Abstract 17114: Whose Work is It? Patient Perspectives on Challenges in Heart Failure Self-Management

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Renee Leverty ◽  
Leslie Chang ◽  
Jose Barcenas ◽  
James James Campbell ◽  
Kirsten Dahlgren ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Behavior Change ◽  
Social Interactions ◽  
Self Care ◽  
Patient Perspectives ◽  
Self Management ◽  
Depth Interviews ◽  
Care Behavior ◽  
Effective Behavior

Introduction: The importance of self-care behaviors in successful heart failure (HF) management is widely recognized. And yet, patient perspectives on strategies to effective carry out the work of behavior change remain relatively unexplored. Methods: From March 2017 to May 2017, we conducted semi-structured, in-depth interviews with 8 HF patients involved in the CONNECT-HF clinical trial and 7 of their respective caregivers. Interviews were audio-recorded and transcriptions were imported to NVivo 11 (Version 11.4.0) for coding and analysis. We used content analysis and a mixed inductive and deductive approach for interpretation of coded text. Results: Patients (n=8) and caregivers (n=7) reported numerous strategies (n=28) for each guideline-based self-care behavior. The over-arching theme contributing to successful, effective behavior change was the value of social support and social interactions in the work of “sticking with it.” Predominant sub-themes included the idea that “knowledge is necessary but not sufficient” for behavior change, and “ building a routine” was critical for life-long self-care to be effective (Table 1). Conclusions: Many of the behavior change barriers and strategies proposed by patients are concepts that are consistent with findings in the field of behavioral economics and have the potential to inform development of effective behavior change tools.

Child ego state and self-care behavior change in heart failure patients

2021 ◽  
Author(s):  
Kiyotaka Yanagihara ◽  
Yoshiharu Kinugasa ◽  
Tetsuro Kunimi ◽  
Syuhei Kaneko ◽  
Nobuhiko Haruki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Behavior Change ◽  
Self Care ◽  
Heart Failure Patients ◽  
Care Behavior

“Sick and tired of being sick and tired”: a qualitative study of a motivational approach to self-care behavior change in persons with heart failure

2004 ◽  
Vol 10 (4) ◽  
pp. S129
Author(s):  
Victoria V. Dickson ◽  
Janet McMahon ◽  
Brenda Reis ◽  
Steven Sayers ◽  
Linda Hoke ◽  
...  
Keyword(s):  
Heart Failure ◽  
Qualitative Study ◽  
Behavior Change ◽  
Self Care ◽  
Care Behavior

9-item European Heart Failure Self-Care Behavior Scale

2009 ◽  
Author(s):  
Tiny Jaarsma ◽  
Kristofer Franzén Årestedt ◽  
Jan Mårtensson ◽  
Kathleen Dracup ◽  
Anna Strömberg
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Behavior Scale ◽  
Care Behavior

A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Self Monitoring ◽  
Heart Failure Questionnaire

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

scholarly journals Self-care in heart failure patients

2015 ◽  
Vol 23 (4) ◽  
pp. 578-586 ◽  
Author(s):  
Ana Paula da Conceição ◽  
Mariana Alvina dos Santos ◽  
Bernardo dos Santos ◽  
Diná de Almeida Lopes Monteiro da Cruz
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Left Ventricular ◽  
The Self ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Failure Index ◽  
Joint Monitoring ◽  
The Mean ◽  
Care Behavior

AbstractObjective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients.Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05.Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007).Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.

Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms

2017 ◽  
Vol 17 (6) ◽  
pp. 496-504 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K Moser ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Self Care ◽  
Signs And Symptoms ◽  
Comprehensive Understanding ◽  
Behavior Scale ◽  
Heart Failure Exacerbation ◽  
The Relationship ◽  
Different Levels ◽  
Care Behavior

Background: Although incomplete understanding of heart failure and its signs and symptoms appears to be a barrier to successful self-care, there are few studies examining the relationship between self-care and levels of comprehensive understanding of heart failure and its signs and symptoms. Aim: To determine whether incomplete understanding of heart failure and its signs and symptoms is associated with self-care in heart failure patients who were recently discharged from the hospital due to heart failure exacerbation. Methods: Patients completed the nine-item European Heart Failure Self-care Behavior scale and questionnaire to assess knowledge of heart failure and its signs and symptoms. Three groups were formed by their different levels of understanding of heart failure and its signs and symptoms. Multivariable linear regression was used to determine whether these three levels of understanding groups predicted self-care after controlling for demographic and clinical variables. Results: Of 571 patients 22.1%, 40.1% and 37.8% had poor, moderate, and complete understanding, respectively. Compared with patients in the poor understanding group, patients in complete and moderate understanding groups were more likely to have better adherence to self-care activities (standardized β = −0.14, 95% confidence interval −3.41, −0.47; standardized β = −0.19, 95% confidence interval −4.26, −1.23, respectively). Conclusions: Fewer than half of the patients had a comprehensive understanding of heart failure and its signs and symptoms, which was associated with poor self-care. Our study suggests that patient education should include contents to promote comprehensive understanding of heart failure and its symptoms, as well as the importance of self-care behaviors.

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