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Costa Rossetto S, Bosco Aprile DC, Lopes Grisante D, Gomes Vancini M, D'Agostino F, Herdman TH, de Lima Lopes J, Batista Santos V, Takáo Lopes C. Development and content validity of educational videos on self-management of fluid restriction and thirst for individuals with heart failure. Int J Nurs Knowl 2024. [PMID: 39073032 DOI: 10.1111/2047-3095.12483] [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: 02/20/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To create and evaluate the content validity of educational videos on self-management of fluid restriction and thirst for individuals with heart failure (HF). METHOD A psychometric study was conducted in three stages: (1) an integrative literature review to identify strategies for self-management of fluid restriction and thirst by individuals with HF; (2) creation of animated videos about strategies for self-management of fluid restriction and thirst; and (3) analysis of the content validity of the educational videos by 11 experts. For each criterion, the content validity ratio (CVR) was calculated; it was considered adequate when <0.636. Suggestions were evaluated by the researchers, and the videos were modified. RESULTS Ten scripts and videos were created, averaging 30 s each. The videos' contents were based on 11 studies retrieved from the review and one specialized website. The videos were evaluated by experts, and adjustments were made when CVR < 0.636 and when allowed by the video production platform. CONCLUSIONS Educational videos were developed and have satisfactory content validity evidence according to expert opinions. IMPLICATIONS FOR NURSING PRACTICE These videos are expected to be used as educational strategies in clinical practice to prevent episodes of decompensation due to excessive fluid volume.
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Affiliation(s)
- Sophia Costa Rossetto
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
- Clínica Einstein Onsites, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Daiane Lopes Grisante
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
| | - Milena Gomes Vancini
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
| | - Fabio D'Agostino
- Saint Camillus International University of Health Sciences (UniCamillus), Rome, Rome, Italy
| | | | - Juliana de Lima Lopes
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
| | - Vinicius Batista Santos
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
| | - Camila Takáo Lopes
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, São Paulo, Brazil
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Wefer F, Möhler R, Dichter MN, Mühring A, Gummert J, Köpke S. Nurse-based counselling on thirst in patients with advanced chronic heart failure : Study protocol for a pilot before-after study and process evaluation. Med Klin Intensivmed Notfmed 2024; 119:147-153. [PMID: 38097772 PMCID: PMC10902023 DOI: 10.1007/s00063-023-01091-y] [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: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Many patients with chronic heart failure (CHF) are critically ill and experience increased thirst. Study aims are to develop and evaluate a nurse-based counselling intervention to promote self-care competencies related to thirst in hospitalised patients with advanced CHF eligible or listed for heart transplantation. METHODS A mixed-methods approach will be adapted with three study phases: (1) development of the nurse-based counselling intervention, (2) feasibility testing and training of nurses, and (3) implementation of the intervention and, evaluation of initial effects and process measures. In phase (1), interviews with hospitalised patients with advanced CHF listed for heart transplantation (n = 10), focus groups (n = 2) and a Germany-wide survey with nurses will be performed. In phase (2), experts experienced with caring for patients with advanced CHF and patients with advanced CHF will be consulted for content validation and pretest of the counselling intervention. The training concept for nurses will be evaluated using questionnaires. In phase (3), a pilot before-after study will be conducted (n = 60). Primary patient-related outcome for the pilot study is thirst intensity using a numeric rating scale. Furthermore, a process evaluation (interviews with patients [n = 10], survey with nurses and physicians) will be performed. Quantitative data will be analysed descriptively, and qualitative data will be analysed using content analysis. Mean values of thirst intensity of the individual measurement points will be evaluated as interrupted time-series analysis using regression analyses. CONCLUSION The development and implementation of a counselling intervention is influenced by various factors. Therefore, it is important to consider all factors throughout the process from development to evaluation.
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Affiliation(s)
- Franziska Wefer
- Care Development, Care Directorate, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany, Georgstr.11, 32545.
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Martin N Dichter
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
| | - Andrea Mühring
- Transplantation unit, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Jan Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Sascha Köpke
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
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Chen Y, Ding J, Xi Y, Huo M, Mou Y, Song Y, Zhou H, Cui X. Thirst in heart failure: A scoping review. Nurs Open 2023; 10:4948-4958. [PMID: 37247329 PMCID: PMC10333895 DOI: 10.1002/nop2.1818] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/24/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
AIM The aim of this study was to summarise the overall picture of thirst-related research in patients with heart failure. DESIGN We conducted a scoping review following the Arskey and O'Malley methodological framework along with the PAGER framework. METHODS PubMed, CINAHL, Web of Science, Embase, The Cochrane Library, Jonna Briggs Institute, ProQuest Database, Google Scholar, PsycINFO, PQDT, CNKI, Wan Fang, VIP and CBM. Additionally, grey literature including grey databases (Opengrey, OpenDoar, Openaire and BASEL Bielefeld Academic Search Engine), conferences or articles (Scopus and Microsoft Academic), graduate theses databases (eTHOS, DART Europe, Worldcat and EBSCO Open Dissertations) and government information media (UK guidance and regulations, USA government websites, EU Bookshop and UN official publications) were searched. The databases were searched from inception to 18 August 2022 for Articles written in English and Chinese. Two researchers independently screened articles based on inclusion and exclusion criteria, and a third researcher adjudicated disagreements. RESULTS We retrieved 825 articles, of which 26 were included. Three themes were summarised from these articles: (a) the incidence of thirst in patients with heart failure; (b) the thirst-related factors in patients with heart failure; and (c) the intervention measures of thirst in patients with heart failure.
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Affiliation(s)
- Yaya Chen
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
- Cardiovascular DepartmentThe First People's Hospital of Li CountyLixianGansuChina
| | - Jin Ding
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Yingbo Xi
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Minfeng Huo
- Department of Basic MedicineGansu University of Chinese MedicineLanzhouGansuChina
| | - Yingjian Mou
- Cardiovascular DepartmentThe First People's Hospital of Li CountyLixianGansuChina
| | - Yu Song
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
| | - Hailing Zhou
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Xiaoqin Cui
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
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Eng SH, Waldréus N, González B, Ehrlin J, Díaz V, Rivas C, Velayos P, Puertas M, Ros A, Martín P, Lupón J, Bayes-Genis A, Jaarsma T. Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC Heart Fail 2021; 8:2492-2501. [PMID: 33942551 PMCID: PMC8318476 DOI: 10.1002/ehf2.13395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/23/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022] Open
Abstract
Aims This study aimed to evaluate psychometric properties of the Spanish version of the Thirst Distress Scale for patients with Heart Failure (TDS‐HF) and to describe thirst distress‐associated factors in outpatients at a heart failure (HF) clinic in Spain. Thirst is common in patients with HF, but thirst distress has rarely been addressed and may significantly decrease quality of life. Methods and results A cross‐sectional study was performed assessing perceived thirst distress by patients with HF during the preceding 3 days, with the TDS‐HF (scores 8 to 40). Univariable and multivariable linear regression analyses were performed to identify variables independently associated with thirst distress. Three‐hundred two HF outpatients were included (age 67 ± 12 years, 74% male, HF duration 82 ± 75 months, left ventricular ejection fraction 42 ± 14%). Most patients were on treatment with fluid restriction (99%), sodium restriction (99%), and diuretics (70%). The psychometric evaluation of the Spanish version of the TDS‐HF showed satisfactory item‐total and inter‐item correlations (range from 0.77 to 0.85 and 0.60 to 0.84, respectively), and internal consistency was 0.95 (Cronbach's alpha). The majority perceived mild to moderate thirst distress, and 18% perceived it as high or severe. The mean score obtained was 16.2 ± 9.3 (median 13, Q1–Q3 8–20). Higher serum urea {beta coefficient 1.6 [95% confidence interval (CI) 0.267 to 2.92], P = 0.019} and lower potassium [beta coefficient −3.63 (85% CI −6.32 to −0.93), P = 0.009] remained significantly associated with thirst distress in the multivariable analysis, together with the dose of diuretics [beta coefficient 2.98 (95% CI 1.37 to 4.59), P < 0.001]. Treatment with angiotensin receptor blocker showed an independent protective effect [beta coefficient −3.62 (95% CI −6.89 to −0.345), P = 0.03]. Conclusions The psychometric evaluation of the Spanish version of the TDS‐HF showed good psychometric properties. One in five patients experienced severe distress by thirst, but the majority had mild to moderate thirst distress. The dose of diuretics and angiotensin receptor blocker treatment influence thirst distress and could be clinically important targets to relieve thirst distress in patients with HF.
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Affiliation(s)
- Sanna Hagelberg Eng
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Nana Waldréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Beatriz González
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Jenny Ehrlin
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Violeta Díaz
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Carmen Rivas
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Patricia Velayos
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - María Puertas
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Alba Ros
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Paula Martín
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Josep Lupón
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Bayes-Genis
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Tiny Jaarsma
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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Abstract
PURPOSE OF REVIEW Thirst is a common and burdensome symptom of heart failure, which impacts adversely on quality of life. To date, there is limited research on the prevalence of thirst, the factors associated with thirst and interventions to help manage thirst in heart failure. This review summarizes key empirical research developments of thirst. RECENT FINDINGS Recent research shows that the heart failure syndrome, medications, self-care practice such as fluid restriction and anxiety contributes greatly to increased thirst in patients with heart failure. In addition, predictors such as being younger, male patient, with high symptom burden and serum urea is also associated with thirst. There are no intervention studies to manage thirst, only reports of various strategies recommended to heart failure patients in clinical practice. SUMMARY Despite the burden of thirst in heart failure patients, strategies to relieve thirst remains insufficiently addressed in literature. Further research to improve the understanding of the severity of thirst and its relationship to possible factors associated with thirst is required in order to develop future interventions to either prevent or alleviate troublesome thirst in patients with heart failure.
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Zheng C, Li M, Kawada T, Inagaki M, Uemura K, Sugimachi M. Frequent drinking of small volumes improves cardiac function and survival in rats with chronic heart failure. Physiol Rep 2017; 5:5/21/e13497. [PMID: 29122962 PMCID: PMC5688786 DOI: 10.14814/phy2.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/11/2017] [Indexed: 11/24/2022] Open
Abstract
Fluid retention is the main reason for the high hospitalization rate among patients with chronic heart failure (CHF). Given the lack of knowledge about fluid intake regulation and its consequences in patients with CHF, current guidelines do not provide clear direction for fluid management. Using a rat model of CHF, we investigated altering drinking behaviors and explored fluid management strategies. CHF was induced by ligating the left anterior descending coronary arteries in 8‐week‐old, male, Sprague‐Dawley rats. A custom‐designed drop counting and feedback control system was used to record and modulate drinking behaviors. During the first month after an induced myocardial infarction (MI), we observed that the spontaneous per drinking volume (PDV) was significantly increased in animals with prolonged intervals between drinking episodes. In addition, there was a significant inverse correlation between the early PDV and the post‐MI lifespan (r = −0.907; P < 0.001). Moreover, modulating the drinking behavior of rats with CHF to involve frequent drinking of small PDVs significantly enhanced hemodynamics and prevented cardiac remodeling, with a significant improvement in the 180‐day survival rate, compared with animals allowed to drink freely (50% vs. 36%; P < 0.01). The results of dynamic PDV changes, after MI, suggest that an impaired thirst mechanism is associated with the sensing and regulating of fluid balance in rats with CHF. These results suggest that increasing the drinking frequency, with small PDVs, may be beneficial to preventing progression of cardiac dysfunction in CHF.
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Affiliation(s)
- Can Zheng
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
| | - Meihua Li
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
| | - Masashi Inagaki
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
| | - Kazunori Uemura
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center; Osaka Japan
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