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Jin Y, Bowers BJ, Cotton QD, Ersig AL. Self-identified culturally related stressors that influence self-care in older adults with multiple chronic conditions: A qualitative study. J Clin Nurs 2024; 33:1550-1561. [PMID: 38151803 DOI: 10.1111/jocn.16979] [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: 10/30/2023] [Revised: 11/30/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023]
Abstract
AIM To identify culturally related stressors that influence self-care in Chinese older adults with multiple chronic conditions. BACKGROUND Effective self-care can improve health outcomes for chronic conditions, but implementing self-care is challenging. Individuals with multiple chronic conditions face even more self-care complexity than those with single chronic conditions, generating additional stressors. Although stressors have been found to negatively influence self-care in multiple chronic conditions, the role of culture in generating stressors has been neglected. DESIGN This paper reports on the qualitative component of a larger mixed-methods study. Two free-response items in a survey were used to identify culturally related stressors that influence self-care. This report adhered to the SRQR guideline checklist. METHODS Data were collected between January and April 2022. One hundred and thirty-eight free text responses asking participants to identify stressors that influenced their self-care effectiveness were analysed sequentially using deductive content analysis and thematic analysis. RESULTS Findings from deductive content analysis largely confirmed published work in Western literature on stressors complicating self-care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems. CONCLUSION Chinese older adults with multiple chronic conditions identified a wide range of stressors that impacted their day-to-day self-care. This study provided valuable insights into culturally related stressors in older adults with multiple chronic conditions. Findings deepened our knowledge of cultural influences on the success of self-care in older adults with multiple chronic conditions, suggesting the potential for reaching populations across different cultures and regions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Stressors that might influence self-care ability are important for nurses to assess in people with multiple chronic conditions. The design of self-care interventions should take a culturally tailored intergenerational family-centred approach to help mitigate the impact of stressors and ultimately improve patient outcomes. IMPACT What problem did the study address? Stressors documented in older adults with MCCs have all been generated from research with Western populations. China is now home to the largest population of older people in the world. Understanding the influence of culturally relevant stressors on self-care in Chinese older adults with MCCs is lacking. What were the main findings? Findings from deductive content analysis largely confirmed published work in Western literature on stressors that complicated self-care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors in older adults with MCCs in China: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems. Where and on whom will the research have an impact? The research will have an impact on guiding nurses' assessment of culturally relevant stressors' impact on self-care for older adults with MCCs. In addition, findings could inform research and policy development to aim at mitigating the impact of culturally based stressors on self-care. REPORTING METHOD This study adhered to the Standards for Reporting Qualitative Research (SRQR) guideline checklist. PATIENT OR PUBLIC CONTRIBUTION During the member-checking process, the validation of findings for accuracy was carried out by 10 participants, who also found resonance between these findings and their own experiences.
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Affiliation(s)
- Yuanyuan Jin
- School of Nursing, Medical College of Soochow University, Suzhou, China
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Barbara J Bowers
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Quinton D Cotton
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Anne L Ersig
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Santero M, Song Y, Beltran J, Medina-Aedo M, Canelo-Aybar C, Valli C, Rocha C, León-García M, Salas-Gama K, Kaloteraki C, Niño de Guzmán E, Ballester M, González-González AI, Poortvliet R, van der Gaag M, Spoiala C, Gurung P, Willemen F, Cools I, Bleeker J, Kancheva A, Ertl J, Laure T, Kancheva I, Pacheco-Barrios K, Zafra-Tanaka JH, Tsokani S, Veroniki AA, Seitidis G, Christogiannis C, Kontouli KM, Groene O, Sunol R, Orrego C, Heijmans M, Alonso-Coello P. Effectiveness and Cost-Effectiveness of Self-Management Interventions for Adults Living with Heart Failure to Improve Patient-Important Outcomes: An Evidence Map of Randomized Controlled Trials. Healthcare (Basel) 2024; 12:302. [PMID: 38338187 PMCID: PMC10855227 DOI: 10.3390/healthcare12030302] [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: 11/07/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
Self-management interventions (SMIs) may enhance heart failure (HF) outcomes and address challenges associated with disease management. This study aims to review randomized evidence and identify knowledge gaps in SMIs for adult HF patients. Within the COMPAR-EU project, from 2010 to 2018, we conducted searches in the databases MEDLINE, CINAHL, Embase, Cochrane, and PsycINFO. We performed a descriptive analysis using predefined categories and developed an evidence map of randomized controlled trials (RCTs). We found 282 RCTs examining SMIs for HF patients, comparing two to four interventions, primarily targeting individual patients (97%) globally (34 countries, only 31% from an European country). These interventions involved support techniques such as information sharing (95%) and self-monitoring (62%), often through a mix of in-person and remote sessions (43%). Commonly assessed outcomes included quality of life, hospital admissions, mortality, exercise capacity, and self-efficacy. Few studies have focused on lower socio-economic or minority groups. Nurses (68%) and physicians (30%) were the primary providers, and most studies were at low risk of bias in generating a random sequence for participant allocation; however, the reporting was noticeably unclear of methods used to conceal the allocation process. Our analysis has revealed prevalent support techniques and delivery methods while highlighting methodological challenges. These findings provide valuable insights for researchers, clinicians, and policymakers striving to optimize SMIs for individuals living with HF.
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Affiliation(s)
- Marilina Santero
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Yang Song
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Jessica Beltran
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Melixa Medina-Aedo
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Claudia Valli
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
| | - Claudio Rocha
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Montserrat León-García
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Karla Salas-Gama
- Quality, Process and Innovation Direction, Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain
| | - Chrysoula Kaloteraki
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain
| | | | - Rune Poortvliet
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Marieke van der Gaag
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Cristina Spoiala
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Pema Gurung
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Fabienne Willemen
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Iza Cools
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Julia Bleeker
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Angelina Kancheva
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Julia Ertl
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Tajda Laure
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Ivana Kancheva
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Kevin Pacheco-Barrios
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain
| | - Jessica Hanae Zafra-Tanaka
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain
| | - Sofia Tsokani
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Areti Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada;
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Georgios Seitidis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Christos Christogiannis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Katerina Maria Kontouli
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Oliver Groene
- OptiMedis, 20095 Hamburg, Germany
- Faculty of Management, Economics and Society, University of Witten/Herdecke, 58455 Witten, Germany
| | - Rosa Sunol
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain (R.S.)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 08007 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (R.P.); (A.K.); (I.K.); (M.H.)
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain; (M.S.); (M.M.-A.); (C.C.-A.); (C.V.); (M.L.-G.)
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Chen J, Luo W, Yang X, Xiao J, Zhan B, Liu Y, Wu Y. Self-management theories, models and frameworks in patients with chronic heart failure: A scoping review. Nurs Open 2024; 11:e2066. [PMID: 38268258 PMCID: PMC10724582 DOI: 10.1002/nop2.2066] [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: 02/27/2023] [Revised: 10/07/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The aim of this study was to synthesize the self-management theory, model and frameworks of patients with chronic heart failure, focusing on construction process, methods and existing problems. BACKGROUND Although the self-management theories have been created and verified for those patients with chronic heart failure, no reviews have been performed to integrate these theories. DESIGN A scoping review of recent literature (without a date limit) was conducted. METHODS A comprehensive literature search was performed. If the study reported the construction of a self-management theory, model or framework about chronic heart failure cases, it would be included in the review. RESULTS Fourteen studies were included, which could be categorized into situation-specific theory, middle-range theory and other theory models (including conceptual model, hypothetic regression model and identity description model). It also includes the update and validation of theories, the situation-specific theoretical of caregiver contributions extended from situation-specific theories and the nurse-led situation-specific theory in different contexts. CONCLUSION Self-management might contribute to start an education programme before patients with chronic heart failure (CHF) begin their chronic disease live as an individual. Our scoping review indicates that a series of self-management theories, models and frameworks for CHF patients have been developed, but more studies are still needed to validate and support these theories according to their cultural contexts.
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Affiliation(s)
- Jie Chen
- Department of Cardiovascular MedicineShenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Wei‐Xiang Luo
- Department of NursingShenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Xiu‐Fen Yang
- Department of GeriatricShenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Ju‐Lan Xiao
- Department of Thoracic SurgeryShenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Bai‐Xue Zhan
- Department of NephrologyLonghua Branch of Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Yang Liu
- Department of Operation RoomShenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenGuangdongChina
| | - Yan‐Ni Wu
- Department of NursingNanfang Hospital, Southern Medical UniversityGuangzhou CityGuangdongChina
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Lancey A, Slater CE. Heart failure self-management: a scoping review of interventions implemented by allied health professionals. Disabil Rehabil 2023:1-12. [PMID: 37975543 DOI: 10.1080/09638288.2023.2283105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Heart failure (HF) is typically managed using both medical and patient self-management interventions. Individuals with HF often have frequent readmissions to hospital for medical management. Effective self-management can help to reduce the exacerbation of HF symptoms and the frequency of readmissions. METHODS A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines was conducted to identify literature on the interventions used by allied health professionals to promote HF self-management. A search strategy was implemented, and articles were reviewed by two independent reviewers. RESULTS Twenty articles met the inclusion criteria. Articles included interventions from physical therapy, nutrition, social work, and occupational therapy, as well as other health professions in team-based programs. The most common interventions were verbal education, textual information, monitoring resources, and skills practice. Interventions addressed diet/fluid control, exercise and activity, symptom monitoring, medication management, cardiovascular disease knowledge, and mental health. Many interventions were theory informed. CONCLUSION There is nascent evidence that interventions promoting HF self-management positively impact health and quality of life outcomes. HF self-management is multi-faceted and requires interprofessional collaboration. Further work is warranted exploring the impact of theory-informed interventions, and the effectiveness of interventions on self-management competence and desired health outcomes.
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Affiliation(s)
- Allyson Lancey
- Department of Occupational Therapy, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Craig E Slater
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA, USA
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Allana S, Norris C, Hussain A, Clark A. A scoping review and intersectionality-based analysis of heart failure telehealth interventions for vulnerable populations. J Adv Nurs 2023; 79:4097-4111. [PMID: 37409794 DOI: 10.1111/jan.15756] [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: 09/01/2022] [Revised: 05/28/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
AIMS To map the existing body of heart failure (HF) telehealth interventions for vulnerable populations, and to conduct an intersectionality-based analysis utilizing a structured checklist. DESIGN A scoping review and intersectionality-based analysis. DATA SOURCES The search was conducted in March 2022 in the following databases: MEDLINE, CINAHL, Scopus and the Cochrane Central Register of Controlled Trials, ProQuest Dissertations and Theses Global. REVIEW METHODS First, the titles and abstracts were screened, and then the entire articles were screened against the inclusion criteria. Two of the investigators screened the articles independently in Covidence. The studies included and excluded at various stages of screening were depicted through a PRISMA flow diagram. The quality of the included studies was assessed based on the mixed methods appraisal tool (MMAT). Each study was read thoroughly and the intersectionality-based checklist by Ghasemi et al. (2021) was applied, whereby a yes/no response was marked for each question on the checklist and the relevant supporting data were extracted. RESULTS A total of 22 studies were included in this review. About 42.2% of the responses indicated that studies incorporated the principles of intersectionality at the 'problem identification' stage, followed by 42.9% and 29.44% responses indicating incorporation of these principles at the 'design and implementation' and 'evaluation' stages respectively. CONCLUSIONS The findings suggest that the research around HF telehealth interventions for vulnerable populations is not adequately grounded in appropriate theoretical underpinning. The principles of intersectionality have been applied mostly to the problem identification and the intervention development and implementation stages, and not so much at the evaluation stage. Future research must fill the identified gaps in this area of research. NO PATIENT OR PUBLIC CONTRIBUTION Since this was a scoping, there was no patient contribution to this work; however, based on this study's findings, we are undertaking patient-centred studies with patient contribution.
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Freedland KE, Skala JA, Carney RM, Steinmeyer BC, Rich MW. Outcomes of a tailored self-care intervention for patients with heart failure and major depression: A secondary analysis of a randomized controlled trial. Int J Nurs Stud 2023; 147:104585. [PMID: 37611354 DOI: 10.1016/j.ijnurstu.2023.104585] [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: 12/12/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Depression is a recognized barrier to heart failure self-care, but there has been little research on interventions to improve heart failure self-care in depressed patients. OBJECTIVES To investigate the outcomes of an individually tailored self-care intervention for patients with heart failure and major depression, and to determine whether the adequacy of self-care at baseline, the severity of depression or anxiety, or other factors affect the outcomes of this intervention. DESIGN Secondary analysis of data from a pre-registered randomized controlled trial (NCT02997865). METHODS Outpatients with heart failure and comorbid major depression (n = 139) were randomly assigned to cognitive behavior therapy or usual care for depression. In addition, an experienced cardiac nurse provided the tailored self-care intervention to all patients in both arms of the trial starting eight weeks after randomization. Weekly self-care intervention sessions were held between Weeks 8 and 16; the frequency was tapered to biweekly or monthly between Weeks 17 and 32. The Self-Care of Heart Failure Index (v6.2) was used to assess self-care outcomes, with scores ≥70 on each of its three scales (Maintenance, Management, and Confidence) being consistent with adequate self-care. The Week 16 Maintenance scale score was the primary outcome for this analysis. RESULTS At baseline, 107 (77%) of the patients scored in the inadequate self-care range on the Maintenance scale. Between Weeks 8 and 16, Maintenance scores improved more in patients with initially inadequate than initially adequate self-care (11.9 vs. 3.2 points, p = .003). Sixty-six (48%) of the patients with initially inadequate Maintenance scores achieved scores in the adequate range by Week 32 (p < .0001). Covariate-adjusted predictors of better Maintenance outcomes included adequate Maintenance at baseline (p < .0001), higher anxiety at baseline (p < .05), and higher dosages of the self-care intervention (p < .0001). Neither treatment with cognitive behavior therapy nor less severe major depression predicted better self-care outcomes. CONCLUSIONS Depressed patients with inadequate heart failure self-care are able to achieve clinically significant improvements in self-care with the help of an individually tailored self-care intervention. Further refinement and testing are needed to increase the intervention's potential for clinical implementation.
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Affiliation(s)
- Kenneth E Freedland
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Judith A Skala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert M Carney
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian C Steinmeyer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael W Rich
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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Guan J, Zhang Y, You S, Li Y, Zhao H, Bu W, Xie Y. Application of protection motivation theory in epidemic prevention in patients with respiratory diseases under the COVID-19 pandemic: A cross-sectional study. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:1058-1066. [PMID: 37666659 PMCID: PMC10542998 DOI: 10.1111/crj.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/26/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This study aimed to investigate the effects of nursing intervention based on protection motivation theory (PMT) on patients with respiratory diseases in the context of the Coronavirus Disease 2019 (COVID-19) pandemic. METHODS A total of 74 patients with respiratory diseases who were hospitalized from June 2020 to February 2021 were enrolled and stratified into a control group (n = 37) and an experimental group (n = 37) according to a stratified random sampling method. The control group adopted a routine nursing intervention program of the respiratory department, whereas the experimental group received a PMT-based nursing intervention program on the basis of the control group. Chronic Disease Self-Management Study Measures (CDSMS) and Self-Efficacy for Managing Chronic Diseases 6-item Scale (SECD6) were used to evaluate the effect of PMT intervention before intervention, after 1 week, and after 4 weeks of intervention. The levels of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC and peak expiratory flow (PEF) were measured to evaluate pulmonary function. RESULTS Before the intervention, there were no significant differences in the scores of CDSMS and SECD6 scales and liver function indexes between the two groups (p > 0.05). After 1 and 4 weeks of intervention, the scores of CDSMS and SECD6 scales of the experimental group were significantly higher than those of the control group (p < 0.0001). The indexes of pulmonary function of the experimental group were improved, but there was no significant difference compared with the control group (p > 0.05). CONCLUSION Nursing intervention based on PMT contributes to the improvement of self-management behaviors and self-efficacy, which is conducive to the prognoses of patients.
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Affiliation(s)
- Jian Guan
- Department of Respiration, the First People's Hospital of Huzhouthe First Affiliated Hospital of Huzhou UniversityHuzhouChina
| | | | - Shan You
- School of NursingHuzhou UniversityHuzhouChina
| | - Yujing Li
- Department of Nursing, the First People's Hospital of Huzhouthe First Affiliated Hospital of Huzhou UniversityHuzhouChina
| | - Hongxing Zhao
- Department of Radiology, the First People's Hospital of Huzhouthe First Affiliated Hospital of Huzhou UniversityHuzhouChina
| | - Weiqin Bu
- Department of Endoscopy Center, the First People's Hospital of Huzhouthe First Affiliated Hospital of Huzhou UniversityHuzhouChina
| | - Yanping Xie
- Department of Respiration, the First People's Hospital of Huzhouthe First Affiliated Hospital of Huzhou UniversityHuzhouChina
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Düzel B, Saygili M, Özer Ö, Zubaroğlu Yanardağ M. The effect of patient empowerment on patient activation level: A review of individuals with cardiovascular diseases. Chronic Illn 2023; 19:665-674. [PMID: 37062944 DOI: 10.1177/17423953231170400] [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] [Indexed: 04/18/2023]
Abstract
OBJECTIVES The aim of this study is to examine the effect of patient empowerment on patient activation level in individuals with cardiovascular diseases. METHODS The population of the study is adult individuals receiving inpatient treatment in the Cardiology clinic of a city hospital operating in Turkey. In the study, convenience sampling method was applied, and a questionnaire was conducted from 543 patients. RESULTS As a result of the analyses made in the study, positive and low correlations were detected between the patient empowerment scale sub-dimensions and the patient activation level. According to regression analysis results, it was identified that the patient empowerment sub-dimensions together accounted for 6.4% of the total variance on the patient activation level, and the increase in the 'knowledge and understanding' levels of the patients statistically increased their perceptions of the patient activation level. DISCUSSION The results show that by providing patient empowerment in individuals with chronic diseases, their active participation can be increased in the treatment processes and consequently in the chronic disease management.
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Affiliation(s)
- Barış Düzel
- Department of Cardiology, Mersin City Hospital, Mersin, Turkey
| | - Meltem Saygili
- Department of Healthcare Management, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Turkey
| | - Özlem Özer
- Department of Healthcare Management, Faculty of Gulhane Health Sciences, University of Health Sciences Turkey, Ankara, Turkey
| | - Melek Zubaroğlu Yanardağ
- Department of Social Work, Faculty of Economics and Administrative Sciences, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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Son Y, Kim S, Lee W, Won H, Cho JH, Hong J, Choi H, Kim D, Lim A, Kim HM. The effects of a 24-week interactive text message-based mobile health intervention for enhancing self-care behaviours of patients with heart failure: A quasi-experimental study. Nurs Open 2023; 10:6309-6319. [PMID: 37313589 PMCID: PMC10416075 DOI: 10.1002/nop2.1878] [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: 12/27/2022] [Revised: 04/03/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023] Open
Abstract
AIMS The aim of this study was to identify the effects of a 24-week interactive text message-based mobile health intervention (called) on enhancing the self-care behaviours of patients with heart failure. BACKGROUND Whether text message-based mobile health intervention can be used to improve long-term adherence to self-care behaviours among heart failure patients remains unclear. DESIGN A quasi-experimental study with a pretest-post-test design and repeated measures. METHODS Data from 100 patients (mean age, 58.78 years; 83.0% men) were analysed. The intervention group (n = 50) used the program over 24 weeks, which consisted of weekly goal setting and interactive text messaging, while the control group (n = 50) received usual care. Trained research assistants collected data using self-reported Likert questionnaires. Primary (self-care behaviours) and secondary (health literacy, eHealth literacy, and disease knowledge) outcome variables were measured at baseline and at 1, 3 and 6 months after intervention for follow-up. RESULTS The findings showed that the intervention group demonstrated significantly better self-care behaviours than the control group during the 6 months. Notably, the trajectory of self-care behaviours of the patients in the intervention group showed a steep rise between the first- and third-month follow-up, followed by high stability between the third- and sixth-month follow-up. In addition, the intervention group had significantly higher disease knowledge than the control group at the first- and sixth-month follow-up. CONCLUSIONS We found that the program, as an interactive text messaging service, may be an optimal strategy for improving long-term adherence to self-care behaviours through motivating and providing social support. RELEVANCE TO THE NURSING PRACTICE The WithUs program can help nurses and other healthcare professionals to track patients' health indicators such as symptom severity, diet and physical activity. In addition, nurses can take an important role in evaluating the efficacy of the app in relation to patients' health outcome. PATIENT OR PUBLIC CONTRIBUTION Patients have completed a self-reported questionnaire after providing informed consent.
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Affiliation(s)
- Youn‐Jung Son
- Red Cross College of Nursing, Chung‐Ang UniversitySeoulSouth Korea
| | - Sang‐Wook Kim
- Heart and Brain Hospital, Chung‐Ang University Gwangmyeong HospitalChung Ang University College of MedicineSeoulSouth Korea
| | - Wang‐Soo Lee
- Division of Cardiology, Chung‐Ang University HospitalChung‐Ang University College of MedicineSeoulSouth Korea
| | - Hoyoun Won
- Division of Cardiology, Chung‐Ang University HospitalChung‐Ang University College of MedicineSeoulSouth Korea
| | - Jun Hwan Cho
- Heart and Brain Hospital, Chung‐Ang University Gwangmyeong HospitalChung Ang University College of MedicineSeoulSouth Korea
| | - Joonhwa Hong
- Department of Thoracic and Cardiovascular Surgery, Chung‐Ang University HospitalChung‐Ang University College of MedicineSeoulSouth Korea
| | - Hong‐Jae Choi
- Graduate School of Nursing, Chung‐Ang UniversitySeoulSouth Korea
| | - Da‐Young Kim
- Graduate School of Nursing, Chung‐Ang UniversitySeoulSouth Korea
| | - Arum Lim
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
| | - Hyue Mee Kim
- Division of Cardiology, Chung‐Ang University HospitalChung‐Ang University College of MedicineSeoulSouth Korea
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10
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Freedland KE, Skala JA, Carney RM, Steinmeyer BC, Rich MW. Treatment of depression and inadequate self-care in patients with heart failure: One-year outcomes of a randomized controlled trial. Gen Hosp Psychiatry 2023; 84:82-88. [PMID: 37406374 DOI: 10.1016/j.genhosppsych.2023.06.001] [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: 04/19/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Both depression and inadequate self-care are common in patients with heart failure. This secondary analysis examines the one-year outcomes of a randomized controlled trial of a sequential approach to treating these problems. METHODS Patients with heart failure and major depression were randomly assigned to usual care (n = 70) or to cognitive behavior therapy (n = 69). All patients received a heart failure self-care intervention starting 8 weeks after randomization. Patient-reported outcomes were assessed at Weeks 8, 16, 32, and 52. Data on hospital admissions and deaths were also obtained. RESULTS One year after randomization, Beck Depression Inventory (BDI-II) scores were - 4.9 (95% C.I., -8.9 to -0.9; p < .05) points lower in the cognitive therapy than the usual care arm, and Kansas City Cardiomyopathy scores were 8.3 (95% C.I., 1.9 to 14.7; p < .05) points higher. There were no differences on the Self-Care of Heart Failure Index or in hospitalizations or deaths. CONCLUSIONS The superiority of cognitive behavior therapy relative to usual care for major depression in patients with heart failure persisted for at least one year. Cognitive behavior therapy did not increase patients' ability to benefit from a heart failure self-care intervention, but it did improve HF-related quality of life during the follow-up period. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02997865.
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Affiliation(s)
- Kenneth E Freedland
- Department of Psychiatry, 4320 Forest Park Avenue, Suite 301, St. Louis, MO 63108, United States of America.
| | - Judith A Skala
- Department of Psychiatry, 4320 Forest Park Avenue, Suite 301, St. Louis, MO 63108, United States of America
| | - Robert M Carney
- Department of Psychiatry, 4320 Forest Park Avenue, Suite 301, St. Louis, MO 63108, United States of America
| | - Brian C Steinmeyer
- Department of Psychiatry, 4320 Forest Park Avenue, Suite 301, St. Louis, MO 63108, United States of America
| | - Michael W Rich
- Cardiovascular Division of the Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
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11
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Vellone E, Rebora P, Iovino P, Ghizzardi G, Baricchi M, Alvaro R, Sili A, Barello S, Ausili D, Trenta AM, Pedroni C, Dellafiore F, Arrigoni C, Riegel B, Caruso R. Remote motivational interviewing to improve patient self-care and caregiver contribution to self-care in heart failure (REMOTIVATE-HF): Rationale, design, and methodology for a multicentre randomized controlled trial. Res Nurs Health 2023; 46:190-202. [PMID: 36566360 DOI: 10.1002/nur.22289] [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: 03/28/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/26/2022]
Abstract
In patients with heart failure (HF), self-care, and caregiver contribution to self-care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self-care and contribution to self-care, respectively, and struggle to perform related tasks. Face-to-face motivational interviewing (MI) effectively improves self-care and caregiver contribution to self-care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self-care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self-care management, self-care monitoring, and self-efficacy; HF symptoms; generic and disease-specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self-care, self-efficacy, and preparedness. We will conduct a two-arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in-person healthcare professional interventions imposed by the COVID-19 pandemic, it is essential to evaluate whether MI is also effective remotely.
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Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | | | - Marina Baricchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Serena Barello
- Department of Psychology, EngageMinds Hub-Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alessia M Trenta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Cardiology Center Monzino IRCCS, University of Milan-Bicocca, Milan, Italy
| | | | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, North Sydney, Australia
- International Center for Self-Care Research
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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12
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Keirns NG, Ouaddi S, Dunsiger S, Locatelli G, Gathright EC, Black E, Tripolone J, Breault C, Riegel B, Cohen R, Salmoirago-Blotcher E. Mind Your Heart-II: Protocol for a behavioral randomized controlled trial of mindfulness training to promote self-care in patients with comorbid heart failure and cognitive impairment. Contemp Clin Trials 2023; 126:107094. [PMID: 36682491 PMCID: PMC10026453 DOI: 10.1016/j.cct.2023.107094] [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: 10/29/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Heart failure (HF) self-care is a robust predictor of prognosis in HF patients. Cognitive impairment is a common comorbidity in HF patients and constitutes a major challenge to HF self-care. Mindfulness training (MT) has been shown to improve cognitive function and interoception, two components essential to promoting effective HF self-care. OBJECTIVES The aims of the Mind Your Heart-II (MYH-II) study are to investigate the effects of MT on HF self-care via changes in cognitive function and interoception in patients with comorbid HF and cognitive impairment, and to study the process by which MT can improve cognitive function via vagal control. We hypothesize that MT will improve cognitive function, interoception, and vagal control, resulting in enhanced HF self-care, compared to control participants. METHODS MYH-II is a mechanistic parallel phase II behavioral randomized controlled trial. We will enroll 176 English or Spanish-speaking patients with comorbid chronic HF and mild cognitive impairment. Participants will be randomized to either: (1) 8-week phone-delivered MT + Enhanced Usual Care (EUC), or (2) EUC alone. Participants will complete baseline, end-of-treatment (3 months), and follow-up (9 months) assessments. The primary outcome is cognitive function (NIH Toolbox Fluid Cognition Composite Score). Additional key outcomes include: interoception (heartbeat tracking task, Multidimensional Assessment of Interoceptive Awareness), HF self-care (Self-Care of Heart Failure Index v7.2), and vagal control (high-frequency heart rate variability). IMPLICATIONS If study hypotheses are confirmed, phone-based MT may be a key tool for improving HF self-care, and possibly clinical outcomes, in HF patients with comorbid cognitive impairment.
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Affiliation(s)
- Natalie G Keirns
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
| | - Sara Ouaddi
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, USA
| | - 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, Melbourne, Australia
| | - Emily C Gathright
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Emma Black
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Janice Tripolone
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Christopher Breault
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Barbara Riegel
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Australia; Center for Home Care Policy & Research at VNS Health, New York, NY, USA
| | - Ronald Cohen
- Cognitive Aging and Memory Program, McKnight Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Elena Salmoirago-Blotcher
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Lifespan Cardiovascular Institute, The Miriam Hospital, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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13
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Simonelli N, Bolgeo T, Iovino P, Di Matteo R, Maconi A, Vellone E. Self-care in coronary heart disease patient and caregiver dyads (HEARTS-IN-DYADS)-Protocol of a multicenter longitudinal study. Res Nurs Health 2023; 46:37-47. [PMID: 36538334 DOI: 10.1002/nur.22286] [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: 02/14/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Abstract
Self-care performed by patients and the caregiver contribution to this self-care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi-center longitudinal study designed to investigate the self-care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self-care, the predictors of patient and caregiver self-care, the mediating role of self-efficacy, and the self-care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient-caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self-care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions.
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Affiliation(s)
- Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Tatiana Bolgeo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing Midwifery and Paramedicin Australian Catholic University, Melbourne, Victoria, Australia
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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14
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Exploring Health Literacy Categories in Patients With Heart Failure: A Latent Class Analysis. J Cardiovasc Nurs 2023; 38:13-22. [PMID: 36508237 DOI: 10.1097/jcn.0000000000000889] [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: 12/15/2022]
Abstract
BACKGROUND Although a growing number of studies have demonstrated that patients' health literacy is associated with health outcomes, the exact relationship between them is not clear. AIMS AND OBJECTIVES The aim of this study was to explore latent classes of health literacy in patients with heart failure and analyze the differences among different groups. DESIGN AND METHODS This is a cross-sectional survey. Patients diagnosed with heart failure were selected from 3 tertiary hospitals in Tianjin, China, from March 2019 to November 2019. We measured patients' health literacy using the Health Literacy Scale for Chronic Patients. Latent class analysis was carried out based on the patients' Health Literacy Scale for Chronic Patients scores. Multinomial logistic regression was used to identify the predictive indicators of the latent classes. RESULTS The health literacy of patients with heart failure was divided into 3 different latent classes, named "high health literacy group," "low literacy high dependence group," and "moderate literacy high willingness group." There were statistically significant differences in gender, age, smoking history, marital status, education level, household income level, and quality of life among different health literacy classes. Low education level and household income level predicted poor health literacy. CONCLUSION There were 3 latent classes for the health literacy of patients with heart failure. Different health literacy classes exhibited their own distinctive characteristics. Patients in the "moderate literacy high willingness group" had the worst quality of life. Understanding the specific types of health literacy in patients with heart failure facilitates targeted nursing interventions to improve their quality of life.
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15
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Roussia S, Muthu P, Ilesanmi RE. Self-care Management in Heart Failure Using Roy Adaptation Theory-guided Intervention in the United Arab Emirates. SAGE Open Nurs 2023; 9:23779608231160484. [PMID: 36895709 PMCID: PMC9989373 DOI: 10.1177/23779608231160484] [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: 11/25/2022] [Revised: 01/05/2023] [Accepted: 02/12/2023] [Indexed: 03/08/2023] Open
Abstract
Purpose To assess the knowledge and practice of self-care management among patients with heart failure (HF) after Roy adaptation theory-guided educational program. Methodology One group quasi-experimental pretest-posttest design of 30 purposively selected patients with HF was conducted. Outcomes were examined under three domains: knowledge, self-care maintenance, and monitoring pre- and post-intervention, using a validated instrument based on four adaptive modes of Roy's theory. Major results Most of the respondents were male (76.6%) and 56.7% were over 60 years of age. At the pretest, only 16.7% demonstrated adequate knowledge of self-care, and 76.7% reported poor practices in the domains of self-care maintenance and monitoring. Also, 90% scored poorly in self-care management. Knowledge of self-care practices increased at post-test (93.3%). There was a significant difference in knowledge (t = 15.79, df = 29, p < .001) and practice (t = 9.35, df = 29, p < .001) pre- and post-intervention. However, there was no significant association between selected demographic characteristics, knowledge, and self-care practice (p > .05). Conclusion Knowledge and practice of self-care management are poor among patients with HF. However, theory-driven practice can enhance care and patients' quality of life.
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Affiliation(s)
- Soufiane Roussia
- RAK Medical and Health Sciences University, Ras Alkhiama, UAE.,Cardiac Intensive Care Unit, Sheik Shakhbout Medical City, Abu Dhabi, UAE
| | - Priyalatha Muthu
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, UAE
| | - Rose Ekama Ilesanmi
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, UAE.,Department of Nursing, University of Ibadan, Ibadan, Nigeria
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16
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Liu L, Chen Y, Xie J. Association of GNRI, NLR, and FT3 with the Clinical Prognosis of Older Patients with Heart Failure. Int Heart J 2022; 63:1048-1054. [DOI: 10.1536/ihj.22-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Luqiong Liu
- Department of General Medicine, Shanghai Fifth People's Hospital, Fudan University
| | - Yangqin Chen
- Department of General Medicine, Shanghai Fifth People's Hospital, Fudan University
| | - Juan Xie
- Department of General Medicine, Shanghai Fifth People's Hospital, Fudan University
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17
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Son YJ, Kim EY. The effectiveness and usability of a novel mobile phone-based self-care intervention for patients with heart failure: A mixed-methods pilot study. Eur J Cardiovasc Nurs 2022; 22:254-263. [PMID: 35997293 DOI: 10.1093/eurjcn/zvac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/12/2022]
Abstract
AIM To evaluate the preliminary effectiveness and usability of a novel mobile phone-based self-care intervention (named WithUs) for patients with heart failure (HF). METHODS AND RESULTS We conducted a mixed-methods pilot study with group pretest-posttest design and usability testing. Participants were 26 Korean HF patients (20 men; median age 62 years) who took part in this study after hospital discharge. Data were collected at baseline and after the 24-week intervention, using questionnaires and interviews. The outcome variables were eHealth literacy, disease knowledge, and self-care behaviours. The Wilcoxon signed-rank test was used to compare the pre- and post-intervention results. Thematic analysis was used for analysing qualitative data. The WithUs programme improved the eHealth literacy (p = .005), disease knowledge (p < .001), and self-care behaviours (p < .001) of patients with HF. The median score of total app usability was 4.1 out of 5 (interquartile range = 4.0-5.0). Four themes were identified which complemented the quantitative results. These were increased awareness of the importance of routine self-care behaviours, enhanced motivation toward self-care behaviours, challenges adapting to the new app, and suggestions for improving app adoption. CONCLUSION The app was effective in improving adherence to self-care behaviours, eHealth literacy, and disease knowledge in patients with HF. The usability evaluation results showed that the app is usable and has the potential to support HF patients in self-care. However, the app needs to be modified to improve its adoption.
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Affiliation(s)
- Youn Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Eun Young Kim
- Soonchunhyang University, Cheonan, South Korea, Dongnamgu, Soonchunhyang 6Gil 31
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18
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Nowlin J, Will B, Miller B, Bena JF, Morrison SM, Albert NM. Distractions when viewing in-hospital heart failure self-care videos and change in heart failure self-care knowledge. Heart Lung 2022; 53:67-71. [DOI: 10.1016/j.hrtlng.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/24/2022] [Accepted: 02/02/2022] [Indexed: 11/04/2022]
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19
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Yingtong M, Wei Z, Hanjun H, Tingting Z, Xiaohua G. The effects of early exercise on cardiac rehabilitation-related outcome in acute heart failure patients: a systematic review and meta-analysis. Int J Nurs Stud 2022; 130:104237. [DOI: 10.1016/j.ijnurstu.2022.104237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 10/18/2022]
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20
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Leigh JW, Gerber BS, Gans CP, Kansal MM, Kitsiou S. Smartphone Ownership and Interest in Mobile Health Technologies for Self-care Among Patients With Chronic Heart Failure: Cross-sectional Survey Study. JMIR Cardio 2022; 6:e31982. [PMID: 35029533 PMCID: PMC8800088 DOI: 10.2196/31982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/18/2021] [Accepted: 11/21/2021] [Indexed: 12/26/2022] Open
Abstract
Background Heart failure (HF) is a highly prevalent chronic condition that places a substantial burden on patients, families, and health care systems worldwide. Recent advances in mobile health (mHealth) technologies offer great opportunities for supporting many aspects of HF self-care. There is a need to better understand patients’ adoption of and interest in using mHealth for self-monitoring and management of HF symptoms. Objective The purpose of this study is to assess smartphone ownership and patient attitudes toward using mHealth technologies for HF self-care in a predominantly minority population in an urban clinical setting. Methods We conducted a cross-sectional survey of adult outpatients (aged ≥18 years) at an academic outpatient HF clinic in the Midwest. The survey comprised 34 questions assessing patient demographics, ownership of smartphones and other mHealth devices, frequently used smartphone features, use of mHealth apps, and interest in using mHealth technologies for vital sign and HF symptom self-monitoring and management. Results A total of 144 patients were approached, of which 100 (69.4%) participated in the study (63/100, 63% women). The participants had a mean age of 61.3 (SD 12.25) years and were predominantly Black or African American (61/100, 61%) and Hispanic or Latino (18/100, 18%). Almost all participants (93/100, 93%) owned a cell phone. The share of patients who owned a smartphone was 68% (68/100). Racial and ethnic minorities that identified as Black or African American or Hispanic or Latino reported higher smartphone ownership rates compared with White patients with HF (45/61, 74% Black or African American and 11/18, 61% Hispanic or Latino vs 9/17, 53% White). There was a moderate and statistically significant association between smartphone ownership and age (Cramér V [ΦC]=0.35; P<.001), education (ΦC=0.29; P=.001), and employment status (ΦC=0.3; P=.01). The most common smartphone features used by the participants were SMS text messaging (51/68, 75%), internet browsing (43/68, 63%), and mobile apps (41/68, 60%). The use of mHealth apps and wearable activity trackers (eg, Fitbits) for self-monitoring of HF-related parameters was low (15/68, 22% and 15/100, 15%, respectively). The most popular HF-related self-care measures participants would like to monitor using mHealth technologies were physical activity (46/68, 68%), blood pressure (44/68, 65%), and medication use (40/68, 59%). Conclusions Most patients with HF have smartphones and are interested in using commercial mHealth apps and connected health devices to self-monitor their condition. Thus, there is a great opportunity to capitalize on the high smartphone ownership among racial and ethnic minority patients to increase reach and enhance HF self-management through mHealth interventions.
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Affiliation(s)
- Jonathan W Leigh
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.,Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Ben S Gerber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worchester, MA, United States
| | - Christopher P Gans
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Mayank M Kansal
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
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