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

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

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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 (Preprint)

10.2196/preprints.17714 ◽

2020 ◽

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. CLINICALTRIAL ClinicalTrials.gov NCT03877328; https://clinicaltrials.gov/ct2/show/NCT03877328 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17714

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PENGALAMAN PERAWAT MELAKUKAN LATIHAN AKTIFITAS FISIK PADA PASIEN CONGESTIVE HEART FAILURE

Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan ◽

10.34008/jurhesti.v3i1.22 ◽

2018 ◽

Vol 3 (1) ◽

pp. 50

Author(s):

Deni Susyanti ◽

Mompang Tua Parlagutan ◽

Muchti Yuda Pratama

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Congestive Heart Failure ◽

Physical Exercise ◽

Sampling Technique ◽

Congestive Heart Failure Patient ◽

The Body ◽

Descriptive Phenomenology ◽

Heart Failure Patients ◽

Exercise Activity

People with congestive heart failure (CHF) need a comprehensive rehabilitative program to restore physical abilities post-attacks and prevent re-attacks. Physical exercise in congestive heart failure (CHF) patients is aimed at optimizing the physical capacity of the body, providing counseling to patients and families in preventing worsening and helping patients to return to physical activity as before congestive heart failure (CHF). This study aims to explore in depth the experience of nurses doing physical exercise exercises in congetive heart failure patients. The research design used is descriptive phenomenology. Participants in this study amounted to 6 participants selected by purposive sampling technique. The data collected were in-depth interviews completed with field notes and then made in verbatim and analyzed using Colaizzi's approach. The research results found four themes, namely: the implementation of physical exercise exercise congestive heart failure patient is not optimal; increased knowledge of nurses and patients; the need for support from the hospital; and expectations for the exercise of physical activity. The results showed that things that could affect physical exercise activity in congestive heart failure patients were standard operating procedures, nurse knowledge, hospital support; and expectations for the exercise of physical activity. This study provides an understanding of the nurse's understanding of physical activity exercises so that nurses are able to provide appropriate nursing care.Keywords: experience, physical activity exercise, congetive heart failure

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Assessment of Heart Failure Patients’ Interest in Mobile Health Apps for Self-Care: Survey Study (Preprint)

10.2196/preprints.14332 ◽

2019 ◽

Author(s):

Albert Sohn ◽

William Speier ◽

Esther Lan ◽

Kymberly Aoki ◽

Gregg Fonarow ◽

...

Keyword(s):

Heart Failure ◽

Mobile Health ◽

Self Care ◽

The United States ◽

Survey Study ◽

Health Concern ◽

Smartphone App ◽

Waiting Room ◽

Heart Failure Patients ◽

Patient Reported

BACKGROUND Heart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders. OBJECTIVE The objective of this study was to ascertain heart failure patients’ interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app. METHODS In the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board–approved questionnaires. The survey measured patients’ interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients’ health-related quality of life through patient-reported outcomes. RESULTS Participants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (<italic>P</italic><.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (<italic>P</italic><.05). CONCLUSIONS The majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology.

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Assessment of Heart Failure Patients’ Interest in Mobile Health Apps for Self-Care: Survey Study

JMIR Cardio ◽

10.2196/14332 ◽

2019 ◽

Vol 3 (2) ◽

pp. e14332 ◽

Cited By ~ 6

Author(s):

Albert Sohn ◽

William Speier ◽

Esther Lan ◽

Kymberly Aoki ◽

Gregg Fonarow ◽

...

Keyword(s):

Heart Failure ◽

Mobile Health ◽

Self Care ◽

The United States ◽

Survey Study ◽

Health Concern ◽

Smartphone App ◽

Waiting Room ◽

Heart Failure Patients ◽

Patient Reported

Background Heart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders. Objective The objective of this study was to ascertain heart failure patients’ interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app. Methods In the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board–approved questionnaires. The survey measured patients’ interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients’ health-related quality of life through patient-reported outcomes. Results Participants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (P<.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (P<.05). Conclusions The majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology.

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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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Relation Between Sleep Quality and Physical Activity in Chronic Heart Failure Patients

Recent Advances in Cardiovascular Drug Discovery (Formerly Recent Patents on Cardiovascular Drug Discovery) ◽

10.2174/157489011797377004 ◽

2011 ◽

Vol 6 (3) ◽

pp. 161-167 ◽

Cited By ~ 3

Author(s):

Kazuhiro P. Izawa ◽

Satoshi Watanabe ◽

Koichiro Oka ◽

Koji Hiraki ◽

Yuji Morio ◽

...

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Chronic Heart Failure ◽

Sleep Quality ◽

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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SYMPERHEART: an intervention to support symptom perception in persons with heart failure and their informal caregiver: a feasibility quasi-experimental study protocol

BMJ Open ◽

10.1136/bmjopen-2021-052208 ◽

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.

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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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