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Santesmases-Masana R, González-de Paz L, Hernández-Martínez-Esparza E, Kostov B, Navarro-Rubio MD. Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1625. [PMID: 31075932 PMCID: PMC6539518 DOI: 10.3390/ijerph16091625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 01/10/2023]
Abstract
Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.
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Affiliation(s)
- Rosalia Santesmases-Masana
- School of Nursing, Hospital Santa Creu i Sant Pau. Universitat Autònoma de Barcelona (UAB), 08025, Barcelona, Spain.
| | - Luis González-de Paz
- Les Corts Primary Healthcare Center, Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08028 Barcelona, Spain.
| | | | - Belchin Kostov
- Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08028 Barcelona, Spain.
| | - Maria Dolors Navarro-Rubio
- Patient Experience Department, Hospital Sant Joan de Deu, Esplugues del Llobregat, Universitat Internacional de Catalunya, Sant Cugat del Vallés, 08950 Esplugues de Llobregat, Spain.
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Gheorghiu V, Barkley TW. Identification and Prevention of Secondary Heart Failure: A Case Study. Crit Care Nurse 2017; 37:29-35. [PMID: 28765352 DOI: 10.4037/ccn2017478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Heart failure, a complex clinical syndrome affecting millions of Americans, is associated with high morbidity and mortality and a significant financial burden on the health care system. Recent health care reform efforts have focused on reducing 30-day heart failure hospital readmissions, increasing the cost-effectiveness of care provided to heart failure patients, and improving health outcomes for these patients. This case report describes an acutely ill patient with multiple comorbidities who was not initially admitted for heart failure but who developed acute decompensated heart failure during his hospital stay. The purpose of this in-depth analysis is to discuss the role of bedside nurses and advanced practice nurses in managing heart failure, describe the challenges of identifying secondary heart failure in patients with complex conditions, and suggest methods of improving health-related outcomes to prevent hospital readmissions.
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Affiliation(s)
- Vlad Gheorghiu
- Vlad Gheorghiu is a graduate student in the Adult-Gerontology Acute Care Nurse Practitioner Program at the School of Nursing at California State University, Los Angeles, California. .,Thomas W. Barkley Jr is coordinator of the Adult-Gerontology Acute Care Nurse Practitioner Program and director of nurse practitioner programs at the School of Nursing at California State University, Los Angeles, California.
| | - Thomas W Barkley
- Vlad Gheorghiu is a graduate student in the Adult-Gerontology Acute Care Nurse Practitioner Program at the School of Nursing at California State University, Los Angeles, California.,Thomas W. Barkley Jr is coordinator of the Adult-Gerontology Acute Care Nurse Practitioner Program and director of nurse practitioner programs at the School of Nursing at California State University, Los Angeles, California
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Bennett AL, Munkholm P, Andrews JM. Tools for primary care management of inflammatory bowel disease: Do they exist? World J Gastroenterol 2015; 21:4457-4465. [PMID: 25914455 PMCID: PMC4402293 DOI: 10.3748/wjg.v21.i15.4457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/09/2015] [Accepted: 03/12/2015] [Indexed: 02/06/2023] Open
Abstract
Healthcare systems throughout the world continue to face emerging challenges associated with chronic disease management. Due to the likely increase in chronic conditions in the future it is now vital that cooperation and support between specialists, generalists and primary health care physicians is conducted. Inflammatory bowel disease (IBD) is one such chronic disease. Despite specialist care being essential, much IBD care could and probably should be delivered in primary care with continued collaboration between all stakeholders. Whilst most primary care physicians only have few patients currently affected by IBD in their caseload, the proportion of patients with IBD-related healthcare issues cared for in the primary care setting appears to be widespread. Data suggests however, that primary care physician’s IBD knowledge and comfort in management is suboptimal. Current treatment guidelines for IBD are helpful but they are not designed for the primary care setting. Few non-expert IBD management tools or guidelines exist compared with those used for other chronic diseases such as asthma and scant data have been published regarding the usefulness of such tools including IBD action plans and associated supportive literature. The purpose of this review is to investigate what non-specialist tools, action plans or guidelines for IBD are published in readily searchable medical literature and compare these to those which exist for other chronic conditions.
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Blais C, Dai S, Waters C, Robitaille C, Smith M, Svenson LW, Reimer K, Casey J, Puchtinger R, Johansen H, Gurevich Y, Lix LM, Quan H, Tu K. Assessing the burden of hospitalized and community-care heart failure in Canada. Can J Cardiol 2013; 30:352-8. [PMID: 24565257 DOI: 10.1016/j.cjca.2013.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/16/2013] [Accepted: 12/16/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The surveillance of heart failure (HF) is currently conducted using either survey or hospital data, which have many limitations. Because Canada is collecting medical information in administrative health data, the present study seeks to propose methods for the national surveillance of HF using linked population-based data. METHODS Linked administrative data from 5 Canadian provinces were analyzed to estimate prevalence, incidence, and mortality rates for persons with HF between 1996/1997 and 2008/2009 using 2 case definitions: (1) 1 hospitalization with an HF diagnosis in any field (H_Any) and (2) 1 hospitalization in any field or at least 2 physician claims within a 1-year period (H_Any_2P). One hospitalization with an HF diagnosis code in the most responsible diagnosis field (H_MR) was also compared. Rates were calculated for individuals aged ≥ 40 years. RESULTS In 2008/2009, combining the 5 provinces (approximately 82% of Canada's total population), both age-standardized HF prevalence and incidence were underestimated by 39% and 33%, respectively, with H_Any when compared with H_Any_2P. Mortality was higher in patients with H_MR compared with H_Any. The degree of underestimation varied by province and by age, with older age groups presenting the largest differences. Prevalence estimates were stable over the years, especially for the H_Any_2P case definition. CONCLUSIONS The prevalence and incidence of HF using inpatient data alone likely underestimates the population rates by at least 33%. The addition of physician claims data is likely to provide a more inclusive estimate of the burden of HF in Canada.
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Affiliation(s)
- Claudia Blais
- Institut national de santé publique du Québec, Québec City, Québec, Canada; Faculté de pharmacie, Université Laval, Québec City, Québec, Canada
| | - Sulan Dai
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
| | - Chris Waters
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Cynthia Robitaille
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Mark Smith
- Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada
| | - Lawrence W Svenson
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Kim Reimer
- BC Ministry of Health, Victoria, British Columbia, Canada
| | - Jill Casey
- Nova Scotia Health and Wellness, Halifax, Nova Scotia, Canada
| | - Rolf Puchtinger
- Saskatchewan Ministry of Health, Regina, Saskatchewan, Canada
| | - Helen Johansen
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yana Gurevich
- Canadian Institute for Health Information, Toronto, Ontario, Canada
| | - Lisa M Lix
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hude Quan
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen Tu
- Institute for Clinical Evaluative Sciences; Department of Family and Community Medicine, University of Toronto; University Health Network, Toronto Western Hospital Family Health Team, Toronto, Ontario, Canada
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Mickelson R, Holden R. Assessing the distributed nature of home-based heart failure medication management in older adults. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/1541931213571165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Non-adherence to medications in older adult chronic heart failure (CHF) patients suggests the difficulty these patients experience with medication management tasks. This qualitative study explored home-based medication management and how activities were distributed across persons, artifacts, time and space using a distributed cognition framework. Interviews with CHF patients (N = 27) and their informal caregivers (N=11) were content analyzed for cross-cutting themes about distributed task performance. Results illustrated problem areas within this distributed system such as representational discordance, communication difficulties, and lack of portability of information across environments. Implications for future design of interventions include the need for portability and exchange of information, portability of medications and reminder devices, and improved communication across the distributed system.
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Affiliation(s)
| | - Richard Holden
- Department of Medicine, Vanderbilt University, Nashville, TN
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN
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