scholarly journals Research on the Application Value of Comfort Nursing Intervention in the Nursing of Senile Chronic Heart Failure

2020 ◽  
Vol 9 (3) ◽  
pp. 60
Author(s):  
Fengjiao Yan ◽  
Chao Wang ◽  
Peizhen Pan ◽  
Shuang Wang ◽  
Lishan Lv

<p><strong>Objective</strong><strong>:</strong> To analyze the application value of comfort nursing intervention in senile chronic heart failure nursing. <strong>Methods:</strong> The 120 heart failures discharged from our hospital in 2018 and 2019 were selected. The changes in nursing satisfaction, specialty nursing quality indicators and the incidence of pressure ulcers in hospitalized patients were compared and analyzed between the two groups. <strong>Results:</strong> The average satisfaction degree of the two groups was 97.48% and 97.22% respectively, and the difference between the groups was statistically significant (P&lt;0.05). The correct rates of acute left heart failure in the two groups were 99.56% and 98.13%, and the difference between the groups was statistically significant (P&lt;0.05), and two groups of patients with cardiac Ⅲ class above intake control accuracy was 99.95% and 99.99%, and the difference between groups was statistically significant (P&gt;0.05), and the incidence of pressure ulcer was 0.18‰ and 0, and there was no significant difference between the two groups. <strong>Conclusion:</strong> Comfort nursing intervention has achieved good nursing satisfaction and clinical effect in elderly patients with heart failure.</p>

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Mahdieh Abdolahi ◽  
Mohammad Mahdi Doustmohamadi ◽  
Hojjat Sheikhbardsiri

BACKGROUND: Cardiac failure is one of the most common chronic diseases with high rate of morbidity and mortality. Fatigue and decreased ability to perform daily activities are of the most common complications of this disease. The purpose of this study was to determine the effect of an educational plan based on Roy adaptation model on fatigue and daily activities in patients with heart failure.METHODS: This experimental study was performed on 60 heart failure patients admitted in two educational hospitals supervised by the Kerman University of Medical Sciences in 2019. Sample was randomly assigned into two intervention and control groups. The intervention group received the care plan through a face-toface and group training program in 6 sessions at one month. Interval followed by a follow-up period for 4 weeks later. Fatigue level was calculated based on piper fatigue scale, and daily activities were calculated by Barthes scale.RESULTS: The finding indicated that there was a significant difference between the two groups (control and intervention) after the intervention. The result showed that the intervention group had significantly lower mean scores in fatigue and higher mean scores in daily activities compared to the control group after intervention P ≤ .05. There was a significant relationship between fatigue and daily activities of life with frequency of hospitalization and duration of disease in both groups, P ≤ .05.CONCLUSION: Implementation of Roy model-based education program as a low-cost, effective, and non-aggressive nursing intervention can reduce fatigue, and improve daily activities in patients with heart failure.


2021 ◽  
Vol 7 (4) ◽  
pp. 347-352
Author(s):  
Xiao-Li Sun ◽  
Zhao-Yun Shi ◽  
Na Wang

Objective To observe the effect of continuous nursing intervention on exercise tolerance and rehospitalization rate in patients with chronic heart failure. Methods 134 patients with chronic heart failure admitted to our hospital were divided into two groups, routine nursing intervention group (control group) and continuous nursing intervention group (observation group), with 67 cases in each group. The resting and peak heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were recorded. The change of 6min walking distance, modified European Heart Failure Self-Care Behavior Scale (EHFSCB-9) and quality of life (SF-36) of the two groups were compared before and after intervention, and moreover, rehospitalization rate of heart failure of two groups 6 months after discharge was compared between the two groups. Results: Before intervention, there was no significant difference between the two groups (P>0.05). After intervention, there was no significant difference in resting and peak HR, SBP and DBP between the two groups and those before intervention (P>0.05). Further comparison between the two groups showed that there was no significant difference in resting and peak HR, SBP and DBP between the observation group and the control group (P>0.05). After intervention, 6min walking distance and SF-36 scale scores (role physical, physiological function, physical pain, energy, health status, social function, mental health and emotional function) were increased in the two groups (P<0.05). Further comparison between the two groups showed that 6min walking distance and SF-36 scale scores (except somatic pain score and role physical score) in the observation group were higher than those in the control group (P<0.05), and the EHFSCB-9 scores in the two groups decreased gradually after intervention (P<0.05). Further comparison between the two groups showed that the EHFSCB-9 scores in the observation group (except low salt diet score and taking medicine based on doctor's advice score) were lower than those in the control group (P<0.05). The rehospitalization rate of heart failure within 6 months after discharge was 11.91% in the observation group, significantly lower than 25.37% in the control group, and the difference was significant (P<0.05). Conclusion: Continuous nursing intervention can strengthen the self-care ability of patients with chronic heart failure, improve exercise tolerance and quality of life, and reduce the rehospitalization rate to heart failure within 6 months.


2022 ◽  
Vol 12 (1) ◽  
pp. 50
Author(s):  
Yusuke Yumita ◽  
Yuji Nagatomo ◽  
Makoto Takei ◽  
Mike Saji ◽  
Ayumi Goda ◽  
...  

The optimal heart rate (HR) in patients with heart failure with reduced ejection fraction (HFrEF) has been ill-defined. Recently, a formula was proposed for estimating the target heart rate (THR), which eliminates the overlap between the E and A wave (E-A overlap). We aim to validate its prognostic significance in the multicenter WET-HF registry. This study used data from 647 patients with HFrEF hospitalized for acute decompensated HF (ADHF). The patients were divided into the 2 groups by THR. The primary endpoint was defined as the composite of all-cause death and ADHF readmission. The THR successfully discriminated the incidence of the primary endpoint, whereas no significant difference was observed in the primary endpoint when dividing the patients by uniform cutoff 70 bpm. HR at discharge ≤ THR was inversely associated with the primary endpoint. Restricted cubic spline analysis demonstrated the difference between HR at discharge, and THR (ΔHR) from −10 to ±0 was associated with a lower risk of primary endpoint and ΔHR from ±0 to +15 was associated with a higher risk. THR discriminated long-term outcomes in patients with HFrEF more efficiently than the uniform cutoff, suggesting that it may aid in tailored HR reduction strategies.


2021 ◽  
Vol 7 (5) ◽  
pp. 1509-1515
Author(s):  
Xiao-li Sun ◽  
Zhao-yun Shi ◽  
Na Wang

To observe the effect of continuous nursing intervention on exercise tolerance and rehospitalization rate in patients with chronic heart failure. Methods 134 patients with chronic heart failure admitted to our hospital were divided into two groups, routine nursing intervention group (control group) and continuous nursing intervention group (observation group), with 67 cases in each group. The resting and peak heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were recorded. The change of 6min walking distance, modified European Heart Failure Self-Care Behavior Scale (EHFSCB-9) and quality of life (SF-36) of the two groups were compared before and after intervention, and moreover, rehospitalization rate of heart failure of two groups 6 months after discharge was compared between the two groups. Results : Before intervention, there was no significant difference between the two groups (P>0.05). After intervention, there was no significant difference in resting and peak HR, SBP and DBP between the two groups and those before intervention (P>0.05). Further comparison between the two groups showed that there was no significant difference in resting and peak HR, SBP and DBP between the observation group and the control group (P>0.05). After intervention, 6min walking distance and SF-36 scale scores (role physical, physiological function, physical pain, energy, health status, social function, mental health and emotional function) were increased in the two groups (P<0.05). Further comparison between the two groups showed that 6min walking distance and SF-36 scale scores (except somatic pain score and role physical score) in the observation group were higher than those in the control group (P<0.05), and the EHFSCB-9 scores in the two groups decreased gradually after intervention (P<0.05). Further comparison between the two groups showed that the EHFSCB-9 scores in the observation group (except low salt diet score and taking medicine based on doctor’s advice score) were lower than those in the control group (P<0.05). The rehospitalization rate of heart failure within 6 months after discharge was 11.91% in the observation group, significantly lower than 25.37% in the control group, and the difference was significant (P<0.05). Conclusion : Continuous nursing intervention can strengthen the self-care ability of patients with chronic heart failure, improve exercise tolerance and quality of life, and reduce the rehospitalization rate to heart failure within 6 months.


2021 ◽  
Vol 7 ◽  
Author(s):  
Wilson Matthew Raffaello ◽  
Joshua Henrina ◽  
Ian Huang ◽  
Michael Anthonius Lim ◽  
Leonardo Paskah Suciadi ◽  
...  

Heart failure is currently one of the leading causes of morbidity and mortality. Patients with heart failure often present with acute symptoms and may have a poor prognosis. Recent evidence shows differences in clinical characteristics and outcomes between de novo heart failure (DNHF) and acute decompensated chronic heart failure (ADCHF). Based on a better understanding of the distinct pathophysiology of these two conditions, new strategies may be considered to treat heart failure patients and improve outcomes. In this review, the authors elaborate distinctions regarding the clinical characteristics and outcomes of DNHF and ADCHF and their respective pathophysiology. Future clinical trials of therapies should address the potentially different phenotypes between DNHF and ADCHF if meaningful discoveries are to be made.


2017 ◽  
Author(s):  
Mary N. Woessner ◽  
Itamar Levinger ◽  
Christopher Neil ◽  
Cassandra Smith ◽  
Jason D Allen

BACKGROUND Chronic heart failure is characterized by an inability of the heart to pump enough blood to meet the demands of the body, resulting in the hallmark symptom of exercise intolerance. Chronic underperfusion of the peripheral tissues and impaired nitric oxide bioavailability have been implicated as contributors to the decrease in exercise capacity in these patients. nitric oxide bioavailability has been identified as an important mediator of exercise tolerance in healthy individuals, but there are limited studies examining the effects in patients with chronic heart failure. OBJECTIVE The proposed trial is designed to determine the effects of chronic inorganic nitrate supplementation on exercise tolerance in both patients with heart failure preserved ejection fraction (HFpEF) and heart failure reduced ejection fraction (HFrEF) and to determine whether there are any differential responses between the 2 cohorts. A secondary objective is to provide mechanistic insights into the 2 heart failure groups’ exercise responses to the nitrate supplementation. METHODS Patients with chronic heart failure (15=HFpEF and 15=HFrEF) aged 40 to 85 years will be recruited. Following an initial screen cardiopulmonary exercise test, participants will be randomly allocated in a double-blind fashion to consume either a nitrate-rich beetroot juice (16 mmol nitrate/day) or a nitrate-depleted placebo (for 5 days). Participants will continue daily dosing until the completion of the 4 testing visits (maximal cardiopulmonary exercise test, submaximal exercise test with echocardiography, vascular function assessment, and vastus lateralis muscle biopsy). There will then be a 2-week washout period after which the participants will cross over to the other treatment and complete the same 4 testing visits. RESULTS This study is funded by National Heart Foundation of Australia and Victoria University. Enrolment has commenced and the data collection is expected to be completed in mid 2018. The initial results are expected to be submitted for publication by the end of 2018. CONCLUSIONS If inorganic nitrate supplementation can improve exercise tolerance in patients with chronic heart failure, it has the potential to aid in further refining the treatment of patients in this population. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000906550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368912 (Archived by WebCite at http://www.webcitation.org/6xymLMiFK)


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hossein Habibzadeh ◽  
Akram Shariati ◽  
Farshad Mohammadi ◽  
Salman Babayi

Abstract Background Heart failure is a common and chronic heart condition with high prevalence and mortality rates. This debilitating disease as an important predictor of health outcomes is directly related to patients' quality of life. Given that one of the main goals of heart failure treatment is to promote patients' quality of life and health status, conducting effective nursing interventions seems to be necessary in this regard. Therefore, the present study aimed to determine the effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure. Methods This is an experimental study in which a total of 80 patients with heart failure were recruited and randomly allocated to two groups of intervention and control (n = 40 in each group). The educational program was designed based on Pender's health promotion model and then provided for the patients in the intervention four subgroups (10 person in each group) during six sessions. Data were collected at three time-points of before, immediately after, and three months after the intervention using a demographic questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were then analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA) and p value less than 0.05 was taken as statistically significant. Results Based on the results of the present study, no statistically significant difference was shown in terms of demographic characteristics between the two groups. It was also indicated that there was a statistically significant difference in the mean scores of all dimensions of quality of life (except in the physical dimension) between the two groups so that the overall mean score of quality of life increased significantly in the intervention group after the intervention (p < .05). Moreover, there were significant increases in the mean scores of health-promoting behaviors (except in the domain of physical activity) in the intervention group compared to the control group (p < .05) after intervention. Conclusions This study demonstrates a trend that Pender's health promotion model is effective in improving the quality of life of patients with heart failure except of the physical dimension, and strengthening their health-promoting behaviors in all dimensions except of the physical activity dimension.


The Clinician ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 36-42
Author(s):  
E. S. Trofimov ◽  
A. S. Poskrebysheva ◽  
N. А. Shostak

Objective: to evaluate vasopressin (VP) concentration in patients with varying severity of chronic heart failure (CHF), intensity of clinical symptoms, and decreased level of left ventricular ejection fraction (LVEF). Materials and methods. In total, 120 patients (44 males, 76 females) with CHF of varying genesis (mean age 72.12 ± 10.18 years) and 30 clinically healthy individuals (18 males, 12 females) as a control group (mean age 33.4 ± 6.23 years) were examined. All patients underwent comprehensive clinical and instrumental examination in accordance with the standards for patients with CHF. The VP level was determined using ELISA. Statistical analysis was performed using the IBM SPSS Statistics v. 23 software.Results. The patients with CHF had significantly higher blood VP levels compared to the control group (72.91 ± 53.9 pg/ml versus 6.6 ± 3.2 pg/ml respectively; p <0.01). At the same time, patients with stage III CHF had significantly lower VP levels than patients with stages IIВ and IIА (35.61 ± 21.53 pg/ml versus 71.67 ± 48.31 pg/ml and 86.73 ± 59.78 pg/ml respectively; p<0.01). A similar picture was observed for the functional classes (FC). For instance, for CHF FC II and III, the VP level was 91.93 ± 67.13 pg/ml and 77.95 ± 54.01 pg/ml respectively, while for FC IV it decreased to 50.49 ± 28.18 pg/ml (p <0.01). The VP concentration in patients who subsequently perished was significantly lower than in patients who survived (48.79 ± 26.30 pg/ml versus 79.72 ± 57.73 pg/ml; p = 0.012). Moreover, in patients with LVEF <50 %, the VP level was significantly lower than in patients with LVEF >50 % (59.43 ± 42.51 pg/ml versus 86.43 ± 62.46 pg/ml respectively; p <0.05).Conclusion. The observed significant differences in VP in patients with stage III and IV CFH can indicate depletion of neurohumoral mediators in this patient category. However, a correlation between the VP level and the level of LVEF decrease can indicate a significant difference in the role of VP in CHF pathogenesis in patients with preserved and decreased LVEF. This observation requires further research.


2018 ◽  
Vol 54 (6) ◽  
pp. 351-357 ◽  
Author(s):  
Brian C. Bohn ◽  
Rim M. Hadgu ◽  
Hannah E. Pope ◽  
Jerrica E. Shuster

Background: Thiazide diuretics are often utilized to overcome loop diuretic resistance when treating acute decompensated heart failure (ADHF). In addition to a large cost advantage, several pharmacokinetic advantages exist when administering oral metolazone (MTZ) compared with intravenous (IV) chlorothiazide (CTZ), yet many providers are reluctant to utilize an oral formulation to treat ADHF. The purpose of this study was to compare the increase in 24-hour total urine output (UOP) after adding MTZ or CTZ to IV loop diuretics (LD) in patients with heart failure with reduced ejection fraction (HFrEF). Methods and Results: From September 2013 to August 2016, 1002 patients admitted for ADHF received either MTZ or CTZ in addition to LD. Patients were excluded for heart failure with preserved ejection fraction (HFpEF) (n = 469), <24-hour LD or UOP data prior to drug initiation (n = 129), or low dose MTZ/CTZ (n = 91). A total of 168 patients were included with 64% receiving CTZ. No significant difference was observed between the increase in 24-hour total UOP after MTZ or CTZ initiation (1458 [514, 2401] mL vs 1820 [890, 2750] mL, P = .251). Conclusions: Both MTZ and CTZ similarly increased UOP when utilized as an adjunct to IV LD. These results suggest that while thiazide agents can substantially increase UOP in ADHF patients with HFrEF, MTZ and CTZ have comparable effects.


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