the patients were depressive. The patients who had poor self-care behavior, were females, had poor social support, had a current history of smoking, and had duration of chronic heart failure >1 year need special attention. Therefore, all referral hospitals need efforts to focus on those problems and target improvements of depressive symptoms.
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Seid MA, Abdela OA, Zeleke EG. Adherence to self-care recommendations and associated factors among adult heart failure patients. From the patients' point of view. PLoS One 2019; 14:e0211768. [PMID: 30730931 PMCID: PMC6366768 DOI: 10.1371/journal.pone.0211768] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/20/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Nowadays, heart failure (HF) related morbidity and mortality rate is increasing globally. Younger populations happen to be more affected by HF in sub- Saharan African than the western countries. Even though medications, low sodium diet, regular exercise, and weight monitoring are essential to control heart failure symptoms and its exacerbation, poor adherence to these self-care recommendations is contributing to an increased in hospitalization, morbidity, and mortality. Therefore, this study aimed to assess heart failure patients' adherence to self-care recommendations and its associated factors. METHODS A hospital-based cross-sectional study was conducted on 310 adult heart failure patients attending Gondar University referral hospital from February to May 2017. The participants were selected by systematic random sampling technique. Data were collected through face to face interview and from the patients' medical records. The data were analyzed using SPSS version 20. A binary logistic regression model was used to check the effect of different factors on the patients' adherence level. RESULTS Of 310 study participants only 22.3% (95% CI, 17.4%-26.8%) of heart failure patients reported good adherence to their self-care recommendations. Adherence to self-care recommendation was positively associated with being male in gender (AOR = 2.34, 95% CI: 1.18-4.62), good level of heart failure knowledge (AOR = 2.49, 95% CI: 1.276-4.856) and free from chronic comorbid diseases (AOR = 2.57, 95% CI: 1.28-5.14). CONCLUSION Overall, heart failure patients' adherence to self-care recommendations is poor and selective. Being male in gender, had no chronic comorbidity, and a good level of heart failure knowledge were positively associated with adherence to self-care recommendations. It is therefore strategic to plan improving heart failure patients' knowledge about heart failure signs, symptoms and its management approaches, to improve the patients' adherence level.
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Affiliation(s)
| | | | - Ejigu Gebeye Zeleke
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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17
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Yazew KG, Salih MH, Beshah DT. Self-care behavior and associated factors among adults with heart failure at cardiac follow-up clinics in West Amhara Region Referral Hospitals, Northwest Ethiopia, 2017. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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18
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Gender differences in self-care maintenance and its associations among patients with chronic heart failure. Int J Nurs Sci 2018; 6:58-64. [PMID: 31406870 PMCID: PMC6608650 DOI: 10.1016/j.ijnss.2018.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/28/2018] [Accepted: 11/29/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives To identify the gender differences in self-care maintenance and its associations among chronic heart failure patients using the Information-Motivation-Behavioral Skills model. Methods Two hundred and ten patients (54.0% female) with chronic heart failure participated in this cross-sectional study. Self-care, knowledge of heart failure, social support and illness perception were measured using the Self-Care of Heart Failure Index, the questionnaire of heart failure knowledge, the Perceived Social Support Scale, and the Revised Illness Perception Questionnaire, respectively. Results Mean scores for self-care maintenance were 51.4 ± 14.8 in men and 55.6 ± 14.1 in women (t = -2.066, P < 0.05). Associated factors of self-care maintenance were social support and self-care confidence in men and the knowledge of heart failure, self-care management and self-care confidence in women. The relationship between social support and self-care maintenance was meditated by self-care confidence in men, whereas the relationship between knowledge of heart failure and self-care maintenance was meditated by self-care management and self-care confidence in women. Conclusions Self-care maintenance were inadequate in both genders with chronic heart failure. Interventions for enhancing social support and self-care confidence in men patients, and strengthening knowledge of heart failure, self-care management and self-care confidence in women patients, may facilitate self-care maintenance.
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19
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Givi M, Shafie D, Garakyaraghi M, Yadegarfar G, Roohafza HR, Ahmadi SA, Nouri F, Sarrafzadegan N. Patients Characteristics and Preliminary Outcomes of Heart Failure Registry in A Middle-Income Country: Persian Registry of Cardiovascular Disease/Heart Failure (PROVE/HF). Galen Med J 2018; 7:e1026. [PMID: 34466426 PMCID: PMC8343763 DOI: 10.22086/gmj.v0i0.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/06/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Persian Registry of Cardiovascular disease/Heart Failure (PROVE/HF) aimed to studied the demographic, clinical, and diagnostic characteristics and treatment of patients hospitalized for heart failure (HF) and to follow them for short- and long-term outcomes. Its pilot phase started in 2015 in Isfahan aiming to evaluate its feasibility to be scaled up at the national level in later stages. This article describes the method and preliminary results of the first year registry. MATERIALS AND METHODS Information of hospitalized patients with preserved and low ejection fraction, were gathered. Patients were followed for 1, 6, and 12 months. During follow-up, information of the patients' current status, medications used during hospitalization, and in case of death, the cause and place were assessed. RESULT PROVE/ HF enrolled 787 patients in the first year. The mean age of patients was 70.74 ±12.01 years, and 60.7% of them were men. The most frequent risk factors for the development of HF in the recruited patients was ischemic heart disease (77.9%), and hypertension (63.7%), respectively. The re-admission rate for patients with HF was at least once in 16% and continued until the fifth to ninth re-admission over a one-year period. Among 787 registered patients, 30.9% died in the first year of follow-up, and the in-hospital mortality was 6.2%. The mean hospitalization period was 4.88 days, and 64.2% were hospitalized for >3 days. CONCLUSION The annual rate of re-admission and mortality was high, and the use of medication was less than the recommended one inaccordance with the guidelines for the treatment of heart failure.
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Affiliation(s)
- Mahshid Givi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafie
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Garakyaraghi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghasem Yadegarfar
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Roohafza
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Abdollah Ahmadi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Koirala B, Himmelfarb CD, Budhathoki C, Tankumpuan T, Asano R, Davidson PM. Factors affecting heart failure self-care: An integrative review. Heart Lung 2018; 47:539-545. [PMID: 30316455 DOI: 10.1016/j.hrtlng.2018.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Binu Koirala
- School of Nursing, Johns Hopkins University, United States.
| | - Cheryl Dennison Himmelfarb
- Institute for Clinical Translational Research, School of Nursing, Johns Hopkins University, United States
| | | | | | - Reiko Asano
- School of Nursing, Johns Hopkins University, United States
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21
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Asgari S, Roohani M, Amini K, Faghihzadeh S. Investigating Death Anxiety and its Relationship with Some Demographic Variables in Patients with Heart Failure in Zanjan 2018. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.2.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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22
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Li CC, Chang SR, Shun SC. The self-care coping process in patients with chronic heart failure: A qualitative study. J Clin Nurs 2018; 28:509-519. [PMID: 30091501 DOI: 10.1111/jocn.14640] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/03/2018] [Accepted: 08/02/2018] [Indexed: 11/26/2022]
Abstract
AIM To understand the self-care coping process among chronic heart failure patients. BACKGROUND Previous studies have been carried out to understand the experience and the challenges of living with chronic heart failure. However, the coping processes that patients use to overcome self-care challenges are less understood. DESIGN A qualitative design with qualitative content analysis of data was employed. METHODS Purposive sampling was conducted to recruit inpatients with chronic heart failure between March 1, 2014-March 1, 2015, in a teaching hospital in Taiwan. Semi-structured interviews (N = 27) were completed, and a content analysis was performed using an inductive method to explore the self-care coping processes in patients with chronic heart failure. RESULTS The findings were categorised into three themes: (a) responding to chronic heart failure self-care (dealing with negative emotions, accepting reality and struggling between a self-care regime and self preference), (b) finding ways to live with chronic heart failure (enhancing understanding and knowledge about chronic heart failure, maintaining outer and inner self, engaging positively/negatively with others and relying on religious thoughts and seeking consolation) and (c) reinterpreting chronic heart failure and performing meaning-oriented coping (re-evaluating the meaning of life, assigning a new perspective for chronic heart failure and discovering a deeper meaning behind it). CONCLUSION Self-appearance concerns should be given more attention by healthcare professionals. Meaning-oriented coping was found to be helpful to cope with the challenges of chronic heart failure. Thus, there is a need to develop interventions associated with meaning-oriented coping to enhance coping strategies for chronic heart failure patients. RELEVANCE TO CLINICAL PRACTICE It is suggested for healthcare professionals to understand an individual's coping process and support people with chronic heart failure who struggle with self-care coping. Furthermore, specific interventions including meaning-oriented interventions might benefit people with chronic heart failure to cope more successfully.
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Affiliation(s)
- Chia-Chien Li
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiow-Ru Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiow-Ching Shun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Tawalbeh LI, Al-Smadi AM, AlBashtawy M, AlJezawi M, Jarrah M, Musa AS, Aloush S. The Most and the Least Performed Self-Care Behaviors Among Patients With Heart Failure in Jordan. Clin Nurs Res 2018; 29:108-116. [PMID: 29862838 DOI: 10.1177/1054773818779492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Assessing self-care is important aspects among patients with heart failure. However, few studies were conducted to assess self-care among patients with heart failure in Jordan. Therefore, this study aimed to assess the most and the least performed maintenance self-care behaviors and to examine the relationship between maintenance self-care behaviors and selected sociodemographics. A cross-sectional design utilizing a convenience sample of 226 patients with heart failure was used. The maintenance self-care mean was 53.89 and considered below the clinical target level (≥70). Asking for low salt item and performing physical exercises were the most performed self-care behaviors, while "trying to avoid getting sick" and "checking ankles for swelling" were the least performed self-care behaviors. Limited self-care behaviors indicated the need to implement cardiac education that may improve self-care behaviors. Cardiac education should target mainly patients with low income, low educational level, elderly, living alone, unemployed, and who are using traditional treatment.
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Affiliation(s)
| | | | | | | | - Mohamad Jarrah
- Jordan University of Science and Technology, Irbid, Jordan
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24
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The Effect of Cardiac Education on Knowledge and Self-care Behaviors Among Patients With Heart Failure. Dimens Crit Care Nurs 2018; 37:78-86. [DOI: 10.1097/dcc.0000000000000285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Müller-Tasch T, Löwe B, Lossnitzer N, Frankenstein L, Täger T, Haass M, Katus H, Schultz JH, Herzog W. Anxiety and self-care behaviour in patients with chronic systolic heart failure: A multivariate model. Eur J Cardiovasc Nurs 2017; 17:170-177. [PMID: 28718661 DOI: 10.1177/1474515117722255] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. METHODS The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS). The Patient Health Questionnaire (PHQ) was used to assess anxiety, the PHQ-9 was used to measure depression severity. Differences between patients with and without anxiety were assessed with the respective tests. Associations between anxiety, self-care and other predictors were analysed using linear regressions. RESULTS Of the 308 participating patients, 35 (11.4%) fulfilled the PHQ criteria for an anxiety disorder. These patients took antidepressants more frequently (11.8% versus 2.3%, p = .02), had had more contacts with their general practitioner within the last year (11.8 ± 16.1 versus 6.7 ± 8.6, p = .02), and had a higher PHQ-9 depression score (12.9 ± 5.7 versus 6.5 ± 4.7, p < .01) than patients without anxiety disorder. Anxiety and self-care were negatively associated (ß = -0.144, r2 = 0.021, p = 0.015). The explanation of variance was augmented in a multivariate regression with the predictors age, sex, education, living with a partner, and New York Heart Association (NYHA) class ( r2 = 0.098) when anxiety was added ( r2 = 0.112). Depression further increased the explanation of variance (ß = -0.161, r2 = 0.131, p = 0.019). CONCLUSIONS Anxiety is negatively associated with self-care behaviour in patients with CHF. However, this effect disappears behind the stronger influence of depression on self-care. The consideration of mental comorbidities in patients with CHF is important.
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Affiliation(s)
- Thomas Müller-Tasch
- 1 Department of Psychosomatic Medicine and Psychotherapy, Klinikum am Weissenhof, Germany.,2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Bernd Löwe
- 3 Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,4 Schön Clinic Hamburg-Eilbek, Hamburg, Germany
| | - Nicole Lossnitzer
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Lutz Frankenstein
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Tobias Täger
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Markus Haass
- 6 Department of Cardiology, Theresien Hospital Mannheim, Mannheim, Germany
| | - Hugo Katus
- 5 Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- 2 Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
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26
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Shim JL, Hwang SY. [Development and Effects of a Heart Health Diary for Self-Care Enhancement of Patients with Heart Failure]. J Korean Acad Nurs 2017; 46:881-893. [PMID: 28077835 DOI: 10.4040/jkan.2016.46.6.881] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/02/2016] [Accepted: 11/12/2016] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. METHODS A randomized control-group pretestposttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. RESULTS At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p=.016) and exercise related self-efficacy (t=-3.44, p=.001) compared to the control group. CONCLUSION The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.
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Affiliation(s)
- Jae Lan Shim
- School of Nursing, Hanyang University, Seoul, Korea
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27
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Sedlar N, Lainscak M, Mårtensson J, Strömberg A, Jaarsma T, Farkas J. Factors related to self-care behaviours in heart failure: A systematic review of European Heart Failure Self-Care Behaviour Scale studies. Eur J Cardiovasc Nurs 2017; 16:272-282. [PMID: 28168895 DOI: 10.1177/1474515117691644] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Self-care is an important element in the comprehensive management of patients with heart failure. The European Heart Failure Self-Care Behaviour Scale (EHFScBS) was developed and tested to measure behaviours performed by the heart failure patients to maintain life, healthy functioning, and wellbeing. AIMS The purpose of this review was to evaluate the importance of factors associated with heart failure self-care behaviours as measured by the EHFScBS. METHODS Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to search major health databases (PubMed, Scopus and ScienceDirect). Obtained associating factors of heart failure self-care were qualitatively synthesised and the association levels of most commonly addressed factors were further explored. RESULTS We identified 30 studies that were included in the review; a diverse range of personal and environmental factors associated with self-care behaviours in heart failure patients were identified. Age, health-related quality of life, gender, education, New York Heart Association class, depressive symptoms and left ventricular ejection fraction were most often correlated with the EHFScBS score. Consistent evidence for the relationship between self-care behaviours and depression was found, while their association with New York Heart Association class and health-related quality of life was non-significant in most of the studies. Associations with other factors were shown to be inconsistent or need to be further investigated as they were only addressed in single studies. CONCLUSION A sufficient body of evidence is available only for a few factors related to heart failure self-care measured by the EHFScBS and indicates their limited impact on patient heart failure self-care. The study highlights the need for further exploration of relationships that would offer a more comprehensive understanding of associating factors.
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Affiliation(s)
| | - Mitja Lainscak
- 2 Department of Internal Medicine, General Hospital Murska Sobota, Slovenia.,3 Faculty of Medicine, University of Ljubljana, Slovenia
| | | | - Anna Strömberg
- 5 Department of Medical and Health Sciences, Linköping University, Sweden.,6 Department of Cardiology, Linköping University, Sweden
| | - Tiny Jaarsma
- 7 Department of Social and Welfare Studies, Linköping University, Sweden.,8 Mary MacKillop Institute for Health Research, Australian Catholic University, Australia
| | - Jerneja Farkas
- 1 National Institute of Public Health, Slovenia.,9 Department of Research, General Hospital Murska Sobota, Slovenia
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Lee JO, Song R. [Symptom Management to Predict Quality of Life in Patients with Heart Failure: A Structural Equation Modeling Approach]. J Korean Acad Nurs 2016; 45:846-56. [PMID: 26805497 DOI: 10.4040/jkan.2015.45.6.846] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 05/20/2015] [Accepted: 08/12/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE The focus of this study was on symptom management to predict quality of life among individuals with heart failure. The theoretical model was constructed based on situation-specific theory of heart failure self-care and literature review. METHODS For participants, 241 outpatients at a university hospital were invited to the study from May 19 to July 30, 2014. Data were collected with structured questionnaires and analyzed using SPSSWIN and AMOS 20.0. RESULTS The goodness of fit index for the hypothetical model was .93, incremental fit index, .90, and comparative fit index, .90. As the outcomes satisfied the recommended level, the hypothetical model appeared to fit the data. Seven of the eight hypotheses selected for the hypothetical model were statistically significant. The predictors of symptom management, symptom management confidence and social support together explained 32% of the variance in quality of life. The 28% of variance in symptom management was explained by symptom recognition, heart failure knowledge and symptom management confidence. The 4% of variance in symptom management confidence was explained by social support. CONCLUSION The hypothetical model of this study was confirmed to be adequate in explaining and predicting quality of life among patients with heart failure through symptom management. Effective strategies to improve quality of life among patients with heart failure should focus on symptom management. Symptom management can be enhanced by providing educational programs, encouraging social support and confidence, consequently improving quality of life among this population.
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Affiliation(s)
- Ja Ok Lee
- The Catholic University Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Rhayun Song
- College of Nursing, Chungnam National University, Daejeon, Korea.
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Woods LS, Walker KN, Duff JS. Heart failure patients' experiences of non-pharmacological self-care. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjca.2016.11.10.498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leanna S Woods
- Clinical Nurse Specialist, St Vincent's Private Hospital Sydney and University of Tasmania, Australia
| | - Kim N Walker
- Professor of Healthcare Improvement, St Vincent's Private Hospital Sydney and University of Tasmania, Australia
| | - Jed S Duff
- Senior Research Fellow, St Vincent's Private Hospital Sydney and University of Tasmania, Australia
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Gowani A, Ahmed HI, Khalid W, Muqeet A, Abdullah S, Khoja S, Kamal AK. Facilitators and barriers to NCD prevention in Pakistanis-invincibility or inevitability: a qualitative research study. BMC Res Notes 2016; 9:282. [PMID: 27215828 PMCID: PMC4877737 DOI: 10.1186/s13104-016-2087-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCD) are the leading causes of death globally. In Pakistan, they are among the top ten causes of mortality, especially in the productive age group (30-69 years). Evidence suggests that health perceptions and beliefs strongly influence the health behavior of an individual. We performed focus group interviews to delineate the same so as to design the user interface of a non-invasive stroke risk monitoring device. METHODS It was a qualitative study, designed to explore how health perceptions and beliefs influence behavior for NCD prevention. Four focus group discussions (FGD) were conducted with 30 stable participants who had diabetes mellitus, ischemic heart disease, blood pressure, and stroke. The data was collected using a semi-structured interview guide designed to explore participants' perceptions of their illnesses, self-management behaviors and factors affecting them. The interviews were transcribed and content analysis was done using steps of content analysis by Morse and Niehaus [10]. RESULTS Medication adherence, self-monitoring of blood sugars and blood pressures, and medical help seeking were the commonly performed self-management behaviors by the participants. Personal experience of illness, familial inheritance of disease, education and fear of premature death when life responsibilities were unfulfilled, emerged as strong facilitators of self-management behaviors. A sense of personal invincibility, Fatalism or inevitability, lack of personal threat realization, limited knowledge, inadequate health education, health care and financial constraints appeared as key barriers to the self-management of chronic disease in participants. CONCLUSIONS Behavioural interventional messaging will have to engender a sense of personal vulnerability and yet empower self-efficacy solutions at the individual level to deal with both invincibility and inevitability barriers to adoption of healthy behavior.
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Affiliation(s)
- Ambreen Gowani
- Stroke Service Research Nurse, Aga Khan University, Karachi, Pakistan
| | - Hafiz Imtiaz Ahmed
- Technology Development, Aga Khan Development Network, eHealth Resource Center, Karachi, Pakistan
| | - Wardah Khalid
- Fogarty Cerebrovascular Research Fellow, The International Cerebrovascular Translational Clinical Research Training Program (Fogarty International Center, National Institutes of Health), Aga Khan University, Karachi, Pakistan
| | - Abdul Muqeet
- eHealth Innovation, Global, Aga Khan Development Network, eHealth Resource Center, Karachi, Pakistan
| | | | - Shariq Khoja
- Tech4Life Enterprises, Canada, and Technical Advisor-Evidence, Capacity and Policy mHealth Alliance, United Nations Foundation, Washington, USA
| | - Ayeesha Kamran Kamal
- Section of Neurology, Department of Medicine, Stroke Fellowship Program, International Cerebrovascular Translational Clinical Research Training Program, Fogarty International Center and the National Institute of Neurologic Disorders and Stroke, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
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Abstract
OBJECTIVE Psychological distress has been associated with poor outcomes in patients with chronic heart failure (HF), which is assumed to be partly due to poor HF self-care behavior. This systematic review and meta-analysis describes the current evidence concerning psychological determinants of self-care in patients with chronic HF. METHODS Eligible studies were systematically identified by searching electronic databases PubMed, PsycINFO, and the Conference Proceedings Citation Index (Web of Science) for relevant literature (1980-October 17, 2014). Study quality was assessed according to the level of risk of bias. Quantitative data were pooled using random-effects models. RESULTS Sixty-five studies were identified for inclusion that varied considerably with respect to sample and study characteristics. Risk of bias was high in the reviewed studies and most problematic with regard to selection bias (67%). Depression (r = -0.19, p < .001), self-efficacy (r = 0.37, p < .001), and mental well-being (r = 0.14, p = .030) were significantly associated with self-reported self-care. Anxiety was not significantly associated with either self-reported (r = -0.18, p = .24) or objective self-care (r = -0.04, p = .79), neither was depression associated with objectively measured medication adherence (r = -0.05, p = .44). CONCLUSIONS Psychological factors (depression, self-efficacy, and mental well-being) were associated with specific self-care facets in patients with chronic HF. These associations were predominantly observed with self-reported indices of self-care and not objective indices. Methodological heterogeneity and limitations preclude definite conclusions about the association between psychological factors and self-care and should be addressed in future research.
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Kato NP, Kinugawa K, Sano M, Kogure A, Sakuragi F, Kobukata K, Ohtsu H, Wakita S, Jaarsma T, Kazuma K. How effective is an in-hospital heart failure self-care program in a Japanese setting? Lessons from a randomized controlled pilot study. Patient Prefer Adherence 2016; 10:171-81. [PMID: 26937177 PMCID: PMC4762442 DOI: 10.2147/ppa.s100203] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although the effectiveness of heart failure (HF) disease management programs has been established in Western countries, to date there have been no such programs in Japan. These programs may have different effectiveness due to differences in health care organization and possible cultural differences with regard to self-care. Therefore, the purpose of this study was to evaluate the effectiveness of a pilot HF program in a Japanese setting. METHODS We developed an HF program focused on enhancing patient self-care before hospital discharge. Patients were randomized 1:1 to receive the new HF program or usual care. The primary outcome was self-care behavior as assessed by the European Heart Failure Self-Care Behavior Scale (EHFScBS). Secondary outcomes included HF knowledge and the 2-year rate of HF hospitalization and/or cardiac death. RESULTS A total of 32 patients were enrolled (mean age, 63 years; 31% female). There was no difference in the total score of the EHFScBS between the two groups. One specific behavior score regarding a low-salt diet significantly improved compared with baseline in the intervention group. HF knowledge in the intervention group tended to improve more over 6 months than in the control group (a group-by-time effect, F=2.47, P=0.098). During a 2-year follow-up, the HF program was related to better outcomes regarding HF hospitalization and/or cardiac death (14% vs 48%, log-rank test P=0.04). In Cox regression analysis after adjustment for age, sex, and logarithmic of B-type natriuretic peptide, the program was associated with a reduction in HF hospitalization and/or cardiac death (hazard ratio, 0.17; 95% confidence interval, 0.03-0.90; P=0.04). CONCLUSION The HF program was likely to increase patients' HF knowledge, change their behavior regarding a low-salt diet, and reduce HF hospitalization and/or cardiac events. Further improvement focused on the transition of knowledge to self-care behavior is necessary.
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Affiliation(s)
- Naoko P Kato
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- JSPS Postdoctoral Fellow for Research Abroad, Tokyo, Japan
- Correspondence: Naoko P Kato, Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo 1138655, Japan, Tel +81 3 5800 9082, Fax +81 3 5800 9082, Email
| | - Koichiro Kinugawa
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Miho Sano
- Department of Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Asuka Kogure
- Department of Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Fumika Sakuragi
- Department of Pharmacy, The University of Tokyo Hospital, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kihoko Kobukata
- Department of Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Department of Clinical Data Management, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Sanae Wakita
- Department of Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Keiko Kazuma
- Department of Adult Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Mechanism of engaging self-management behavior in rural heart failure patients. Appl Nurs Res 2015; 30:222-7. [PMID: 27091282 DOI: 10.1016/j.apnr.2015.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/14/2015] [Accepted: 09/27/2015] [Indexed: 01/04/2023]
Abstract
AIM The purpose of this study was to examine the relationships among self-efficacy, patient activation and SM in rural heart failure patients discharged from critical access hospitals. BACKGROUND Heart failure is one of the most disabling and resource-consuming chronic conditions. Compared to their urban counterparts, rural heart failure patients had higher healthcare utilizations and worse health outcomes. Self-management (SM) plays a significant role in improving patients' outcomes and reducing healthcare use. Despite persistent recommendations of SM, engagement in SM still remains low in rural heart failure patients. SM is a complex behavior, which is influenced by various factors. Evidence on the efficacy of interventions to promote SM is limited and inconsistent. One reason is that the mechanism of engagement of SM in the rural heart failure population has not been fully understood. METHODS A correlational study was conducted using secondary data from a randomized control trial aimed to improve SM adherence. Path analysis was used to test the hypothesis of patient activation mediating the effect of self-efficacy on SM. RESULTS Data were collected from a sample of 101 heart failure patients (37% males) with an average age of 70 years. The final model provided a good fit to the data, supporting the hypothesis that self-efficacy contributes to SM through activation. CONCLUSION The results of this study showed that effective SM interventions should be designed to include strategies to promote both self-efficacy and activation.
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Transformation of potential medical demand in China: A system dynamics simulation model. J Biomed Inform 2015; 57:399-414. [DOI: 10.1016/j.jbi.2015.08.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 07/20/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
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Li CC, Shun SC. Understanding self care coping styles in patients with chronic heart failure: A systematic review. Eur J Cardiovasc Nurs 2015; 15:12-9. [DOI: 10.1177/1474515115572046] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 01/19/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Chia-Chien Li
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiow-Ching Shun
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Niakan M, Paryad E, Kazemnezhad Leili E, Sheikholeslami F. Depressive symptoms effect on self care behavior during the first month after myocardial infarction. Glob J Health Sci 2015; 7:382-91. [PMID: 25946944 PMCID: PMC4802175 DOI: 10.5539/gjhs.v7n4p382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/06/2014] [Accepted: 11/28/2014] [Indexed: 11/21/2022] Open
Abstract
Aim: To determine the effect of severity of depression symptoms on self care behavior in 15th and 30th day after myocardial infarction (MI). Materials and Methods: Gathering data for this cross sectional study was done by Beck depression and self care behavior questionnaires in a heart especial hospital in Rasht in north of Iran. Sample size was 132 after MI patients and data collected from June 2011 to January 2012. Results: Scores of depression symptoms in 15th and 30th day after MI and score of self care behavior in these days had significant difference (P<0.0001). Spearman test showed self care behavior had significant relationship with depression symptoms (P<0.0001). GEE model also showed with control of socio demographic and illness related factors, depression symptoms can decrease self care behavior scores (P<0.001). Conclusion: Severity of depression symptoms increase in 15th to 30th day after MI. This issue can affect on self care behavior. This issue is emphasized on nurses’ notice to plan suitable self care program for these patients.
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Affiliation(s)
| | - Ezzat Paryad
- Social Determinants of Health Research Center (SDHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Ok JS, Choi H. Factors Affecting Adherence to Self-care Behaviors among Outpatients with Heart Failure in Korea. ACTA ACUST UNITED AC 2015. [DOI: 10.7475/kjan.2015.27.2.242] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jong Sun Ok
- Division of Cardiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Heejung Choi
- Department of Nursing, Konkuk University, Chungju, Korea
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Young L, Barnason S, Do V. Promoting self-management through adherence among heart failure patients discharged from rural hospitals: a study protocol. F1000Res 2014; 3:317. [PMID: 25844160 PMCID: PMC4367517 DOI: 10.12688/f1000research.5998.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 11/20/2022] Open
Abstract
Background Heart failure is one of the most prevalent chronic conditions in adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients’ health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure patients discharged from rural hospitals. Objective This article describes the study design and research methods used to implement and evaluate the intervention. Method Our intervention is a 12-week patient activation (Patient AcTivated Care at Home [PATCH]) to improve self-management adherence. Patients were randomized into two parallel groups (12-week PATCH intervention + usual care vs. usual care only) to evaluate the effectiveness of this intervention. Outcomes were measured at baseline, 3 and 6 months. Discussion This study aimed to examine the effectiveness of a rural theory based, advance practice nurse led, activation enhancing intervention on the self-management adherence in heart failure patients residing in rural areas. Our expectation is to facilitate adherence to self-management behaviors in heart failure patients following discharge from rural hospitals and decrease complications and hospital readmissions, leading to the reduction of economic burden. Clinical Trial Registration Information: ClinicalTrials.gov;
https://register.clinicaltrials.gov/ NCT01964053
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Affiliation(s)
- Lufei Young
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Lincoln, NE 68588-0220, USA
| | - Sue Barnason
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Lincoln, NE 68588-0220, USA
| | - Van Do
- Department of Health Services Research & Administration College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4350, USA
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Kato N, Kinugawa K, Nakayama E, Tsuji T, Kumagai Y, Imamura T, Maki H, Shiga T, Hatano M, Yao A, Miura C, Komuro I, Nagai R. Insufficient self-care is an independent risk factor for adverse clinical outcomes in Japanese patients with heart failure. Int Heart J 2014; 54:382-9. [PMID: 24309448 DOI: 10.1536/ihj.54.382] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Self-care is a cornerstone for the successful management of heart failure (HF). The purpose of this study was to examine the impacts of HF self-care on prognosis in Japanese patients with HF. A total of 283 HF outpatients (age 64 ± 14, 70% male, 52% HFrEF) were enrolled. We asked patients to answer about their adhevence to 5 self-care behaviors (medication, eating a low-sodium diet, regular exercise, daily weight check, and treatment seeking behavior). On the basis of the results, we classified patients into a good self-care group and a poor self-care group. The primary outcome was HF hospitalization and/or cardiac death. In total, 65% of patients were classified into the poor self-care group. During a median follow-up of 2 years, cardiac events occurred more frequently in the poor self-care group (22% versus 9.6%, P = 0.013). Poor self-care was an independent risk factor for cardiac events in Cox regression analysis adjusted for clinical parameters (hazard ratio = 2.86, P = 0.005). Poor self-care was also associated with an increased number of HF hospitalizations as well as an extended length of hospital stay for HF. Poor knowledge about HF was an independent determinant for poor self-care in multivariate logistic regression analysis (odds ratio = 0.92, P = 0.019). Insufficient self-care is an independent risk factor for cardiac events in Japanese patients with HF.
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Affiliation(s)
- Naoko Kato
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine
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Guo Y, Lip GYH, Banerjee A. Heart failure in East Asia. Curr Cardiol Rev 2014; 9:112-22. [PMID: 23597295 PMCID: PMC3682395 DOI: 10.2174/1573403x11309020004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 12/02/2012] [Accepted: 01/19/2013] [Indexed: 12/21/2022] Open
Abstract
Heart failure (HF) carries a major burden of disease in East Asia, with high associated risk of mortality and morbidity. In recent decades, the epidemiology of HF has changed with social and economical development in East Asia. The burden of HF is still severe in East Asia. The prevalence of HF ranges from 1.3% to 6.7% throughout the region. As aetiological factors, ischaemic heart disease has increased and valvular disease reduced in most East Asian countries. Diuretics are the most commonly used drugs (51.0%-97%), followed by renin-angiotensin system (RAS) inhibitors (59%-77%), with angiotensin-converting enzyme inhibitors, ACEI, (32%-52%) and has angiotensin-2 receptor blockers, ARBs (31%-44%) in similar proportions. β-blocker use has also increased in recent years. Total mortality from HF ranges from 2% to 9% in China, Taiwan, Singapore, Thailand, and Japan. Age>65 years, diabetes mellitus, anaemia, renal dysfunction and atrial fibrillation (AF) are associated with adverse outcome. More prospective, region-specific data are still required, particularly regarding new drug therapies such as eplerenone and ivabradine.
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Affiliation(s)
- Yutao Guo
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
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Cocchieri A, Riegel B, D'Agostino F, Rocco G, Fida R, Alvaro R, Vellone E. Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. Eur J Cardiovasc Nurs 2013; 14:126-36. [PMID: 24366984 DOI: 10.1177/1474515113518443] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Self-care improves outcomes in patients with heart failure; however, no studies have been conducted on this topic in Italy. AIMS We aimed to describe self-care in Italian adults with heart failure and to identify sociodemographic and clinical determinants of self-care. METHODS A cross-sectional design was used to study 1192 heart failure patients enrolled across Italy. We measured self-care using the Self-Care of Heart Failure Index version 6.2, which measures self-care maintenance, management and confidence. Sociodemographic and clinical data were tested as potential determinants of self-care. RESULTS The mean age of the sample was 72 (SD = 11) years; 58% were male. In the three areas of self-care, scores ranged from 53.18 to 55.26 and few people were adequate in self-care (14.5% to 24.4% of the sample). Self-care behaviours particularly low in this population were symptom monitoring, exercise, use of reminders to take medicines and symptom recognition. Confidence in the ability to keep oneself free of symptoms and relieve symptoms was low. Taking fewer medications, poor cognition, older age, having a caregiver, being male and having heart failure for a shorter time predicted poor self-care maintenance. Poor cognition, not being employed, being male, and having worse New York Heart Association class predicted poor self-care management. Poor cognition, taking fewer mediations, older age, and male gender predicted poor self-care confidence. CONCLUSION Self-care is poor in Italian heart failure patients. Determinants of poor self-care identified in this study can help to target patients' education. Male gender and poor cognition were consistently associated with poor self-care maintenance, management and confidence.
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Affiliation(s)
- Antonello Cocchieri
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome Tor Vergata, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Fabio D'Agostino
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome Tor Vergata, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, Rome, Italy
| | - Roberta Fida
- Department of Psychology, Sapienza University, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome Tor Vergata, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome Tor Vergata, Italy
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Cené CW, Haymore LB, Dolan-Soto D, Lin FC, Pignone M, Dewalt DA, Wu JR, Jones CD, Corbie-Smith G. Self-care confidence mediates the relationship between perceived social support and self-care maintenance in adults with heart failure. J Card Fail 2013; 19:202-10. [PMID: 23482082 DOI: 10.1016/j.cardfail.2013.01.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 01/03/2013] [Accepted: 01/22/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Social support may be associated with heart failure (HF) self-care; however, the mechanisms are not well understood. We examined the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships. METHODS Cross-sectional survey of HF patients seen in outpatient clinic settings. Our outcome (HF self-care maintenance and self-care management) and mediator (HF self-care confidence) variables were assessed with the Self-Care of Heart Failure Index. Perceived emotional/informational support was assessed with the Medical Outcomes Study social support survey. We performed regression analyses to examine associations between perceived support and HF self-care behaviors. Mediation analysis was performed according to the Baron and Kenny method. RESULTS We surveyed 150 HF patients (mean age 61 y; 51% female; 43% black). More emotional/informational support was associated with better self-care maintenance (β = 0.13; P = .04). More emotional/information support was associated with better self-care management in unadjusted (β = 0.23; P = .04), but not adjusted (β = 0.20, P = .10), analysis. Self-care confidence mediates the association between perceived support and self-care maintenance (percent change in β coefficient was 32%) and management (percent change in β coefficient was 20%). CONCLUSION Perceived emotional/informational support is associated with better self-care maintenance and possibly better self-care management. Greater self-care confidence is one mediating mechanism.
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Affiliation(s)
- Crystal W Cené
- Division of General Internal Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
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Determinants of heart failure self-care behaviour in community-based patients: a cross-sectional study. Eur J Cardiovasc Nurs 2012; 12:167-76. [DOI: 10.1177/1474515112439964] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tung HH, Chen SC, Yin WH, Cheng CH, Wang TJ, Wu SF. Self care behavior in patients with heart failure in Taiwan. Eur J Cardiovasc Nurs 2012; 11:175-82. [PMID: 21382750 DOI: 10.1016/j.ejcnurse.2011.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to describe the self-care behaviors and associated demographic factors affecting such behaviors in the heart failure population in Taiwan. METHODS A descriptive, cross-sectional, correlational design was used in this study and 86 heart failure patients were sampled by convenience sampling. Demographic questionnaire and Self-Care of Heart Failure Index, V. 6 were used to collect these data. Descriptive statistic, correlation coefficient and multiple regression were used to analyze the data. RESULTS The result indicated a low level of self-care maintenance and management although self-care confidence was adequate. Patients who were married had better self-care maintenance and self-care confidence than those who were single. Self-care confidence was a determinant of self-care maintenance. CONCLUSION This study provided detailed information on self-care behavior status in heart failure patients in Taiwan.
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Affiliation(s)
- Heng-Hsin Tung
- National Taipei University of Nursing and Health Science, 365 Ming Te Road PeiTou, Taipei 112, Taiwan, ROC.
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Kato N, Kinugawa K, Sano M, Seki S, Kogure A, Kobukata K, Ochiai R, Wakita S, Kazuma K. Development of self-care educational material for patients with heart failure in Japan: a pilot study. Nurs Health Sci 2012; 14:156-64. [DOI: 10.1111/j.1442-2018.2011.00673.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jasmine TJX, Wai-Chi SC, Hegney DG. The impact of knowledge and beliefs on adherence to cardiac rehabilitation programs in patients with heart failure: A systematic review. ACTA ACUST UNITED AC 2012; 10:399-470. [PMID: 27820582 DOI: 10.11124/01938924-201210070-00001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Heart failure is a global health problem which affects a large percentage of the older population. Cardiac rehabilitation programs have been implemented to aid patients in successfully managing their heart condition. However, non-adherence to cardiac rehabilitation programs is common in this group of patients. This results in higher morbidity and mortality rates, rehospitalisation and ultimately higher healthcare costs. There is a need to have a better understanding of the impact that knowledge and beliefs have on patients' adherence levels, so that healthcare providers can implement appropriate strategies to promote their adherence. OBJECTIVES This review aimed to establish the best evidence regarding the impact of knowledge and beliefs on adherence to cardiac rehabilitation programs in patients with heart failure; and to make recommendations for healthcare practice and future research. INCLUSION CRITERIA Patients above the age of 18, who had been diagnosed with heart failure and had been admitted to a cardiac rehabilitation program in inpatient or outpatient settings.This review considered studies that evaluated the impact of heart failure patients' knowledge and beliefs of their disease, medication, diet, exercise and other lifestyle change recommendations, on their adherence to cardiac rehabilitation programs.Heart failure patients' knowledge, beliefs and adherence toward their medication regime, low-sodium diet, exercise, and other lifestyle change recommendations.Quantitative study designs published in the English language, up to December 2010 were considered for inclusion. SEARCH STRATEGY Using a three-step search strategy, the following databases were assessed: CINAHL, PubMed, SCOPUS, Web of Science, OvidSP, MDConsult, ScienceDirect, Sociological Abstracts, Mosby's Nursing Consult, Mednar and TRIP. METHODOLOGICAL QUALITY Two independent reviewers assessed each paper for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute. DATA EXTRACTION Information was extracted by two independent reviewers, from each paper using the standardised data extraction tool from the Joanna Briggs Institute. DATA SYNTHESIS The findings are presented in narrative form, as statistical pooling was not possible, due to the different instruments used in measuring the outcomes. RESULTS Twelve quantitative studies were included in this review (one RCT, one pre-test/post-test single group study, and ten descriptive studies). The present findings suggest that the relationship between knowledge and adherence is unclear. However, patient beliefs on medication, symptom monitoring, illness and control were found to have stronger associations of adherence to cardiac rehabilitation programs.Implications for practice Healthcare institutions need to provide adequate support for patients with heart failure; individualise adherence-enhancing interventions to cater for varying patient needs; and work on empowering patients.Implications for research Future quantitative research should be undertaken to investigate the relationship between knowledge and beliefs, determine their combined effect on adherence and examine the effectiveness of strategies used to improve patient knowledge and beliefs. Quantitative and qualitative studies could also be conducted to ascertain the factors correlated with patient knowledge, beliefs, and adherence.
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Affiliation(s)
- Tan Jia Xing Jasmine
- 1National University Hospital Collaborating Centre, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore
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Kato N, Kinugawa K, Seki S, Shiga T, Hatano M, Yao A, Hirata Y, Kazuma K, Nagai R. Quality of Life as an Independent Predictor for Cardiac Events and Death in Patients With Heart Failure. Circ J 2011; 75:1661-9. [DOI: 10.1253/circj.cj-10-1308] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Naoko Kato
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichiro Kinugawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Satomi Seki
- Department of Adult Nursing, Graduate School of Medicine, The University of Tokyo
| | - Taro Shiga
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Atsushi Yao
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yasunobu Hirata
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Keiko Kazuma
- Department of Adult Nursing, Graduate School of Medicine, The University of Tokyo
| | - Ryozo Nagai
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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