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Slightam C, Risbud R, Guetterman TC, Nevedal AL, Nelson KM, Piette JD, Trivedi RB. Patient, caregiving partner, and clinician recommendations for improving heart failure care in the Veterans Health Administration. Chronic Illn 2022; 18:330-342. [PMID: 33115281 DOI: 10.1177/1742395320966366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Heart Failure (HF) care requires substantial care coordination between patients, patients' informal caregivers, and clinicians, but few studies have examined recommendations from all three perspectives. The objective of this study was to understand and identify shared recommendations to improve HF self-care from the perspective of VA persons with HF, their caregiving partners, and clinicians. METHODS Secondary data analysis from a study of semi-structured interviews with 16 couples (persons with HF and their caregiving partners) and 13 clinicians (physicians, nurses, other specialists) from a large Veterans Affairs (VA) hospital. Interviews were double-coded, and analyzed for themes around commonly used or recommended self-care strategies. RESULTS Three themes emerged: (1) Couples and clinicians believe that improvements are still needed to existing HF education, especially the need to be tailored to learning style and culture, (2) Couples and clinicians believe that technology can facilitate better HF self-care, and (3) Couples and clinicians believe that caregiving partners are part of the self-care team, and should be involved in care management to support the person with HF. DISCUSSION Recommendations from couples and clinicians address barriers to HF self-care and encourage patient-centered care.
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Affiliation(s)
- Cindie Slightam
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Rashmi Risbud
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | | | - Andrea L Nevedal
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Karin M Nelson
- Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA
| | - John D Piette
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Ranak B Trivedi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.,School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Santos GC, Liljeroos M, Hullin R, Denhaerynck K, Wicht J, Jurgens CY, Schäfer-Keller P. SYMPERHEART: an intervention to support symptom perception in persons with heart failure and their informal caregiver: a feasibility quasi-experimental study protocol. BMJ Open 2021; 11:e052208. [PMID: 34315799 PMCID: PMC8317123 DOI: 10.1136/bmjopen-2021-052208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Symptom perception in heart failure (HF) has been identified as crucial for effective self-care, and is related to patient and health system outcomes. There is uncertainty regarding the feasibility and acceptability of symptom perception support and doubts regarding how to include informal caregivers. This study aims to test the feasibility, acceptability and outcome responsiveness of an intervention supporting symptom perception in persons with HF and their informal caregiver. METHODS AND ANALYSIS A feasibility study with a quasi-experimental pretest and post-test single group design is conducted. The convenience sample consists of 30 persons with HF, their informal caregivers and six nurses. SYMPERHEART is an evidence-informed intervention that targets symptom perception by educational and support components. Feasibility is measured by time-to-recruit; time-to-deliver; eligibility rate; intervention delivery fidelity rate. Acceptability is measured by rate of consent, retention rate, treatment acceptability and the engagement in the intervention components. Outcome responsiveness includes: HF self-care (via the Self-care of Heart Failure Index V.7.2); perception of HF symptom burden (via the Heart Failure Somatic Perception Scale V.3); health status (via the Kansas City Cardiomyopathy Questionnaire-12); caregivers' contribution to HF self-care (via the Caregiver Contribution to Self-Care of Heart Failure Index 2); caregivers' burden (via the Zarit Burden Interview). Clinical outcomes include HF events, hospitalisation reason and length of hospital stay. Descriptive statistics will be used to report feasibility, acceptability, patient-reported outcomes (PRO) and clinical outcomes. PRO and caregiver-reported outcome responsiveness will be reported with mean absolute change and effect sizes. ETHICS AND DISSEMINATION The study is conducted according to the Declaration of Helsinki. The Human Research Ethics Committee of the Canton of Vaud, Switzerland, has approved the study. Written informed consent from persons with HF and informal caregivers are obtained. Results will be published via peer reviewed and professional journals, and further disseminated via congresses. TRIAL REGISTRATION NUMBER ISRCTN18151041.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Roger Hullin
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Justine Wicht
- Service d'Aide et de Soins à Domicile de la Sarine, Fribourg, Switzerland
| | - Corrine Y Jurgens
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Petra Schäfer-Keller
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Santos GC, Liljeroos M, Dwyer AA, Jaques C, Girard J, Strömberg A, Hullin R, Schäfer-Keller P. Symptom perception in heart failure - Interventions and outcomes: A scoping review. Int J Nurs Stud 2020; 116:103524. [PMID: 32063295 DOI: 10.1016/j.ijnurstu.2020.103524] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Symptom perception in heart failure has recently been described as essential in the self-care process bridging self-care maintenance and self-care management. Accordingly, symptom perception appears to be critical for improving patient outcomes such as decreased hospital readmission and increased survival. OBJECTIVES To explore what interventions have been reported on heart failure symptom perception and to describe outcomes responsive to symptom perception. DESIGN We conducted a scoping review using PRISMA Extension for Scoping Reviews. DATA SOURCES Structured searches of Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, Joanna Briggs Institute and Grey literature databases. REVIEW METHODS Two authors independently screened references for eligibility. Eligible articles were written in English, French, German, Swedish, Italian or Spanish and concerned symptom perception in adults with heart failure. Data were extracted and charted in tables by three reviewers. Results were narratively summarized. RESULTS We identified 99 eligible studies from 3055 references. Seven interventional studies targeted symptom perception as the single intervention component. Mixed results have been found: while some reported decreased symptom frequency, intensity and distress, enhanced health-related quality of life, improved heart failure self-care maintenance and management as well as a greater ability to mention heart failure symptoms, others found more contacts with healthcare providers or no impact on anxiety, heart failure self-care nor a number of diary reported symptoms. Additional interventional studies included symptom perception as one component of a multi-faceted intervention. Outcomes responsive to symptom perception were improved general and physical health, decreased mortality, heart failure decompensation, as hospital/emergency visits, shorter delays in seeking care, more consistent weight monitoring, improved symptom recognition as well as self-care management, decreased hospital length of stay and decreased costs. CONCLUSIONS While many studies allowed to map a comprehensive overview of interventions supporting symptom perception in heart failure as well as responsiveness to outcomes, only a few single component intervention studies targeting symptom perception have been reported and study designs preclude assessing intervention effectiveness. With regard to multiple component interventions, the specific impact of symptom perception interventions on outcomes remains uncertain to date. Well-designed studies are needed to test the effectiveness of symptom perception interventions and to elucidate relationships with outcomes.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland; PhD Student at Institute of Higher Education and Research in Healthcare IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010 Lausanne, Switzerland.
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, 631 88 Eskilstuna, Sweden.
| | - Andrew A Dwyer
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, Massachusetts 02467, United State of America.
| | - Cécile Jaques
- Medical Library, Research and Education Department, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland.
| | - Josepha Girard
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Roger Hullin
- Department of cardiology, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland; Faculty of biology and medicine, University of Lausanne, CH-1015 Lausanne, Switzerland.
| | - Petra Schäfer-Keller
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
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Alpert CM, Smith MA, Hummel SL, Hummel EK. Symptom burden in heart failure: assessment, impact on outcomes, and management. Heart Fail Rev 2018; 22:25-39. [PMID: 27592330 DOI: 10.1007/s10741-016-9581-4] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Evidence-based management has improved long-term survival in patients with heart failure (HF). However, an unintended consequence of increased longevity is that patients with HF are exposed to a greater symptom burden over time. In addition to classic symptoms such as dyspnea and edema, patients with HF frequently suffer additional symptoms such as pain, depression, gastrointestinal distress, and fatigue. In addition to obvious effects on quality of life, untreated symptoms increase clinical events including emergency department visits, hospitalizations, and long-term mortality in a dose-dependent fashion. Symptom management in patients with HF consists of two key components: comprehensive symptom assessment and sufficient knowledge of available approaches to alleviate the symptoms. Successful treatment addresses not just the physical but also the emotional, social, and spiritual aspects of suffering. Despite a lack of formal experience during cardiovascular training, symptom management in HF can be learned and implemented effectively by cardiology providers. Co-management with palliative medicine specialists can add significant value across the spectrum and throughout the course of HF.
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Affiliation(s)
- Craig M Alpert
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michael A Smith
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA.,Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA
| | - Scott L Hummel
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Ellen K Hummel
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. .,Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, MI, USA. .,University of Michigan Frankel Cardiovascular Center, 1500 East Medical Center Dr., SPC 5233, Ann Arbor, MI, 48109-5233, USA.
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Park LG, Dracup K, Whooley MA, McCulloch C, Jin C, Moser DK, Clark RA, Pelter MM, Biddle M, Howie Esquivel J. Symptom Diary Use and Improved Survival for Patients With Heart Failure. Circ Heart Fail 2017; 10:e003874. [PMID: 29158435 PMCID: PMC5705062 DOI: 10.1161/circheartfailure.117.003874] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 10/11/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Attention to symptoms of weight gain and dyspnea are central tenets of patient education in heart failure (HF). However, it is not known whether diary use improves patient outcomes. The aims of this study were to compare mortality among rural patients with HF who completed versus did not complete a daily diary of weight and symptom self-assessment and to identify predictors of diary use. METHODS AND RESULTS This is a secondary analysis of a 3-arm randomized controlled trial on HF education of self-care with 2 intervention groups versus control who were given diaries for 24 months to track daily weight, HF symptoms, and response to symptom changes. Mean age was 66±13, 58% were men, and 67% completed diaries (n=393). We formed 5 groups (no use, low, medium, high, and very high) based on the first 3 months of diary use and then analyzed time to event (cardiac mortality, all-cause mortality, and HF-related readmission) starting at 3 months. Compared with patients with no diary use, high and very high diary users were less likely to experience all-cause mortality (P=0.02 and P=0.01, respectively). Self-reported sedentary lifestyle was associated with less diary use in an adjusted model (odds ratio, 0.66; 95% confidence interval, 0.46-0.95; P=0.03). Depression and sex were not significant predictors of diary use in the adjusted model. CONCLUSIONS In this study of 393 rural patients with HF, we found that greater diary use was associated with longer survival. These findings suggest that greater engagement in self-care behaviors is associated with better HF outcomes. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00415545.
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Affiliation(s)
- Linda G Park
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.).
| | - Kathleen Dracup
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Mary A Whooley
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Charles McCulloch
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Chengshi Jin
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Debra K Moser
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Robyn A Clark
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Michele M Pelter
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Martha Biddle
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
| | - Jill Howie Esquivel
- From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.); and School of Nursing and Midwifery, Flinders University, Adelaide, Australia (R.A.C.)
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Kwekkeboom KL, Bratzke LC. A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure. J Cardiovasc Nurs 2016; 31:457-68. [PMID: 26065388 PMCID: PMC4675700 DOI: 10.1097/jcn.0000000000000274] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. OBJECTIVE A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. METHODS CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life. The 2 authors evaluated study quality, abstracted data elements from each study, and synthesized findings. RESULTS Thirteen articles describing 9 unique studies met criteria and were included in the review. Five studies tested relaxation strategies, 3 tested meditation strategies, and 1 tested a guided imagery strategy. Of the 9 studies, 7 demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared with attention control or usual care conditions and reduced pain, dyspnea, fatigue, and sleep disturbance within treatment groups (pretreatment to posttreatment). Symptom-related quality of life was improved with meditation compared with attention control and usual care conditions and improved pre- to post-guided imagery. CONCLUSIONS Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings but indicate potential beneficial effects of relaxation, meditation, and guided imagery on heart failure-related symptoms. Future research should test cognitive-behavioral strategies in rigorously designed efficacy trials, using samples selected for their symptom experience, and measure pain, dyspnea, fatigue, and sleep disturbance outcomes with targeted symptom measures.
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Affiliation(s)
- Kristine L Kwekkeboom
- Kristine L. Kwekkeboom, PhD, RN Professor, School of Nursing, University of Wisconsin-Madison. Lisa C. Bratzke, PhD, RN, ANP-BC Assistant Professor, School of Nursing, University of Wisconsin-Madison
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American Association of Heart Failure Nurses Position Paper on Educating Patients with Heart Failure. Heart Lung 2015; 44:173-7. [DOI: 10.1016/j.hrtlng.2015.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Yayehd K, Damorou F, N'cho Mottoh MP, Tchérou T, Johnson A, Pessinaba S, Tété Y, Diziwiè AM. [Compliance to treatment in heart failure patients in Lomé]. Ann Cardiol Angeiol (Paris) 2013; 62:22-27. [PMID: 22560891 DOI: 10.1016/j.ancard.2012.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Accepted: 03/17/2012] [Indexed: 05/31/2023]
Abstract
BACKGROUND The incidence and prevalence rates of the heart failure in the world approach epidemic proportions. The evaluation of the follow-up of the treatment of heart failure can allow the setting up of strategies to reduce the frequency of decompensations and improve the quality of life of these patients. OBJECTIVES To estimate the compliance to treatment and factors liable to influence it in Togolese patients suffering from heart failure. PATIENTS AND METHODS This study was carried out from January 1st, 2008 to June 30th, 2009 in the department of cardiology of the university teaching hospital Campus in Lomé and included prospectively, patients with chronic heart failure hospitalized for acute decompensation and of which the heart failure was diagnosed and treated for at least 3 months. Questionnaires were filled to estimate the compliance to medication, to diet, as well as knowledge of the patients on their disease and their relationship with their doctor and their family. RESULTS In the 103 patients included, we noticed no good compliance to medication; there were 74.7% of bad compliance to medication, 47.3% of good compliance to diet; 62.1% of patients had enough knowledge on their disease, 29.1% considered that their doctor did not grant them enough time; 57.3% estimated to have no necessary support of their family. Bad compliance to treatment was correlated to the existence or not of a health care insurance (OR=115.5; 95% CI=21.51-620.08; P<0.0001); this difference persisted after adjusting for age, sex and monthly income (OR=99.65; 95% CI=18.87-587.21; P=0.001). Bad compliance was not associated with monthly income (OR=0.93; 95% CI=0.37-2.28; P=0.944); it was neither influenced by traditional therapy (OR=1.58 95% CI=0.64-3.91; P=0.43), nor recovery prayers (OR=1.6; 95% CI=0.62-4.13; P=0.45), nor frequency of tablets intake (≥3 intake day), OR=0.169; 95% CI=0.05-0.49; P=0.43. CONCLUSION The compliance to medication in Togolese heart failure patients was very low and essentially correlated to the absence of health care insurance.
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Affiliation(s)
- K Yayehd
- Service de cardiologie, centre hospitalier universitaire Campus de Lomé, 03 BP 30284 Lomé, Togo.
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