scholarly journals Symptom perception in heart failure: a scoping review on definition, factors and instruments

2019 ◽  
Vol 19 (2) ◽  
pp. 100-117 ◽  
Author(s):  
Gabrielle Cécile Santos ◽  
Maria Liljeroos ◽  
Andrew A Dwyer ◽  
Cécile Jaques ◽  
Josepha Girard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sex Education ◽  
Scoping Review ◽  
Grey Literature ◽  
Self Care ◽  
Symptom Perception ◽  
Heart Failure Symptom ◽  
Patient Reported ◽  
Instrument Measuring ◽  
Heart Failure Hospitalisation

Background: Symptom perception in heart failure has been identified as crucial for effective self-care that is a modifiable factor related to decreased hospital readmission and improved survival. Aims: To review systematically the heart failure symptom perception literature and synthesise knowledge on definition, description, factors and instruments. Methods: We conducted a scoping review including studies reporting patient-reported symptom perception in adults with heart failure. Structured searches were conducted in Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, JBI and grey literature. Two authors independently reviewed references for eligibility. Data were charted in tables and results narratively summarised. Results: The search yielded 3057 references, of which 106 were included. The definition of heart failure symptom perception comprised body listening, monitoring signs, recognising, interpreting and labelling symptoms, and furthermore awareness of and assigning meaning to the change. Symptom monitoring, recognition and interpretation were identified as challenging. Symptom perception facilitators include prior heart failure hospitalisation, heart failure self-care maintenance, symptom perception confidence, illness uncertainty and social support. Barriers include knowledge deficits, symptom clusters and lack of tools/materials. Factors with inconsistent impact on symptom perception include age, sex, education, experiences of living with heart failure, comorbidities, cognitive impairment, depression and symptom progression. One instrument measuring all dimensions of heart failure symptom perception was identified. Conclusion: Heart failure symptom perception definition and description have been elucidated. Several factors facilitating or hampering symptom perception are known. Further research is needed to determine a risk profile for poor symptom perception – which can then be taken into consideration when supporting heart failure self-care.

scholarly journals 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 ◽  
Vol 11 (7) ◽  
pp. e052208
Author(s):  
Gabrielle Cécile Santos ◽  
Maria Liljeroos ◽  
Roger Hullin ◽  
Kris Denhaerynck ◽  
Justine Wicht ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Informal Caregiver ◽  
Informal Caregivers ◽  
Self Care ◽  
Symptom Perception ◽  
Convenience Sample ◽  
Failure Index ◽  
Patient Reported ◽  
Quasi Experimental

IntroductionSymptom 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 analysisA 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 disseminationThe 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 numberISRCTN18151041.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

scholarly journals Chronic heart failure patients’ experiences of German healthcare services: a protocol for a scoping review

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025685 ◽  
Author(s):  
Mirjam Dieckelmann ◽  
Felix Reinhardt ◽  
Klaus Jeitler ◽  
Thomas Semlitsch ◽  
Jasper Plath ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Scoping Review ◽  
Grey Literature ◽  
Healthcare Services ◽  
Subjective Expectations ◽  
Scoping Reviews ◽  
Holistic Understanding ◽  
Ethical Approval ◽  
Research Questions

IntroductionChronic heart failure (CHF) is a heterogeneous condition requiring complex treatment from diverse healthcare services. An increasingly holistic understanding of healthcare has resulted in contextual factors such as perceived quality of care, as well as patients’ acceptance, preferences and subjective expectations of health services, all gaining in importance. How patients with CHF experience the use of healthcare services has not been studied within the scope of a systematic review in a German healthcare context. The aim of this scoping review is therefore to review systematically the experiences of patients affected by CHF with healthcare services in Germany in the literature and to map the research foci. Further objectives are to identify gaps in evidence, develop further research questions and to inform decision makers concerned with improving healthcare of patients living with CHF.Methods and analysisThis scoping review will be based on a broad search strategy involving systematic and comprehensive electronic database searches in MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Cochrane’s Database of Systematic Reviews, grey literature searches, as well as hand searches through reference lists and non-indexed key journals. The methodological procedure will be based on an established six-stage framework for conducting scoping reviews that includes two independent reviewers. Data will be systematically extracted, qualitatively and quantitatively analysed and summarised both narratively and visually. To ensure the research questions and extracted information are meaningful, a patient representative will be involved.Ethics and disseminationEthical approval will not be required to conduct this review. Results will be disseminated through a clearly illustrated report that will be part of a wider research project. Furthermore, it is intended that the review’s findings should be made available to relevant stakeholders through conference presentations and publication in peer-reviewed journals (knowledge transfer). Protocol registration in PROSPERO is not applicable for scoping reviews.

Anxiety and self-care behaviour in patients with chronic systolic heart failure: A multivariate model

2017 ◽  
Vol 17 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Thomas Müller-Tasch ◽  
Bernd Löwe ◽  
Nicole Lossnitzer ◽  
Lutz Frankenstein ◽  
Tobias Täger ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Anxiety Disorder ◽  
Sex Education ◽  
Nyha Class ◽  
Systolic Heart Failure ◽  
Self Care ◽  
Heart Association ◽  
Depression Score ◽  
Negatively Associated

Background: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. Methods: The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS). The Patient Health Questionnaire (PHQ) was used to assess anxiety, the PHQ-9 was used to measure depression severity. Differences between patients with and without anxiety were assessed with the respective tests. Associations between anxiety, self-care and other predictors were analysed using linear regressions. Results: Of the 308 participating patients, 35 (11.4%) fulfilled the PHQ criteria for an anxiety disorder. These patients took antidepressants more frequently (11.8% versus 2.3%, p = .02), had had more contacts with their general practitioner within the last year (11.8 ± 16.1 versus 6.7 ± 8.6, p = .02), and had a higher PHQ-9 depression score (12.9 ± 5.7 versus 6.5 ± 4.7, p < .01) than patients without anxiety disorder. Anxiety and self-care were negatively associated (ß = −0.144, r2 = 0.021, p = 0.015). The explanation of variance was augmented in a multivariate regression with the predictors age, sex, education, living with a partner, and New York Heart Association (NYHA) class ( r2 = 0.098) when anxiety was added ( r2 = 0.112). Depression further increased the explanation of variance (ß = −0.161, r2 = 0.131, p = 0.019). Conclusions: Anxiety is negatively associated with self-care behaviour in patients with CHF. However, this effect disappears behind the stronger influence of depression on self-care. The consideration of mental comorbidities in patients with CHF is important.

scholarly journals Understanding the use of patient-reported data by health care insurers: A scoping review

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244546
Author(s):  
Anne Neubert ◽  
Óscar Brito Fernandes ◽  
Armin Lucevic ◽  
Milena Pavlova ◽  
László Gulácsi ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Scoping Review ◽  
Business Models ◽  
Grey Literature ◽  
Process Indicators ◽  
Patient Reported ◽  
Reported Data ◽  
And Function ◽  
Health Insurers

Background Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers. Methods The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer. Results Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people. Conclusions The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer’s business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly.

scholarly journals Development of Cognitive and Physical Exercise Systems, Clinical Recordings, Large-Scale Data Analytics, and Virtual Coaching for Heart Failure Patients: Protocol for the BioTechCOACH-ForALL Project

10.2196/17714 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17714
Author(s):  
Antonis Billis ◽  
Niki Pandria ◽  
Sophia-Anastasia Mouratoglou ◽  
Evdokimos Konstantinidis ◽  
Panagiotis Bamidis
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Physical Exercise ◽  
Real Life ◽  
Self Care ◽  
Study Phase ◽  
Lab Experiment ◽  
Home Study ◽  
Heart Failure Patients ◽  
Patient Reported

Background Heart failure is a chronic disease affecting patient morbidity and mortality. Current guidelines for heart failure patient treatment are focused on improving their clinical status, functional capacity, and quality of life. However, these guidelines implement numerous instructions including medical treatment adherence, physical activity, and self-care management. The complexity of the therapeutic instructions makes them difficult to follow especially by older adults. Objective The challenge of this project is to (1) measure real-life adherence to a regular physical exercise program and (2) attempt to influence older adult patients with heart failure toward embracing a more physically active self-care lifestyle. Methods This research consists of two studies, including a lab experiment and a pragmatic evaluation of technology at patients’ homes. The lab experiment aims at exploring in an objective way (measuring neurophysiological responses to stimuli) patient engagement with different characteristics of virtual agents, while the home study is a 3-phase prospective study where the developed technology platform is tested by heart failure patients in their own home environments. Patients undergo evaluation of their physical activity and cognitive status using standard evaluation methods (6-minute walk test, questionnaires) and receive wearable devices to accurately measure everyday life activity levels (home study phases 1-3). During home study phases 2 and 3, exergames (serious games for physical exercise) to provide a physical exercise plan as a joyful activity are delivered to patients’ private households and e-coaching techniques are implemented in the final phase (home study phase 3) of the protocol, to influence patient attitudes toward a more healthy and recommended lifestyle. Results The trial is still ongoing. Recruitment is ongoing, and the project has progressed for some participants through phase 2 of the home study. The sample size for both studies is 28 participants; 10 have already been included in the study, and both baseline clinical and patient-reported outcome data are retrieved. Phases 2 and 3 of the home pilot study are expected to be completed within 6 months. Conclusions The main challenge of the project is the change of attitude of older age heart failure patients through an e-coaching system. Given the adoption of a cocreation and living lab approach and the main objective for real-life evaluation, the project is ready to react to any collected feedback, even during the implementation of the research plan. Clinical assessment and objective evaluation are expected to provide all required information for reliable findings. Trial Registration ClinicalTrials.gov NCT03877328; https://clinicaltrials.gov/ct2/show/NCT03877328 International Registered Report Identifier (IRRID) DERR1-10.2196/17714

scholarly journals Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS)

2016 ◽  
Vol 4 (2) ◽  
pp. e74 ◽  
Author(s):  
Ruth M Masterson Creber ◽  
Mathew S Maurer ◽  
Meghan Reading ◽  
Grenny Hiraldo ◽  
Kathleen T Hickey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mobile Phone ◽  
Mobile Application ◽  
Care Management ◽  
Rating Scale ◽  
Self Care ◽  
Symptom Monitoring ◽  
Heart Failure Symptom

scholarly journals Symptom perception in heart failure – Interventions and outcomes: A scoping review

2020 ◽  
pp. 103524
Author(s):  
Gabrielle Cécile Santos ◽  
Maria Liljeroos ◽  
Andrew A. Dwyer ◽  
Cécile Jaques ◽  
Josepha Girard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Scoping Review ◽  
Symptom Perception

scholarly journals Protocol for a scoping review of skin self-care of people with spinal cord injury

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017860 ◽  
Author(s):  
Daniella Karine Souza Lima ◽  
Soraia Dornelles Schoeller ◽  
Neide da Silva Knihs ◽  
Caroline Porcelis Vargas ◽  
Adriana Dutra Tholl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Scoping Review ◽  
Grey Literature ◽  
Secondary Analysis ◽  
Self Care ◽  
Evidence Base ◽  
Cord Injury ◽  
Ethical Approval ◽  
Health Rehabilitation

IntroductionIn recent years, increasing methodological references have been used in scientific research; these are points of support in the search for evidence, formulation and elaboration of instruments, scales, guideline and protocols. However, significant variability currently exists in scoping review conduct and reporting, thus limiting the potential of the methodology to advance research and practice about skin self-care of people with spinal cord injury (SCI). Our objective was to perform a scoping review protocol within the health rehabilitation context of people with SCI, focusing on skin self-care.Methods and analysisThe protocol was developed by using the scoping review methodological framework proposed by Arksey and O’Malley and further refined by the Joanna Briggs Institute, incorporating insights from more recent innovations in scoping review methodology. Sensitive searches of 13 electronic databases from 2007 to 2017 will be supplemented by grey literature searches. Two reviewers using a tool developed for this scoping review will screen eligible studies.Ethics and disseminationThe scoping review will undertake a secondary analysis of previously collected data and does not require ethical approval; however, the ethical precepts of copyright will be respected. The results will facilitate a better understanding of the practical health rehabilitation context of people with SCI, the impacts of these rehabilitations and how to build an evidence base for this work in the future.

The influence of dyadic congruence and satisfaction with dyadic type on patient self-care in heart failure

2020 ◽  
pp. 147451512096000
Author(s):  
Andrew Bugajski ◽  
Harleah Buck ◽  
Valentina Zeffiro ◽  
Hailey Morgan ◽  
Laura Szalacha ◽  
...  
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Multilevel Models ◽  
Self Care ◽  
Secondary Data ◽  
Symptom Perception ◽  
Level Data ◽  
Patient Symptom ◽  
Heart Failure Exacerbation ◽  
The Impact

Background: Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined. Aims: The purpose of this study was to examine the role of dyadic-type congruence on patient self-care (maintenance, symptom perception, and management) while controlling for actor and partner effects. Methods: This secondary data analysis of 277 dyads consisted of a series of multilevel models to examine the impact of dyadic congruence on a patient’s self-care maintenance, symptom perception, and self-care management. Patient-level and caregiver-level data were input into each model simultaneously to account differential appraisals of factors related to the dyad. Results: Bivariate analyses yielded dyad congruence which was associated with better patient self-care maintenance, symptom perception and management. However, after multilevel models were constructed, dyad congruence was found to be a significant predictor of patient’s symptom perception scores, but not self-care maintenance or management scores. Caregiver’s satisfaction with the dyad was differentially and significantly associated with self-care – it was inversely associated with patient self-care maintenance and positively associated with patient self-care management. Conclusion: This is the first study, to our knowledge, reporting that congruence in heart failure dyads is associated with better patient symptom perception and this advances our prior hypothesis that dyad typologies could be used to predict patient self-care performance. Since symptom perception is the key to preventing heart failure exacerbation, screening heart failure patient and caregiver dyads for congruence is important in clinical settings.

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