Strategies for Behavior Change in Patients With Heart Failure

2004 ◽  
Vol 13 (4) ◽  
pp. 305-313 ◽  
Author(s):  
Sara Paul ◽  
Nancee V. Sneed
Keyword(s):  
Heart Failure ◽  
Behavior Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Signs And Symptoms ◽  
Lifestyle Changes ◽  
Readiness For Change ◽  
Dietary Sodium ◽  
Actual Behavior ◽  
Patients With Heart Failure

Appropriate management of chronic heart failure and its signs and symptoms requires a considerable amount of participation by patients. Behavioral changes that prevent or minimize signs and symptoms and disease progression are just as important as the medications prescribed to treat the heart failure. The most difficult lifestyle changes include smoking cessation, weight loss, and restriction of dietary sodium. The Transtheoretical Model is a framework for assessing and addressing the concept of readiness for behavior change, which occurs in a 6-step process. The model consists of 3 dimensions: the stages of change, the processes of change on which interventions are based, and the action criteria for actual behavior. The stages of change are discussed, and interventions are presented to assist patients with heart failure in progressing through those stages toward maintenance of changed lifestyle behaviors. Methods for measuring the level of readiness for change of patients with heart failure are also presented, because correct staging is required before appropriate interventions matched to a patient’s stage can be delivered.

Readiness for Behavioral Changes in Patients With Heart Failure

2003 ◽  
Vol 12 (5) ◽  
pp. 444-453 ◽  
Author(s):  
Nancee V. Sneed ◽  
Sara C. Paul
Keyword(s):  
Heart Failure ◽  
Transtheoretical Model ◽  
Stage Of Change ◽  
Exercise Program ◽  
Lifestyle Changes ◽  
Readiness For Change ◽  
Behavioral Changes ◽  
High Sodium ◽  
Patients With Heart Failure ◽  
Stage Of Readiness

• Background Successful self-care in heart failure often requires lifestyle changes such as avoiding sodium, excess fluid intake, alcohol, and tobacco; exercising regularly; and losing weight. The Transtheoretical Model, a framework for making behavioral changes, proposes that change requires a series of stages. • Objectives To identify the stage of readiness for change in 6 lifestyle behaviors important in heart failure and to determine differences in signs and symptoms of heart failure, self-reported knowledge of the disease, and self-reported behavior between patients who have taken action and patients who have not. • Method A mail survey of 250 patients with heart failure. • Results Most respondents reported consistent avoidance of tobacco (90.6%), alcohol (87.9%), sodium (81%), and excess fluid (72.6%) and regular participation in exercise (67.1%) and trying to lose weight (64.7%). Yet only 38.7% had a regular exercise program, and 94.2% had eaten high-sodium foods in the preceding 24 hours. Knowledge of heart failure was low (mean score, 67.4%) and did not differ by stage of change. Only 30.4% of the respondents were at their desired weight, and most overweight subjects had been trying to lose weight for more than 6 months. • Conclusions Although respondents thought they were consistently adhering to recommended guidelines for changes in lifestyle, actual reported behaviors did not always support this evaluation. Use of the stage of change tool to assess stage of readiness to make lifestyle changes may not work well in patients with heart failure, perhaps because of the number and complexity of the changes needed.

scholarly journals The profile of client's readiness for change and preference to typical processes of change

Psihologija ◽  
2004 ◽  
Vol 37 (1) ◽  
pp. 89-108 ◽  
Author(s):  
Vesna Gavrilov-Jerkovic
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Readiness For Change ◽  
Transtheoretical Model Of Change ◽  
Processes Of Change ◽  
Theoretical Part ◽  
Research Author ◽  
Paper Author

In the theoretical part of this paper author considers the difficulties to define phenomenon of patient's readiness to change and proposes dimensions of transtheoretical model of change, that is, stages of change and processes as conceptual frames for exceeding those difficulties. Through the research author investigates the possibility to identify typical profiles of patient's readiness from the data about measured levels of particular stages of change. The results infer that several typical profiles of readiness can be identified and that it is possible that these profiles could be connected with tendency of patients to prefer passive or action-restructure processes of change.

Measuring Readiness to Change Substance Use, Alcohol Use, and Cannabis Use: An Experimental Manipulation of Cognitive Effort

2021 ◽  
Author(s):  
Frank J Schwebel ◽  
Jude G. Chavez ◽  
Matthew Pearson
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Behavior Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Statistical Tests ◽  
Cognitive Effort ◽  
Cannabis Use ◽  
Actual Behavior ◽  
Negative Consequences

The Transtheoretical Model supports that readiness to change should predict actual substance-related behavior change, though this relationship is surprisingly modest. Across several behavioral domains, individuals tend to have unrealistic expectations regarding the amount of effort and time required to successfully change one’s behaviors, dubbed the False Hope Syndrome. Based on the False Hope Syndrome, we expect that the standard method of measuring self-reported readiness to change is inaccurate and overestimated. To test this hypothesis, we experimentally manipulated the level of cognitive effort or focus on the practical implications of changing substance use prior to completing readiness to change measures. College students from a large southwestern university who reported using substances in the past 30 days (n = 345) were recruited from a psychology department participant pool to complete this experimental study online. Participants were randomized to one of three conditions: 1) standard low effort condition, 2) medium effort condition (had to select likes/dislikes of substance use, and negative consequences of changing one’s use), and 3) high effort condition (also provided text responses to how they would handle difficult situations related to changing their substance use). We conducted one-way ANOVAs with Tukey post-hoc comparisons to examine differences on three measures of readiness to change: the University of Rhode Island Change Assessment (URICA) scale for overall substance use as well as the readiness and motivation rulers for overall substance use, alcohol use, and cannabis use. Contrary to our hypothesis, all significant statistical tests supported higher cognitive effort conditions reporting higher readiness to change. Although effect sizes were modest, higher cognitive effort appeared to increase self-reported readiness to change substance use. To address the present study’s limitations, additional work is needed to test how self-reported readiness to change relates to actual behavior change when assessed under the different effort conditions.

Chronic heart failure diagnosis: symptoms, signs, and the ECG

ESC CardioMed ◽  
2018 ◽  
pp. 1758-1762
Author(s):  
Pardeep S. Jhund
Keyword(s):  
Heart Failure ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Response To Treatment ◽  
Cardiac Resynchronization ◽  
Patients With Heart Failure ◽  
Third Heart Sound ◽  
Therapeutic Decision Making ◽  
Heart Failure Diagnosis

The clinical history aims to elicit the symptoms that are commonly experienced by patients with heart failure such as dyspnoea, paroxysmal nocturnal dyspnoea, orthopnoea, and fatigue. The history may also provide clues as to the aetiology of heart failure and symptoms that suggest alternative diagnoses. Similarly, signs that are elicited on clinical examination are used to support the diagnosis of heart failure. In addition, they can be used to determine prognosis and assess response to treatment or the need for more intensive treatment. Common signs such as peripheral oedema, jugular venous distension, and pulmonary crackles are less specific for the diagnosis of heart failure than others such as a third heart sound. The presence of some clinical signs may help determine the aetiology of heart failure and indicate other potential diagnoses that may present like heart failure but require very different treatment. While signs and symptoms are used in conjunction with imaging evidence and raised natriuretic peptides to make the diagnosis of heart failure, the electrocardiogram (ECG) still plays a central role. The ECG can be used to determine underlying aetiology (such as evidence of prior myocardial infarction) and guide therapeutic decision-making such as the need for cardiac resynchronization therapy in those with bundle branch block. Information on symptoms, signs, and investigations such as the ECG need to be integrated to ensure the accurate diagnosis and optimal treatment of patients with heart failure.

scholarly journals Stages of change and factors associated with misperceived eating behavior in obese individuals

2016 ◽  
Vol 29 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Lydiane Bragunci BEDESCHI ◽  
Aline Cristine Souza LOPES ◽  
Luana Caroline dos SANTOS
Keyword(s):  
Food Intake ◽  
Behavior Change ◽  
Eating Behavior ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Vegetable Intake ◽  
Saturated Fatty Acids ◽  
Cross Sectional ◽  
Factors Associated ◽  
Maintenance Stage

ABSTRACT Objective: To evaluate the stages of behavior change related to fat and fruit/vegetable intakes and the factors associated with misperceived eating behavior (pseudo-maintenance). Methods: This cross-sectional study collected sociodemographic, socioeconomic, health, and food intake data from obese individuals (n=103) aged ≥20 years. Stages of behavior change according to the Transtheoretical Model were measured for fat and fruit/vegetable intakes. The pseudo-maintenance stage was reclassified in subjects in the action/maintenance stage who had inappropriate food habits. Multiple logistic regression models were proposed to assess the factors associated with misperceptions. Results: The prevalences of pseudo-maintenance for fat and fruit/vegetable intakes were 23.3 and 19.4%, respectively. The factors associated with misperceived fat intake were overconsumption of saturated fatty acids (OR=3.84; 1.18-12.56) and age (OR=1.06; 1.02-1.11), and with fruit and vegetable intake, income (OR=0.99; 0.98-0.99). Conclusion: The results reveal that perceived eating behavior and actual food intake diverge from anthropometric and health data, signaling the need of different intervention strategies to raise awareness in this group for the need of modifications.

The Transtheoretical Model of Health Behavior Change

1997 ◽  
Vol 12 (1) ◽  
pp. 38-48 ◽  
Author(s):  
James O. Prochaska ◽  
Wayne F. Velicer
Keyword(s):  
At Risk ◽  
Health Behavior ◽  
Behavior Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Basic Research ◽  
Health Behavior Change ◽  
Decisional Balance ◽  
Computer Based ◽  
At Risk Populations

The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment procedures. The most promising outcomes to date have been found with computer-based individualized and interactive interventions. The most promising enhancement to the computer-based programs are personalized counselors. One of the most striking results to date for stage-matched programs is the similarity between participants reactively recruited who reached us for help and those proactively recruited who we reached out to help. If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.

scholarly journals The effect of dietary sodium restriction on neurohumoral activity and renal dopaminergic response in patients with heart failure

2004 ◽  
Vol 6 (5) ◽  
pp. 593-599 ◽  
Author(s):  
Margarida Alvelos ◽  
António Ferreira ◽  
Paulo Bettencourt ◽  
Paula Serrão ◽  
Manuel Pestana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Patients With Heart Failure ◽  
Dietary Sodium Restriction

scholarly journals Lifestyle changes in descendants of parents with diabetes type 2

2007 ◽  
Vol 15 (5) ◽  
pp. 909-913 ◽  
Author(s):  
Rosalinda Guerra-Juárez ◽  
Esther C. Gallegos ◽  
Ricardo M. Cerda-Flores
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Activity Patterns ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Lifestyle Changes ◽  
Life Styles ◽  
Study Participants ◽  
Carbohydrate Intolerance

This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. Results and conclusion: 68% of the children was classified as obese, 42% with insulin resistance, and 15% with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37%; more people younger than 40 and women report decreasing in the consumption of fat food (Xi² = 6.04, p = .020; and 4.41, p = .040, respectively). These results suggest a high influence of environmental factors on the participants' unhealthy life styles.

scholarly journals Gambaran karakteristik gagal jantung pada anak di RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Agnes A. Anthonius ◽  
Erling D. Kaunang ◽  
Ari L. Runtunuwu
Keyword(s):  
Heart Failure ◽  
Signs And Symptoms ◽  
Health Department ◽  
The Body ◽  
Shortness Of Breath ◽  
Design Data ◽  
Cross Sectional ◽  
Patients With Heart Failure ◽  
Characteristic Features ◽  
Cross Sectional Design

Abstract: Heart failure is the inability of the heart to pump adequate blood that fulfils the metabolic demands of the body, including growth. In Indonesia, it is still difficult to find the prevalence and incidence of heart failure in children. This study was aimed to determine the characteristic features of heart failure in children at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study with a cross-sectional design. Data were obtained from the medical records of pediatric patients with heart failure within the period of January 2013 to August 2016 in the Child Health Department at Prof. Dr. R. D. Kandou Hospital. The results showed that there were 69 children with heart failure; the most common were females and age 12-18 years. The most common signs and symptoms were shortness of breath, fever, and cough. Heart murmurs and gallop were frequently found. Hepatomegaly, splenomegaly, ascites and edema of the legs were not commonly found. The electrocardiogram results were mostly sinus rhythm. The echocardiography results were mostly mitral regurgitation. The most common comorbid disease was rheumatic heart disease. Conclusion: At Prof. Dr. R. D. Kandou Hospital, heart failure in children was mostly found among females and age of 12-18 years. Most of the children showed shortness of breath, fever, and cough.Keywords: heart failure, child, characteristic features Abstrak: Gagal jantung merupakan ketidakmampuan jantung sebagai pompa darah untuk memenuhi secara adekuat kebutuhan metabolisme tubuh termasuk pertumbuhan. Di Indonesia sendiri masih sulit menemukan data prevalensi dan insiden gagal jantung pada anak. Penelitian ini bertujuan mengetahui gambaran karakteristik gagal jantung pada anak di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deksriptif retrospektif dengan desain potong lintang. Data penelitian diambil dari rekam medik pasien anak dengan gagal jantung periode Januari 2013 sampai Agustus 2016 di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 69 anak, terbanyak pada usia 12-18 tahun dan jenis kelamin perempuan. Tanda dan gejala terbanyak ialah sesak napas, demam, dan batuk. Bising jantung dan galop banyak ditemukan. Hepatomegali, splenomegali, ascites dan edema tungkai tidak banyak ditemukan. Hasil elektrokardiogram terbanyak ditemukan ialah irama sinus. Hasil ekokardiografi terbanyak ditemukan ialah regurgitasi mitral. Penyakit penyerta terbanyak ialah penyakit jantung rematik. Simpulan: Gagal jantung anak di RSUP Prof. Dr. R. D. Kandou Manado terbanyak pada usia 12-18 tahun, jenis kelamin perempuan, dengan gejala klinik sesak napas, demam, dan batuk. Kata kunci: gagal jantung, anak, gambaran karakteristik

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