The Effects of a Clinical Nurse Specialist-Led, Telephone-Based Intervention on Hospital Readmissions, Quality of Life, and Self-care Behaviors of Heart Failure Patients

Long term of heart failure symptoms will affect the patient functional status and ability to do self-care appropriately. Decreasing functional status and self-care ability will certainly affect the quality of life of patients. This study aimed to determine the relationship of self-care with the quality of life of heart failure patients that undergoing treatment at Heart Polyclinic of Mangusada Hospital. The research design was descriptive correlational using cross sectional approach. The study was conducted in January-February 2019. Total respondent participated were 61 respondents and were taken using a purposive sampling technique. Self care of heart index (SCHFI) questionnaire and the Minnesota Living With Heart Failure Questionnaire (MLHFQ) were used. The results showed that the average of self-care score was 45.25 and the average score of the quality of life was 60.67. Analysis using the Spearman Rank test obtained p-value = 0,000 and r = 0.506. It can be concluded that self care had a significant correlation on quality of life patients with heart failure in Mangusada Hospital. We recommended that nursing service providers play an active role in providing education and motivation to heart failure patients to improve self-care abilities.

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A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease (COPD)

Frontiers of Nursing ◽

10.2478/fon-2018-0019 ◽

2018 ◽

Vol 5 (2) ◽

pp. 147-156

Author(s):

Hua Yin ◽

Ling Yang ◽

Qiao Ye

Keyword(s):

Quality Of Life ◽

Clinical Nurse Specialist ◽

Chronic Obstructive ◽

Nurse Specialist ◽

Nursing Support ◽

Obstructive Pulmonary Disease ◽

Clinical Nurse ◽

Multidisciplinary Cooperation ◽

Positive Effect

Abstract Objective This review aimed to examine the effectiveness of clinical nurse specialist (CNS) interventions in patients with chronic obstructive pulmonary disease (COPD). COPD significantly affects people’s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective. Methods A narrative analysis of the data was performed for the eligible studies. Four databases were chosen: CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration’s risk of bias tool. Results A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS’s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality of life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD. Conclusions The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

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Key elements of interventions for heart failure patients with mild cognitive impairment or dementia: A systematic review

European Journal of Cardiovascular Nursing ◽

10.1177/1474515119865755 ◽

2019 ◽

Vol 19 (1) ◽

pp. 8-19

Author(s):

Louise Hickman ◽

Caleb Ferguson ◽

Patricia M Davidson ◽

Sabine Allida ◽

Sally Inglis ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Systematic Review ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Daily Living ◽

Self Care ◽

Heart Failure Patients

Background: The purpose of this systematic review was to (a) examine the effects of interventions delivered by a heart failure professional for mild cognitive impairment and dementia on cognitive function, memory, working memory, instrumental activities of daily living, heart failure knowledge, self-care, quality of life and depression; and (b) identify the successful elements of these strategies for heart failure patients with mild cognitive impairment or dementia. Methods and results: During March 2018, an electronic search of databases including CINAHL, MEDLINE, EMBASE and PsycINFO was conducted. All randomised controlled trials, which examined an intervention strategy to help heart failure patients with mild cognitive impairment or dementia cope with self-care, were included. An initial search yielded 1622 citations, six studies were included ( N= 595 participants, mean age 68 years). There were no significant improvements in cognitive function and depression. However, significant improvements were seen in memory ( p=0.015), working memory ( p=0.029) and instrumental activities of daily living ( p=0.006). Nurse led interventions improved the patient’s heart failure knowledge ( p=0.001), self-care ( p<0.05) and quality of life ( p=0.029). Key elements of these interventions include brain exercises, for example, syllable stacks, individualised assessment and customised education, personalised self-care schedule development, interactive problem-solving training on scenarios and association techniques to prompt self-care activities. Conclusions: Modest evidence for nurse led interventions among heart failure patients with mild cognitive impairment or dementia was identified. These results must be interpreted with caution in light of the limited number of available included studies.

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