scholarly journals A Smartphone App for Self-Management of Heart Failure in Older African Americans: Feasibility and Usability Study

JMIR Aging ◽  
10.2196/17142 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e17142 ◽  
Author(s):  
Sue P Heiney ◽  
Sara B Donevant ◽  
Swann Arp Adams ◽  
Pearman D Parker ◽  
Hongtu Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
African American ◽  
Health Literacy ◽  
African Americans ◽  
Self Care ◽  
The Self ◽  
Maintenance Management ◽  
Self Management

Background Mobile health (mHealth) apps are dramatically changing how patients and providers manage and monitor chronic health conditions, especially in the area of self-monitoring. African Americans have higher mortality rates from heart failure than other racial groups in the United States. Therefore, self-management of heart failure may improve health outcomes for African American patients. Objective The aim of the present study was to determine the feasibility of using an mHealth app, and explore the outcomes of quality of life, including self-care maintenance, management, and confidence, among African American patients managing their condition after discharge with a diagnosis of heart failure. Methods Prior to development of the app, we conducted qualitative interviews with 7 African American patients diagnosed with heart failure, 3 African American patients diagnosed with cardiovascular disease, and 6 health care providers (cardiologists, nurse practitioners, and a geriatrician) who worked with heart failure patients. In addition, we asked 6 hospital chaplains to provide positive spiritual messages for the patients, since spirituality is an important coping method for many African Americans. These formative data were then used for creating a prototype of the app, named Healthy Heart. Specifically, the Healthy Heart app incorporated the following evidence-based features to promote self-management: one-way messages, journaling (ie, weight and symptoms), graphical display of data, and customized feedback (ie, clinical decision support) based on daily or weekly weight. The educational messages about heart failure self-management were derived from the teaching materials provided to the patients diagnosed with heart failure, and included information on diet, sleep, stress, and medication adherence. The information was condensed and simplified to be appropriate for text messages and to meet health literacy standards. Other messages were derived from interviews conducted during the formative stage of app development, including interviews with African American chaplains. Usability testing was conducted over a series of meetings between nurses, social workers, and computer engineers. A pilot one-group pretest-posttest design was employed with participants using the mHealth app for 4 weeks. Descriptive statistics were computed for each of the demographic variables, overall and subscales for Health Related Quality of Life Scale 14 (HQOL14) and subscales for the Self-Care of Heart Failure Index (SCHFI) Version 6 using frequencies for categorical measures and means with standard deviations for continuous measures. Baseline and postintervention comparisons were computed using the Fisher exact test for overall health and paired t tests for HQOL14 and SCHFI questionnaire subscales. Results A total of 12 African American participants (7 men, 5 women; aged 51-69 years) diagnosed with heart failure were recruited for the study. There was no significant increase in quality of life (P=.15), but clinically relevant changes in self-care maintenance, management, and confidence were observed. Conclusions An mHealth app to assist with the self-management of heart failure is feasible in patients with low literacy, low health literacy, and limited smartphone experience. Based on the clinically relevant changes observed in this feasibility study of the Healthy Heart app, further research should explore effectiveness in this vulnerable population.

scholarly journals Self-Management Intervention to Improve Self-Care and Quality of Life in Heart Failure Patients

2012 ◽  
Vol 19 (4) ◽  
pp. E9-E16 ◽  
Author(s):  
Heng-Hsin Tung ◽  
Chun-Yu Lin ◽  
Kuei-Ying Chen ◽  
Chien-Jung Chang ◽  
Yu-Ping Lin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Care ◽  
Self Management ◽  
Heart Failure Patients ◽  
Management Intervention

scholarly journals Evaluation of a Mobile Phone App for Patients With Pollen-Related Allergic Rhinitis: Prospective Longitudinal Field Study

10.2196/15514 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15514
Author(s):  
Manuela Glattacker ◽  
Martin Boeker ◽  
Robin Anger ◽  
Frank Reichenbach ◽  
Adrian Tassoni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Health Literacy ◽  
Mobile Phone ◽  
Self Efficacy ◽  
The Self ◽  
Self Management ◽  
Prospective Longitudinal

Background Mobile health apps have great potential to support the self-management of chronic conditions such as allergic diseases, which constitute significant challenges in health care. However, the health app market is confusing for users, as it is vast, dynamic, and lacks scientific evidence regarding the effectiveness of the apps on offer. To our knowledge, no health app for pollen-related allergic rhinitis has been evaluated. Objective The aim of our study was to evaluate the Husteblume mobile phone health app, developed in Germany to facilitate the self-management of pollen-related allergic rhinitis. Methods We evaluated usability and changes in quality of life, health literacy, and self-efficacy for managing one’s chronic disease. We conducted 2 online surveys of registered users of the app, 1 before and 1 after the 2017 pollen season, allowing for the analysis of both cross-sectional and longitudinal data in a field setting. Results The sample comprised 661 app users at the first measurement point and 143 users at follow-up. The subgroup of study participants at follow-up rated the usability of the app as good or very good. There were no significant changes in patient-reported outcomes such as quality of life, health literacy, and self-efficacy between the 2 measurement points (P>.05). However, those reached at follow-up perceived subjective improvements due to the app: 55.9% (80/143) reported being subjectively better informed about their allergy, 27.3% (39/143) noted improved quality of life, 33.6% (48/143) reported subjectively better coping with their allergy, and 28.0% (40/143) felt better prepared for the consultation with their physician. Finally, 90.9% (130/143) users did not identify any adverse effects of the app. Conclusions Despite some methodological caveats, the results of the evaluation of the Husteblume app are encouraging for the subgroup using the app in the long term. However, further studies evaluating the effectiveness of the app are needed. Trial Registration German Clinical Trials Register DRKS00011897; https://tinyurl.com/yxxrg9av

scholarly journals Heart failure inpatient"s self-care behaviour: mulricenter approach focousing on gender differences

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
BM Delgado ◽  
IVO Lopes ◽  
E Mendes ◽  
MARIA Loureiro ◽  
L Preto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Confidence Interval ◽  
Ejection Fraction ◽  
Self Care ◽  
Left Ventricular ◽  
The Self ◽  
Positive Correlation ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Heart failure is often characterized by low exercise capacity and great impairment on performance in activities of daily living. The correct management of the disease can prevent the worsening of symptoms and promote a better quality of life. Self-care behaviour plays an important role on patient"s quality of life. Aim The aims of this study are to evaluate the self-care behaviour in a sample of heart failure inpatients, using the Self-Care Heart Failure Index (SCHFI) and to understand whether gender and patophisiologic characteristics does interfere on it. Methods Cross-sectional multicenter study enrolling 225 heart failure inpatients from eight hospitals. At admission, patient’s functional capacity was evaluated as well as their self-care behaviour, using the SCHFI Portuguese v6.2. Comparison between self-care behaviour with gender was performed. Also some correaltions were perfomed with the total sample of patients, aiming to understand which were the variables that may interfere with the socre of each sub-scale of the self-care HF index.  Results Patients’ mean age was 68.4 ± 10.7 years old, 68% were male and 82.3% have reduced ejection fraction. A mean value of 47.9, 35.6 and 38.8 points was found in the SCHFI score of the sections self-care maintenance (SCMt), self-care management (SCMg) and self-care confidence (SCC), respectively. Heart failure inpatients present inadequate levels of self-care behaviour. No difference was found between genders on any section of the SCHFI. Among all variables, only the number of CVRFs and the left ventricular ejection fraction had significant differences. Males had better results, but not with a statistically significant difference. Association tests (ANOVA) between different variables and the score of each section of the SCHFI were perfomred. Only in the NYHA there are variables associated with a better self-care, namely in the SCMg (p = 0.011) and in SCC (p = 0.010). Correlations were made using the numeric variables age, CVRF, BI, LCADL, SCMt, SCMg and SCC, in order to understand the influence of the variables with each other. All the three dimesnions present a positive correlation, at 99% confidence interval between them (SCMt with SCMg: r = 0.365, p < 0.000; SCMt with SCC: r = 0.272, p < 0.000 and SCMg with SCC: r = 0.670, p < 0.000). In addition, SCMt presents a positive correlation with age at a 95% confidence interval (r = 0.158, p = 0.018). Negative correlations were found between 1) BI and age (r=-0.151, p = 0.023), at a 95% confidence interval and 2) BI with LCALD (r=-0.407, p < 0.000), at a 99% confidence interval. Regarding NYHA functional class and left ventricular systolic function, only NYHA class II patients present a statistically significant difference in SCMg and SCC comparing to Class III and IV patients (who do not present differences between them).  Conclusion The results do not suggest a relationship between gender and pathophysiological characteristics with self-care behaviour.

scholarly journals The impact of e-Health interventions on promoting Self-Care in Chronic Patients: an Umbrella Review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Chronic Conditions ◽  
Self Care ◽  
Health Interventions ◽  
Self Management ◽  
Improve Quality ◽  
Umbrella Review ◽  
Copd Patients

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.

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).

scholarly journals Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Self Management ◽  
Diabetic Patients ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

Influence of Human-oriented Nursing Mode on Self-Care Ability, Unhealthy Emotion and Quality of Life of Patients with Benign Prostatic Hyperplasia

2021 ◽  
Vol 7 (4) ◽  
pp. 635-646
Author(s):  
Feifei Peng ◽  
Guangchi Xu ◽  
Caihong Zhu ◽  
Lanchun Sun ◽  
Bo Dong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Postoperative Complications ◽  
Self Care ◽  
Nursing Intervention ◽  
Prostatic Hyperplasia ◽  
The Self ◽  
Nursing Satisfaction ◽  
Before And After

To explore the influence of human-oriented nursing mode on the self-care ability, unhealthy emotion and quality of life of patients with benign prostatic hyperplasia (BPH), 147 patients with BPH admitted to our hospital from February 2018 to August 2019 were selected and all patients were separated into two groups on the basis of the nursing intervention mode. 77 cases in the research group (RG) were given the human-oriented nursing mode and 70 cases in the control group (CG) were given the conventional nursing mode. The bladder irrigation time (BIT), indwelling catheter time (ICT), postoperative hospitalization time (PHT) and the incidence rate of postoperative complications were observed in the two groups after nursing intervention. Before and after nursing intervention, the self-care ability of patients was evaluated in the two groups by Exercise of Self-Care Agency Scale (ESCA). In the two groups, the anxiety and depression status were evaluated by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The Quality of Life Scale for Benign Prostatic Hyperplasia Patient (BPHQLS) was applied to evaluate the quality of life in both groups before and after nursing intervention. The International Prostate Symptom Score (IPSS) was used to assess the lower urinary tract symptoms (LUTS) of patients in the two groups before and after nursing intervention. The self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction in the two groups. The BIT, ICT and PHT in RG after nursing intervention were obviously lower than those in CG, and the incidence of postoperative complications in RG was also obviously lower than that in CG (p < 0.05). The ESCA score of patients in RG after nursing intervention was significantly higher than that in CG (P < 0.05). The SAS and SDS scores of patients in RG after nursing intervention were significantly lower than those in CG (P < 0.05). The BPHQLS score in RG after nursing intervention was obviously higher than that in CG (P < 0.05). The IPSS score of patients in RG after nursing intervention was obviously lower than that in CG (p < 0.05). The nursing satisfaction score in RG after nursing intervention was obviously higher than that in CG (p < 0.05).Condusion: The application effect of the human-oriented nursing mode on patients with BPH is definite, which can improve self-care ability, unhealthy emotion and effectively ameliorate the quality of life.

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