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Gondim MC, da Silva RC, da Silva AKB, Vieira FVM, Guimarães JV, Siqueira KM, Cavalcante AMRZ. Self-care for people with heart failure: the importance of tele-nursing in the COVID-19 pandemic. Rev Lat Am Enfermagem 2024; 32:e4227. [PMID: 39140562 PMCID: PMC11321188 DOI: 10.1590/1518-8345.6975.4227] [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: 08/21/2023] [Accepted: 03/12/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE to describe factors of influence of telenursing on naturalistic decision making about self-care of people with heart failure during COVID-19. METHOD this is a descriptive study with a qualitative approach, with 16 participants interviewed after hospitalization for decompensated heart failure. The data was collected using audio and video technology and submitted to content analysis, guided by the Situation-Specific Theory of Heart Failure Self-Care. RESULT two thematic categories emerged from the analysis: Self-care as a decision-making process and Factors influencing decision-making, which describe tele-nursing as a support resource for people with heart failure, during changes in care in the pandemic period. CONCLUSION it was possible to understand the relationship between telenursing and the establishment of a bond, in order to stimulate naturalistic decision-making by people with heart failure in their daily lives in a coherent way, leading to better health outcomes. HIGHLIGHTS (1) Different barriers compromise the decision-making of people with heart failure.(2) Nursing theories can guide coherent self-care attitudes.(3) Continuity of care and a support network are necessary after hospitalization.(4) Emotional support for people with heart failure must go hand in hand with conventional treatment.(5) The bond through tele-nursing provides positive health outcomes.
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Affiliation(s)
- Micaelle Costa Gondim
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Ricardo Costa da Silva
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
- Universidade Estadual de Goiás, Ceres, GO, Brazil
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de Sousa MM, Nepomuceno AMT, Feitosa RP, Loureiro LDSN, Silva RA, Fernandes MDGM, Oliveira SHDS. Contribution of informal caregivers to self-care in individuals with heart failure. Rev Bras Enferm 2024; 77:e20230492. [PMID: 39082554 PMCID: PMC11290721 DOI: 10.1590/0034-7167-2023-0492] [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: 12/04/2023] [Accepted: 04/02/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVES to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure. METHODS a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers' contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman's correlation. RESULTS the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction. CONCLUSIONS informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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Buck HG, Howland C, Stawnychy MA, Aldossary H, Cortés YI, DeBerg J, Durante A, Graven LJ, Irani E, Jaboob S, Massouh A, Oberfrank NDCF, Saylor MA, Wion RK, Bidwell JT. Caregivers' Contributions to Heart Failure Self-care: An Updated Systematic Review. J Cardiovasc Nurs 2024; 39:266-278. [PMID: 38306302 PMCID: PMC11291720 DOI: 10.1097/jcn.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
BACKGROUND A previous systematic review reporting the contributions of informal, unpaid caregivers to patient heart failure (HF) self-care requires updating to better inform research, practice, and policy. OBJECTIVE The aim of this study was to provide an updated review answering the questions: (1) What specific activities do informal caregivers of adults with HF take part in related to HF self-care? (2) Have the activities that informal caregivers of adults with HF take part in related to HF self-care changed over time? (3) What are the gaps in the science? METHODS This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, CINAHL, EMBASE, and Cochrane CENTRAL databases were searched. Eligible studies involved an informal, unpaid caregiver of an adult with HF as a study variable or participant. Caregiving activities were benchmarked using the theory of self-care in chronic illness. RESULTS Two thousand one hundred fifty-four research reports were identified, of which 64 met criteria. Caregivers' contributions occurred in self-care maintenance (91%), monitoring (54%), and management (46%). Activities performed directly on or to the patient were reported more frequently than activities performed for the patient. Change over time involved the 3 domains differentially. Gaps include ambiguous self-care activity descriptions, inadequate caregiving time quantification, and underrepresented self-care monitoring, supportive, and communication activities. CONCLUSIONS Newly identified caregiver-reported activities support updating the theory of self-care in chronic illness to include activities currently considered ancillary to HF self-care. Identified gaps highlight the need to define specific caregiving activities, determine task difficulty and burden, and identify caregiver self-care strategy and education needs. Exposing the hidden work of caregiving is essential to inform policy and practice.
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Thapa A, Chung ML, Wu JR, Latimer A, Lennie TA, Mudd-Martin G, Lin CY, Thompson JH, Kang J, Moser DK. Mediation by Fatalism of the Association Between Symptom Burden and Self-care Management in Patients With Heart Failure. J Cardiovasc Nurs 2024; 39:229-236. [PMID: 37830904 PMCID: PMC11014896 DOI: 10.1097/jcn.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Clinicians and researchers often assume that symptom burden is associated with self-care management (SCM) in patients with heart failure (HF). However, that association is often not borne out in simple regression analyses and may be because another variable mediates the association. Fatalism is an appropriate candidate for mediation and is the belief that circumstances are predetermined without opportunity for control by individuals. OBJECTIVE Our objective was to determine whether fatalism mediated the relationship of symptom burden with SCM among adults with HF. METHODS We conducted a secondary analysis (N = 95) from a clinical trial. We used Self-care of HF Index to measure SCM, the Memorial Symptom Assessment Scale-HF for symptom burden, and the Cardiovascular Disease Fatalism Instrument to measure fatalism. We used the PROCESS macro to evaluate mediation. RESULTS Symptom burden was not directly associated with SCM (effect coefficient [ C '] = 0.0805; 95% confidence interval, -0.048 to 0.209; P = .217). There was, however, an indirect pathway between symptom burden and SCM through fatalism ( ab = -0.040; 95% confidence interval, -0.097 to -0.002). Those with higher symptom burden were more fatalistic ( a = 0.004, P = .015), and greater fatalism was associated with worse SCM ( b = -9.132, P = .007). CONCLUSION Symptom burden, not directly associated with SCM, is associated through the mediator of fatalism. Interventions to improve SCM should include strategies to mitigate fatalistic views. Self-care management interventions should focus on promoting internal locus of control or increasing perceptions of perceived control to decrease fatalism and improve engagement in self-care.
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Affiliation(s)
- Ashmita Thapa
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Misook L. Chung
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Jia-Rong Wu
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Abigail Latimer
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Terry A. Lennie
- Senior Associate Dean and Marion E. McKenna Professor in Nursing Leadership College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Gia Mudd-Martin
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Chin-Yen Lin
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | | | - JungHee Kang
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
| | - Debra K. Moser
- Assistant Dean of PhD Program & Scholarly Affairs & Linda C. Gill, Professor in Nursing, College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
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Tian X, Li X, Zhang Q, Qiao X, Li X, Zhang Z. Improving therapeutic outcomes in heart failure with reduced nonvalvular ejection fraction: A clinical study of heart failure education intervention. Clin Cardiol 2024; 47:e24265. [PMID: 38682726 PMCID: PMC11057052 DOI: 10.1002/clc.24265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/31/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE The current study delves into the impact of heart failure education intervention on improving therapeutic outcomes for heart failure (HF) patients with reduced nonvalvular ejection fraction. METHODS There involved a total of 60 HF patients with non-valvular ejection fraction reduction who met the inclusion requirements. Patients enrolled were randomly distributed into an observation group and a control group. The observation group received heart failure education intervention, while the control group received conventional intervention. The therapeutic effect, changes in physical indicators, cardiac function indicators, coagulation function, self-management scale scores, and the incidence of adverse cardiovascular events were meticulously evaluated. RESULTS The total effective proportion in the observation group was 96.67%, which was significantly higher than the control group's proportion of 76.67% (p < .05). After treatment, several parameters in the observation group showed significant improvements compared to the control group: hs-CRP, IL-6, LVEDV value, LVESV value, PT value, APTT value, and TT value were all evidently lower in the observation group. Additionally, the cardiac index, LVEF value, and heart failure self-management scale fraction were significantly higher in the observation group compared to the control group (p < .05). Furthermore, the incidence of adverse cardiovascular events in the observation group was only 6.67%, which was significantly lower than the control group's incidence of 20.00% (p < .05). CONCLUSION Heart failure education intervention demonstrates effectiveness in improving the therapeutic outcomes for HF patients and reduced nonvalvular ejection fraction. Additionally, it enhances patients' self-management abilities. Given these positive results, it is highly recommended to promote and implement HF education intervention in clinical practice.
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Affiliation(s)
- Xueli Tian
- Department of PediatricsThe Second Affiliated Hospital of Xingtai Medical CollegeXingtaiChina
| | - Xiaozeng Li
- Ward One, Department of CardiologyXingtai Central HospitalXingtaiHebeiChina
| | - Qingqing Zhang
- CCU, Department of CardiologyXingtai Central HospitalXingtaiHebeiChina
| | - Xiangling Qiao
- CCU, Department of CardiologyXingtai Central HospitalXingtaiHebeiChina
| | - Xin Li
- CCU, Department of CardiologyXingtai Central HospitalXingtaiHebeiChina
| | - Zijian Zhang
- Department of EmergencyXingtai Central HospitalXingtaiHebeiChina
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Ziacchi M, Molon G, Giudici V, Botto GL, Viscusi M, Brasca F, Santoro A, Curcio A, Manzo M, Mauro E, Biffi M, Costa A, Dell’Aquila A, Casale MC, Boriani G. Integration of a Smartphone HF-Dedicated App in the Remote Monitoring of Heart Failure Patients with Cardiac Implantable Electronic Devices: Patient Access, Acceptance, and Adherence to Use. J Clin Med 2023; 12:5528. [PMID: 37685593 PMCID: PMC10488122 DOI: 10.3390/jcm12175528] [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: 07/17/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
(200 w) Introduction. Remote monitoring (RM) of cardiac implantable electronic device (CIED) diagnostics helps to identify patients potentially at risk of worsening heart failure (HF). Additionally, knowledge of patient HF-related symptoms is crucial for decision making. Patient smartphone applications may represent an ideal option to remotely collect this information. PURPOSE To assess real-world HF patient access, acceptance, and adherence to use of an HF-dedicated smartphone application (HF app). METHODS In this study, 10 Italian hospitals administered a survey on smartphone/app use to HF patients with CIED. The subgroup who accepted it downloaded the HF app. Mean 1-year adherence of the HF app use was evaluated. RESULTS A total of 495 patients (67 ± 13 years, 79% males, 26% NYHA III-IV) completed the survey, of which 84% had access to smartphones and 85% were willing to use the HF app. In total, 311/495 (63%) downloaded the HF app. Patients who downloaded the HF app were younger and had higher school qualification. Patients who were ≥60 years old had higher mean 1-year adherence (54.1%) than their younger counterparts (42.7%; p < 0.001). Hospitals with RM-dedicated staff had higher mean 1-year patient adherence (64.0% vs. 33.5%; p < 0.001). Adherence to HF app decreased from 63.3% (weeks_1-13) to 42.2% (weeks_40-52, p < 0.001). CONCLUSIONS High access and acceptance of smartphones/apps by HF patients with CIED allow HF app use for RM of patient signs/symptoms. Younger patients with higher school qualifications are more likely to accept HF app; however, older patients have higher long-term adherence.
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Affiliation(s)
- Matteo Ziacchi
- Istituto di Cardiologia, IRCCS Azienda Ospedaliero Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Giulio Molon
- IRCCS Sacro Cuore Don Calabria, 37024 Negrar, Italy; (G.M.); (A.C.)
| | - Vittorio Giudici
- Cardiologia Riabilitativa, ASST Bergamo EST, 24068 Seriate, Italy;
| | | | | | - Francesco Brasca
- Department of Cardiovascular Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, 20095 Milano, Italy;
| | | | | | - Michele Manzo
- AOU S. Giovanni di Dio e Ruggi d’ Aragona, 84131 Salerno, Italy;
| | - Erminio Mauro
- Policlinico di Modena, AOU Modena, 41125 Modena, Italy;
| | - Mauro Biffi
- Istituto di Cardiologia, IRCCS Azienda Ospedaliero Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Alessandro Costa
- IRCCS Sacro Cuore Don Calabria, 37024 Negrar, Italy; (G.M.); (A.C.)
| | - Andrea Dell’Aquila
- Elettrofisiologia e Aritmologia, ASST Bergamo EST, 24068 Seriate, Italy;
| | | | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy;
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