An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients

AbstractObjective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients.Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients).Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints.Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness.

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Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091625 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1625 ◽

Cited By ~ 2

Author(s):

Rosalia Santesmases-Masana ◽

Luis González-de Paz ◽

Elvira Hernández-Martínez-Esparza ◽

Belchin Kostov ◽

Maria Dolors Navarro-Rubio

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Chronic Heart Failure ◽

Primary Healthcare ◽

Self Care ◽

Cross Sectional ◽

Heart Failure Patients ◽

Care Practices ◽

Primary Healthcare Centers

Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.

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Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial

Journal of Telemedicine and Telecare ◽

10.1177/1357633x19899261 ◽

2020 ◽

pp. 1357633X1989926 ◽

Cited By ~ 1

Author(s):

Lucía M Yanicelli ◽

Carla B Goy ◽

Viviana del C González ◽

Gerardo N Palacios ◽

Ernesto C Martínez ◽

...

Keyword(s):

Heart Failure ◽

Clinical Trial ◽

Usual Care ◽

Treatment Adherence ◽

Intervention Group ◽

Self Care ◽

Control Group ◽

Heart Failure Patients ◽

Home Telemonitoring

Introduction The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients. Methods A randomized clinical trial that compares the efficacy of a home telemonitoring system –intervention group versus usual care control group – among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients’ self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period. Results 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence ( p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients ( p = 0.03) and a worsened self-care in the control group ( p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided. Discussion This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels. Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093

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A Study to Develop and Evaluate the Effectiveness of a Mobile App: Samrudheart on Self-Care Management of a Patient with Heart Failure in Terms of Knowledge, Practice, and Adherence to Treatment among Heart Failure Patients in Safdarjung Hospital, New Delhi

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210637 ◽

2021 ◽

Vol 11 (6) ◽

pp. 234-248

Author(s):

Poonam . ◽

Madhumita Dey ◽

R. G Mathur

Keyword(s):

Heart Failure ◽

Care Management ◽

Self Care ◽

Mobile App ◽

New Delhi ◽

Adherence To Treatment ◽

Heart Failure Patients ◽

Knowledge Practice ◽

Safdarjung Hospital

Topic: A study to develop and evaluate the effectiveness of mobile app: Samrudheart on self-care management of patient with heart failure in terms of knowledge, practice, and adherence to treatment among heart failure patients in Safdarjung Hospital, New Delhi. Objectives: The objectives of the study were to develop and evaluate the effectiveness of mobile app: Samrudheart on self-care management of patient with heart failure, to assess and evaluate the knowledge, practice, and adherence to the treatment of heart failure patients, to find the relationship between knowledge, practice, and adherence to treatment after the administration of mobile app, on heart failure patients, to find the association between knowledge, practice, and adherence to treatment of heart failure patients after the administration of mobile app on selfcare management of heart failure with selected variables like age, sex, education status, family income, BMI, duration of illness, smoking, tobacco use, alcohol intake, lifestyle, diet, regular follow-up. Methodology: The research approach was the quasi-experimental approach. The Research design was one group pre-test and post-test control group design. The research setting selected for the study was cardiology OPD of VMMC and Safdarjung Hospital, New Delhi. The sample was comprised of (60) Heart Failure patients attending cardiology OPD. The independent variable in the study was a mobile app: Samrudheart and reminder call for adherence to treatment on self-care management of a patient with heart failure and the dependent variable was knowledge, practice, and adherence to treatment on self-care management of heart failure. The tool used for data collection were demographic data of sample characteristics, health determinant data of sample characteristics, structured knowledge questionnaire, structured practice checklist, structured adherence to the treatment rating scale, and structured opinionnaire. The KR-20, inter-observer and cronbach alpha formula was used to assess the reliability of tools. Results: Major findings of the study revealed that initially, the heart failure patients had poor knowledge, practice, and adherence to treatment on self-care management of heart failure. The mobile app was found to be effective in improving the knowledge, practice, and adherence to treatment of heart failure patients. There was no significant association between the knowledge, treatment adherence and not influenced by the selected variables except the practice scores are influenced by the regular follow up. Conclusion: Findings revealed that the mobile app: Samrudheart was found to be an effective strategy in improving the knowledge, practice, and adherence to treatment on self-care management of a patient with heart failure. Key words: Mobile App, Self-care management, Knowledge, Practice, Adherence, Heart Failure Patients.

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263 Clinical determinants of self-care behaviour in elderly heart failure patients

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(04)90188-9 ◽

2004 ◽

Vol 3 (1) ◽

pp. 63

Author(s):

D DELSINDACO

Keyword(s):

Heart Failure ◽

Self Care ◽

Heart Failure Patients

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IMPACT OF HEALTH LITERACY ON KNOWLEDGE, SELF-CARE AND CLINICAL OUTCOMES IN HEART FAILURE PATIENTS

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2018.07.263 ◽

2018 ◽

Vol 34 (10) ◽

pp. S93

Author(s):

J. McConnery ◽

F. Foroutan ◽

A. Alba ◽

H. Ross ◽

J. MacIver

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Clinical Outcomes ◽

Self Care ◽

Heart Failure Patients

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Long-term Clinical Follow-up of Japanese Heart Failure Patients Received ICD Therapy for Primary Prevention of Sudden Cardiac Death

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2008.07.049 ◽

2008 ◽

Vol 14 (7) ◽

pp. S140-S141

Author(s):

Kenji Ando ◽

Yoshimitsu Soga ◽

Masahiko Goya ◽

Shinichi Shirai ◽

Shinya Nagayama ◽

...

Keyword(s):

Heart Failure ◽

Primary Prevention ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Icd Therapy ◽

Heart Failure Patients

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Twin peaks diversity with sacubitril/valsartan treatment responses in cardiomyopathic heart failure patients of non-ischemic compared to ischemic etiologies

European Heart Journal ◽

10.1093/ehjci/ehaa946.1056 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

H.Y Chang ◽

W.R Chiou ◽

P.L Lin ◽

C.Y Hsu ◽

C.T Liao ◽

...

Keyword(s):

Heart Failure ◽

Primary Endpoint ◽

Ischemic Cardiomyopathy ◽

Ventricular Remodeling ◽

Left Ventricular Ejection ◽

Funding Source ◽

Heart Failure Patients ◽

Twin Peaks ◽

All Cause Mortality

Abstract Background Ischemic cardiomyopathy (ICM) has been associated with increased mortality when compared with non-ischemic cardiomyopathy (NICM) from several heart failure (HF) cohorts. Instead, PARADIGM study demonstrated similar event rates of cardiovascular (CV) death, all-cause mortality and HF readmissions between ICM and NICM patients. Although the beneficiary effect of sacubitril/valsartan (SAC/VAL) compared to enalapril on these endpoints was consistent across etiologic categories, PARADIGM study did not analyze the effect of ventricular remodeling of SAC/VAL on patients with different HF etiologies, which may significantly affect treatment outcomes. Purpose We aim to compare alterations of left ventricular ejection fraction (LVEF) following SAC/VAL treatment and its association with clinical outcomes in patients with different HF etiologies. Methods Treatment with angiotensin receptor neprilysin inhibitor for Taiwan heart failure patients (TAROT-HF) study is a multicenter study which enrolled 1552 patients with LVEF <40%, whom had been on SAC/VAL treatment from 9 hospitals between 2017 and 2018. After excluding patients without having follow-up echocardiographic studies, patients were grouped by HF etiologies and by LVEF changes following treatment for 8-month period. LVEF improvement ≥15% was defined as “significant improvement”, 5–15% as “marginal improvement”, and <5% or worse as “lack of improvement”. The primary endpoint was a composite of CV death or a first hospitalization for HF. Mean follow-up period was 726 days. Results A total of 1230 patients were analyzed. Patients with ICM were significantly older, more male, and prone to have associated hypertension and diabetes. On the other hand, patients with NICM had lower LVEF and higher likelihood of atrial fibrillation. LVEF increase was significantly greater in patients with NICM compared to those with ICM (11.2±12.4% vs. 6.9±9.8, p<0.001). The effect of ventricular remodeling of SAC/VAL on patients with NICM showed twin peaks diversity (Significant improvement 37.1%, lack of improvement 42.3%), whereas in patients with ICM the proportions of significant, marginal and lack of improvement groups were 19.4%, 28.2% and 52.4%, respectively. The primary endpoint showed twin peaks diversity also in patients with NICM in line with LVEF changes: adjusted HR for patients with NICM and significant improvement was 0.41 (95% CI 0.29–0.57, p<0.001), for patients with NICM and lack of improvement was 1.54 (95% CI 1.22–1.94, p<0.001). Analyses for CV death, all-cause mortality, and HF readmission demonstrated consistent results. Conclusion Patients with NICM had higher degree of LVEF improvement than those with ICM following SAC/VAL treatment, and significant improvement of LVEF in NICM patients may indicate favorable outcome. NICM patients without response to SAC/VAL treatment should serve as an indicator for poor clinical outcome and warranted meticulous HF management. Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Cheng Hsin General Hospital

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Role of nurses to improve self-care in heart failure patients: a systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckz185.360 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Massimi ◽

C De Vito ◽

M L Rega ◽

P Villari ◽

G Damiani

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Meta Analysis ◽

Self Care ◽

Educational Interventions ◽

Management Skills ◽

Short Term ◽

Post Discharge ◽

Individual Level ◽

Heart Failure Patients

Abstract Introduction Heart Failure (HF) is a pandemic chronic disease with a prevalence up to 3% in the general population, representing the main cause of hospitalization for people over 65. Self-care plays a central role in the management of patients with HF, showing evidence of effectiveness in reducing re-hospitalization rates and mortality. Methods We carried out a systematic review and meta-analysis to assess the efficacy of nurse-led educational interventions Vs usual care in improving self-care skills of patients with chronic HF. The main biomedical databases were searched for Randomized Control Trials (RCTs) of nurse-led educational interventions performed on adults with a previous diagnosis of HF. Improvement of HF self-management skills (self-care level) was summarized by calculating the standardized mean difference (SMD) and 95% confidence intervals (CI) stratified for the length of the follow-up. Results Globally, 14 RCTs were included involving 2078 participants. Ten studies showed the efficacy of the interventions at 3 months (short term) with a SMD of 0.78 (95% CI 0.38-1.18) in favor of the self-care education interventions. Five studies reported on self-care abilities at 6-9 months (medium term), not showing statistically significant results (SMD 0.35, 95%CI 0.11-0.81). The long-term effect of the educational interventions showed no statistically significant improvement in self-care behaviors (three studies, SMD 0.05, 95CI% 0.12 - 0.22). Conclusions These results show that nursing educational interventions improve self-care behaviors in HF, but mainly in the short term. Intensive educational interventions led by nurses, associated with appropriate continuity and transition of care, can determine the best outcomes for patients with HF, strengthening self-care behaviors over time. This approach could have a major impact not only on individual level, but on the general reduction of complications, hospitalization, medical costs and ultimately mortality. Key messages Nurse-led educational programs have a short-term efficacy in enhancing self-care behaviors among heart failure patients. Post-discharge repeated educational interventions, along with timely and shared plans ruling the transition between the hospital and the other providers, are strongly needed.

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