Testing a Middle -Range Theory of Heart Failure Self-Care

2021 ◽  
Vol 34 (4) ◽  
pp. 378-391
Author(s):  
Sumayya A. Attaallah ◽  
Rosalind M. Peters ◽  
Ramona Benkert ◽  
Hossein Yarandi ◽  
Sandra Oliver-McNeil ◽  
...  
Keyword(s):  
Heart Failure ◽  
Latent Variable ◽  
Self Care ◽  
Middle Range Theory ◽  
Conditioning Factors ◽  
Middle Range ◽  
Patients With Heart Failure ◽  
Range Theory ◽  
Care Deficit

A middle-range theory of heart failure self-care, derived from the self-care deficit theory of nursing, was tested among 175 Arab American older adults with heart failure. The middle-range theory achieved good statistical fit, but not all hypothesized relationships were supported. Specifically, conceptualizing basic conditioning factors as a single latent variable was not supported. However, individual factors of depression, social support, and time living with heart failure had a direct effect on both self-care agency and quality of life. Understanding predictors and outcomes of self-care within a theoretical framework is essential in caring for patients with heart failure.

Developing a Middle-Range Theory of Heart Failure Self-Care

2021 ◽  
Vol 34 (2) ◽  
pp. 168-177
Author(s):  
Sumayya A. Attaallah ◽  
Rosalind M. Peters ◽  
Ramona Benkert ◽  
Hossein Yarandi ◽  
Sandra Oliver-McNeil ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Self Care ◽  
Empirical Literature ◽  
Middle Range Theory ◽  
Nursing Science ◽  
Middle Range ◽  
Operational Systems ◽  
Range Theory ◽  
Orem's Theory

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.

scholarly journals Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 418-429
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Care Management ◽  
Controlled Trial ◽  
Self Care ◽  
Fluid Restriction ◽  
Symptom Recognition ◽  
Patients With Heart Failure ◽  
Randomised Controlled

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).

Abstract 11916: Changes in Symptoms Predicted Changes in Health-Related Quality of Life in Patients With Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seongkum Heo ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
Eugene Smith ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Physical Symptoms ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Behavioral Variables ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Background: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL), which is associated with high hospitalization rates. Physical symptoms have been associated with poor HRQOL. However, whether improvement in physical symptoms actually leads to improvement in HRQOL has not fully examined in patients with HF. Purpose: To examine the effects of changes in physical symptoms on changes in HRQOL at 12 months, after controlling for age, comorbidities, New York Heart Association (NYHA) functional class, and modifiable psychosocial and behavioral factors. Methods: Data on physical symptoms (Symptom Status Questionnaire-HF) and HRQOL (Minnesota Living with Heart Failure) were collected from 94 patients with HF (mean age 58 ± 14 years, 44% male, 58% NYHA functional class II/III) at baseline and 12 month follow-up. Age, comorbidities, and NYHA functional class were collected using standard questionnaires at baseline. Psychosocial variables (depressive symptoms [Patient Health Questionnaire], perceived control [Control Attitudes Scale-Revised], and social support [Multidimensional Scale of Perceived Social Support]) and behavioral variables (medication adherence [Micro-Electro-Mechanical Systems], sodium intake [24-hour urine], and self-care management [Self-care management subscale of the Self-Care of Heart Failure Index]) were collected at baseline. Hierarchical multiple regression analyses were used to analyze the data. Results: The mean score changes in physical symptoms and HRQOL were -3.8 (± 14.1) and -9.2 (± 24.1), respectively (negative scores indicate improvement.). Among the sociodemographic and clinical characteristics, psychosocial variables, behavioral variables, baseline physical symptoms, and changes in physical symptoms, only changes in physical symptoms predicted changes in HRQOL at 12 months (F = 6.384, R2 = .46, p < .001). Improvement in physical symptoms led to improvement in HRQOL. Conclusion: It is critical to improve physical symptoms to improve HRQOL. Thus, development and delivery of effective interventions targeting improvement in physical symptoms are warranted in this population.

Factors Associated With Self-Care Among Patients Receiving Hemodialysis: A Cross-Sectional Observational Study

2021 ◽  
pp. RTNP-D-20-00042
Author(s):  
Juhyun Lee ◽  
Dabok Noh
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Self Efficacy ◽  
Self Care ◽  
Middle Range Theory ◽  
Health Motivation ◽  
Middle Range ◽  
Range Theory ◽  
Stage Renal Disease ◽  
End Stage

Background and PurposeThe global increase in prevalence of individuals with end-stage renal disease is a rising concern. Self-care is an essential and important component of chronic disease management. Poor self-care in patients receiving hemodialysis is associated with an increased risk of mortality and hospitalization. This study aimed to identify predictive factors for self-care in patients receiving hemodialysis based on a middle-range theory of self-care for chronic illness.MethodsAdult patients with end-stage renal disease receiving hemodialysis were recruited at an artificial kidney unit in a general hospital. Data from 131 patients were analyzed. Self-report questionnaires assessed hemodialysis-related knowledge, health motivation, self-efficacy, social support, access to care, and self-care.ResultsParticipants who had a family caregiver showed significantly higher selfcare scores than those who did not, and self-care scores were higher in patients who reported hypertension as a causal disease of end-stage renal disease than in those who did not. Self-care was significantly correlated with knowledge, health motivation, self-efficacy, social support, and access to care. The study’s regression model showed that self-efficacy, health motivation, and knowledge were predictive variables influencing self-care, and the explanatory power of this model was 55.9%.Implications for PracticeThe results support the middle-range theory of self-care for chronic illness. Strategies and education to improve self-efficacy, health motivation, and knowledge must be incorporated when designing self-care programs. Nursing interventions that patients can participate in with their family members might facilitate improving self-care.

A Correlational Study of Illness Knowledge, Self-Care Behaviors, and Quality of Life in Elderly Patients With Heart Failure

2014 ◽  
Vol 22 (2) ◽  
pp. 136-145 ◽  
Author(s):  
Min-Hui Liu ◽  
Chao-Hung Wang ◽  
Yu-Yen Huang ◽  
Wen-Jin Cherng ◽  
Kai-Wei Katherine Wang
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Elderly Patients ◽  
Self Care ◽  
Correlational Study ◽  
Illness Knowledge ◽  
Patients With Heart Failure

scholarly journals A Middle-Range Theory of Self-Care of Chronic Illness

2012 ◽  
Vol 35 (3) ◽  
pp. 194-204 ◽  
Author(s):  
Barbara Riegel ◽  
Tiny Jaarsma ◽  
Anna Strömberg
Keyword(s):  
Chronic Illness ◽  
Self Care ◽  
Middle Range Theory ◽  
Middle Range ◽  
Range Theory
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