Activities of daily living for old persons in primary health care with chronic heart failure

Background: Dyspnoea is a common symptom of chronic heart failure (CHF). In the community setting, patients with CHF are most often women. Aim: To examine the impact of gender on the description of dyspnoea and to explore which clinical variables support a diagnosis of CHF. Methods: From four primary health care centres, 158 patients with CHF were included. Patients were examined with echocardiography and a cardiologist assessed the diagnosis of CHF. The patients filled in a questionnaire containing 11 descriptors of dyspnoea. Results: A diagnosis of CHF was confirmed in 87 (55%) patients (47 males and 40 females). One descriptor, I feel that I am suffocating, was significantly scored higher in CHF patients ( p=0.014) as compared to non-CHF patients. Three descriptors, My breath does not go in all the way ( p=0.006), I feel that I am suffocating ( p=0.040), and I cannot get enough air ( p=0.0327) were significantly scored higher among men with CHF, compared to no descriptor among women with CHF. Being male (OR=2.7; CI: 1.3–5.6, p=0.008), having diabetes (OR=5.6; CI: 1.7–18.2, p=0.004), IHD (OR=3.3; CI: 1.3–8.5, p=0.014), and a borderline significance for age (OR=1.04; CI: 0.99–1.08, p=0.058) predicted a confirmed diagnosis of CHF. Conclusion: Three descriptors of dyspnoea were associated with CHF among men, whereas no such association was found among women. Our results suggest that gender is an important factor and should—together with age, underlying heart disease, and diabetes—be taken into account when symptoms are evaluated in the diagnosis of CHF in primary care.

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Global functionality and associated factors in the older adults followed by Home Care in Primary Health Care

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.5026.3476 ◽

2021 ◽

Vol 29 ◽

Author(s):

Mariane Lurdes Predebon ◽

Gilmara Ramos ◽

Fernanda Laís Fengler Dal Pizzol ◽

Naiana Oliveira dos Santos ◽

Lisiane Manganelli Girardi Paskulin ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Home Care ◽

Activities Of Daily Living ◽

Daily Living ◽

Timed Up And Go ◽

Primary Health ◽

Instrumental Activities ◽

Total Dependence

Objective: to analyze the association of global functionality with the main functional systems and the sociodemographic variables of older adults followed by Home Care in Primary Health Care. Method: a cross-sectional study with 124 older people developed through home interviews. Functionality was assessed by Basic Activities of Daily Living (Barthel) and Instrumental Activities of Daily Living (Lawton and Brody); the main functional systems were assessed using the Mini-Mental State Exam, by the Timed Up and Go test, by the Geriatric Depression Scale (15 items), and questionnaire with sociodemographic variables. Bivariate and multivariate analyses were applied (Poisson Regression). Results: 46% of the older adults showed moderate/severe/total dependence for basic activities and instrumental activities had a median of 12. In the multivariate analysis, there was an association between moderate/severe/total dependence on basic activities with cognitive decline (p=0.021) and bedridden/wheelchair users (p=0.014). Regarding the dependence on instrumental activities, there was an association with age ≥80 years (p=0.006), single/divorced marital status (p=0.013), cognitive decline (p=0.001), bedridden/wheelchair (p=0.020), and Timed Up and Go ≥20 seconds (p=0.048). Conclusion: the decline in cognitive and mobility was associated with poor functionality in basic and instrumental activities. The findings highlight the need to monitor Home Care for these individuals and serve as guidelines for health actions.

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Interaction between chronic pain and impairment in activities of daily living towards utilisation of the primary health care sector in elderly people in Austria

European Journal of Public Health ◽

10.1093/eurpub/cku161.129 ◽

2014 ◽

Vol 24 (suppl_2) ◽

Author(s):

TE Dorner ◽

TA Stamm ◽

K Hoffmann ◽

R Kutalek ◽

K Pieber

Keyword(s):

Health Care ◽

Chronic Pain ◽

Primary Health Care ◽

Activities Of Daily Living ◽

Elderly People ◽

Daily Living ◽

Health Care Sector ◽

Primary Health

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Using NT-proBNP to Detect Chronic Heart Failure in Elderly Patients with Chronic Obstructive Pulmonary Disease

ISRN Family Medicine ◽

10.5402/2013/273864 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Elzbieta Kaszuba ◽

Bartlomiej Wagner ◽

Håkan Odeberg ◽

Anders Halling

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Health Care ◽

Primary Health Care ◽

Chronic Heart Failure ◽

Elderly Patients ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Primary Health

Objective. To detect chronic heart failure in elderly patients with a registered diagnosis of chronic obstructive pulmonary disease (COPD) treated in Swedish primary health care using natriuretic peptide NT-proBNP. Design. A cross-sectional study. Setting. Two primary health care centres in southeastern Sweden each with about 9000 listed patients. Subjects. Patients aged 65 years and older with a registered diagnosis of COPD. Main Outcome Measures. Percentage of patients with elevated NT-proBNP, percentage of patients with abnormal left ventricular function assessed by echocardiography, and association between elevated NT-proBNP and symptoms, signs, and electrocardiography. Results. Using NT-proBNP threshold of 1200 pg/mL, we could detect and confirm chronic heart failure in 5.6% of the study population with concurrent COPD. An elevated level of NT-proBNP was only associated with nocturia and abnormal electrocardiography. Conclusions. We found considerably fewer cases of heart failure in patients with COPD than could be expected from the results of previous studies. Our study shows the need for developing improved strategies to enhance the validity of a suspected heart failure diagnosis in patients with COPD.

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