What matters to patients with heart failure? The influence of non-health-related goals on patient adherence to self-care management

2015 ◽  
Vol 98 (8) ◽  
pp. 927-934 ◽  
Author(s):  
Karen M. Zhang ◽  
Kathleen Dindoff ◽  
J. Malcolm O. Arnold ◽  
Jeanine Lane ◽  
Leora C. Swartzman
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Patient Adherence ◽  
Self Care ◽  
Patients With Heart Failure ◽  
Health Related ◽  
What Matters

Abstract 270: Prediction of Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Seongkum Heo ◽  
Jinshil Kim ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Self Care ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Modifiable Factors ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Introduction: Patients with heart failure (HF) report that good health-related quality of life (HRQOL) is more valuable than longer survival, and improvement in HRQOL after discharge has been associated with lower rates of hospitalization. However, HRQOL in patients with HF is remarkably poorer than that in patients with other chronic diseases. To improve HRQOL effectively, it is critical to examine comprehensive modifiable predictors. However, to our knowledge, this has not been examined in patients with HF. Purpose: To examine baseline psychosocial, behavioral, and physical predictors of HRQOL at 12 months in patients with HF. Methods: We collected data on HRQOL at 12 months using the Minnesota Living with Heart Failure Questionnaire and other data at baseline from 94 patients with HF (mean age 58 ± 14 years). We collected data on all psychosocial variables, one behavioral variable, and one physical variable using questionnaires: depressive symptoms (Patient Health Questionnaire), perceived control (Control Attitudes Scale-Revised), social support (Multidimensional Scale of Perceived Social Support), self-care management (Self-care management subscale of the Self-Care of Heart Failure Index), and HF symptoms (Symptom Status Questionnaire-HF). We assessed one physical factor (New York Heart Association [NYHA] functional class) using in-depth interview. We assessed two behavioral factors using objective measures: medication adherence (Micro-Electro-Mechanical Systems) and sodium intake (24-hour urine). Covariates were age and comorbidity. Multiple regression analysis was used to address the purpose. Results: After controlling for covariates, among multidimensional psychosocial, behavioral, and physical variables, 3 modifiable factors (medication adherence [p = .001], HF symptoms [p = .011], and NYHA functional class [p < .001]) significantly predicted 12-month HRQOL (F = 11.853, R 2 = .59, p < .001). Conclusion: The findings of this study demonstrate multidimensional, modifiable predictors that interventions can target to improve HRQOL. Clinicians and researchers can target improvement in self-care, HF symptoms, and NYHA functional class to improve HRQOL, and, in turn, to reduce hospitalization rates.

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).

The relationship between health literacy and self-care in patients with heart failure

2021 ◽  
pp. 1-10
Author(s):  
Katie Nesbitt ◽  
Huiyun Du ◽  
Paul Nolan ◽  
Susie Cartledge ◽  
Parichat Wonggom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Literacy ◽  
Patient Group ◽  
Care Management ◽  
Self Care ◽  
Randomised Control Trial ◽  
Adequate Health Literacy ◽  
Patients With Heart Failure ◽  
Literacy Knowledge ◽  
The Relationship

Background/Aims Research has shown that health literacy can influence an individual's ability to practise self-care, particularly for patients with heart failure. This study aimed to assess health literacy and its relationship with heart failure knowledge and self-care practices in this patient group. Methods An observational sub-study was conducted with the data from a large randomised control trial that evaluated the relationship between patients' health literacy, general literacy, knowledge of heart failure and self-care. Results A total of 36 participants were recruited, of which 33 (89.9%) had adequate levels of health literacy. Health literacy was positively associated with heart failure knowledge. However, 67.7% of participants with adequate health literacy were found to have inadequate levels of self-care management. Conclusions Health literacy may facilitate better heart failure knowledge, but it does not necessarily lead to improved self-care management in patients with heart failure. This suggest that clinicians need to put more emphasis on translating knowledge into behavioural changes for self-care in this patient group.

Abstract 11916: Changes in Symptoms Predicted Changes in Health-Related Quality of Life in Patients With Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seongkum Heo ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
Eugene Smith ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Physical Symptoms ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Behavioral Variables ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Background: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL), which is associated with high hospitalization rates. Physical symptoms have been associated with poor HRQOL. However, whether improvement in physical symptoms actually leads to improvement in HRQOL has not fully examined in patients with HF. Purpose: To examine the effects of changes in physical symptoms on changes in HRQOL at 12 months, after controlling for age, comorbidities, New York Heart Association (NYHA) functional class, and modifiable psychosocial and behavioral factors. Methods: Data on physical symptoms (Symptom Status Questionnaire-HF) and HRQOL (Minnesota Living with Heart Failure) were collected from 94 patients with HF (mean age 58 ± 14 years, 44% male, 58% NYHA functional class II/III) at baseline and 12 month follow-up. Age, comorbidities, and NYHA functional class were collected using standard questionnaires at baseline. Psychosocial variables (depressive symptoms [Patient Health Questionnaire], perceived control [Control Attitudes Scale-Revised], and social support [Multidimensional Scale of Perceived Social Support]) and behavioral variables (medication adherence [Micro-Electro-Mechanical Systems], sodium intake [24-hour urine], and self-care management [Self-care management subscale of the Self-Care of Heart Failure Index]) were collected at baseline. Hierarchical multiple regression analyses were used to analyze the data. Results: The mean score changes in physical symptoms and HRQOL were -3.8 (± 14.1) and -9.2 (± 24.1), respectively (negative scores indicate improvement.). Among the sociodemographic and clinical characteristics, psychosocial variables, behavioral variables, baseline physical symptoms, and changes in physical symptoms, only changes in physical symptoms predicted changes in HRQOL at 12 months (F = 6.384, R2 = .46, p < .001). Improvement in physical symptoms led to improvement in HRQOL. Conclusion: It is critical to improve physical symptoms to improve HRQOL. Thus, development and delivery of effective interventions targeting improvement in physical symptoms are warranted in this population.

scholarly journals Validity and reliability of the Korean version of self-care of heart failure index

2018 ◽  
Vol 8 (10) ◽  
pp. 96 ◽  
Author(s):  
Jin Shil Kim ◽  
Minjeong An ◽  
Hyojeong Seo ◽  
Seon Young Hwang ◽  
Jae Lan Shim
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Self Care ◽  
Psychometric Testing ◽  
Validity And Reliability ◽  
Failure Index ◽  
Korean Version ◽  
Reliability Estimates ◽  
Patients With Heart Failure ◽  
Therapeutic Recommendations

Purpose: Self-care and associated decisions for therapeutic recommendations have been a focus of attention recently in Korea. The purpose of this study was to address the dimensionality and reliability of a Korean version of Self-care of Heart Failure Index (SCHFI v.6.2), a measure of self-care of patients with heart failure within a clinical context.Methods: The study sample completed 120 surveys that consisted of demographic variables and the SCHFI v.6.2, which was created to measure self-care maintenance, self-care management, and self-care confidence in HF patients. Confirmatory factor analysis using Mplus verified a robust structural fit of the three dimensionality for each subscale.Results: Self-care maintenance, CFI = .92, TLI = .88, SRMR = .06, RMSEA = .07; self-care management, CFI = .93, TLI = .78, SRMR = .05, RMSEA = .24; self-care confidence, CFI = .95, TLI = .92, SRMR = .05, RMSEA = .13. Multidimensionality yielded the self-care maintenance scale having 4-factor structures, while each self-care management and confidence scale had a unidimensionality. Reliability estimates using methods compatible with each scale’s dimensionality were adequate to high, ranging from .71 to .96.Conclusions: Psychometric testing of the SCHFI demonstrates a sound model fit, with desirable reliability estimates given each scale dimensionality, using Cronbach’s alpha coefficient and alternative options.

scholarly journals A psychometric evaluation of the Caregiver Contribution to Self-Care of Heart Failure Index in a Thai population

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nittaya Srisuk ◽  
Nutchanath Wichit ◽  
David R. Thompson ◽  
Chantal F. Ski
Keyword(s):  
Heart Failure ◽  
Factor Analysis ◽  
Care Management ◽  
Self Care ◽  
The Self ◽  
Thai Population ◽  
Heart Failure Patients ◽  
Failure Index ◽  
Patients With Heart Failure ◽  
Confirmatory Factor

Abstract Background Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. Methods The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. Results The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald’s omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98–1.00; root-mean-square error of approximation = 0.00–0.07). Conclusions The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.

scholarly journals Does Symptom Recognition Improve Self-Care in Patients With Heart Failure? A Growth Latent Model

2021 ◽  
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Care Management ◽  
Self Care ◽  
Control Group ◽  
Fluid Restriction ◽  
Symptom Recognition ◽  
Patients With Heart Failure ◽  
The Impact

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing 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 self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p&lt;.001) and emergency admission (IRR 4.24; p&lt;.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (&beta;Slope. Assign-ment_group=-.881; p&lt;.001) and in the quality of life (&beta;Slope. Assignment_group=1.739; p&lt;.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.

Self-Care Behaviors, Symptom Status, and Health-Related Quality of Life in Patients with Heart Failure

2008 ◽  
Vol 14 (6) ◽  
pp. S106
Author(s):  
Seongkum Heo ◽  
Terry A. Lennie ◽  
Susan J. Pressler ◽  
Sandra B. Dunbar ◽  
Debra K. Moser ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Care ◽  
Health Related Quality ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related ◽  
Symptom Status

Symptom perception management education improves self-care in patients with heart failure

Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Joana Pereira Sousa ◽  
Cláudia Oliveira ◽  
Miguel Pais-Vieira
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Complex Intervention ◽  
Care Management ◽  
Self Care ◽  
Symptom Perception ◽  
Structured Interviews ◽  
Symptom Recognition ◽  
Patients With Heart Failure

BACKGROUND: Patients with heart failure often have difficulty recognizing signs and symptoms of the disease, which delays seeking help, and therefore interferes with patient engagement and self-care management. Early detection of these symptoms could lead to care-seeking and avoid hospitalizations. OBJECTIVE: The purpose of this study was to design a complex intervention through a systematic literature review and qualitative study. METHODS: Our design followed the Medical Research Council’s recommendations. To design a complex intervention, we combined a systematic literature review on education, symptom recognition, and self-care management in patients with heart failure, and semi-structured interviews with cardiology healthcare providers and patients with heart failure admitted to a cardiology ward. RESULTS: The systematic literature review identified 582 studies published between 2005 and 2014, of which four were included in the final review. These suggested that patient education focused on symptom recognition, combined with reinforcements, led to better self-care behaviors. Additionally, content analysis of semi-structured interviews revealed three themes: health management, behavior management, and support received. CONCLUSIONS: Combining the findings of the literature review and the themes that emerged from the semi-structured interviews, we proposed the development and implementation of a complex intervention on symptom perception and fluid management.

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