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Clifford C, Twerenbold R, Hartel F, Löwe B, Kohlmann S. Somatic symptom disorder symptoms in individuals at risk for heart failure: A cluster analysis with cross-sectional data from a population-based cohort study. J Psychosom Res 2024; 184:111848. [PMID: 38941711 DOI: 10.1016/j.jpsychores.2024.111848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Identifying whether experienced symptom burden in individuals with medical predisposition indicates somatic symptom disorder (SSD) is challenging, given the high overlap in the phenomenology of symptoms within this group. This study aimed to enhance understanding SSD in individuals at risk for heart failure. SUBJECTS AND METHODS Cross-sectional data from the Hamburg City Health Study was analyzed including randomly selected individuals from the general population of Hamburg, Germany recruited from February 2016 to November 2018. SSD symptoms assessed with the Somatic Symptom Scale-8 and the Somatic Symptom Disorder-12 scale were categorized by applying cluster analysis including 412 individuals having at least 5% risk for heart failure-related hospitalization within the next ten years. Clusters were compared for biomedical and psychological factors using ANOVA and chi-square tests. Linear regressions, adjusting for sociodemographic, biomedical, and psychological factors, explored associations between clusters with general practitioner visits and quality of life. RESULTS Three clusters emerged: none (n = 215; 43% female), moderate (n = 151; 48% female), and severe (n = 46; 54% female) SSD symptom burden. The SSS-8 mean sum scores were 3.4 (SD = 2.7) for no, 6.4 (SD = 3.4) for moderate, and 12.4 (SD = 3.7) for severe SSD symptom burden. The SSD-12 mean sum scores were 3.1 (SD = 2.6) for no, 12.2 (SD = 4.2) for moderate, and 23.5 (SD = 6.7) for severe SSD symptom burden. Higher SSD symptom burden correlated with biomedical factors (having diabetes: p = .005 and dyspnea: p ≤ .001) and increased psychological burden (depression severity: p ≤ .001; anxiety severity: p ≤ .001), irrespective of heart failure risk (p = .202). Increased SSD symptoms were associated with more general practitioner visits (β = 0.172; p = .002) and decreased physical quality of life (β = -0.417; p ≤ .001). CONCLUSION Biomedical factors appear relevant in characterizing individuals at risk for heart failure, while psychological factors affect SSD symptom experience. Understanding SSD symptom diversity and addressing subgroup needs could prove beneficial.
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Affiliation(s)
- Caroline Clifford
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
| | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Germany.
| | - Friederike Hartel
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Germany.
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
| | - Sebastian Kohlmann
- Department of General Internal and Psychosomatic Medicine, University Medical Center Heidelberg, Germany.
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Kim H, Hong B, Kim S, Kang SM, Park J. Chemotherapy-related cardiotoxicity and its symptoms in patients with breast cancer: a scoping review. Syst Rev 2024; 13:167. [PMID: 38937811 PMCID: PMC11212164 DOI: 10.1186/s13643-024-02588-z] [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: 12/25/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Chemotherapy-related cardiotoxicity is a significant concern because it is a major cause of morbidity. This study aimed to provide in-depth information on the symptoms of chemotherapy-related cardiotoxicity (CRCT) by exploring literature that concurrently reports the types and symptoms of CRCT in patients with breast cancer. METHODS A scoping review was performed according to an a priori protocol using the Joanna Briggs Institute's guidelines. The participants were patients with breast cancer. The concept was the literature of specifically reported symptoms directly matched with CRCT and the literature, in English, from 2010, and the context was open. The search strategy included four keywords: "breast cancer," "chemotherapy," "cardiotoxicity," and "symptoms." All types of research designs were included; however, studies involving patients with other cancer types, animal subjects, and symptoms not directly related to CRCT were excluded. Data were extracted and presented including tables and figures. RESULTS A total of 29 articles were included in the study, consisting of 23 case reports, 4 retrospective studies, and 2 prospective studies. There were no restrictions on the participants' sex; however, all of them were women, except for one case report. The most used chemotherapy regimens were trastuzumab, capecitabine, and doxorubicin or epirubicin. The primary CRCT identified were myocardial dysfunction and heart failure, followed by coronary artery disease, pulmonary hypertension, and other conditions. Major tests used to diagnose CRCT include echocardiography, electrocardiography, serum cardiac enzymes, coronary angiography, computed tomography, and magnetic resonance imaging. In all case reports, CRCT was diagnosed through an incidental checkup according to the patient's symptom presentation; however, only 10 of these studies showed a baseline checkup before chemotherapy. The five most common CRCT symptoms were dyspnea, chest pain, peripheral edema, fatigue, and palpitations, which were assessed by patient-reported symptom presentation rather than using a symptom assessment tool. Dyspnea with trastuzumab treatment and chest pain with capecitabine treatment were particularly characteristic. The time for first symptom onset after chemotherapy ranged from 1 hour to 300 days, with anthracycline-based regimens requiring 3-55 days, trastuzumab requiring 60-300 days, and capecitabine requiring 1-7 days. CONCLUSIONS This scoping review allowed data mapping according to the study design and chemotherapy regimens. Cardiac assessments for CRCT diagnosis were performed according to the patient's symptoms. There were approximately five types of typical CRCT symptoms, and the timing of symptom occurrence varied. Therefore, developing and applying a CRCT-specific and user-friendly symptom assessment tool are expected to help healthcare providers and patients manage CRCT symptoms effectively.
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Affiliation(s)
- Hyunjoo Kim
- Graduate School, College of Nursing, Yonsei University, 50 Yonsei-ro, Seoul, South Korea
- Severance Cardiovascular Hospital, Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea
| | - Bomi Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea
| | - Sanghee Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea
| | - Seok-Min Kang
- Department of Internal Medicine, Division of Cardiology, Heart Failure Center, Severance Hospital, Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea
| | - Jeongok Park
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea.
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Gerymski R, Latusek-Mierzwa M. Network Analysis of Sexual Well-Being in Women with Heart Failure: The Psychocardiological Perspective. Healthcare (Basel) 2024; 12:817. [PMID: 38667579 PMCID: PMC11050502 DOI: 10.3390/healthcare12080817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Sexuality is an important sphere of every person's life. Sexual dysfunctions and sexual dissatisfaction may also be present in cardiac diseases. Individuals affected by heart failure (HF) deserve special attention since it can be the final stage of many cardiac diseases. Therefore, it is important to verify potential correlates of sexual well-being in individuals with HF. This study was conducted online between 2019 and 2023, and 262 Polish women aged between 18 and 59 years (M = 45.48; SD = 7.65) participated in it. The Short Sexual Well-Being Scale, Depression Anxiety and Stress Scale, Fatigue Assessment Scale, and authors' questionnaire were used. Relationships between tested variables were verified with the use of network analysis performed with the EBICglasso estimator. Centrality assessment showed that sexual well-being had the highest values of betweenness, closeness and degree, followed by fatigue and depression measures. Sexual well-being was negatively related to the number of declared sexual dysfunctions, fatigue, stress and depression levels. Participants' age and HF duration were not related to the sexual well-being of tested women. Multiple additional partial correlations were detected. The obtained results show that sexuality may be a central sphere of life in women with HF and that one's sexuality should not be negated when working with cardiac patients.
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Affiliation(s)
- Rafał Gerymski
- Department of Health Psychology and Quality of Life, Institute of Psychology, Opole University, 45-040 Opole, Poland
| | - Maria Latusek-Mierzwa
- St. Hedwig’s Provincial Specialist Hospital, 45-221 Opole, Poland;
- Doctoral School of the University of Opole, 45-040 Opole, Poland
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Wang Z, Conley S, Redeker NS, Tocchi C. An Evolutionary Concept Analysis in People With Heart Failure-Symptom Clusters or Symptom Cluster Profiles? ANS Adv Nurs Sci 2024; 47:166-187. [PMID: 37185222 DOI: 10.1097/ans.0000000000000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The concept of symptom clusters in heart failure (HF) has been defined and measured inconsistently. We used Rodgers' evolutionary method to review related concepts in the HF literature. Symptom clusters and symptom cluster profiles are characterized by multiple symptoms, a synergistic relationship, and result in a myriad of poor outcomes. Researchers should carefully consider the conceptual differences underpinning symptom clusters and symptom cluster profiles and choose the appropriate concept aligned with their research questions, empirical methods, and target HF population.
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Affiliation(s)
- Zequan Wang
- Author Affiliations University of Connecticut School of Nursing, Storrs (Ms Wang and Drs Redeker and Tocchi); and The Mayo Clinic, Rochester, Minnesota (Dr Conley)
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Locatelli G, Iovino P, Pasta A, Jurgens CY, Vellone E, Riegel B. Cluster analysis of heart failure patients based on their psychological and physical symptoms and predictive analysis of cluster membership. J Adv Nurs 2024; 80:1380-1392. [PMID: 37788062 DOI: 10.1111/jan.15890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
AIM Patients with heart failure experience multiple co-occurring symptoms that lower their quality of life and increase hospitalization and mortality rates. So far, no heart failure symptom cluster study recruited patients from community settings or focused on symptoms predicting most clinical outcomes. Considering physical and psychological symptoms together allows understanding how they burden patients in different combinations. Moreover, studies predicting symptom cluster membership using variables other than symptoms are lacking. We aimed to (a) cluster heart failure patients based on physical and psychological symptoms and (b) predict symptom cluster membership using sociodemographic/clinical variables. DESIGN Secondary analysis of MOTIVATE-HF trial, which recruited 510 heart failure patients from a hospital, an outpatient and a community setting in Italy. METHODS Cluster analysis was performed based on the two scores of the Hospital Anxiety-Depression scale and two scores of the Heart-Failure Somatic Perception Scale predicting most clinical outcomes. ANOVA and chi-square test were used to compare patients' characteristics among clusters. For the predictive analysis, we split the data into a training set and a test set and trained three classification models on the former to predict patients' symptom cluster membership based on 11 clinical/sociodemographic variables. Permutation analysis investigated which variables best predicted cluster membership. RESULTS Four clusters were identified based on the intensity and combination of psychological and physical symptoms: mixed distress (high psychological, low physical symptoms), high distress, low distress and moderate distress. Clinical and sociodemographic differences were found among clusters. NYHA-class (New York Heart Association) and sleep quality were the most important variables in predicting symptom cluster membership. CONCLUSIONS These results can support the development of tailored symptom management intervention and the investigation of symptom clusters' effect on patient outcomes. The promising results of the predictive analysis suggest that such benefits may be obtained even when direct access to symptoms-related data is absent. IMPLICATIONS These results may be particularly useful to clinicians, patients and researchers because they highlight the importance of addressing clusters of symptoms, instead of individual symptoms, to facilitate symptom detection and management. Knowing which variables best predict symptom cluster membership can allow to obtain such benefits even when direct access to symptoms-data is absent. IMPACT Four clusters of heart failure patients characterized by different intensity and combination of psychological and physical symptoms were identified. NYHA class and sleep quality appeared important variables in predicting symptom cluster membership. REPORTING METHOD The authors have adhered to the EQUATOR guidelines STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION Patients were included only for collecting their data.
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Affiliation(s)
- Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Alessandro Pasta
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Corrine Y Jurgens
- Connell School of Nursing, Boston College, Massachusetts, Boston, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Barbara Riegel
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
- School of Nursing, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Truong HP, Nguyen KM, Tran HT, Hoang SV. Assessment of Health-Related Quality of Life in Patients with Chronic Heart Failure: A Cross-Sectional Study in Vietnam. Cureus 2023; 15:e51098. [PMID: 38274935 PMCID: PMC10809020 DOI: 10.7759/cureus.51098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Heart failure is currently a global health issue, imposing a burden on disease prevalence and mortality rates for patients, while simultaneously impacting the quality of life for affected individuals. Data on assessing the health-related quality of life (HRQoL) of patients with chronic heart failure in developing countries, including Vietnam, is still limited. This study was conducted with the aim of describing the quality of life of patients with chronic heart failure in Vietnam. Methods This cross-sectional investigation enrolled 140 chronic heart failure outpatients, utilizing a convenience sample at Hai Duong Province Hospital, Vietnam, spanning from December 2021 to April 2022. Essential patient variables encompassing age, gender, and heart failure duration were gathered. Surveying of patients took place at the outpatient clinic during chronic heart failure follow-up visits using the 36-Item Short Form Health Survey (SF-36) questionnaire. The SF-36 comprises eight dimensions: (1) Physical functioning, (2) Role limitations due to physical health, (3) Bodily pain, (4) General health perceptions, (5) Vitality, (6) Social role functioning, (7) Role limitations due to emotional health, and (8) Mental health. Component analysis of the SF-36 revealed two distinct concepts: a physical component summary (PCS) reflecting the physical aspect and a mental component summary (MCS) reflecting the mental aspect. Results The research involved 140 participants diagnosed with chronic heart failure, having a median age of 59 years (interquartile range (IQR): 52-63). Among them, 61.4% were male, and 50% exhibited reduced left ventricular ejection fraction (LVEF) (≤ 40%). The role limitations due to the physical health domain indicated the lowest score, registering a median value of 0 (IQR 0-25). Domains with median scores below the 25-point threshold encompassed role limitations due to physical health (0 points). Those with scores ranging from 25 to 49 points constituted general health perceptions (25 points), role limitations due to emotional health (33.3 points), vitality (45 points), and mental health (48 points). Bodily pain and social role functioning achieved median scores at a moderate level (50-74 points), scoring 62 and 62.5 points, respectively. The overall HRQoL score on the SF-36 scale was 45.2 (IQR: 32.1-58.7) points. Median scores for the PCS and MCS were 44.3 (IQR: 30.5-52) and 47.0 (IQR: 32.6-65.4), respectively. No statistically significant differences in PCS and MCS scores were observed when subgroup analysis was performed based on variables like age, gender, or LVEF. However, in the vitality domain, female patients exhibited a significantly lower median score than male patients (p-value = 0.046). In the physical functioning domain, individuals aged ≥ 60 had lower median scores than those aged < 60 years (p = 0.022). Additionally, the group with LVEF ≤ 40% had lower median scores compared to the group with LVEF > 40% (p = 0.038) in role limitations due to emotional health domain. Conclusion In Vietnam, the HRQoL in the outpatient population with chronic heart failure was notably low when assessed using the SF-36 questionnaire. Large-scale, multicenter studies are needed to provide stronger, more conclusive evidence.
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Affiliation(s)
- Hung P Truong
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Kha M Nguyen
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Hien T Tran
- Department of Cardiology, Hai Duong Hospital, Hai Duong, VNM
| | - Sy V Hoang
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
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Yang HR, Xu XD, Shaikh AS, Zhou BT. Efficacy and Safety of Sacubitril/Valsartan Compared With ACEI/ARB on Health-Related Quality of Life in Heart Failure Patients: A Meta-Analysis. Ann Pharmacother 2023; 57:907-917. [PMID: 36475871 DOI: 10.1177/10600280221140575] [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] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Data on the effects of sacubitril/valsartan compared with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) on health-related quality of life (HRQoL) are limited. OBJECTIVE To evaluate the comparative effects between sacubitril/valsartan and ACEI/ARB on HRQoL, a systematic review and meta-analysis were performed. METHODS PubMed, EMBASE, Web of Science, and ClinicalTrials.gov were searched from inception to March 2, 2022 for randomized controlled trials that compared the HRQoL scores, including Kansas City Cardiomyopathy Questionnaire (KCCQ), Minnesota Living with Heart Failure Questionnaire (MLHFQ), or Medical Outcomes Study Short-Form Health Survey 12 or 36 (SF-12/36), between sacubitril/valsartan and ACEI/ARB. After screening, studies that met the inclusion criteria were eventually included and analyzed. RESULTS A total of 8 studies with 17 390 patients (8693 patients used sacubitril/valsartan, and 8697 patients used ACEI/ARB) were included in this study. Five of these studies used KCCQ, 1 used SF-12/36, 1 used MLHFQ, and 1 used both KCCQ and SF-12/36. The KCCQ overall summary score and its subscales were significantly higher in sacubitril/valsartan compared with ACEI/ARB in heart failure patients with reduced ejection fraction, but were similar in heart failure patients with preserved ejection fraction. Sacubitril/valsartan conferred similar HRQoL scores in MLHFQ and SF-12/36 to ACEI/ARB. The most frequently reported adverse event for sacubitril/valsartan is hypotension and the risk is higher than for ACEI/ARB. CONCLUSIONS Sacubitril/valsartan may have the potential to improve HRQoL in heart failure patients with reduced ejection fraction compared with ACEI/ARB. Hypotension is the most common adverse event with sacubitril/valsartan compared with ACEI/ARB. The results of this study may contribute to the rational use of sacubitril/valsartan.
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Affiliation(s)
- Hua-Rong Yang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-di Xu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
- Department of Medicinal Chemistry, School of Pharmacy, Fudan University, Shanghai, China
| | - Abdul Sami Shaikh
- Department of Pharmacy, Shah Abdul Latif University, Khairpur, Pakistan
| | - Bo-Ting Zhou
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
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Bang C, Park S. Symptom Clusters, Psychological Distress, and Quality of Life in Patients with Atrial Fibrillation. Healthcare (Basel) 2023; 11:healthcare11091353. [PMID: 37174895 PMCID: PMC10178728 DOI: 10.3390/healthcare11091353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/17/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
Background: Patients with atrial fibrillation (AF) experience diverse symptoms such as palpitations, dizziness, and fainting that lead to depression, anxiety, and poor quality of life. Management of symptoms is fundamental for AF, and with the increasing prevalence of AF, studies on management of symptoms in patients with AF are needed. Objectives: This study aimed to assess symptom clusters according to symptom severity in patients with atrial fibrillation and evaluate the relationships between symptom cluster groups and the psychological distress and quality of life of these patients. Design: A descriptive survey was used in this study. Methods: A total of 175 patients were included in this study. Data regarding symptoms, psychological distress, and quality of life were obtained using structured questionnaires and analyzed using frequency and percentage, mean and standard deviation, cluster analysis, t-testing, Chi-square testing, Pearson's correlation coefficient, and multiple regression analysis. The Euclidean distance square of the hierarchical cluster was used to form symptom cluster groups. Results: Two groups of symptom clusters were formed based on the seven most common symptoms (i.e., chest palpitations, fatigue/tiredness, dizziness, lack of energy, pulse skipping, insomnia, and heavy breathing) of atrial fibrillation patients. Psychological distress and quality of life showed significant correlations with the symptom cluster groups (p < 0.001). Conclusion: Symptoms of atrial fibrillation increased patients' depression and anxiety, and further affected their quality of life. Therefore, management of symptoms is critical to maintaining a high quality of life. Nursing interventions based on the characteristics of symptom cluster groups must be developed and attempted.
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Affiliation(s)
- Chohee Bang
- Department of Nursing, College of Health Science, Honam University, Gwangju 62399, Republic of Korea
| | - Sookyung Park
- School of Nursing, Korea University, Seoul 02841, Republic of Korea
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Dos Reis MC, Nascimento JA, de Andrade GN, Costa ACDS, Takada JY, Mansur ADP, Bocchi EA, Dos Santos GMS, Spertus JA, Nakagawa NK. Validation of the Portuguese Version of the Kansas City Cardiomyopathy Questionnaire-12. J Cardiovasc Dev Dis 2023; 10:jcdd10040162. [PMID: 37103041 PMCID: PMC10144930 DOI: 10.3390/jcdd10040162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
The Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) is a simple, feasible, and sensitive questionnaire developed in English for assessing the health status (symptoms, function, and quality of life) of patients with heart failure (HF). We aimed to assess the internal consistency and construct validity of the Portuguese version of KCCQ-12. We administered the KCCQ-12, the Minnesota Living Heart Failure (MLHFQ), and the New York Heart Association (NYHA) classification by telephone. Internal consistency was assessed with Cronbach's Alpha (α-Cronbach) and construct validity with correlations to the MLHFQ and NYHA. Internal consistency was high (α-Cronbach = 0.92 for the Overall Summary score and 0.77-0.85 for the subdomains). Construct validity was supported by finding high correlations between the KCCQ-12 Physical Limitation and the Symptom Frequency domains with the physical domain of the MLHFQ (r = -0.70 and r = -0.76, p < 0.001 for both) and the Overall Summary scale with NYHA classifications (r = -0.72, p < 0.001). The Portuguese version of KCCQ-12 has high internal consistency and shows a convergent construct validity with other measures quantifying the health status of patients with chronic HF and can be used confidently in Brazil for research and clinical care.
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Affiliation(s)
- Mariane Cecilia Dos Reis
- Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-903, SP, Brazil
| | - Juliana Araújo Nascimento
- Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-903, SP, Brazil
| | - Geisa Nascimento de Andrade
- Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-903, SP, Brazil
| | - Ana Cláudia de Souza Costa
- Department of Nursing, Pontifical Catholic University of Minas Gerais, Poços de Caldas 37714-620, MG, Brazil
| | - Julio Yoshio Takada
- Unidade Clínica de Coronariopatias Crônicas, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de SaoPaulo, Sao Paulo 05508-030, SP, Brazil
| | - Antonio de Padua Mansur
- Serviço de Prevenção, Cardiopatia na Mulher e Reabilitação Cardiovascular, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 05508-030, SP, Brazil
| | - Edimar Alcides Bocchi
- Unidade Clínica de Insuficiência Cardíaca, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 05508-030, SP, Brazil
| | | | - John A Spertus
- Healthcare Institute for Innovations in Quality, Saint Luke's Mid America Heart Institute, University of Missouri, Kansas City, MO 64110, USA
| | - Naomi Kondo Nakagawa
- Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01246-903, SP, Brazil
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Farghaly A, Fitzsimons D, Bradley J, Sedhom M, Atef H. The Need for Breathing Training Techniques: The Elephant in the Heart Failure Cardiac Rehabilitation Room: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14694. [PMID: 36429418 PMCID: PMC9690833 DOI: 10.3390/ijerph192214694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although solid evidence has indicated that respiratory symptoms are common amongst patients with chronic heart failure (CHF), state-of-the-art cardiac rehabilitation (CR) programs do not typically include management strategies to address respiratory symptoms. This study investigated the effect of the addition of breathing exercises (BE) to the CR programs in CHF. METHODS In a two parallel-arm randomized controlled study (RCT), 40 middle-aged patients with CHF and respiratory symptoms were recruited and randomized into two equal groups (n = 20); group (A): standard CR with BE and group (B): standard CR alone. Primary outcomes were respiratory parameters and secondary outcomes included cardiovascular and cardiopulmonary outcomes. All the participants attended a program of aerobic exercise (three sessions/week, 60-75% MHR, 45-55 min) for 12 weeks, plus educational, nutritional, and psychological counseling. Group (A) patients attended the same program together with BE using inspiratory muscle training (IMT) and breathing calisthenics (BC) (six sessions/week, 15-25 min) for the same duration. RESULTS There was a significant improvement in the respiratory outcomes, and most of the cardiovascular and cardiopulmonary outcomes in both groups with a greater change percentage in group A (p < 0.05). CONCLUSIONS These results indicate that the addition of BE to the CR programs in CHF is effective and is a "patient-centered" approach.
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Affiliation(s)
- Abeer Farghaly
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder & Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen’s University of Belfast, Belfast, UK
| | - Judy Bradley
- Wellcome Trust-Wolfson NI Clinical Research Facility, Queen’s University Belfast, Belfast, UK
| | - Magda Sedhom
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hady Atef
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder & Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Hoxha I, Guda B, Hoti A, Zhubi E, Selmani E, Avdiu B, Cegllar J, Marušič D, Osmani A. Clinical Decision-Making for Heart Failure in Kosovo: A Conjoint Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14638. [PMID: 36429362 PMCID: PMC9690698 DOI: 10.3390/ijerph192214638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Heart failure represents a life-threatening progressive condition. Early diagnosis and adherence to clinical guidelines are associated with improved outcomes for patients with heart failure. However, adherence to clinical guidelines remains limited in Kosovo. OBJECTIVE To assess the clinical decision-making related to heart failure diagnosis by evaluating clinicians' preferences for clinical attributes. METHOD Conjoint analysis with 33 clinical scenarios with physicians employed in public hospitals in Kosovo. SETTING Two public hospitals in Kosovo that benefited from quality improvement intervention. PARTICIPANTS 14 physicians (internists and cardiologists) in two hospitals in Kosovo. OUTCOME MEASURES The primary outcome was the overall effect of clinical attributes on the decision for heart failure diagnosis. RESULTS When considering clinical signs, the likelihood of a heart failure diagnosis increased for ages between 60 to 69 years old (RRR, 1.88; CI 95%, 1.05-3.34) and a stable heart rate (RRR, 1.93; CI 95%, 1.05-3.55) and decreased for the presence of edema (RRR, 0.23; CI 95%, 0.15-0.36), orthopnea (RRR, 0.31; CI 95%, 0.20-0.48), and unusual fatigue (RRR, 0.61; CI 95%, 0.39-0.94). When considering clinical examination findings, the likelihood for heart failure diagnosis decreased for high jugular venous pressure (RRR, 0.49; CI 95%, 0.32-0.76), pleural effusion (RRR, 0.35; CI 95%, 0.23-0.54), hearing third heart sound, (RRR, 0.50; CI 95%, 0.33-0.77), heart murmur (RRR, 0.57; CI 95%, 0.37-0.88), troponin levels (RRR, 0.59; CI 95%, 0.38-0.91), and NTproBNP levels (RRR, 0.36; CI 95%, 0.24-0.56). CONCLUSIONS We often found odd and wide variations of clinical signs and examination results influencing the decision to diagnose a person with heart failure. It will be important to explore and understand these results better. The study findings are important for existing quality improvement support efforts and contribute to the standardization of clinical decision-making in the public hospitals in the country. This experience and this study can provide valuable impetus for further examination of these efforts and informing policy and development efforts in the standardization of care in the country.
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Affiliation(s)
- Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Research Unit, Heimerer College, 10000 Prishtina, Kosovo
- Lux Development, 10000 Prishtina, Kosovo
| | - Besim Guda
- General Hospital of Gjilan, 60000 Gjilan, Kosovo
| | - Ali Hoti
- General Hospital of Prizren, 20000 Prizren, Kosovo
| | - Esra Zhubi
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
| | - Erza Selmani
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Research Unit, Heimerer College, 10000 Prishtina, Kosovo
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12
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Graven LJ, Abbott L, Schluck G. The coping in heart failure (COPE-HF) partnership intervention for heart failure symptoms: Implications for palliative care. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2124144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
| | - Laurie Abbott
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Glenna Schluck
- Florida State University College of Nursing, Tallahassee, FL, USA
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13
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Assessment of health-related quality of life in patients with heart failure: a cross-sectional study in Saudi Arabia. Health Qual Life Outcomes 2022; 20:128. [PMID: 36042486 PMCID: PMC9425984 DOI: 10.1186/s12955-022-02040-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region.
Methods A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16. Results The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46–6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38–5.16). Conclusions Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients.
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14
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Qiu C, Yu DSF, Song D, Wang X. The prognostic impact of symptom clusters in patients with heart failure: A systematic review and meta-analysis. J Adv Nurs 2022; 78:2713-2730. [PMID: 35608172 DOI: 10.1111/jan.15302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/11/2022] [Accepted: 05/07/2022] [Indexed: 10/18/2022]
Abstract
AIM To determine the impact of symptom clusters on clinical outcomes among heart failure patients. DESIGN Systematic review and meta-analysis. DATA SOURCES Peer-reviewed articles were searched from 12 English and Chinese language databases from inception to August 2021. REVIEW METHODS Narrative syntheses were first conducted to integrate symptom clusters reported in the identified studies. This was followed by meta-analysis to synthesize the evidence on the association or predictive effects of symptom clusters on clinical outcomes. RESULTS Twelve studies were identified. Among studies which identified highly correlated symptoms as in a cluster, meta-analysis indicated that severe congestive (r = .45, 95% CI = 0.38-0.52), weary (r = .41, 95% CI = 0.33-0.50), ischaemic (r = .29, 95% CI = 0.04-0.51) and stress-related (r = .62, 95% CI = 0.31-0.81) symptom clusters were correlated with a poorer health-related quality of life. As for studies used latent class to identified patient cohorts of similar symptom pattern, high symptom cohorts (hazard ratio = 1.86, 95% CI = 1.39-2.48) and incongruent physical and psycho-cognitive symptom cohorts was associated with a significantly higher risk (hazard ratio = 2.10, 95% CI = 1.44-3.07) of combined event rate relative to low symptom presentation. CONCLUSIONS This review has identified the impact of symptom clusters on clinical outcomes in heart failure patients. In addition to the classical physical symptoms highlighted in the clinical management guidelines, our findings suggested the important predictive role of psycho-cognitive and weary symptoms in determining the clinical outcomes of HF patients. IMPACT This review concluded the promising prospect of symptom clusters in shaping clinical outcomes of heart failure. The findings highlighted the importance of integrating care to minimize the disease impact on psycho-cognitive function and weary symptoms among this clinical cohort. The review also inform the direction on how to advance the knowledge on symptom clusters among this clinical cohort.
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Affiliation(s)
- Chen Qiu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Dan Song
- Nursing Department, Shenzhen Qianhai and Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Xiaobing Wang
- Office of Teaching and Research, School of Nursing, Shanxi Datong University, Datong, China
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15
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Murakami N, Baggett ND, Schwarze ML, Ladin K, Courtwright AM, Goldberg HJ, Nolley EP, Jain N, Landzberg M, Wentlandt K, Lai JC, Shinall MC, Ufere NN, Jones CA, Lakin JR. Top Ten Tips Palliative Care Clinicians Should Know About Solid Organ Transplantation. J Palliat Med 2022; 25:1136-1142. [PMID: 35275707 PMCID: PMC9467633 DOI: 10.1089/jpm.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Solid organ transplantation (SOT) is a life-saving procedure for people with end-stage organ failure. However, patients experience significant symptom burden, complex decision making, morbidity, and mortality during both pre- and post-transplant periods. Palliative care (PC) is well suited and historically underdelivered for the transplant population. This article, written by a team of transplant specialists (surgeons, cardiologists, nephrologists, hepatologists, and pulmonologists), PC clinicians, and an ethics specialist, shares 10 high-yield tips for PC clinicians to consider when caring for SOT patients.
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Affiliation(s)
- Naoka Murakami
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathan D Baggett
- Division of Emergency Medicine, Health Partners Institute/Regions Hospital, St. Paul, Minnesota, USA
| | | | - Keren Ladin
- Department of Occupational Therapy, Tufts University, Medford, Massachusetts, USA.,Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | - Andrew M Courtwright
- Department of Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hilary J Goldberg
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Eric P Nolley
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nelia Jain
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael Landzberg
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kirsten Wentlandt
- Division of Palliative Care, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jennifer C Lai
- Department of Medicine, University of California, San Francisco, California, USA
| | - Myrick C Shinall
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Section of Palliative Care, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nneka N Ufere
- Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joshua R Lakin
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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16
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Zhang J, Chai X, Ye Y, Zhao Q, Fan X. Association between sleep and quality of life in heart failure patient-caregiver dyads and mediation of fatigue: An actor-partner interdependence mediation model. J Adv Nurs 2022; 78:2436-2447. [PMID: 35133026 DOI: 10.1111/jan.15174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/02/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
AIMS Quality of life is essential to heart failure patients and their family caregivers. This study aimed to examine the mediating role of fatigue in the association between sleep and quality of life in heart failure patient-caregiver dyads. DESIGN A cross-sectional descriptive study was conducted from November 2017 to August 2018. METHODS A total of 269 heart failure patient-caregiver dyads at two hospitals in China were included. The Chinese version of the Pittsburgh Sleep Quality Index, the Chalder Fatigue Scale and the 12-item Short-Form Health Survey were used to collect data on heart failure patients and their family caregivers. The structural equation model was employed in the dyadic analysis based on the actor-partner interdependence mediation model. RESULTS Regarding the actor effects, poor sleep was negatively associated with physical and mental quality of life in heart failure patients and their family caregivers, respectively, and the relationship was mediated by their fatigue. Regarding the partner effects, caregivers' fatigue was positively associated with patients' physical quality of life and mediated the association between caregivers' sleep and patients' physical quality of life. CONCLUSIONS Heart failure patients and their family caregivers experience reduced quality of life when they have poor sleep and fatigue, and caregivers' fatigue is related to patients' improved physical quality of life. Hence, dyadic interventions targeting to improving sleep and fatigue may be beneficial to their quality of life. IMPACT This study highlights the importance of routinely measuring and managing sleep and fatigue for heart failure patients and their family caregivers. Effective dyadic-based interventions that maintain equal attention to family caregivers should be considered by healthcare providers to maximize the improvement of patients' quality of life.
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Affiliation(s)
- Jie Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaohui Chai
- Department of Anesthesiology and Surgery, Qingdao Municipal Hospital Group, Qingdao, Shandong, China
| | - Yi Ye
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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17
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Hao J, Gu L, Liu P, Zhang L, Xu H, Qiu Q, Zhang W. Symptom clusters in patients with colorectal cancer after colostomy: a longitudinal study in Shanghai. J Int Med Res 2021; 49:3000605211063105. [PMID: 34904459 PMCID: PMC8689628 DOI: 10.1177/03000605211063105] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective Research is lacking regarding the experiences of patients after colostomy, which is needed so as to take necessary specific actions. In this study, we aimed to describe the trajectory of symptom clusters experienced by patients after colostomy over time. Methods This was a longitudinal observational study using data from 149 patients with colorectal cancer after colostomy. We investigated symptoms and symptom clusters at 2 weeks, 1 month, 3 months, 6 months, and 1 year after colostomy. Results Four main symptom clusters were identified, including a psychological symptom cluster, digestive and urinary symptom cluster, lack of energy symptom cluster, and pain symptom cluster in patients after colostomy in the first year after surgery. We further explored the symptom trajectory. Conclusions We explored symptom clusters and the trajectory of symptom resolution in patients after colostomy during the first year after surgery. Four stages were proposed to describe the different statuses of symptom clusters experienced by patients. Our findings may provide insight into how to improve symptom management and postoperative quality of life for patients after colostomy.
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Affiliation(s)
- Jianling Hao
- General Surgery Department, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Liyan Gu
- Department of Neurology, No. 905 Hospital of P.L.A. Navy, Shanghai, China
| | - Peng Liu
- General Surgery Department, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated with Naval Medical University, Shanghai, China.,Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Honglian Xu
- General Surgery Department, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Qun Qiu
- General Surgery Department, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Wei Zhang
- Department of Neurology, No. 905 Hospital of P.L.A. Navy, Shanghai, China
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18
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Mohammadi F, Jahromi MS, Bijani M, Karimi S, Dehghan A. Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: a randomized clinical trial. BMC Cardiovasc Disord 2021; 21:535. [PMID: 34772339 PMCID: PMC8588695 DOI: 10.1186/s12872-021-02357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Education can contribute to promotion of the quality of life and reduction of heart anxiety in patients with heart failure, so it is important to find a suitable educational method for these patients. Therefore, the present study was an attempt to determine the effect of multimedia education using teach-back method on the life quality and cardiac anxiety in patients with heart failure. METHODS The present study was a randomized clinical trial. 120 patients with heart failure class I to III and aged less than 60 years old were selected using sequential sampling; then, they were assigned randomly into two intervention groups and one control group. Group A (multimedia education), group B (education using multimedia together with teach-back method), and group C (control). The quality of life and cardiac anxiety were evaluated in the participants of the three groups before, after, 1 month, and 3 months after the intervention. Data were analyzed using descriptive tests, Pearson correlation, Kolmogorov-Smirnov, chi square and ANOVA test in SPSS 22. The significance level was set at P < 0.05. RESULTS No significant differences were found in the mean scores of the quality of life and cardiac anxiety in the control and two intervention groups before the educational intervention. However, immediately after, 1 month and 3 months after the educational intervention, a significant difference was observed between the mean scores of the quality of life and cardiac anxiety in the intervention groups (P < 0.05). CONCLUSION Multimedia education together with Teach-Back method is effective in promoting the quality of life and reducing cardiac anxiety in patients with heart failure. Therefore, it is recommended that health policymakers should use this educational method in providing treatment programs. IRANIAN REGISTRY OF CLINICAL TRIALS 20190917044802N1. Registration date: 5/2/2020.
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Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mitra Sadeghi Jahromi
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, 81936-13119 Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, 81936-13119 Fasa, Iran
| | - Shanaz Karimi
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, 81936-13119 Fasa, Iran
| | - Azizallah Dehghan
- NonCommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
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19
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Liu MH, Chiou AF, Wang CH, Yu WP, Lin MH. Relationship of symptom stress, care needs, social support, and meaning in life to quality of life in patients with heart failure from the acute to chronic stages: a longitudinal study. Health Qual Life Outcomes 2021; 19:252. [PMID: 34742311 PMCID: PMC8572479 DOI: 10.1186/s12955-021-01885-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/19/2021] [Indexed: 11/22/2022] Open
Abstract
Background Patients with heart failure (HF) experience continuous changes in symptom distress, care needs, social support, and meaning in life from acute decompensation to chronic phases. The longitudinal relationship between these four factors and quality of life (QOL) was not fully explored. Aims To simultaneously investigate the relationship between all factors and QOL from hospitalization to 6 months after discharge,
and the impact of the changes in these factors on QOL at different time points. Methods A longitudinal design with panel research (4 time points) was used. From January 2017 to December 2019, patients hospitalized due to acute decompensated HF were consecutively enrolled and followed up for 6 months. Patients were interviewed with questionnaires assessing symptom distress, care needs, social support, meaning in life and QOL at hospitalization and 1, 3 and 6 months after discharge. Results A total of 184 patients completed 6 months of follow-up. From baseline to 6 months, QOL continuously improved along with decreases in symptoms and care needs, but increases in social support and meaning in life. Better QOL was associated with younger age, higher education level, economic independence, less symptom distress and care needs, and stronger meaning in life (p < 0.05). Compared with hospitalization, decreases in care needs and increases in meaning in life at 1, 3 and 6 months were associated with an increase in physical QOL (p < 0.01). The decrease in care needs and increase in meaning in life at 3 months were associated with an increase in mental QOL (p < 0.05). The increase in social support at 6 months was associated with increases in both physical and mental QOL (p < 0.01). Changes in symptom distress were not correlated with changes in QOL from baseline to all time points. In the multivariable analysis, these findings were independent of age, educational level and economic status. Conclusions Although symptom distress is associated with QOL after acute decompensated HF, QOL cannot be improved only by improvement in symptoms. With differential duration of improvement in each factor, the integration of alleviation in care needs and strengthening in social support and meaning in life might provide additional benefits in QOL.
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Affiliation(s)
- Min-Hui Liu
- Heart Failure Research Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, 222 Mai Chin Road, Keelung, Taiwan, ROC.,Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
| | - Ai-Fu Chiou
- School of Nursing, National Yang-Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei, Taiwan, ROC.
| | - Chao-Hung Wang
- Heart Failure Research Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, 222 Mai Chin Road, Keelung, Taiwan, ROC. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
| | - Wen-Pin Yu
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.,Department of Nursing, Chang Gung University of Science and Technology, Keelung, Taiwan, ROC
| | - Mei-Hui Lin
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
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20
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The Determinants of Living with Long-Term Conditions: An International Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910381. [PMID: 34639681 PMCID: PMC8508439 DOI: 10.3390/ijerph181910381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
It is essential that healthcare and social professionals understand the daily lives of people with chronic diseases, and the variables that influence them. The aim of this study was to identify the determinants influencing the process of living with long-term conditions. To investigate this, an observational, international, cross-sectional study was carried out. A consecutive sample of 1788 Spanish-speaking population living with chronic obstructive pulmonary disease, chronic heart failure and type 2 diabetes mellitus were included. Descriptive statistics and multiple linear regression models were performed. The linear regression models identified that social support (β = 0.39, p < 0.001) and the satisfaction with life (β = 0.37, p < 0.001) were the main determinants in the process of living with a long-term condition (49% of the variance). Age (β = -0.08, p = 0.01) and disease duration (β = 0.07, p = 0.01) were determinants only in the chronic heart failure subgroup, and country was significant in the chronic obstructive pulmonary disease subgroup (β = -0.15, p = 0.002). Satisfaction with life and social support were key determinants influencing the process of living with long-term conditions. As such, those aspects should be included in the design of interventions focused on the achievement of a positive living in people with long-term conditions.
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21
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Sethares KA, Chin E. Age and gender differences in physical heart failure symptom clusters. Heart Lung 2021; 50:832-837. [PMID: 34311226 DOI: 10.1016/j.hrtlng.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Gender differences exist in structure and function of the heart resulting in HF symptom variation. Previous HF symptom cluster research described symptom clusters that were linked to functional status, mortality, quality of life and rehospitalization. Age and gender differences between cluster groups were described in one study. OBJECTIVES Identify physical HF symptom clusters and explore age and gender differences between clusters. METHODS Secondary analysis study of adults with HF. Cluster analysis was conducted using hierarchical agglomerative clustering techniques. A pictorial dendrogram output displays clusters. RESULTS Three symptom clusters were identified in this sample of 133 older HF patients that differed by gender (p = 0.04), age (p = 0.00) and beta blocker use (p = 0.01). Symptom clusters were consistent with worsening HF, acute HF and chronic HF. CONCLUSION Symptom clusters differ by age and gender. Education should be directed at increasing patient awareness of their individual symptom clusters.
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Affiliation(s)
- Kristen A Sethares
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd. North Dartmouth 02747, MA, United States.
| | - Elizabeth Chin
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd. North Dartmouth 02747, MA, United States
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22
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Moradi M, Daneshi F, Behzadmehr R, Rafiemanesh H, Bouya S, Raeisi M. Quality of life of chronic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2021; 25:993-1006. [PMID: 31745839 DOI: 10.1007/s10741-019-09890-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite various individual studies on the quality of life (QOL) in patients with CHF, a comprehensive study has not yet been conducted; therefore, this study aims to assess the QOL of CHF patients. In the present systematic review and meta-analysis, PubMed, Scopus, and the Web of science databases were searched from January 1, 2000, to December 31, 2018, using QOL and heart failure as keywords. The searches, screenings, quality assessments, and data extractions were conducted separately by two researchers. A total of 70 studies including 25,180 participants entered the final stage. The mean QOL score was 44.1 (95% confidence interval (CI) 40.6, 47.5; I2 = 99.3%) using a specific random effects method in 40 studies carried out on 12,520 patients. Moreover, according to the geographical region, heart failure patients in the Americas had higher scores. In 14 studies, in which a general SF-36 survey was implemented, the average physical component score (PCS) and mental component score (MCS) were 33.3 (95% CI 31.9, 34.7; I2 = 88.0%) and 50.6 (95% CI 43.8, 57.4; I2 = 99.3%), respectively. The general and specific tools used in this study indicated moderate and poor QOL, respectively. Therefore, it is necessary to carry out periodic QOL measurements using appropriate tools as part of the general care of CHF patients.
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Affiliation(s)
- Mandana Moradi
- Clinical Pharmacy Department, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
| | - Fereshteh Daneshi
- Department of Pediatric Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Razieh Behzadmehr
- Associate Professor of Radiology, Department of Radiology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Hosien Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salehoddin Bouya
- Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mohammad Raeisi
- Varamin-Pishva Branch, Islamic Azad University, Varamin, Iran
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Sethares KA, Viveiros JD, Ayotte B. Uncertainty levels differ by physical heart failure symptom cluster. Appl Nurs Res 2021; 60:151435. [PMID: 34247783 DOI: 10.1016/j.apnr.2021.151435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/06/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of uncertainty, unpredictable symptoms, and unknown illness trajectory are frequent concerns reported in heart failure (HF) literature. Illness uncertainty can lead to difficulty interpreting symptoms, potentially impacting outcomes. Impaired functional status, quality of life, all-cause mortality, rehospitalization, and event-free survival are predicted by symptom clusters. No studies to date describe levels of uncertainty by physical symptom cluster in HF. AIMS Describe physical HF symptom clusters and determine if uncertainty levels differ by symptom cluster. METHODS Results are based on a secondary analysis of data from patients hospitalized with an acute exacerbation of HF. The Heart Failure Somatic Perception Scale (HFSPS) and Mishel's Uncertainty in Illness Scale (MUIS-C) were completed. Symptom clusters were determined by hierarchical agglomerative clustering. Controlling for age and gender, ANCOVA (post hoc LSD) analyses explored uncertainty levels by symptom cluster group. RESULTS One hundred and thirty-three primarily older (76.4 ± 12.1), Caucasian (92.5%) adults (55.2% male), with an ischemic HF etiology (71.6%) were enrolled. Three clusters were found: 1. Shortness of breath, n = 47, 2. Edema, n = 39, and 3. Cardiac, n = 43. Adjusting for age and gender, uncertainty levels differed by cluster group (p ≤ 0.001), with edema cluster members reporting greater illness uncertainty than cardiac cluster members (74.6 vs 69.5, respectively, p = 0.033). CONCLUSIONS Differences exist in illness uncertainty levels based on the symptom experience of patients with HF. Care and management of HF symptoms should include a complete assessment of unique symptom cluster profiles.
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Affiliation(s)
- Kristen A Sethares
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, United States.
| | - Jennifer D Viveiros
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, United States
| | - Brian Ayotte
- Department of Psychology, College of Arts and Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, United States
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24
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Wang L, Fang W, An Y, Chen C, Fan X. Identification of factors associated with social dysfunction in patients with heart failure. Eur J Cardiovasc Nurs 2021; 20:475-484. [PMID: 33778889 DOI: 10.1093/eurjcn/zvaa027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/29/2020] [Accepted: 11/24/2020] [Indexed: 11/13/2022]
Abstract
AIMS Social dysfunction is adversely associated with individuals' physical and mental quality of life. However, little is known about the status of social dysfunction and its associated factors in patients with heart failure. Our study aimed to reveal the prevalence of social dysfunction, and the associations between fatigue, dyspnoea, anxiety, depression, social connectedness, and social dysfunction in patients with heart failure. METHODS AND RESULTS We assessed the social dysfunction, fatigue, dyspnoea, anxiety, depression, and social connectedness using self-report questionnaires among 291 patients (64.13 ± 11.84 years, 53.3% male) with heart failure. Two stepwise forward logistic regression models were employed to identify the factors associated with social dysfunction, and the area under receiver operating characteristic curve was used to calculate the variance of the associated factors accounting for social dysfunction. Of the 291 patients, 76.6% reported social dysfunction. The logistic regression model after adjusting co-variables showed that fatigue [odds ratio (OR) 4.233, 95% confidence interval (CI) 1.778-10.081], dyspnoea (OR 0.866, 95% CI 0.756-0.991), depression (OR 1.173, 95% CI 1.037-1.328) were positively associated with social dysfunction, whereas social connectedness (OR 0.394, 95% CI 0.203-0.764) was negatively associated with social dysfunction. Four factors explained 84.5% of the variance of social dysfunction in patients with heart failure. CONCLUSIONS Social dysfunction is prevalent in patients with heart failure, and fatigue, dyspnoea, depression, and social connectedness are the associated factors. The findings indicate that the key to helping heart failure patients return to social life may be to attenuate fatigue, dyspnoea, and depression and to improve social connectedness.
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Affiliation(s)
- Lyu Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Wenjie Fang
- Department of Gerontology, School of Humanities, Shandong Management University, Jinan, Shandong, PR China
| | - Yan An
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Cancan Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
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25
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Readmitted Patients With Heart Failure Sick, Tired, and Symptomatic: A Qualitative Descriptive Study From a Quaternary Academic Medical Center. J Cardiovasc Nurs 2021; 37:248-256. [PMID: 33591059 DOI: 10.1097/jcn.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Heart failure (HF) readmissions will continue to grow unless we have a better understanding of why patients with HF are readmitted. Our purpose was to gain an understanding, from the patients' perspective, of how patients with HF viewed their discharge instructions and how they felt when they got home and were then readmitted in less than 30 days. METHODS AND RESULTS We used a qualitative descriptive approach using semistructured interviews with 22 patients with HF. Most participants had multimorbidities, were classified as New York Heart Association class III (n = 13) with reduced ejection fraction (n = 20), and were on home inotrope therapy (n = 13). The overarching theme that emerged was that these participants were sick, tired, and symptomatic. Additional categories within this theme highlight discharge instructions as being clear and easily understood; rich descriptions of physical, emotional, and other symptoms leading up to readmission; and reports of daily activities including what "good" and "not good" days looked like. Moreover, when participants experienced an exacerbation of their HF symptoms, they were sick enough to be readmitted to the hospital. CONCLUSION Our findings confirm ongoing challenges with a complex group of sick patients with HF, with the majority on home inotropes with reduced ejection fraction, who developed an unavoidable progression of their illness and subsequent hospital readmission.
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26
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Olivera MJ, Fory JA, Buitrago G. Comparison of Health-Related Quality of Life in Outpatients with Chagas and Matched Non-Chagas Chronic Heart Failure in Colombia: A Cross-Sectional Analysis. Am J Trop Med Hyg 2021; 104:951-958. [PMID: 33534736 DOI: 10.4269/ajtmh.20-0335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/01/2020] [Indexed: 02/05/2023] Open
Abstract
Chagas disease represents an important cause of heart failure (HF) and affects health-related quality of life (HRQoL). The study aimed to evaluate and compare the HRQoL of patients with chagasic HF and matched non-Chagas controls to identify factors associated with HRQoL. A cross-sectional study with pair-matched controls was conducted in Colombia. From October 2018 to December 2019, a total of 84 HF patients were screened for study subjects. Four were excluded, resulting in 80 patients for the analysis, among whom 40 patients with Chagas were enrolled as cases and 40 gender- and age-matched non-Chagas patients as controls. The Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) were used to measure HRQoL. Demographic, clinical, and laboratory data were obtained from each subject. Health-related quality of life scores were significantly worse among the Chagas group than among the non-Chagas group in the KCCQ domains of physical functioning and symptoms and in the MLWHFQ scale. In the multivariate analysis, the variables associated with lower HRQoL scores were living alone, obesity, having less than 12 years of education, and an increase in left ventricular diameters in the systole and diastole. Health-related quality of life in patients with chronic HF is impaired across all domains. Chagas patients showed worse HRQoL scores than non-Chagas patients. Six variables, some potentially modifiable, were independently associated with worse HRQoL.
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Affiliation(s)
- Mario J Olivera
- 1Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, D.C., Colombia
| | - Johana A Fory
- 2Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, D.C., Colombia
| | - Giancarlo Buitrago
- 3Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.,4Hospital Universitario Nacional de Colombia, Bogotá, D.C., Colombia
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27
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Lopez KD, Chae S, Michele G, Fraczkowski D, Habibi P, Chattopadhyay D, Donevant SB. Improved readability and functions needed for mHealth apps targeting patients with heart failure: An app store review. Res Nurs Health 2021; 44:71-80. [PMID: 33107056 PMCID: PMC8270757 DOI: 10.1002/nur.22078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023]
Abstract
To maintain their quality of life and avoid hospitalization and early mortality, patients with heart failure must recognize and respond to symptoms of exacerbation. A promising method for engaging patients in their self-care is through mobile health applications (mHealth apps). However, for mHealth to have its greatest chance for improving patient outcomes, the app content must be readable, provide useful functions and be based in evidence. The study aimed to determine: (1) readability, (2) types of functions, and (3) linkage to authoritative sources of evidence for self-care focused mHealth apps targeting heart failure patients that are available in the Apple and Google Play Stores. We systematically searched for mHealth apps targeting patients with heart failure in the Apple and Google Play Stores and applied selection criteria. Readability of randomly selected informational paragraphs were determined using Flesch-Kincaid grade level test tool in Microsoft Word. Ten mHealth apps met our criteria. Only one had a reading grade level at or below the recommended 6th grade reading level (average 9.35). The most common functions were tracking, clinical data feedback, and non-data-based reminders and alerts. Only three had statements that clearly linked the mHealth app content to trustworthy, evidence-based sources. Only two had interoperability with the electronic health record and only one had a communication feature with clinicians. Future mHealth designs that are tailored to patients' literacy level and have advanced functions may hold greater potential for improving patient outcomes.
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Affiliation(s)
| | - Sena Chae
- The University of Iowa College of Nursing, Iowa City, Iowa, USA
| | - Girgis Michele
- Creighton University College of Nursing, Omaha, Nebraska
| | - Dan Fraczkowski
- University of Illinois at Chicago, College of Nursing, Chicago, Illinois, USA
| | - Pantea Habibi
- University of Illinois at Chicago, College of Engineering, Chicago, Illinois, USA
| | | | - Sara B. Donevant
- University of South Carolina, College of Nursing, Columbia, South Carolina, USA
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28
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Ambrosio L, Perez-Manchon D, Carvajal-Carrascal G, Fuentes-Ramirez A, Caparros N, Ruiz de Ocenda MI, Timonet E, Navarta-Sanchez MV, Rodriguez-Blazquez C. Psychometric Validation of the Living with Chronic Illness Scale in Patients with Chronic Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020572. [PMID: 33445479 PMCID: PMC7828024 DOI: 10.3390/ijerph18020572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 01/06/2023]
Abstract
It is necessary to develop self-reported instruments that evaluate the process of living with chronic heart failure (HF) holistically. The Living with Chronic Illness Scale—HF (LW-CI-HF) is the only available tool to evaluate how patients are living with HF. The aim is to analyse the psychometric properties of the LW-CI scale in the HF population. An international, cross-sectional validation study was carried out in 603 patients living with HF from Spain and Colombia. The variables measured were living with HF, perceived social support, satisfaction with life, quality of life and global impression of severity. The LW-CI-HF scale presented good data quality and acceptability. All domains showed high internal consistency with Cronbach’s alpha coefficient ≥ 0.7. The intraclass correlation coefficient for the total score was satisfactory (0.9) in test–retest reliability. The LW-CI-HF correlated 0.7 with social support and quality of life measures. Standard error of measurement was 6.5 for total scale. The LW-CI-HF scale is feasible, reliable and valid. However, results should be taken with caution in order to be used in clinical practice to evaluate the complex process of living with HF. Further research is proposed.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Correspondence: ; Tel.: +44-(0)23-8059-7591
| | | | - Gloria Carvajal-Carrascal
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Alejandra Fuentes-Ramirez
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Neus Caparros
- Faculty of Legal and Social Science, La Rioja University, 26004 La Rioja, Spain;
| | | | - Eva Timonet
- Department of Cardiology, Costa del Sol Hospital, 29603 Malaga, Spain;
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29
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Factors associated with health-related quality of life in Chinese patients with heart failure: a cross-sectional study. Collegian 2020. [DOI: 10.1016/j.colegn.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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30
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Wang G, Liu X, Yang Q. Symptom clusters and quality of life in Chinese patients with heart failure. Collegian 2020. [DOI: 10.1016/j.colegn.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Wang X, Tang L, Howell D, Zhang Q, Qiu R, Zhang H, Ye Z. Theory-guided interventions for Chinese patients to adapt to heart failure: A quasi-experimental study. Int J Nurs Sci 2020; 7:391-400. [PMID: 33195750 PMCID: PMC7644562 DOI: 10.1016/j.ijnss.2020.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/20/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure. Methods A quasi-experimental study was conducted in Hangzhou, China, from March 2018 to November 2019. A convenience sample of 112 participants with heart failure from a multi-campus hospital was enrolled. Participants were allocated into an intervention group (n = 55) and a control group (n = 57) according to their hospitalized campus. A culturally-tailored care plan intervention based on the Roy Adaptation Model was performed in the intervention group. The control group received bedside patient education and a regular booklet for HF home care before discharge. Heart ultrasound, Minnesota Living with Heart Failure Questionnaire (MLHFQ), a knowledge survey, Self-care Heart failure Index (SCHFI), and Coping and Adaptation Processing Scale-Short Form (CAPS-SF) were used to measure patients’ levels of adaptation of physical function, self-concept, role function, and interdependence at baseline and six months after discharge. Results Ninety-one participants with complete data, 43 in the intervention group and 48 in the control group, were included in the analysis for the primary endpoints and showed adaptive improvement trends. Most patients in the intervention group completed 60% or more of the given interventions. At the sixth month after discharge, compared with the control group, the intervention group had improved adaptive behaviors showing higher scores of the MLHFQ (70.90 ± 22.45 vs. 54.78 ± 18.04), heart failure-related knowledge (13.79 ± 2.45 vs. 10.73 ± 4.28), SCHFI maintenance (57.67 ± 13.22 vs. 50.35 ± 10.88), and CAPS-SF (40.23 ± 4.36 vs. 38.27 ± 2.60) at the six-month follow-up (P < 0.05). There were no significant differences between the two groups in the scores of left ventricular ejection fraction, scores of SCHFI management and SCHFI confidence subscales (P > 0.05). Conclusions The findings reported evidence of positive adaptation in patients with heart failure, indicating that the Roy Adaptation Model is an effective guide for developing an implemented framework for the nursing practice of the patients. The culturally-tailored care plan intervention is helpful to improve adaptation of patients with heart failure.
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Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.,Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Leiwen Tang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Doris Howell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Qi Zhang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Ruolin Qiu
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Hui Zhang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Zhihong Ye
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
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32
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Hu Y, Jiang J, Xu L, Wang C, Wang P, Yang B, Tao M. Symptom clusters and quality of life among patients with chronic heart failure: A cross-sectional study. Jpn J Nurs Sci 2020; 18:e12366. [PMID: 32857469 DOI: 10.1111/jjns.12366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/09/2020] [Accepted: 06/28/2020] [Indexed: 12/28/2022]
Abstract
AIM This study aimed to identify symptom clusters among patients with chronic heart failure (HF) and examine their independent relationships with quality of life (QoL). METHODS A descriptive cross-sectional design was adopted, and 201 Chinese participants were recruited. Their symptom profiles and QoL were assessed using the Memorial Symptom Assessment Scale-Heart Failure and Minnesota Living with Heart Failure Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Pearson's correlation analysis and multiple regression analysis were conducted to examine their independent relationships with QoL. RESULTS Six distinct symptom clusters were identified: the fatigue, dyspneic, discomfort, congestive, ischemic, and emotional symptom clusters. These six symptom clusters accounted for 57.508% of the variance in patient symptom experiences and were positively related to their overall QoL. Moreover, the fatigue (β = .317, p < .001), dyspneic (β = .228, p < .001), congestive (β = .363, p < .001), and emotional (β = .200, p < .001) symptom clusters independently predicted QoL. CONCLUSION The six symptom clusters that were identified in this study and the relationships that they shared with QoL are expected to inform future approaches to symptom management. Interventions that target these symptom clusters will improve the QoL of patients with HF.
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Affiliation(s)
- Yinyi Hu
- School of Nursing, Zunyi Medical University, Zunyi, China.,Department of Nursing, Fourth People's Hospital of Guiyang, Guiyang, China
| | - Jiaoming Jiang
- School of Nursing, Zunyi Medical University, Zunyi, China
| | - Liyuan Xu
- School of Nursing, Zunyi Medical University, Zunyi, China
| | - Cui Wang
- Department of Pediatric Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Pengxiao Wang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Biwen Yang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ming Tao
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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