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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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Keogh A, Brennan C, Johnston W, Dickson J, Leslie SJ, Burke D, Megyesi P, Caulfield B. Six-Month Pilot Testing of a Digital Health Tool to Support Effective Self-Care in People With Heart Failure: Mixed Methods Study. JMIR Form Res 2024; 8:e52442. [PMID: 38427410 PMCID: PMC10959238 DOI: 10.2196/52442] [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: 09/04/2023] [Revised: 10/26/2023] [Accepted: 11/22/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Digital tools may support people to self-manage their heart failure (HF). Having previously outlined the human-centered design development of a digital tool to support self-care of HF, the next step was to pilot the tool over a period of time to establish people's acceptance of it in practice. OBJECTIVE This study aims to conduct an observational pilot study to examine the usability, adherence, and feasibility of a digital health tool for HF within the Irish health care system. METHODS A total of 19 participants with HF were provided with a digital tool comprising a mobile app and the Fitbit Charge 4 and Aria Air smart scales for a period of 6 months. Changes to their self-care were assessed before and after the study with the 9-item European HF Self-care Behavior Scale (EHFScBS) and the Minnesota Living with HF Questionnaire (MLwHFQ) using a Wilcoxon signed rank test. After the study, 3 usability questionnaires were implemented and descriptively analyzed: the System Usability Scale (SUS), Wearable Technology Motivation Scale (WTMS), and Comfort Rating Scale (CRS). Participants also undertook a semistructured interview regarding their experiences with the digital tool. Interviews were analyzed deductively using the Theoretical Domains Framework. RESULTS Participants wore their devices for an average of 86.2% of the days in the 6-month testing period ranging from 40.6% to 98%. Although improvements in the EHFScBS and MLwHFQ were seen, these changes were not significant (P=.10 and P=.70, respectively, where P>.03, after a Bonferroni correction). SUS results suggest that the usability of this system was not acceptable with a median score of 58.8 (IQR 55.0-60.0; range 45.0-67.5). Participants demonstrated a strong motivation to use the system according to the WTMS (median 6.0, IQR 5.0-7.0; range 1.0-7.0), whereas the Fitbit was considered very comfortable as demonstrated by the low CRS results (median 0.0, IQR 0.0-0.0; range 0.0-2.0). According to participant interviews, the digital tool supported self-management through increased knowledge, improved awareness, decision-making, and confidence in their own data, and improving their social support through a feeling of comfort in being watched. CONCLUSIONS The digital health tool demonstrated high levels of adherence and acceptance among participants. Although the SUS results suggest low usability, this may be explained by participants uncertainty that they were using it fully, rather than it being unusable, especially given the experiences documented in their interviews. The digital tool targeted key self-management behaviors and feelings of social support. However, a number of changes to the tool, and the health service, are required before it can be implemented at scale. A full-scale feasibility trial conducted at a wider level is required to fully determine its potential effectiveness and wider implementation needs.
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Affiliation(s)
- Alison Keogh
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Carol Brennan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William Johnston
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
| | - Jane Dickson
- Physiotherapy Department, Beacon Hospital, Dublin, Ireland
- Cardiology, Beacon Hospital, Dublin, Ireland
| | | | - David Burke
- Cardiology, Beacon Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Peter Megyesi
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- Insight Centre Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Niriayo YL, Yemane B, Asgedom SW, Teklay G, Gidey K. Prevalence and predictors of poor self-care behaviors in patients with chronic heart failure. Sci Rep 2024; 14:1984. [PMID: 38263418 PMCID: PMC10805850 DOI: 10.1038/s41598-024-52611-5] [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: 07/13/2023] [Accepted: 01/21/2024] [Indexed: 01/25/2024] Open
Abstract
Despite the indispensable role of self-care behavior in managing heart failure, the practice of self-care behavior remains poor, especially in developing countries. There is a scarcity of research focusing on poor self-care behavior and its determinants within our specific context. Therefore, the objective of this study was to investigate the prevalence and predictors of poor self-care behavior among ambulatory heart failure patients. A facility-based cross-sectional study was conducted at a tertiary care hospital in Ethiopia, involving patients with heart failure. We utilized the European Heart Failure Self-Care Behavior Scale (EHFScBS-9) to evaluate adherence to self-care behaviors. Data were gathered through patient interviews and a review of medical records. A binary logistic regression analysis was performed to identify predictors of poor self-care behavior in heart failure patients. We included a total of 343 participants in the final analysis of this study. The findings revealed that a majority of the patients (73.8%) demonstrated poor overall self-care behavior. Specifically, the majority of patients did not engage in regular exercise (76.1%), failed to consult doctors in case of rapid weight gain (75.6%), did not monitor weight daily (71.5%), did not restrict fluid intake (69.9%), and did not contact doctors in case of experiencing fatigue (68.6%). Additionally, 32.4% of patients did not reach out to doctors when experiencing shortness of breath, 30% did not restrict salt intake, 29% did not adhere to prescribed medication, and only 7% did not consult doctors if edema occurred. Our findings indicated that rural residence (AOR: 5.76, 95% CI: 2.47-13.43), illiteracy (AOR: 2.64, 95% CI: 1.52-6.31), prior hospitalization (AOR: 2.09, 95% CI: 1.21-3.61), and taking five or more medications (AOR: 1.83, 1.01-3.33) were significant predictors of poor self-care behavior. In conclusion, a majority of the participants in our study demonstrated poor self-care behavior. Risk factors for this behavior included rural residence, illiteracy, prior hospitalization, and taking five or more medications. Therefore, it is crucial to prioritize these high-risk patients and implement interventional programs aimed at improving self-care behaviors and overall treatment outcomes in heart failure patients.
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Affiliation(s)
- Yirga Legesse Niriayo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Bisrat Yemane
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Solomon Weldegebreal Asgedom
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Gebrehiwot Teklay
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Deckwart O, Koehler K, Lezius S, Prescher S, Koehler F, Winkler S. Effects of remote patient management on self-care behaviour in heart failure patients: results from the randomized TIM-HF2 trial. Eur J Cardiovasc Nurs 2023; 22:786-794. [PMID: 36752782 DOI: 10.1093/eurjcn/zvad019] [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: 07/09/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023]
Abstract
AIMS Remote patient management (RPM) in heart failure (HF) patients has beneficial clinical effects. This analysis investigates the effects of RPM used in the Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial on HF-specific self-care. METHODS AND RESULTS From 2013 to 2017, 1538 HF outpatients (age 70.3 ± 10.5 years, 70% men, 52%/47% NYHA II/III, 65% LVEF ≤45%) with a recent HF hospitalization were included to the study and randomized to usual care (UC) plus RPM (n = 796) or UC only (n = 775), with a 12-month follow-up. Self-reported self-care behaviour at baseline and at end of study was assessed with the 9-item European Heart Failure Self-care Behaviour Scale (EHFScBS-9), obtaining 1321 patients with valid baseline and follow-up questionnaires for the analysis. EHFScBS-9 sum scores increased in the RPM group (n = 667) from 78.7 ± 17 to 84.5 ± 14 and in the UC group (n = 654) from 79.0 ± 17 to 80.0 ± 16 from baseline to 12 months [difference in means (MD) 4.58 (3.02, 6.14); P < 0.001] with highest improvement [8.66 (3.52; 13.81)] in patients living alone and having an inadequate (<70) baseline EHFScBS-9. There were differences between both groups in item 'I weight myself every day' [MD -1.13 (-1.24, -1.02); P < 0.001] and item 'I take my medication as prescribed' [MD -0.06 (-0.10, -0.01); P = 0.014]. No correlation was found between the EHFScBS-9 score and the efficacy of RPM on the TIM-HF2 primary endpoint of percentage of days lost due to unplanned cardiovascular hospitalization or death of any cause. CONCLUSIONS RPM improves HF-specific self-care behaviour by achieving a better adherence to recommended HF regimen. REGISTRATION ClinicalTrials.gov: NCT01878630.
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Affiliation(s)
- Oliver Deckwart
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Centre for Cardiovascular Telemedicine, 10117 Berlin, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
- Nurse Practice Development Department, Goethe University, University Hospital, 60318 Frankfurt, Germany
| | - Kerstin Koehler
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Centre for Cardiovascular Telemedicine, 10117 Berlin, Germany
| | - Susanne Lezius
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, 20246 Hamburg, Germany
| | - Sandra Prescher
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Centre for Cardiovascular Telemedicine, 10117 Berlin, Germany
| | - Friedrich Koehler
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Centre for Cardiovascular Telemedicine, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
| | - Sebastian Winkler
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Centre for Cardiovascular Telemedicine, 10117 Berlin, Germany
- Department of Internal Medicine, BG Klinikum Unfallkrankenhaus Berlin GmbH, Warener Str. 7, 12683 Berlin, Germany
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Jiang Y, Zhang C, Hong J, Tam WWS, Ramachandran HJ, Wang W. Relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-confidence among patients with heart failure: Cross-sectional analysis of structural equation modelling. Int J Nurs Stud 2023; 147:104590. [PMID: 37741260 DOI: 10.1016/j.ijnurstu.2023.104590] [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: 11/23/2022] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Promoting self-care behaviours in heart failure management is an important goal and challenge for healthcare systems worldwide. Using the situation-specific theory of heart failure self-care, this study examined the relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-care confidence in these relationships. METHOD We analysed the baseline data from a previous randomised controlled trial study involving 213 patients with heart failure. Structural equation modelling was used to test our hypothesised model that included age, income, education, depression, anxiety, number of comorbidities, social support, self-care confidence, and self-care behaviours. Depression and anxiety were measured by the Hospital Anxiety and Depression Scale. Social support was measured by the Short Form of the Social Support Questionnaire satisfaction subscale. The Self-Care of Heart Failure Index (version 6.2) was used to assess self-care confidence and self-care behaviours (i.e., self-care maintenance and self-care management). RESULT The final model included age, depression, social support, and self-care confidence as independent variables. Age had a direct relationship with self-care maintenance (β = 0.235, p < 0.001) but not self-care management (β = 0.067, p = 0.179); better social support was directly associated with higher levels of self-care confidence (β = 0.267, p < 0.001); and higher levels of self-care confidence were associated with better self-care maintenance (β = 0.573, p < 0.001) and self-care management (β = 0.683, p < 0.001). The result showed an indirect relationship between social support and self-care maintenance through the mediator of self-care confidence (β = 0.153, p < 0.001), as well as an indirect relationship between social support and self-care management through self-care confidence (β = 0.182, p < 0.001). CONCLUSION Satisfactory social support can increase self-care confidence, thereby increasing self-care maintenance and management. The findings of this study also implied that self-care maintenance can increase with increasing age. Future interventions directly targeting assessment and management of self-care confidence, available social support, and the age of patients may help enhance their heart failure self-care behaviours.
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Affiliation(s)
- Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Ingadottir B, Jaarsma T, Norland K, Ketilsdóttir A. Sense of Security Mediates the Relationship Between Self-care Behavior and Health Status of Patients With Heart Failure: A Cross-sectional Study. J Cardiovasc Nurs 2023; 38:537-545. [PMID: 37816081 DOI: 10.1097/jcn.0000000000000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
BACKGROUND Promoting patients' sense of security is among the goals of nursing care within heart failure management. OBJECTIVE The aim of this study was to examine the role of sense of security in the relationship between self-care behavior and health status of patients with heart failure. METHODS Patients recruited from a heart failure clinic in Iceland answered a questionnaire about their self-care (European Heart Failure Self-care Behavior Scale; possible scores, 0-100), their sense of security (Sense of Security in Care-Patients' Evaluation; possible scores, 1-100), and their health status (Kansas City Cardiomyopathy Questionnaire, including symptoms, physical limitations, quality of life, social limitations, and self-efficacy domains; possible scores, 0-100). Clinical data were extracted from electronic patient records. Regression analysis was used to examine the mediation effect of sense of security on the relationship between self-care and health status. RESULTS The patients (N = 220; mean [SD] age, 73.6 [13.8] years; 70% male, 49% in New York Heart Association functional class III) reported a high sense of security (mean [SD], 83.2 [15.2]) and inadequate self-care (mean [SD], 57.2 [22.0]); their health status, as assessed by all domains of the Kansas City Cardiomyopathy Questionnaire, was fair to good except for self-efficacy, which was good to excellent. Self-care was associated with health status ( P < .01) and sense of security ( P < .001). Regression analysis confirmed the mediating effect of sense of security on the relationship between self-care and health status. CONCLUSIONS Sense of security in patients with heart failure is an important part of daily life and contributes to better health status. Heart failure management should not only support self-care but also aim to strengthen sense of security through positive care interaction (provider-patient communication) and the promotion of patients' self-efficacy, and by facilitating access to care.
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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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Kamath D, Abdullakutty J, Granger B, Kulkarni S, Bhuvana K, Salazar L, Shifra S, Idiculla J, Narendra J, Varghese K, Xavier D. A randomized controlled trial evaluating a theory driven, complex intervention centered on task sharing and mobile health to improve selfcare and outcomes in heart failure - The PANACEA-HF RCT: Design and rationale. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 34:100310. [PMID: 38510948 PMCID: PMC10945930 DOI: 10.1016/j.ahjo.2023.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/15/2023] [Accepted: 07/15/2023] [Indexed: 03/22/2024]
Abstract
Background We developed a three-pronged complex intervention to improve selfcare and deliver whole person care for patients with heart failure, underpinned by the 'extant cycle' theory - a theory based on our formative work. Methods This is a 3 centre, 2-arm, 1:1, open, adaptive stratified, randomized controlled trial. We included patients aged ≥ 18 years with heart failure, taking any of the key guideline directed medical treatments, with a history of or currently on a high ceiling diuretic. We excluded end stage renal disease, clinically diagnosed severe mental illness or cognitive dysfunction and having no caregivers. Interventions included, (i) trained hospital based lay health worker mediated assessment of patients' current selfcare behaviour, documenting barriers and facilitators and implementing a plan to 'transition' the patient toward optimal selfcare. (ii) m-health mediated remote monitoring and (iii) dose optimization through a 'physician supervisor'. Results We recruited 301 patients between Jan 2021 and Jan 2022. Mean age was 59.8 (±11.7) years, with 195 (64.8 %) from rural or semi-urban areas and 67.1 % having intermediate to low health literacy. 190 (63.1 %) had an underlying ischemic cardiomyopathy. In the intervention arm, 142 (94.1 %) had a Selfcare in Heart Failure Index (SCHFI) score of ≤70, with significant barriers being 'lack of knowledge' 105 (34.5 %) and 'behavioural passivity' 23 (7.5 %). Conclusion This is the first South Asian trial evaluating a complex intervention underpinned by behaviour change theory for whole person heart failure care. These learnings can be applied to heart failure patient care in other resource constrained health systems.
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Affiliation(s)
- D.Y. Kamath
- Pharmacology, St. John's Medical College, Bengaluru, India
| | | | - B.B. Granger
- Duke University School of Nursing, Durham, NC, USA
| | - S. Kulkarni
- Medicine, St. John's Medical College, Bengaluru, India
| | - K.B. Bhuvana
- Pharmacology, St. John's Medical College, Bengaluru, India
| | - L.J. Salazar
- Psychiatry, St. John's Medical College, Bengaluru, India
| | - S. Shifra
- Pharmacology, St. John's Medical College, Bengaluru, India
| | - J. Idiculla
- Internal Medicine, St. John's Medical College, Bengaluru, India
| | - J. Narendra
- Cardiology, Nanjappa Hospital, Shivamogga, Karnataka, India
| | - K. Varghese
- Cardiology, St. John's Medical College, Bengaluru, India
| | - D. Xavier
- Pharmacology, St. John's Medical College, Bengaluru, India
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Bekele F, Tafese L, Demsash AW, Tesfaye H, Labata BG, Fekadu G. Adherence to self-care practices and associated factors among heart failure patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0288824. [PMID: 37611019 PMCID: PMC10446213 DOI: 10.1371/journal.pone.0288824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/04/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Heart failure is the leading cause of hospital stays, medical expenses, and fatalities, and it is a severe problem for worldwide public health. Successful heart failure therapy requires a high level of self-care as well as devotion to different elements of the treatment plan. Despite the positive effects of heart failure self-care on health outcomes, many heart failure patients engage in insufficient self-care behaviors. Additionally, conflicting information has been found regarding the prevalence and predictors of self-care behaviors in Ethiopia. As a result, this review's objective is to provide an overview of the most recent studies on Ethiopian heart failure patients' self-care practices. METHODS We have used four databases such as PubMed, Science Direct, Scopus and Google Scholar. Eventually, the final systematic review and meta-analysis contained eleven papers that matched the eligibility requirements. A systematic data extraction check list was used to extract the data, and STATA version 14 was used for the analysis. Heterogeneity was evaluated using the I2 tests and the Cochrane Q test statistic. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test were utilized. RESULT The pooled magnitude of adherence to self-care was 35.25% (95%CI: 27.36-43.14). The predictors of good adherence to self-care behavior includes heart failure knowledge (odds ratio = 5.26; 95% CI, 3.20-8.65), absence of depressive symptoms (odds ratio = 3.20;95% CI,1.18-8.70), higher level of education (AOR = 3.09;95%CI,1.45-6.61), advanced New York Heart Association (NYHA) class (odds ratio = 2.66; 95% CI, 1.39-5.07), absence of comorbidity(odds ratio = 2.92; 95% CI,1.69-5.06) and duration of heart failure symptoms(odds ratio = 0.37; 95% CI, 0.24-0.58). CONCLUSION The extent of self-care behavior adherence is shown to be low among heart failure patients. This study showed a positive relationship between self-care behavior and factors such as proper understanding of heart failure, the absence of co-morbidity, depression, higher levels of education, a longer duration of heart failure symptoms, and advanced classes of heart failure disease. Therefore, a continuous health education should be given for patients to enhance their understanding of heart failure. Besides, special attention should be given for patients having co-morbidity and depressive symptom.
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Affiliation(s)
- Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Lalise Tafese
- Department of Health Informatics, College of Health Science, Mattu University, Mattu, Ethiopia
| | | | - Hana Tesfaye
- Department of Midwifery, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Busha Gamachu Labata
- Department of Pharmacy, College of Health Science, Wallaga University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, College of Health Science, Wallaga University, Nekemte, Ethiopia
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China
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Min D, Lee J, Ahn JA. A Qualitative Study on the Self-Care Experiences of People with Heart Failure. West J Nurs Res 2023; 45:646-652. [PMID: 37085988 DOI: 10.1177/01939459231169102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
We aimed to explore in-depth experiences and emotions of people with heart failure within the context of self-care. A qualitative descriptive study was conducted using semi-structured interviews. Ten patients were recruited from an outpatient clinic at a university-affiliated hospital in South Korea between September and November 2019. Data were analyzed using a thematic content analysis approach. Participants were 68-86 years old, and 80% were men. Five themes of the self-care experiences of persons with heart failure were identified: "Suddenly diagnosed with heart failure," "Unpredictable symptoms and unprepared for self-care," "Dependent on caring family on a heartbreaking uphill," "Self-care efforts with apprehension," and "Continued self-care efforts with expert help." Programs to support self-care for people with heart failure are needed and should be developed by incorporating patients' needs and reflecting their uncertainty and vulnerability.
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Affiliation(s)
- Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Jeonbuk, Korea
| | - Jungeun Lee
- College of Nursing, University of Rhode Island, Kingston, RI, USA
| | - Jeong-Ah Ahn
- College of Nursing and Research Institute of Nursing Science, Ajou University, Suwon, Korea
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11
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Lee KS, Moser DK, Dracup K. The association between comorbidities and self-care of heart failure: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:157. [PMID: 36973664 PMCID: PMC10045230 DOI: 10.1186/s12872-023-03166-2] [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: 10/14/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Because heart failure (HF) is a debilitating chronic cardiac condition and increases with age, most patients with HF experience a broad range of coexisting chronic morbidities. Comorbidities present challenges for patients with HF to successfully perform self-care, but it is unknown what types and number of comorbidities influence HF patients' self-care. The purpose of this study was to explore whether the number of cardiovascular and non-cardiovascular conditions are associated with HF self-care. METHODS Secondary data analysis was performed with 590 patients with HF. The number of cardiovascular and non-cardiovascular conditions was calculated using the list of conditions in the Charlson Comorbidity Index. Self-care was measured with the European HF self-care behavior scale. Multivariable linear regression was performed to explore the relationship between the types and number of comorbidities and self-care. RESULTS Univariate analysis revealed that a greater number of non-cardiovascular comorbidities was associated with poorer HF self-care(β=-0.103), but not of more cardiovascular comorbidities. In the multivariate analysis, this relationship disappeared after adjusting for covariates. Perceived control and depressive symptoms were associated with HF self-care. CONCLUSION The significant relationship between the number of non-cardiovascular comorbidities and HF self-care was not independent of perceived control and depressive symptoms. This result suggests a possible mediating effect of perceived control and depressive symptoms on the relationship between HF self-care and the number and type of comorbidities.
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Affiliation(s)
- Kyoung Suk Lee
- College of Nursing, the Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
| | - Debra K. Moser
- College of Nursing, University of Kentucky, Lexington, USA
| | - Kathleen Dracup
- School of Nursing, University of California San Francisco, San Francisco, CA USA
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12
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Association Between Self-care and Resilience: A Cross-sectional Study in Heart Failure Patients. J Cardiovasc Nurs 2023; 38:E70-E77. [PMID: 35389927 DOI: 10.1097/jcn.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Self-care (SC) is a cornerstone in heart failure management and is related to patient outcomes. The continuous and complex demands of SC can be experienced as stressful and may require patients to apply resilient behaviors as they manage their conditions. Resilience may be a helpful factor in performing SC. OBJECTIVE The aim of this study was to determine the association between resilience and SC in patients with heart failure. METHODS A cross-sectional study was performed between January 2020 and January 2021. Participants were asked to complete a questionnaire addressing baseline characteristics, the 2-item Patient Health Questionnaire, the Resilience Evaluation Scale, and the Self-Care of Chronic Illness Inventory, which measures 3 concepts of SC: SC maintenance, SC monitoring, and SC management. Multiple regression analysis was performed to determine whether resilience was associated with SC. RESULTS Eighty-six patients were included, and 74 patients completed the questionnaire. In the univariate analysis, an association was found between resilience and SC maintenance, resulting in an increase in SC for patients with higher resilience (β = 0.24; 95% confidence interval, 0.03-0.96). In the multivariate analysis adjusted and corrected for confounders, no significant associations between resilience and all SC scales were found. CONCLUSION This study could not demonstrate significant associations between resilience and all SC scales. This study contributes to the body of knowledge on factors that can mediate or moderate SC. Further longitudinal research should be performed to study cause-effect relationships.
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Magallón-Botaya R, Méndez-López F, Oliván-Blázquez B, Carlos Silva-Aycaguer L, Lerma-Irureta D, Bartolomé-Moreno C. Effectiveness of health literacy interventions on anxious and depressive symptomatology in primary health care: A systematic review and meta-analysis. Front Public Health 2023; 11:1007238. [PMID: 36844856 PMCID: PMC9948257 DOI: 10.3389/fpubh.2023.1007238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background Affective disorders are a debilitating and very prevalent problem throughout the world. Often these are associated with the onset of comorbidities or a consequence of chronic diseases. Anxiety and depression are associated with poor social and personal relationships, compromised health. We aimed to synthesize evidence from studies measuring the impact of a health literacy (HL) intervention on the improvement of affective disorders. Methods For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, Web of Science, Ibecs, Cuiden, Scielo, Science Direct and Dialnet for exclusively randomized controlled trial studies (RCTs) published between 1 Jan 2011, and 31 May 2022. The search terms employed were "health literacy," "health knowledge," "anxiety," "anxiety disorder," "depression," "depressive disorder," and "adult." The risk of bias assessment was performed using the Cochrane Collaboration Revised Risk of Bias tool (RoB2). We conducted random-effects meta-analyses and explored heterogeneity using meta-regression and a stratified survey. Results Of 2,863 citations found through the initial screening, 350 records were screened by the title and abstract for their themes and relevance. Finally, nine studies complied with the inclusion criteria for the meta-analysis. 66.66% of studies (n = 6) were rated as having a low risk of bias and 33.33% (n = 3) were judged to raise some concerns. The health literacy interventions were associated with -1.378 reduction in depression and anxiety questionnaires scores [95% CI (-1.850, -0.906)]. Low mood disorder scores are associated with better mental health and wellbeing. Conclusion Our findings demonstrate that an HL intervention in relation to the symptoms associated with affective disorders improves the emotional state of patients in PHC, with a moderately positive effect in reducing depression and anxiety.
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Affiliation(s)
- Rosa Magallón-Botaya
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
| | - Fátima Méndez-López
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - David Lerma-Irureta
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Cruz Bartolomé-Moreno
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
- Aragonese Healthcare Service (SALUD), Zaragoza, Spain
- Department of Family and Community Care Teaching - Sector I, Aragonese Healthcare Service, Zaragoza, Spain
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Brons M, Ten Klooster I, van Gemert-Pijnen L, Jaarsma T, Asselbergs FW, Oerlemans MIFJ, Koudstaal S, Rutten FH. Patterns in the Use of Heart Failure Telemonitoring: Post Hoc Analysis of the e-Vita Heart Failure Trial. JMIR Cardio 2023; 7:e41248. [PMID: 36719715 PMCID: PMC9929726 DOI: 10.2196/41248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/04/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research on the use of home telemonitoring data and adherence to it can provide new insights into telemonitoring for the daily management of patients with heart failure (HF). OBJECTIVE We described the use of a telemonitoring platform-including remote patient monitoring of blood pressure, pulse, and weight-and the use of the electronic personal health record. Patient characteristics were assessed in both adherent and nonadherent patients to weight transmissions. METHODS We used the data of the e-Vita HF study, a 3-arm parallel randomized trial performed in stable patients with HF managed in outpatient clinics in the Netherlands. In this study, data were analyzed from the participants in the intervention arm (ie, e-Vita HF platform). Adherence to weight transmissions was defined as transmitting weight ≥3 times per week for at least 42 weeks during a year. RESULTS Data from 150 patients (mean age 67, SD 11 years; n=37, 25% female; n=123, 82% self-assessed New York Heart Association class I-II) were analyzed. One-year adherence to weight transmissions was 74% (n=111). Patients adherent to weight transmissions were less often hospitalized for HF in the 6 months before enrollment in the study compared to those who were nonadherent (n=9, 8% vs n=9, 23%; P=.02). The percentage of patients visiting the personal health record dropped steadily over time (n=140, 93% vs n=59, 39% at one year). With univariable analyses, there was no significant correlation between patient characteristics and adherence to weight transmissions. CONCLUSIONS Adherence to remote patient monitoring was high among stable patients with HF and best for weighing; however, adherence decreased over time. Clinical and demographic variables seem not related to adherence to transmitting weight. TRIAL REGISTRATION ClinicalTrials.gov NCT01755988; https://clinicaltrials.gov/ct2/show/NCT01755988.
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Affiliation(s)
- Maaike Brons
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Iris Ten Klooster
- Department of Psychology, Health and Technology, Center for eHealth Research and Disease Management, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health and Technology, Center for eHealth Research and Disease Management, University of Twente, Enschede, Netherlands
| | - Tiny Jaarsma
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Health, Medicine and Care, Linköping University, Linköping, Sweden
| | - Folkert W Asselbergs
- Department of Cardiology, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands
- Health Data Research UK and Institute of Health Informatics, University College London, London, United Kingdom
| | | | - Stefan Koudstaal
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Frans H Rutten
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Farahani MA, Shariatpanahi S, Tehrani FJ, Boozaripour M. Translation, cross-cultural adaptation, and psychometric evaluation of the Persian version of the Symptom Distress Scale (SDS) in heart failure patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:2. [PMID: 37034855 PMCID: PMC10079198 DOI: 10.4103/jehp.jehp_1505_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/15/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Patients with heart failure experience severe and chronic physical and psychological manifestations while the disease progresses. Assessing the degree of distress caused by manifestations of the disease in patients is the first step in designing and evaluating intervention programs to improve patients' symptoms. The aim of this study was to investigate the psychometric properties of the Persian version of the Symptom Distress Scale in HF patients. MATERIALS AND METHODS This study was conducted via methodological research design from March to November 2019. The translation process and cross-cultural adaptation were performed using a process recommended by the World Health Organization. The face and content validity and internal consistency were used to evaluate the validity and reliability of the instrument. The scale was evaluated by exploratory and confirmatory factor analysis in 300 patients with heart failure, and the obtained data were analyzed using SPSS-22 and AMOS-22 software. RESULTS The content validity of the scale was approved based on the results of the study. One-factor scale with 13 items was used in the confirmatory factor analysis, and the results showed that the instrument had high goodness-of-fit indices. Spearman correlation test for convergent validity showed a correlation between the score obtained by the Scale of Symptoms of Disease and the scores of The European Heart Failure Self-care Behavior scale (9 items) (P < 0.0001). CONCLUSION The Persian version of the Symptom Distress Scale can be used as a valid instrument for people with heart failure due to its desirable psychometric properties.
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Affiliation(s)
- Mansoureh A. Farahani
- Nursing Care Research Center, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Shabnam Shariatpanahi
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh J. Tehrani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Boozaripour
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
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Seid SS, Amendoeira J, Ferreira MR. Self-Care and Quality of Life Among Adult Patients With Heart Failure: Scoping Review. SAGE Open Nurs 2023; 9:23779608231193719. [PMID: 37576941 PMCID: PMC10413905 DOI: 10.1177/23779608231193719] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/10/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Although self-care has a therapeutic effect on heart failure (HF), patients experience a marked reduction in physical and executive function, resulting in poor quality of life (QoL). A literature review revealed limited evidence regarding the possible relationship between self-care and QoL in HF patients. Therefore, this scoping review aimed to identify scientific evidence that examines the extent of self-care, QoL, and relationship between self-care and QoL in patients with HF. Methods Full-text research published from March 23, 2010, to March 23, 2020, written in English, that had content on both self-care and QoL among adult patients with HF was included. A literature search of electronic databases and web searches was conducted for published articles. Four databases were used: MEDLINE, Scopus, Web of Science, and the Cochrane Library. Studies collected from Google and Google Scholar web searches were also included. Results Of 1,537 papers identified by the search, 12 were included. The reviewed studies included 3,127 patients. Ten articles used a cross-sectional study design, whereas the remaining articles used a longitudinal and quasi-experimental design. This review found that the extent of self-care practices among patients with HF was inadequate, a significant proportion of patients enrolled in the reviewed studies had a moderate QoL, and higher self-care practices were associated with a better QoL. Self-care behavior and QoL were affected by social support, sex, age, educational level, place of residence, illness knowledge, presence of comorbidities, and functional classification of HF. Conclusion Self-care behavior was positively correlated with QoL in patients with HF. Self-care and QoL in these patients have been reported to be affected by several factors. Further research with a rigorous study design is recommended to investigate the influence of self-care practices on QoL in patients with HF.
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Affiliation(s)
- Sheka Shemsi Seid
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - José Amendoeira
- School of Nursing, Polytechnic Institute of Santarem, Quality of Life Research Center, Santarem, Portugal
| | - Maria Regina Ferreira
- School of Nursing, Polytechnic Institute of Santarem, Quality of Life Research Center, Santarem, Portugal
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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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Adherence to Self-Care Recommendations and Associated Factors among Adult Heart Failure Patients in West Gojjam Zone Public Hospitals, Northwest Ethiopia. Int J Chronic Dis 2022; 2022:9673653. [PMID: 36590698 PMCID: PMC9798104 DOI: 10.1155/2022/9673653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Self-care practices are an important part of heart failure patient management and essential to control symptoms of the disease and its exacerbation. However, poor adherence to these self-care behaviors could be associated with an increase in hospitalization, morbidity, and mortality. Even if it is an important part of management for heart failure patients, yet information is not adequate in the study area about adherence to self-care recommendations and associated factors among heart failure patients. Purpose To assess self-care recommendation adherence and associated factors among heart failure patients in West Gojjam Zone public hospitals. Methods Institutional-based cross-sectional study was conducted on 304 selected heart failure patients attending follow-up at public hospitals in West Gojjam Zone from March 16 to April 16, 2021. Consecutive sampling technique based on patient arrival with proportional allocation to each hospital was employed to select the study participants. Data were collected through face-to-face interview and reviewing patients' medical records. Data were entered into EpiData version 3.1 and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Binary logistic regression model was fitted to assess the association between adherence to self-care recommendations and associated factors. P value < 0.05 with 95% confidence interval (CI) was considered to declare a statistically significant association in multivariable logistic regression. Results In this study, 304 patients participated with a response rate of 97.4%. Only 32.9% of them had good adherence to self-care recommendations. Having good knowledge on heart failure (adjusted odds ratio (AOR) = 4.6; 95% CI: 1.82, 11.86), no depression (AOR = 6.1; 95% CI: 1.92, 19.37), having strong social support (AOR = 3.57; 95% CI: 1.56-8.33), age 30-49 years (AOR = 3.37; 95% CI: 1.14, 9.89), and college and above level of education (AOR = 6.17; 95% CI: 1.22, 31.25) were factors significantly associated with good adherence to self-care recommendations. Conclusion This study showed that most of the heart failure patients had poor adherence to self-care recommendations. Policymakers and other stakeholders should develop and implement appropriate strategies to increase patients' adherence level to self-care recommendations by emphasizing on addressing identified factors.
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Lee KS, Jeon ES, Park JH, Jung MS, Yun H, Kong HJ, Choi JO. Symptom detection and the relationship with self-care in heart failure. Eur J Cardiovasc Nurs 2022; 21:821-829. [PMID: 35670199 DOI: 10.1093/eurjcn/zvac038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 12/29/2022]
Abstract
AIM Patients with heart failure (HF) may have difficulty detecting symptom changes. However, most research has relied on medical record reviews or patient recall. Therefore, it is important to prospectively explore symptom detection in HF and the relationship with self-care. This study aimed at (i) prospectively identifying distinct symptom detection groups and comparing characteristics among the groups and (ii) exploring the association between symptom detection groups and self-care. METHODS AND RESULTS One hundred and thirty-two patients rated their shortness of breath (SOB) using the modified Borg scale at four-time points after a 6-min walk test (6-MWT). A trained nurse simultaneously and independently rated patients' SOB using the same scale. Latent class growth modelling was used to identify distinct trajectories of the differences in SOB ratings between the patients and nurses after the 6-MWT. After identifying the symptom detection groups, the characteristics of each group were compared, and the relationship between self-care and the symptom detection groups was examined using the multivariate linear regression. Three distinct symptom detection groups were identified: over-estimation (6.1%), consistent (69.7%), and under-estimation (24.2%) groups. There were no significant sample characteristics among the three symptom detection groups, except for attention. There was no relationship between self-care and symptom detection groups. CONCLUSIONS We identified three distinct symptom detection groups, implying that different approaches are needed to improve patients' symptom detection ability. The non-significant relationship between the symptom detection groups and self-care may be because we only measured symptom detection, which is only one aspect of the symptom perception process.
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Affiliation(s)
- Kyoung Suk Lee
- Seoul National University, College of Nursing, The Research Institute of Nursing Science, Seoul, South Korea
| | - Eun-Seok Jeon
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Hyeong Park
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University, School of Medicine, Daejeon, South Korea
| | - Mi Sook Jung
- Chungnam National University, College of Nursing, Deajeon, South Korea
| | - Hyeri Yun
- Chungnam National University, College of Nursing, Deajeon, South Korea
| | - Hee Jin Kong
- Chungnam National University, College of Nursing, Deajeon, South Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Jurgens CY, Lee CS, Aycock DM, Masterson Creber R, Denfeld QE, DeVon HA, Evers LR, Jung M, Pucciarelli G, Streur MM, Konstam MA. State of the Science: The Relevance of Symptoms in Cardiovascular Disease and Research: A Scientific Statement From the American Heart Association. Circulation 2022; 146:e173-e184. [PMID: 35979825 DOI: 10.1161/cir.0000000000001089] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Symptoms of cardiovascular disease drive health care use and are a major contributor to quality of life. Symptoms are of fundamental significance not only to the diagnosis of cardiovascular disease and appraisal of response to medical therapy but also directly to patients' daily lives. The primary purpose of this scientific statement is to present the state of the science and relevance of symptoms associated with cardiovascular disease. Symptoms as patient-reported outcomes are reviewed in terms of the genesis, manifestation, and similarities or differences between diagnoses. Specifically, symptoms associated with acute coronary syndrome, heart failure, valvular disorders, stroke, rhythm disorders, and peripheral vascular disease are reviewed. Secondary aims include (1) describing symptom measurement methods in research and application in clinical practice and (2) describing the importance of cardiovascular disease symptoms in terms of clinical events and other patient-reported outcomes as applicable.
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Mulugeta T, Duguna D, Bekele A, Umeta B. Adherence to Self-Care Behaviors and Associated Factors among Adult Heart Failure Patients Attending Chronic Follow-Up Care at Jimma University Medical Center, Southwest Ethiopia. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2205110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Optimal outcomes and quality of life in patients with heart failure (HF) depend on effective self-care activities. However, patients may experience difficulties, and their performance may be inconsistent.
Aim:
To determine the level of adherence to self-care behaviors and associated factors among adult HF patients attending chronic follow-up care at Jimma University Medical Center (JUMC).
Methods:
A cross-sectional study was conducted between August and September 2021. Data were collected through face-to-face interviews and by reviewing patients’ medical records. The collected data were analyzed using SPSS version 25 and the findings were presented in frequency, percentage, mean (SD), and median (IQR). Multivariate logistic regression was performed to determine factors associated with adherence to self-care behaviors. Odds ratios with 95% confidence intervals and p-values were used to report the findings.
Results:
Out of 266 HF patients, 50.0% had good adherence towards self-care behavior recommendations. The highest following recommendation was taking medication as prescribed (75.5%), followed by a dietary recommendation of a low-salt diet (45.2%). Participants who could not read and write (adjusted odds ratio (AOR) = 0.30 (95% confidence interval (CI) 0.13, 0.71), P = 0.006), had an illness duration greater than or equal to ten years (AOR = 0.31 (95% CI 0.12, 0.82), P = 0.02), in the NYHA class II HF (AOR = 0.33 (95% CI 0.15, 0.73), P = 0.007) were negatively associated with good adherence to self-care behavior recommendations.
Conclusion:
In this study, only half of the respondents had good adherence to self-care behaviors. Lower educational level, longer illness duration, and NYHA class II HF were predictors of poor adherence to self-care. Therefore, nurses should devise strategies to counsel or educate the HF patients on self-care practice recommendations, particularly patients with a lower education level and who lived longer with HF.
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De Maria M, Ausili D, Lorini S, Vellone E, Riegel B, Matarese M. Patient Self-Care and Caregiver Contribution to Patient Self-Care of Chronic Conditions: What Is Dyadic and What It Is Not. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1165-1173. [PMID: 35337754 DOI: 10.1016/j.jval.2022.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/01/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Self-care of chronic conditions involves both patients and their informal caregivers and therefore might be considered as a dyadic phenomenon. Nevertheless, empirical evidence supporting a dyadic construct is unavailable. This study aimed to explore the existence of a dyadic construct in self-care maintenance, monitoring, and management in patients affected by chronic conditions and their informal caregivers. METHODS This study used a cross-sectional design. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory, which measure patient self-care and informal caregivers' contribution to self-care maintenance, monitoring and management. Exploratory Structural Equation Modeling was performed to verify the existence of dyadic latent constructs in each scale in patients and informal caregivers. RESULTS A convenience sample of 493 patients and informal caregivers, with a mean age of 76.47 and 52.76 years, respectively, was studied. In the self-care maintenance scales, 2 correlated factors (r = 0.34, P < .001) were identified, indicating the presence of a dyadic second-order construct. In addition, 2 factors that were not correlated (r = 0.11, P = .064) were identified in the self-care monitoring scales, indicating the absence of a dyadic construct. Finally, we found a 3-factor model in the self-care management scales composed of both patient and caregiver items, indicating a dyadic first-order construct. CONCLUSIONS Knowing which care behaviors are dyadic in chronic conditions is important for tailoring interventions to improve self-care. Self-care maintenance and management would benefit from dyadic interventions, while self-care monitoring would not. The results of this study may illuminate future theoretical and scientific developments in dyadic care of chronic illness.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Silvia Lorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Maria Matarese
- Research Unit of Nursing Science, University Campus Bio-Medico of Rome, Rome, Italy
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Olano-Lizarraga M, Wallström S, Martín-Martín J, Wolf A. Causes, experiences and consequences of the impact of chronic heart failure on the person´s social dimension: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e842-e858. [PMID: 34918403 DOI: 10.1111/hsc.13680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
Chronic heart failure (CHF) is a progressive and disabling condition that significantly impacts patients' daily lives. One of its effects is decreased opportunities to participate in social life, leading to reduced social interaction, loneliness, social isolation and lack of social support to continue with their daily life activities. This study aimed to explore the causes, experiences, and consequences of the impact of CHF on the social dimension of the person. According to the Arksey & O'Malley method, a scoping review of the literature was conducted to examine existing knowledge in the area, summarise existing evidence and identify gaps in the literature. The search was conducted in the PubMed, CINAHL, PsychINFO, Scopus, and Web of Science databases from January 2010 to November 2021. Twenty-six articles were identified. The reasons why CHF influences the social dimension of the person were multifactorial and related to physical aspects, sociodemographics, lifestyle changes and the feelings experienced by these patients. Social relationships play a key role, and the benefits of good social relationships and the impact of poor or inadequate social support were identified. Furthermore, the influence of alterations in the social dimension on the CHF patient's clinical outcomes was described. This approach will help to detect and better understand the bidirectional influence that exists in each person between social isolation, relationships, and support life experiences, self-care activities, and morbi-mortality rates. These findings have shown the importance of detecting higher-risk groups and systematically assessing factors related to the social dimension in all patients with CHF.
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Affiliation(s)
- Maddi Olano-Lizarraga
- School of Nursing, Adult Nursing Care, Universidad de Navarra, Pamplona, Spain
- Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Universidad de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Sara Wallström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Jesús Martín-Martín
- School of Nursing, Adult Nursing Care, Universidad de Navarra, Pamplona, Spain
- Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Universidad de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Axel Wolf
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Jeong Y, Yu H, Hwang B. Self-Care Behaviors Mediate the Impacts of Social Support and Disease Knowledge on Health-Related Quality of Life in Patients With Heart Failure. Clin Nurs Res 2022; 31:1308-1315. [DOI: 10.1177/10547738221092864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was aimed to test the mediation effect of self-care on the associations of social support and heart failure (HF) knowledge with health-related quality of life (HRQOL). We analyzed baseline data from patients with HF ( n = 122) enrolled in a randomized controlled trial. Mediation analysis was conducted using Hayes’ PROCESS macro for SPSS with Model 4, based on the bias-corrected bootstrap method. Higher levels of social support and HF knowledge were associated with better self-care. Better self-care was associated with better HRQOL. While social support and HF knowledge had no significant direct effects on HRQOL, they indirectly affected HRQOL through self-care. Our findings suggest that social support and HF knowledge affect HRQOL indirectly through self-care. To improve the HRQOL in patients with HF, it is necessary to motivate them to perform regular self-care by enhancing their HF knowledge and providing social support. Clinical trial identifier: KCT0002400 ( https://cris.nih.go.kr )
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Affiliation(s)
| | - Heajin Yu
- Seoul National University, Seoul, Korea
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25
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Abstract
BACKGROUND Self-care is important for improving the health outcomes of individuals with chronic heart failure (CHF). However, predictors of self-care behaviors remain unclear in Chinese society. OBJECTIVE The aims of this study were to explore predictors of self-care in Chinese patients with CHF and clarify the complex relationships between predictors and self-care behaviors guided by the Situation-Specific Theory of Heart Failure Self-Care. METHODS A cross-sectional study was conducted among individuals hospitalized with CHF in China. Person, problem, and environmental factors pertaining to self-care were collected by a questionnaire survey. Self-care was assessed by the Self-Care of Heart Failure Index version 6. Direct and indirect relationships between factors and self-care behaviors and the mediating role of self-care confidence were analyzed by the structural equation model. RESULTS In total, 204 participants were involved in this study. The Situation-Specific Theory of Heart Failure Self-Care model demonstrated a good fit (root mean square error of approximation, 0.046; goodness of fit index, 0.966; normed fit index, 0.914; comparative fit index, 0.971). Inadequate self-care capabilities were common among Chinese patients with CHF. Person-related factors (female gender, higher monthly income and educational level), problem-related factors (severe New York Heart Association function class and better instrumental activities of daily living), and environmental factors (better social support and living in more developed areas) were significant predictors of better self-care behaviors ( P < .05). These associations were partly or fully mediated by self-care confidence. CONCLUSION The Situation-Specific Theory of Heart Failure Self-Care can be used to guide research and practice in patients with CHF. Interventions and policies on promoting self-care in Chinese population living with CHF are encouraged, particularly for underserved populations.
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Choi EY, Park JS, Min D, Lee HS, Ahn JA. Association between self-management behaviour and quality of life in people with heart failure: a retrospective study. BMC Cardiovasc Disord 2022; 22:90. [PMID: 35260090 PMCID: PMC8903718 DOI: 10.1186/s12872-022-02535-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background The purpose of this study was to investigate the variables that significantly associated with the quality of life in people with heart failure, and particularly, to identify the association between self-management behaviour and the quality of life. Methods This retrospective study used data from heart failure outpatient clinics at two large tertiary medical centres in Seoul and Suwon, South Korea. We enrolled 119 participants who completed echocardiography and stress tests and responded to questionnaires on self-management behaviour and quality of life. We collected more data on sociodemographic and clinical characteristics and anthropometric and serum blood test results through electronic medical record review. We analysed data using multiple linear regression and the classification and regression tree (CART) method to explore the associated factors with the quality of life in participants with heart failure. Results Participants’ mean age was 74.61 years, and women represented 52.1% of the sample. It showed that cardiac systolic function (β = 0.26, p = .013) and self-management behaviour (β = 0.20, p = .048) were two major associated factors with the quality of life in participants with heart failure in the multiple linear regression analysis. Also, cardiac systolic function and self-management behaviour were shown to be the primary determinants for the quality of life in those with heart failure in the CART analysis. Therefore, self-management behaviour of the participants with heart failure was a significant modifiable factor that can improve their quality of life. Conclusions Healthcare providers should be aware of the importance of self-management in people with heart failure and help promote their quality of life by enhancing their self-management behaviour as own efforts to properly maintain and monitor the health status and prevent further worsening of heart failure.
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Affiliation(s)
- Eui-Young Choi
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Sun Park
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
| | - Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Ah Ahn
- College of Nursing and Research Institute of Nursing Science, Ajou University, Worldcup-ro 164, Yeongtong-gu, Suwon, 16499, Republic of Korea.
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Interplay between psychosocial and heart failure related factors may partially explain limitations in self-efficacy in patients with heart failure and poor self-care behaviour: insights from a real-world cohort of 1,123 patients. Int J Nurs Stud 2022; 129:104233. [DOI: 10.1016/j.ijnurstu.2022.104233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/27/2022]
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Yoshinaga R, Tomita K, Wakayama K, Furuta S, Miyamoto K, Matsuda Y, Matsuo T, Oku K. Factors related to self-care behaviors among hospitalized patients with heart failure in Japan, based on the European Heart Failure Self-Care Behaviour Scale. J Phys Ther Sci 2022; 34:416-421. [PMID: 35698558 PMCID: PMC9170480 DOI: 10.1589/jpts.34.416] [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: 11/10/2021] [Accepted: 03/06/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The characteristics of heart failure in hospitalized patients with poor
self-care behaviors are unknown. We investigated factors associated with self-care
behaviors by using the European Heart Failure Self-Care Behaviour Scale (EHFScBS) in heart
failure patients based on three comprehensive concepts. [Participants and Methods] This
was a cross-sectional single-center study of heart failure patients hospitalized at a
tertiary-care hospital. We investigated age, gender, family living together/apart,
employment, and the Specific Activity Scale (SAS). A physical therapist provided the
EHFScBS one time to determine the patients’ pre-hospital self-care behavior status. The 12
items of the EHFScBS were classified into the following three categories: Maintenance,
Monitoring, and Management. [Results] The median age of the 39 consecutive patients was
81 years. A multiple regression analysis revealed that the factors exhibiting significant
associations were the SAS score (β=0.504) for Management and age (β=−0.403) for the total
EHFScBS score (adjusted by the number of hospitalizations for heart failure). Maintenance
and Monitoring were not significantly associated with the survey items. [Conclusion] These
data indicate that self-care education for hospitalized patients with heart failure leads
to individualized approaches based on characteristics such as age and physical activity
capacity.
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Affiliation(s)
- Ryuji Yoshinaga
- Department of Rehabilitation, National Hospital Organization Nagasaki Medical Center: 2-1001-1 Kubara, Omura-city, Nagasaki 856-8562, Japan
| | - Kohei Tomita
- Department of Rehabilitation, National Hospital Organization Nagasaki Medical Center: 2-1001-1 Kubara, Omura-city, Nagasaki 856-8562, Japan
| | - Kosuke Wakayama
- Department of Rehabilitation, National Hospital Organization Nagasaki Medical Center: 2-1001-1 Kubara, Omura-city, Nagasaki 856-8562, Japan
| | - Shintaro Furuta
- Department of Rehabilitation, National Hospital Organization Nagasaki Medical Center: 2-1001-1 Kubara, Omura-city, Nagasaki 856-8562, Japan
| | - Kotaro Miyamoto
- Department of Rehabilitation, National Hospital Organization Nagasaki Medical Center: 2-1001-1 Kubara, Omura-city, Nagasaki 856-8562, Japan
| | - Yohei Matsuda
- Department of Nursing, National Hospital Organization Nagasaki Medical Center, Japan
| | - Takashi Matsuo
- Department of Cardiology, National Hospital Organization Nagasaki Medical Center, Japan
| | - Koji Oku
- Department of Cardiology, National Hospital Organization Nagasaki Medical Center, Japan
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Rubio R, Palacios B, Varela L, Fernández R, Camargo Correa S, Estupiñan MF, Calvo E, José N, Ruiz Muñoz M, Yun S, Jiménez-Marrero S, Alcoberro L, Garay A, Moliner P, Sánchez-Fernández L, Soria Gómez MT, Hidalgo E, Enjuanes C, Calero-Molina E, Rueda Y, San Saturnino M, Garcimartín P, López-Ibor JV, Segovia-Cubero J, Comin-Colet J. Quality of life and disease experience in patients with heart failure with reduced ejection fraction in Spain: a mixed-methods study. BMJ Open 2021; 11:e053216. [PMID: 34862295 PMCID: PMC8647550 DOI: 10.1136/bmjopen-2021-053216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To gather insights on the disease experience of patients with heart failure (HF) with reduced ejection fraction (HFrEF), and assess how patients' experiences and narratives related to the disease complement data collected through standardised patient-reported outcome measures (PROMs). Also, to explore new ways of evaluating the burden experienced by patients and caregivers. DESIGN Observational, descriptive, multicentre, cross-sectional, mixed-methods study. SETTING Secondary care, patient's homes. PARTICIPANTS Twenty patients with HFrEF (New York Heart Association (NYHA) classification I-III) aged 38-85 years. MEASURES PROMs EuroQoL 5D-5L (EQ-5D-5L) and Kansas City Cardiomyopathy Questionnaire and patient interview and observation. RESULTS A total of 20 patients with HFrEF participated in the study. The patients' mean (SD) age was 72.5 (11.4) years, 65% were male and were classified inNYHA functional classes I (n=4), II (n=7) and III (n=9). The study showed a strong impact of HF in the patients' quality of life (QoL) and disease experience, as revealed by the standardised PROMs (EQ-5D-5L global index=0.64 (0.36); Kansas City Cardiomyopathy Questionnaire total symptom score=71.56 (20.55)) and the in-depth interviews. Patients and caregivers often disagreed describing and evaluating perceived QoL, as patients downplayed their limitations and caregivers overemphasised the poor QoL of the patients. Patients related current QoL to distant life experiences or to critical moments in their disease, such as hospitalisations. Anxiety over the disease progression is apparent in both patients and caregivers, suggesting that caregiver-specific tools should be developed. CONCLUSIONS PROMs are an effective way of assessing symptoms over the most recent time period. However, especially in chronic diseases such as HFrEF, PROM scores could be complemented with additional tools to gain a better understanding of the patient's status. New PROMs designed to evaluate and compare specific points in the life of the patient could be clinically more useful to assess changes in health status.
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Affiliation(s)
| | - Beatriz Palacios
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | - Luis Varela
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | - Raquel Fernández
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | | | | | - Elena Calvo
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Nuria José
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Marta Ruiz Muñoz
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Sergi Yun
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Santiago Jiménez-Marrero
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Lidia Alcoberro
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Alberto Garay
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Pedro Moliner
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Lydia Sánchez-Fernández
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | | | - Encarna Hidalgo
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Cristina Enjuanes
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Esther Calero-Molina
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | | | | | - Paloma Garcimartín
- Outpatients Clinics, Hospital del Mar, Barcelona, Spain
- Department of Biomedical Research in Heart Diseases, Hospital del Mar Institute for Medical Research, Barcelona, Spain
| | - Jorge V López-Ibor
- Department of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Javier Segovia-Cubero
- Department of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
- CIBER of Cardiovascular Diseases, Carlos III Health Institute, Madrid, Spain
| | - Josep Comin-Colet
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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Izadi Avanji FS, Masoudi Alavi N, Akbari H, Saroladan S. Self-Care and Its Predictive Factors in Hemodialysis Patients. J Caring Sci 2021; 10:153-159. [PMID: 34849359 PMCID: PMC8609113 DOI: 10.34172/jcs.2021.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 04/13/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction: Chronic kidney disease is a serious problem and patients need active self-care. This study focuses on the relationship between self-care and its predictive factors in hemodialysis (HD) patients.
Methods: This multicenter correlational study was conducted on 201 HD patients referring to HD centers in the west of Tehran, Iran. A multi-stage sampling method was used to select the samples. Data were collected using self-care Scale, Paloutzian-Ellison Spiritual Well-Being Scale, and Connor Davidson Resilience Questionnaires. Data were analyzed using SPSS software version 13 and descriptive statistics and linear regression with stepwise method.
Results: The mean (SD) scores of self-care, resilience, and spiritual well-being were 35.5 (5.69), 53.4 (12.94), and 97.4 (17.9), respectively. Univariate analysis showed that self-care had a statistically significant relationship with gender, occupation, education, being diabetic, and hyperlipidemia. Self-care positively correlated with the resilience and negatively correlated with age. Multivariate regression indicated that the resilience (β = 0.78, P = 0.001), being diabetic (β = -0.09, P = 0.01), and age (β = -0.11, P = 0.005) could be predictors of self-care. These variables accounted for 78% of variance in self-care in HD patients.
Conclusion: Our results showed that resilience was positively correlated with self–care, but being diabetic and age were negatively correlated with self-care in HD patients. Therefore, the health care providers should pay more attention to HD patients who are diabetic and older, as they are at a higher risk of having impaired self-care.
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Affiliation(s)
- Fatemeh Sadat Izadi Avanji
- Department of Medical Surgical Nursing, School of Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Negin Masoudi Alavi
- Department of Medical Surgical Nursing, School of Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Hosein Akbari
- Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Somayeh Saroladan
- Department of Medical Surgical Nursing, School of Nursing, Kashan University of Medical Sciences, Kashan, Iran
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De Maria M, Ferro F, Vellone E, Ausili D, Luciani M, Matarese M. Self-care of patients with multiple chronic conditions and their caregivers during the COVID-19 pandemic: A qualitative descriptive study. J Adv Nurs 2021; 78:1431-1447. [PMID: 34846083 DOI: 10.1111/jan.15115] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/21/2021] [Accepted: 11/05/2021] [Indexed: 12/23/2022]
Abstract
AIMS Explore the self-care experiences of patients with multiple chronic conditions (MCCs) and caregivers' contributions to patient self-care during COVID-19 pandemic. DESIGN A descriptive qualitative design was used. The COREQ checklist was used for study reporting. METHODS Individual semi-structured interviews were used to collect data from patients with MCCs and caregivers selected from the dataset of an ongoing longitudinal study. Data analysis was performed through deductive thematic analysis. The middle-range theory of self-care of chronic illness, which entails the three dimensions of self-care maintenance, monitoring and management, was used as a theoretical framework to guide data collection and analysis. RESULTS A total of 16 patients and 25 caregivers were interviewed from May to June 2020. The participants were mainly women, with a mean age for patients of 76.25 years and caregivers of 45.76 years; the caregivers were mainly the patients' children (72%). During the pandemic, some patients reported remaining unchanged in their self-care maintenance, monitoring and management behaviours, others intensified their behaviours, and others decreased them. Caregivers played an important role in protecting patients from the risk of contagion COVID-19 and in ensuring patients' self-care of chronic diseases through direct and indirect interventions. CONCLUSIONS Critical events can modify the self-care experiences of chronically ill patients and caregivers' contributions, leading to maintenance, increase or decrease of self-care and contributions to self-care behaviours. IMPACT Patients with MCCs and their caregivers can react in different ways in their performances of self-care and contribution to patients' self-care behaviours when ordinary daily life is disrupted; therefore, nurses should assess such performances during critical events to identify the individuals at risk of reduced self-care and promote the most suitable healthcare services (e.g. eHealth) to implement individualised interventions.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Federico Ferro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-medico University of Rome, Rome, Italy
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de Lira CRN, Akutsu RDC, Costa PRDF, Leite LDO, da Silva KBB, Botelho RBA, Raposo A, Han H, Ariza-Montes A, Araya-Castillo L, Zandonadi RP. Occupational Risks in Hospitals, Quality of Life, and Quality of Work Life: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111434. [PMID: 34769950 PMCID: PMC8582940 DOI: 10.3390/ijerph182111434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/16/2022]
Abstract
This study systematically reviewed the relationship between occupational risks and quality of life (QoL) and quality of work life (QWL) in hospitals. A systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide, and the protocol was submitted on the PROSPERO website (CRD 2019127865). The last search was performed in June 2021 by two independent reviewers in the main databases, a gray literature database, and a manual search (LILACS, MEDLINE/PubMed, PsycINFO, CINAHL, Scopus, Embase, Brazilian Digital Library of Theses and Dissertations, Ovid). As eligibility criteria, we included observational studies, with adult hospital workers, with no restrictions on date and language, any type of instrument to assess QoL and QWL, any definition of QoL and QWL, and studies that presented the relationship between exposure and outcome. Newcastle–Ottawa was used to assess the methodological quality and RTI-Item Bank to assess the risk of bias. Given the impossibility of performing a meta-analysis, a qualitative synthesis was used to present the results. Thus, 11 studies met the criteria and were included in the review, with 6923 individuals aged 18 to 64 years. The studies were mainly carried out with health professionals (81.81%), women (63.60%), and in Asian countries (63.63%). All studies used different instruments and ways to categorize the QoL and QWL, and occupational risks. Only one study assessed occupational noise and another the ergonomic risk. All of them presented a relationship between occupational risk and quality of work life. They pointed to the need for measures to improve the lives of these professionals in the work environment. Therefore, studies show a relationship between occupational risks (noise, ergonomics, and stress) and workers’ perception of low or moderate quality of work life. However, more homogeneous studies are necessary for instruments, conceptualization, and categorization of quality of work life.
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Affiliation(s)
- Carlos Rodrigo Nascimento de Lira
- School of Nutrition, Federal University of Bahia, Avenida Araújo Pinho, n°32, Canela, Salvador CEP: 40110-150, Brazil; (C.R.N.d.L.); (P.R.d.F.C.); (L.d.O.L.); (K.B.B.d.S.)
| | - Rita de Cássia Akutsu
- Department of Nutrition, Campus Darcy Ribeiro, University of Brasilia, Asa Norte, Distrito Federal, Brasília CEP: 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - Priscila Ribas de Farias Costa
- School of Nutrition, Federal University of Bahia, Avenida Araújo Pinho, n°32, Canela, Salvador CEP: 40110-150, Brazil; (C.R.N.d.L.); (P.R.d.F.C.); (L.d.O.L.); (K.B.B.d.S.)
| | - Luana de Oliveira Leite
- School of Nutrition, Federal University of Bahia, Avenida Araújo Pinho, n°32, Canela, Salvador CEP: 40110-150, Brazil; (C.R.N.d.L.); (P.R.d.F.C.); (L.d.O.L.); (K.B.B.d.S.)
- Department of Life Sciences, Bahia State University, Rua Silveira Martins, Cabula, Salvador CEP: 41150-000, Brazil
| | - Karine Brito Beck da Silva
- School of Nutrition, Federal University of Bahia, Avenida Araújo Pinho, n°32, Canela, Salvador CEP: 40110-150, Brazil; (C.R.N.d.L.); (P.R.d.F.C.); (L.d.O.L.); (K.B.B.d.S.)
| | - Raquel B. A. Botelho
- Department of Nutrition, Campus Darcy Ribeiro, University of Brasilia, Asa Norte, Distrito Federal, Brasília CEP: 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
- Correspondence: (A.R.); (H.H.)
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, Seoul 05006, Korea
- Correspondence: (A.R.); (H.H.)
| | - Antonio Ariza-Montes
- Social Matters Research Group, Universidad Loyola Andalucía, C/Escritor Castilla Aguayo, 414004 Córdoba, Spain;
- Faculty of Business Administration, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Luis Araya-Castillo
- Facultad de Economía y Negocios, Universidad Andrés Bello, Santiago de Chile 7591538, Chile;
| | - Renata Puppin Zandonadi
- Department of Nutrition, Campus Darcy Ribeiro, University of Brasilia, Asa Norte, Distrito Federal, Brasília CEP: 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
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Sakane K, Kanzaki Y, Ito T, Hoshiga M. Motivational interviewing as a new approach to improve outcome through self-care behavioural changes in advanced heart failure patient: a case report. Eur Heart J Case Rep 2021; 5:ytab395. [PMID: 34738065 PMCID: PMC8564705 DOI: 10.1093/ehjcr/ytab395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/15/2021] [Accepted: 09/20/2021] [Indexed: 11/14/2022]
Abstract
Abstract
Background
A lack of adherence and inadequate self-care behaviours are common reasons for recurrent hospitalizations among patients with heart failure (HF). Although patients recognize the importance of HF self-care, it is sometimes difficult to correct their behavioural patterns. Motivational interviewing is a communication technique to resolve ambivalence towards changing behaviour, and it has been widely used to promote behavioural changes and improve outcomes in various chronic diseases. We described a case of advanced HF with reduced ejection fraction in which motivational interviewing lead to stabilize the patient’s condition.
Case summary
A 33-year-old man was diagnosed with dilated cardiomyopathy who experienced repeated episodes of HF requiring hospitalization despite optimal guideline-based HF treatment. Transthoracic echocardiography disclosed a severely reduced left ventricular (LV) contraction (LV ejection fraction 18%) and cardiopulmonary exercise testing disclosed markedly reduced functional capacity and increased ventilatory response (peak VO2 of 10.7 mL/min/kg, predicted peak VO2 of 34.7% and VE/VCO2 slope of 35.2). In this case, poor adherence to self-care such as excessive fluid intake and excessive daily activities after hospital discharge was the main cause of recurrent hospitalization for HF. Despite repeated patient education to correct his diet and lifestyle, he could not change his lifestyle behaviour. However, motivational interviewing dramatically helped stabilize the patient’s condition and prevent HF re-hospitalization.
Discussion
In general, patients with advanced HF and reduced ejection fraction despite optimal medical therapy should be evaluated to assess their eligibility of cardiac transplantation or palliative care. Motivational interviewing might represent a new therapeutic approach for stabilizing and preventing HF through self-care behavioural changes, even in patients with advanced HF and severely reduced ejection fraction.
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Affiliation(s)
- Kazushi Sakane
- Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Yumiko Kanzaki
- Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Takahide Ito
- Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Masaaki Hoshiga
- Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
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İlaslan E, Özer Z. Web-Based Training and Telephone Follow-up of Patients With Heart Failure: Randomized Controlled Trial. Comput Inform Nurs 2021; 40:82-89. [PMID: 34570004 DOI: 10.1097/cin.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study was carried out to determine the effect of Web-based training and telephone follow-up on symptom burden and health status in patients with heart failure. Patient training and postdischarge follow-up are necessary to improve symptom management and quality of life in patients with heart failure. In Turkey, Web-based education and phone monitoring are not very common yet. In this parallel randomized controlled trial, patients were allocated to a control group (n = 32) or an intervention group (n = 32). The control group received routine care, and the intervention group was administered the following interventions in addition to routine care: Web-based training, four-session telephone follow-up, and one text message weekly. All results regarding symptom management and quality of life were assessed beginning and at the 12th week. The Consolidated Standards of Reporting Trials checklist was used. In the 12th week after discharge, patients in the intervention group showed a significant improvement in terms of symptom burden and health status compared with the control group.
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Affiliation(s)
- Emine İlaslan
- Author Affiliations: Kumluca Faculty of Health Sciences (Dr İlaslan) and Faculty of Nursing (Dr Özer), Akdeniz University, Antalya/Turkey
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Latifi M, Anvari Tafti M, Davari Dolatabadi N, Rafiei Z, Allahbakhshian Farsani L. E-Health: The Impact of Social Network on Self Care Behavior in Heart Failure Patients toward COVID-19 Epidemic. Adv Biomed Res 2021; 10:15. [PMID: 34476223 PMCID: PMC8378447 DOI: 10.4103/abr.abr_195_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/03/2020] [Accepted: 12/19/2020] [Indexed: 11/04/2022] Open
Abstract
Background Patients with heart failure are one of the high-risk groups for coronary artery. Distance education of self-care behaviors can be effective in preventing the disease. The aim of this study was to investigate the effect of social networks in explaining the awareness of cardiovascular patients' self-care behaviors toward COVID-19. Materials and Methods In the present survey study, 227 patients with a history of heart failure were selected from Shahid Rajaei Hospital in Tehran by the available sampling method (May to July 2020). Data collection tools were the standard European Self-Care Behavior Questionnaire for heart failure and the Dorty Elizabeth Orem self-care model. Data were analyzed using SPSS Version 22. Results The results of the Pearson correlation coefficient showed a positive and relatively strong linear relationship between the variable of the degree of persistence in the use of networks with the eight dimensions of self-care behavior except psychological emotion control (r = -0.39, P = 0.315). Furthermore, a significant weak inverse relationship between the dimension of "cooperation with physicians and treatment staff" (r = -0.22, P = 0.129). Moreover, psychological support (r = -0/034, P = 0.446) was observed with the use of networks. Multivariate regression analysis revealed that the type of activity and participation in networks has a greater share and effect in increasing the score of self-care behavior of 0.55. Conclusions Since the use of networks has a positive effect on patients' self-care behavior, the use of these networks is recommended as a community-based approach in the health system and to improve health and health outcomes.
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Affiliation(s)
- Masoomeh Latifi
- PhD in Information Sciences and Knowledge Studies, Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Motahare Anvari Tafti
- Department of Emergency Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Davari Dolatabadi
- Associate Professor of Health Information Management, Department of Health Information Technology, School of Allied Medical Sciences, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Rafiei
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leili Allahbakhshian Farsani
- PhD in Knowledge and Information Sciences, Vice Chancellor for Research and Technology, Isfahan University of Medical Sciences, Isfahan, Iran
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Bonikowska I, Szwamel K, Uchmanowicz I. Analysis of the Impact of Disease Acceptance, Demographic, and Clinical Variables on Adherence to Treatment Recommendations in Elderly Type 2 Diabetes Mellitus Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8658. [PMID: 34444407 PMCID: PMC8391118 DOI: 10.3390/ijerph18168658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 01/13/2023]
Abstract
This project aimed to analyze the impact of disease acceptance and selected demographic and clinical factors on the adherence to treatment recommendations in elderly type 2 diabetes mellitus patients. The observational study was performed using standardized research questionnaires: the Acceptance of Illness Scale (AIS), the Self-Care of Diabetes Inventory (SCODI), and the Adherence in Chronic Diseases Scale (ACDS). Two hundred patients with T2DM were studied (age M = 70.21 years, SD = 6.63 years). The median degree of disease acceptance was 29 (min-max = 8-40) and the median level of adherence was 24 (min-max = 13-28). Disease acceptance was a significant (p = 0.002) independent predictor of the odds of qualifying for non-adherence OR = 0.903, 95% CI = 0.846-0.963. The respondents gave the lowest scores for glycemic control (Mdn = 38.99, min-max = 8.33-150), and health control (Mdn = 55.88, min-max = 11.76-100). A one-way ANOVA showed that the non-adhering patients were significantly older compared to the adherence group and were taking significantly more diabetes pills per day. The level of disease acceptance was average, but it turned out to be an independent predictor of adherence. Therefore, it is justified to use psychological and behavioral interventions that are aimed at increasing the level of diabetes acceptance in elderly people with T2DM. It is important to have a holistic approach to the patient and to take actions that consider the patient's deficits in the entire biopsychosocial sphere. The obtained result confirmed the legitimacy of interventions aimed at increasing the level of disease acceptance in this group of patients.
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Affiliation(s)
- Iwona Bonikowska
- Institute of Health Sciences, Department Nursing, University of Zielona Góra, 2 Energetyków Street, 65-00 Zielona Góra, Poland
| | - Katarzyna Szwamel
- Institute of Health Sciences, University of Opole, Katowicka Street 68, 45-060 Opole, Poland;
| | - Izabella Uchmanowicz
- Faculty of Health Sciences, Wrocław Medical University, K. Bartla 5, 51-618 Wroclaw, Poland;
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Durante A, De Maria M, Boyne J, Jaarsma T, Juarez-Vela R, Strömberg A, Vellone E. Development and psychometric testing of the European Heart Failure Self-Care behaviour scale caregiver version (EHFScB-C). PATIENT EDUCATION AND COUNSELING 2021; 104:2106-2111. [PMID: 33516593 DOI: 10.1016/j.pec.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The European Heart Failure Self-Care Behaviour Scale (EHFScBS) is used worldwide to measure heart failure (HF) patient self-care, but a caregiver version does not exist. OBJECTIVE To develop and test the European HF Self-Care Behaviour Scale for Caregivers (EHFScBS-C) in a population of informal caregivers of HF patients. METHODS The EHFScBS-C was derived from the EHFScBS to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C was developed in English and then translated into Italian, Spanish and Dutch, after which it was back-translated. EHFScBS-C data were collected from 193 HF caregivers enrolled in Italy, Spain and the Netherlands. RESULTS Exploratory factor analysis revealed two factors with supportive fit indices (CFI = 0.990; RMSEA = 0.048): caregivers' contributions to HF self-care related to medical issues, and caregivers' contributions related to lifestyle. Internal consistency reliability was supported as well (Cronbach's alpha 0.90 for the overall scale). Construct validity was demonstrated with significant correlations with the Caregiver Preparedness Scale. CONCLUSION AND PRACTICE IMPLICATIONS The EHFScBS-C has adequate validity and reliability for its use in clinical practice and research to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C can be used in combination with the EHFScBS to conduct dyadic studies.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Abstract
OBJECTIVES To explore gender and racial differences in heart failure (HF) self-care processes and examine whether gender and race predict HF self-care. METHODS A secondary analysis of baseline data (n = 107) from a longitudinal HF study (54.2% males; 56% non-Caucasians) was conducted. The self-care of heart failure index was used to measure self-care maintenance, management, and confidence. Descriptive statistics and univariate analyses examined gender and racial differences in HF self-care outcomes. Multiple linear regression examined whether gender and race predicted HF self-care maintenance, management, and confidence. RESULTS Univariate analyses indicated that Caucasians reported significantly better self-care maintenance (p = 0.042), while non-Caucasians reported significantly better self-care management (p = 0.003). Males had significantly higher self-care confidence scores versus women (p = 0.017). Multiple regression analysis indicated Caucasian race predicted significantly worse self-care management (β = -11.188; p = 0.006) versus non-Caucasian, while male gender predicted significantly higher self-care confidence scores (β = 7.592; p = 0.010) versus female gender. Gender nor race significantly predicted self-care maintenance. DISCUSSION Although gender and race may influence HF self-care, other factors may be more important. More research is needed to identify individual factors that contribute to HF self-care to improve education and intervention.
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Affiliation(s)
- Lucinda J Graven
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Laurie Abbott
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Sabrina L Dickey
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Glenna Schluck
- Florida State University College of Nursing, Tallahassee, FL, USA
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Habibi H, Sedighi B, Jahani Y, Hasani M, Iranpour A. Self-Care Practices and Related Factors in Patients with Multiple Sclerosis (MS) Based on the Health Belief Model. J Caring Sci 2021; 10:77-83. [PMID: 34222116 PMCID: PMC8242295 DOI: 10.34172/jcs.2021.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 01/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.
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Affiliation(s)
- Hajar Habibi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Sedighi
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Marziyeh Hasani
- Department of Health Education and Promotion, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Calero-Molina E, Hidalgo E, Rosenfeld L, Verdú-Rotellar JM, Verdú-Soriano J, Garay A, Alcoberro L, Jimenez-Marrero S, Garcimartin P, Yun S, Guerrero C, Moliner P, Delso C, Alcober L, Enjuanes C, Comin-Colet J. The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study. Eur J Cardiovasc Nurs 2021; 21:116-126. [PMID: 34008849 DOI: 10.1093/eurjcn/zvab011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/28/2020] [Accepted: 02/12/2021] [Indexed: 11/12/2022]
Abstract
AIMS The assumption that improved self-care in the setting of heart failure (HF) care necessarily translates into improvements in long-term mortality and/or hospitalization is not well established. We aimed to study the association between self-care and long-term mortality and other major adverse HF events (MAHFE). METHODS AND RESULTS We conducted an observational, prospective, cohort study of 1123 consecutive patients with chronic HF. The primary endpoint was all-cause mortality. We used the European Heart Failure Self-care Behaviour Scale 9-item version (EHFSCBS-9) to measure global self-care (overall score) and three specific dimensions of self-care including autonomy-based adherence, consulting behaviour and provider-based adherence. After a mean follow-up of 3.3 years, all-cause death occurred in 487 patients (43%). In adjusted analysis, higher EHFScBS-9 scores (better self-care) at baseline were associated with lower risk of all-cause death [hazard ratio (HR) 0.993, 95% confidence interval (CI) (0.988-0.997), P-value = 0.002], cardiovascular (CV) death [HR 0.989, 95% CI (0.981-0.996), P-value = 0.003], HF hospitalization [HR 0.993, 95% CI (0.988-0.998), P-value = 0.005], and the combination of MAHFE [HR 0.995, 95% CI (0.991-0.999), P-value = 0.018]. Similarly, impaired global self-care [HR 1.589, 95% CI (1.201-2.127), P-value = 0.001], impaired autonomy-based adherence [HR 1.464, 95% CI (1.114-1.923), P-value = 0.006], and impaired consulting behaviour dimensions [HR 1.510, 95% CI (1.140-1.923), P-value = 0.006] were all associated with higher risk of all-cause mortality. CONCLUSION In this study, we have shown that worse self-care is an independent predictor of long-term mortality (both, all-cause and CV), HF hospitalization, and the combinations of these endpoints in patients with chronic HF. Important dimensions of self-care such as autonomy-based adherence and consulting behaviour also determine the risk of all these outcomes in the long term.
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Affiliation(s)
- Esther Calero-Molina
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Encarna Hidalgo
- Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laia Rosenfeld
- Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Advanced Heart Failure and Heart Transplant Unit, Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose Maria Verdú-Rotellar
- Primary Care Service Litoral, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Alberto Garay
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lidia Alcoberro
- Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Santiago Jimenez-Marrero
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paloma Garcimartin
- Head of Advanced Practice Nurses, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.,Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Escuela Superior de Enfermería del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Sergi Yun
- Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Guerrero
- Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pedro Moliner
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Delso
- Primary Care Service Delta del Llobregat, Barcelona, Spain
| | - Laia Alcober
- Primary Care Service Delta del Llobregat, Barcelona, Spain
| | - Cristina Enjuanes
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Comin-Colet
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Community Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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Johansson P, Lundgren J, Andersson G, Svensson E, Mourad G. Internet-based cognitive behavioural therapy and association to self-efficacy, depressive symptoms and physical activity: A secondary analysis of a randomized controlled trial in patients with cardiovascular disease (Preprint). JMIR Cardio 2021; 6:e29926. [PMID: 35657674 PMCID: PMC9206200 DOI: 10.2196/29926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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Affiliation(s)
- Peter Johansson
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
- Unit of Internal Medicine, Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping Univerisity, Norrköping, Sweden
| | - Johan Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | - Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
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42
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Meta approaches in knowledge synthesis in nursing: A bibliometric analysis. Nurs Outlook 2021; 69:815-825. [PMID: 33814160 DOI: 10.1016/j.outlook.2021.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/31/2021] [Accepted: 02/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To analyze the bibliometric patterns of meta-approaches use in nursing research literature. METHODS Descriptive, exploratory and historical bibliometrics analyses were used. The papers were harvested from the Web of Science Core Collection. FINDINGS The search resulted in 2065 publications. The trends in using most individual meta approaches show that the use of meta-analysis is increasing exponentially, the use of meta-synthesis is increasing linearly, while the use of meta-ethnography is constant in last 6 years. Most productive countries were United States of America, United Kingdom and Peoples Republic of China. Most publications were published in the Journal of Advanced Nursing, International Journal of Nursing Studies, and Journal of Clinical Nursing. Twenty-seven percent of all publications were funded. Thirty-four meta approaches were identified. DISCUSSION The study revealed that the trend in the literature production is positive. Research community use of meta-approaches in nursing exhibit considerable growth. Regional concentration of literature production was observed.
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Sanson G, Vellone E, Takao-Lopes C, Barrientos-Trigo S, Porcel-Gálvez AM, Riegel B, D'Agostino F. Filling a gap in standardized nursing terminology. Development of a new nursing diagnosis proposal on heart failure self-care. Int J Nurs Knowl 2021; 33:18-28. [PMID: 33760361 DOI: 10.1111/2047-3095.12324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Heart failure is a highly prevalent chronic health problem associated with poor quality-of-life and negative outcomes. Self-care is a cornerstone in patients suffering from heart failure. Nurses are commonly engaged in enhancing patients' self-care behaviors, but the specific condition of deficit on self-care is not clearly identified by nurses. No nursing diagnoses focused on self-care of heart failure patients is currently available. This study aimed to develop a new nursing diagnosis that focuses on self-care in heart failure patients. DATA SOURCES A concept and content analysis were used. Some steps of the concept analysis were performed through an integrative literature review conducted searching in PUBMED and CINAHL databases to identify attributes, antecedents, and consequences of the diagnosis. Forty-five articles were selected from the 1450 studies found. Then, the content analysis was performed by an international panel of 29 experts. Two Delphi rounds were used to achieve consensus and an item content validity index was calculated for each diagnostic element. DATA SYNTHESIS Integrative review proposed four diagnostic labels, two definitions, 15 defining characteristics, and 44 related factors. After the two Delphi rounds a consensus was reached for each diagnostic indicator with a content validity index ranging from 82.8% to 100%. The nursing diagnosis-labeled heart failure self-care deficit-was validated with a definition, eight defining characteristics, 15 related factors, and five at-risk populations. CONCLUSIONS This diagnosis allows nurses to document patients' self-care in daily clinical practice through a standard nursing terminology, by naming this health problem, describing its etiology, and clinical manifestations. IMPLICATIONS FOR NURSING PRACTICE This new diagnosis is expected to assist nursing clinicians, educators, and students in clinical reasoning with the aim to improve diagnostic accuracy in identifying patients with a heart failure self-care deficit, to select the most appropriate interventions and pursue better outcomes.
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Affiliation(s)
- Gianfranco Sanson
- Assistant Professor, School of Nursing, Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34100, Italy
| | - Ercole Vellone
- Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, Rome, 00133, Italy
| | - Camila Takao-Lopes
- Adjunct Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), R. Napoleão de Barros, 754, São Paulo, 04024-002, Brazil
| | - Sergio Barrientos-Trigo
- Associate Professor, Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, Research Group under the Andalusian Research CTS 1050 Complex Care, Chronicity, and Health Outcomes, University of Seville, C/ Avenzoar, 6, Seville, 41009, Spain
| | - Ana María Porcel-Gálvez
- Associate Professor, Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, Research Group under the Andalusian Research CTS 1050 Complex Care, Chronicity, and Health Outcomes, University of Seville, C/ Avenzoar, 6, Seville, 41009, Spain
| | - Barbara Riegel
- Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, 19104-4217, USA
| | - Fabio D'Agostino
- Assistant Professor, Saint Camillus International University of Health Sciences, Rome, 00131, Italy
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44
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Attaallah SA, Peters RM, Benkert R, Yarandi H, Oliver-McNeil S, Hopp F. Developing a Middle-Range Theory of Heart Failure Self-Care. Nurs Sci Q 2021; 34:168-177. [PMID: 33749431 DOI: 10.1177/0894318420987164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Middle-range nursing theories provide a bridge between the more abstract grand nursing theories, research, and clinical practice. As such, middle-range nursing theories derived from extant nursing theories are critical for developing and advancing both nursing science and practice. This paper describes the strategy used in developing a middle-range theory of heart failure self-care. After integrating theoretical and empirical literature, a hypothetico-deductive approach was used to develop the middle-range theory of heart failure self-care from Orem's theory of self-care. Theoretical substruction was used to provide a graphic representation of the conceptual-theoretical-empirical structure demonstrating the congruence between the theoretical and operational systems.
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Affiliation(s)
| | | | - Ramona Benkert
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Hossein Yarandi
- College of Nursing, Wayne State University, Detroit, MI, USA
| | | | - Faith Hopp
- School of Social Work, Wayne State University, Detroit, MI, USA
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45
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Sedlar N, Lainscak M, Farkas J. Self-care perception and behaviour in patients with heart failure: A qualitative and quantitative study. ESC Heart Fail 2021; 8:2079-2088. [PMID: 33719209 PMCID: PMC8120357 DOI: 10.1002/ehf2.13287] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/14/2021] [Accepted: 02/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background and objective Self‐care strategies in heart failure (HF) are effective for disease management, yet adherence in many patients is inadequate. Reasons are presumably multifactorial but remain insufficiently investigated; thus, we aimed to analyse self‐care adherence and associated factors in outpatients with HF. Methods and results To measure self‐care levels and explore barriers and facilitators to self‐care adherence in patients with HF, quantitative study using the European Self‐Care Behaviour Scale (EHFScBS‐9) (n = 80; NYHA II–III, mean age 72 ± 10 years, 58% male) and qualitative study using semi‐structured interviews (n = 32; NYHA II–III, mean age 73 ± 11, 63% male) were conducted. We detected lowest adherence to regular exercise (39%) and contacts with healthcare provider in case of worsening symptoms (47%), whereas adherence was highest for regular medication taking (94%). Using the EHFScBS‐9 standardized cut‐off score ≤ 70, 51% of patients reported inadequate self‐care. Binary logistic regression analysis showed significant influence of education (OR = 0.314, 95% CI: 0.103–0.959) and perceived control (OR = 1.236, 95% CI: 1.043–1.465) on self‐care adequacy. According to the situation‐specific theory of HF self‐care, most commonly reported factors affecting the process of self‐care were knowledge about HF self‐care behaviours (84%), experience with healthcare professionals (84%), beliefs about their expertise (69%) and habits related to medication taking (72%). Among values, working responsibilities (53%) and maintenance of traditions (31%) appeared as the most prevalent socially based values affecting motivation for self‐care. Situational characteristics related to the person (self‐confidence, 53%; adaptive coping strategies, 88%), problem (burdensome breathing difficulties, 56%; co‐morbidities, 81%) and environment (practical support from family/caregivers, 59%; financial difficulties, 50%) were also commonly reported. Conclusions Various factors, including health‐related beliefs, habits and socially based values, need to be taken into account when planning self‐care interventions in patients with HF. A patient tailored approach should be based on adequate patient evaluation, taking into consideration the particular personal and social context.
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Affiliation(s)
- Natasa Sedlar
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mitja Lainscak
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
| | - Jerneja Farkas
- National Institute of Public Health, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Research, General Hospital Murska Sobota, Murska Sobota, Slovenia
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46
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Jaarsma T, Strömberg A, Dunbar SB, Fitzsimons D, Lee C, Middleton S, Vellone E, Freedland KE, Riegel B. Self-care research: How to grow the evidence base? (reprint). Int J Nurs Stud 2021; 116:103903. [PMID: 33637295 DOI: 10.1016/j.ijnurstu.2021.103903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The number of studies in the area of self-care is growing and international researchers are increasingly developing self-care interventions to improve outcomes of individual patients and communities. However, growth of the evidence is still slow due to challenges with designing and testing self-care interventions. In this article we address major methodological challenges with regard to the definition of self-care, use of theory, and research design, intended to provide guidance to researchers in this field. METHOD During the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019 we identified important issues in existing self-care research. Discussion and literature review lead to eight recommendation for future self-care research. RESULTS In preparation, begin with a theoretically sound definition of self-care. In planning the intervention, build on and extend previous studies. Use theory to develop self-care interventions and consider translational models to guide development, evaluation and implementation of complex self-care interventions. Employ a study design that fits the current phase and objectives of the research and measure self-care and related factors carefully. In reporting, describe the sample and setting sufficiently so that others can draw conclusions about generalizability and applicability to their practice and patient population. In interpretation, describe how the intervention is assumed to work (causal assumptions) and its key components. CONCLUSION Our review of existing self-care research clearly illustrates that the recommendations we provide are needed if we are to substantially grow the evidence base supporting self-care. Embracing a core set of principles will allow us to build on each other's work. Tweetable abstract: A core set of methodological principles is needed to substantially grow the evidence base supporting self-care.
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Affiliation(s)
- T Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, 58381 Linköping, Sweden; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Julius Center, University Medical Center Utrecht, the Netherlands.
| | - A Strömberg
- Department of Health, Medicine and Caring Sciences, Linkoping University, 58381 Linköping, Sweden; Department of Cardiology, Linkoping University, Sweden
| | - S B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, USA
| | - D Fitzsimons
- School of Nursing & Midwifery, Queen's University Belfast, UK
| | - C Lee
- William F. Connell, School of Nursing, Boston College, USA
| | - S Middleton
- Nursing Research Institute, St Vincent's Health Australia & Australian Catholic University, Australia
| | - E Vellone
- University of Rome "Tor Vergata", Italy
| | - K E Freedland
- Department of Psychiatry, Washington University School of Medicine, USA
| | - B Riegel
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Nursing, University of Pennsylvania, USA
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Nordfonn OK, Morken IM, Bru LE, Larsen AI, Husebø AML. Burden of treatment in patients with chronic heart failure - A cross-sectional study. Heart Lung 2021; 50:369-374. [PMID: 33618147 DOI: 10.1016/j.hrtlng.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients with heart failure (HF) must manage both a demanding treatment regimen and self-care, which may lead to a burden of treatment. The purpose of this study was to assess the levels of burdens from treatment and self-care and its associations with psychological distress and health-related quality of life. METHODS In this cross-sectional study we collected self-report data from 125 patients diagnosed with HF, New York Heart Association classification II and III, who received care in a nurse-led HF outpatient clinic. Clinical variables were collected from the medical records. Data analyses comprised descriptive statistics and partial correlations. RESULTS The participants mean age was 67 (±9.2), most were male (74,4%) and the majority had reduced ejection fraction (EF 35.4 ± 10.8). The highest mean burden scores emerged for insufficient medical information (34.65, range 0-86), difficulty with health care service (34.57, range 0-81), and physical and mental fatigue (34.12, range 0-90). Significant positive associations were observed between physical and mental fatigue from self-care, role and social activity limitation, and psychological distress, and health-related QoL. CONCLUSION Burden of treatment is an important aspect of HF treatment as it contributes to valuable knowledge on patient workload. This study emphasizes the need to simplify and tailor the treatment regimens to alleviate the burden.
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Affiliation(s)
- Oda Karin Nordfonn
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway.
| | - Ingvild Margreta Morken
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway; Department of Cardiology, Stavanger University Hospital, PB 8100, 4068 Stavanger, Norway
| | - Lars Edvin Bru
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway
| | - Alf Inge Larsen
- Department of Cardiology, Stavanger University Hospital, PB 8100, 4068 Stavanger, Norway; Department of Clinical Science, University of Bergen, PB 7800, 5020 Bergen, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway
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48
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Baah FO, Chittams J, Carlson B, Sethares KA, Daus M, Moser DK, Riegel B. Sociodemographic Indicators of Social Position and Self-care Maintenance in Adults with Heart Failure. Clin Nurs Res 2021; 30:847-854. [PMID: 33605154 DOI: 10.1177/1054773821995593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social determinants of health (SDH) are known to influence health. Adequate self-care maintenance improves heart failure (HF) outcomes. However, the relationship between self-care maintenance and SDH remains unclear. Explore the relationship between sociodemographic indicators of social position and self-care maintenance in adults with HF. This was a secondary analysis of data from a cross-sectional descriptive study of 543 adults with HF. Participants completed the Self-Care of HF Index and a sociodemographic survey. We used multiple regression with backward elimination to determine which SDH variables were determinants of self-care maintenance. Marital status (p = .02) and race (p = .02) were significant determinants of self-care maintenance. Education (p = .06) was highest in Whites (35.6%). These variables explained only 3.8% of the variance in self-care maintenance. Race, education, and marital status were associated with HF self-care maintenance. SDH is complex and cannot be explained with simple sociodemographic characteristics.
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49
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Kamath DY, Bhuvana KB, Salazar LJ, Varghese K, Kamath A, Idiculla J, Pais P, Kulkarni S, Granger BB, Xavier D. A qualitative, grounded theory exploration of the determinants of self-care behavior among Indian patients with a lived experience of chronic heart failure. PLoS One 2021; 16:e0245659. [PMID: 33503044 PMCID: PMC7840054 DOI: 10.1371/journal.pone.0245659] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Prior reports have documented extremely poor adherence to evidence-based medications among South Asian patients with established chronic cardiovascular diseases. Treatment adherence is now considered a part of the 'self-care' process, the determinants of which have not been adequately explored or explained among South Asian patients with chronic heart failure (CHF). Our objective was to qualitatively ascertain the determinants of the self-care process among Indian patients with a lived experience of heart failure. METHODS We conducted in-depth interviews (audio-recorded) among 22 purposively sampled patients living with chronic heart failure, diagnosed at least 4 weeks prior to the interview and 17 caregivers (n = 39) in a tertiary care teaching hospital in Southern India. We employed an inductive analytical approach using Charmaz's constructivist grounded theory. Initial line-by-line coding and categorization was followed by memo writing, reflexive analysis after interviewing and analyzing four, eight and twelve patients, and at each stage further theoretical sampling was carried out until we reached thematic saturation. We used NVivo ver. 12 to analyze and organize data. RESULTS The mean age of our patients was 61 years and they represented 5 Indian states and spoke seven languages, distributed across socio-economic strata and literacy levels. We classified self-care determinants into 3 broad, simple categories and defined underlying themes namely, negative determinants (passivity, entrenched beliefs, negative affect, lack of knowledge, financial difficulties, and fatalism), intermediate factors (patient expectations, provider/hospital hopping) and facilitators or positive self-care determinants (intrinsic and extrinsic facilitators). Gender and the cultural background of patients' upbringing appear to shape these determinants, thereby affecting self-care decision making in chronic heart failure. CONCLUSION We have empirically described a unique set of self-care determinants among Indian chronic heart failure patients, which in turn are shaped by economic and socio-cultural factors. Assessing for and addressing these determinants during clinical interactions through multi-factorial approaches may help improve self-care among Indian CHF patients, thus improving treatment adherence and clinical outcomes.
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Affiliation(s)
- Deepak Y. Kamath
- Department of Pharmacology, St. John’s Medical College, Bengaluru, Karnataka, India
- Division of Clinical Research and Training, St. John’s Research Institute, Koramangala, Bengaluru, India
| | - K. B. Bhuvana
- Department of Pharmacology, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Luke Joshua Salazar
- Department of Psychiatry, St. John’s Medical College Bengaluru, Karnataka, India
| | - Kiron Varghese
- Department of Cardiology, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Anant Kamath
- School of Development, Azim Premji University, Bengaluru, Karnataka, India
| | - Jyoti Idiculla
- Department of Internal Medicine, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Prem Pais
- Division of Clinical Research and Training, St. John’s Research Institute, Koramangala, Bengaluru, India
| | - Shruthi Kulkarni
- Department of Internal Medicine, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Bradi B. Granger
- Duke University School of Nursing, Durham, NC, United States of America
| | - Denis Xavier
- Department of Pharmacology, St. John’s Medical College, Bengaluru, Karnataka, India
- Division of Clinical Research and Training, St. John’s Research Institute, Koramangala, Bengaluru, India
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50
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da Costa Ferreira N, Takao Lopes C, Moorhead S, Gengo E Silva Butcher RDC. Content validation of the nursing outcome Knowledge Heart Failure Management: Brazilian nurses' opinions. Int J Nurs Knowl 2021; 32:206-214. [PMID: 33438336 DOI: 10.1111/2047-3095.12312] [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: 08/03/2020] [Revised: 11/30/2020] [Accepted: 12/27/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate the content validity of the outcome Knowledge: Heart Failure Management (1835) of the Nursing Outcomes Classification (NOC). METHODS A methodological study conducted in Brazil with nurses with expertise in cardiovascular nursing and nursing process. The nurse experts evaluated the relevance of the indicators for the nursing outcome on a 5-point Likert scale. A total of 55 indicators were analyzed, including 50 NOC indicators, four indicators located from a scoping review, and one suggested by an expert during the content validation process. The relevance ratio supported the categorization of indicators as critical, supplemental, or unnecessary. Relevance ratios of critical and supplemental indicators were summed and divided by the total number of the indicators to calculate the outcome content validity (OCV) score of the nursing outcome. FINDINGS Fifteen nurse experts, mostly females (n = 13) with a mean age of 36.0 ± 6.3 years, 13.9 ± 6.5 years of professional experience, and extensive use of the nursing process in their clinical practice (n = 10), teaching (n = 13), and research (n = 11), participated in this study. Regarding the content validation, 43 (78.2%) out of 55 indicators were categorized as critical (relevance ratio .80-.98), 11 (20%) as supplemental (relevance ratio .67-.79), and one indicator (1.8%) was categorized as unnecessary (relevance ratio .48). The OCV score of the nursing outcome was .87. CONCLUSION The study provided evidence of content validity of 49 indicators of the NOC outcome, Knowledge: Heart Failure Management, and five new indicators identified through the validation process based on nurse experts' opinions. IMPLICATIONS FOR THE NURSING PRACTICE These findings provide evidence-based indicators for the measurement of heart failure patients' knowledge about disease management. As a result, nurses can test the effectiveness of nursing interventions based on valid outcome indicators.
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Affiliation(s)
| | - Camila Takao Lopes
- Adjunct Professor in the Clinical and Surgical Nursing Department of the Paulista School of Nursing, Sao Paulo, SP, Brazil
| | - Sue Moorhead
- Associate Professor, College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Rita de Cassia Gengo E Silva Butcher
- Adjunct Faculty (courtesy), Graduate Program in Adult Health Nursing (PROESA), School of Nursing, University of Sao Paulo, Sao Paulo, SP, Brazil.,Post-doctoral fellow, The Marjory Gordon Program for Clinical Reasoning and Knowledge Development at Boston College, William F. Connell School of Nursing, Boston, Massachusetts, USA
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