scholarly journals Designing and Testing a Treatment Adherence Model Based on the Roy Adaptation Model in Patients With Heart Failure: Protocol for a Mixed Methods Study

10.2196/13317 ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. e13317
Author(s):  
Shabnam Shariatpanahi ◽  
Mansoureh Ashghali Farahani ◽  
Forough Rafii ◽  
Maryam Rassouli ◽  
Amir Kavousi
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Treatment Adherence ◽  
Mixed Methods Study ◽  
Roy Adaptation Model ◽  
Model Based ◽  
Patients With Heart Failure ◽  
Adaptation Model

scholarly journals Designing and Testing a Treatment Adherence Model Based on the Roy Adaptation Model in Patients With Heart Failure: Protocol for a Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Shabnam Shariatpanahi ◽  
Mansoureh Ashghali Farahani ◽  
Forough Rafii ◽  
Maryam Rassouli ◽  
Amir Kavousi
Keyword(s):  
Heart Failure ◽  
Content Analysis ◽  
Mixed Methods ◽  
Conceptual Framework ◽  
Treatment Adherence ◽  
Mixed Methods Study ◽  
Second Phase ◽  
Roy Adaptation Model ◽  
Adherence To Treatment ◽  
Adaptation Model

BACKGROUND Adherence to treatment is an important factor to decrease repeated and costly hospitalization owing to heart failure (HF). The explanation and prediction of medication adherence and other lifestyle recommendations in chronic diseases, including HF, are complex. Theories lead to a better understanding of complex situations as well as the process of changing behavior and explain the reasons for the existence of a problem. OBJECTIVE The aim of this study is to report a protocol for a mixed methods study setting out to investigate the empirical validity of the Roy Adaptation Model as a conceptual framework for explaining and predicting adherence to treatment in patients with HF in Iran. METHODS This mixed methods study consists of an exploratory sequential design to be conducted in 2 phases. The first phase involves identifying the factors associated with treatment adherence in patients with HF through content analysis of the literature and elucidating the perception of participants in the context of Iranian health care where the model of adherence to treatment is designed based on the Roy Adaptation Model. The second phase addresses the interrelationships among variables in the model through a descriptive study using structural equation modeling. Finally, following the summarization and separate interpretation of the qualitative findings and quantitative results, a decision is made about the extent to and ways in which the results of the quantitative stage can be generalized or tested for the qualitative findings. RESULTS Content analysis of the literature in part 1 of the first phase was completed in 2017. Collection and analysis of qualitative data in part 2 of the first phase will be completed soon. The results are expected to be submitted for publication in 2019. Then, the second phase—the quantitative study—will be conducted. CONCLUSIONS The results of this study will provide valuable information about the empirical validity of the Roy Adaptation Model as a conceptual framework for explaining and predicting adherence to treatment in patients with HF, which, to date, have received little attention. The results can be used as a guide for nursing practice and care provision to patients with HF and also to design and implement effective interventions to improve treatment adherence in these patients. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13317

scholarly journals The Effect of an Educational Plan Based on the Roy Adaptation Model for Fatigue and Activities of Daily Living of Patients with Heart Failure Disease

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Mahdieh Abdolahi ◽  
Mohammad Mahdi Doustmohamadi ◽  
Hojjat Sheikhbardsiri
Keyword(s):  
Heart Failure ◽  
Intervention Group ◽  
Nursing Intervention ◽  
Daily Activities ◽  
Control Group ◽  
Roy Adaptation Model ◽  
Educational Plan ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
Adaptation Model

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.

scholarly journals Implementation and Evaluation of a Smartphone-Based Telemonitoring Program for Patients With Heart Failure: Mixed-Methods Study Protocol

2018 ◽  
Vol 7 (5) ◽  
pp. e121 ◽  
Author(s):  
Patrick Ware ◽  
Heather J Ross ◽  
Joseph A Cafazzo ◽  
Audrey Laporte ◽  
Emily Seto
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Study Protocol ◽  
Mixed Methods Study ◽  
Patients With Heart Failure

scholarly journals Implementation and Evaluation of a Smartphone-Based Telemonitoring Program for Patients With Heart Failure: Mixed-Methods Study Protocol (Preprint)

2018 ◽  
Author(s):  
Patrick Ware ◽  
Heather J Ross ◽  
Joseph A Cafazzo ◽  
Audrey Laporte ◽  
Emily Seto
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Health Outcomes ◽  
Study Design ◽  
Standard Of Care ◽  
Specialty Care ◽  
Longitudinal Impact ◽  
Patients With Heart Failure ◽  
Usage Patterns ◽  
The Impact

BACKGROUND Meta-analyses of telemonitoring for patients with heart failure conclude that it can lower the utilization of health services and improve health outcomes compared with the standard of care. A smartphone-based telemonitoring program is being implemented as part of the standard of care at a specialty care clinic for patients with heart failure in Toronto, Canada. OBJECTIVE The objectives of this study are to (1) evaluate the impact of the telemonitoring program on health service utilization, patient health outcomes, and their ability to self-care; (2) identify the contextual barriers and facilitators of implementation at the physician, clinic, and institutional level; (3) describe patient usage patterns to determine adherence and other behaviors in the telemonitoring program; and (4) evaluate the costs associated with implementation of the telemonitoring program from the perspective of the health care system (ie, public payer), hospital, and patient. METHODS The evaluation will use a mixed-methods approach. The quantitative component will include a pragmatic pre- and posttest study design for the impact and cost analyses, which will make use of clinical data and questionnaires administered to at least 108 patients at baseline and 6 months. Furthermore, outcome data will be collected at 1, 12, and 24 months to explore the longitudinal impact of the program. In addition, quantitative data related to implementation outcomes and patient usage patterns of the telemonitoring system will be reported. The qualitative component involves an embedded single case study design to identify the contextual factors that influenced the implementation. The implementation evaluation will be completed using semistructured interviews with clinicians, and other program staff at baseline, 4 months, and 12 months after the program start date. Interviews conducted with patients will be triangulated with usage data to explain usage patterns and adherence to the system. RESULTS The telemonitoring program was launched in August 2016 and patient enrollment is ongoing. CONCLUSIONS The methods described provide an example for conducting comprehensive evaluations of telemonitoring programs. The combination of impact, implementation, and cost evaluations will inform the quality improvement of the existing program and will yield insights into the sustainability of smartphone-based telemonitoring programs for patients with heart failure within a specialty care setting.

scholarly journals Quality of life and disease experience in patients with heart failure with reduced ejection fraction in Spain: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053216
Author(s):  
Raül Rubio ◽  
Beatriz Palacios ◽  
Luis Varela ◽  
Raquel Fernández ◽  
Selene Camargo Correa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Kansas City ◽  
Mixed Methods Study ◽  
Kansas City Cardiomyopathy Questionnaire ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Disease Experience

ObjectivesTo gather insights on the disease experience of patients with heart failure (HF) with reduced ejection fraction (HFrEF), and assess how patients’ experiences and narratives related to the disease complement data collected through standardised patient-reported outcome measures (PROMs). Also, to explore new ways of evaluating the burden experienced by patients and caregivers.DesignObservational, descriptive, multicentre, cross-sectional, mixed-methods study.SettingSecondary care, patient’s homes.ParticipantsTwenty patients with HFrEF (New York Heart Association (NYHA) classification I–III) aged 38–85 years.MeasuresPROMs EuroQoL 5D-5L (EQ-5D-5L) and Kansas City Cardiomyopathy Questionnaire and patient interview and observation.ResultsA total of 20 patients with HFrEF participated in the study. The patients’ mean (SD) age was 72.5 (11.4) years, 65% were male and were classified inNYHA functional classes I (n=4), II (n=7) and III (n=9). The study showed a strong impact of HF in the patients’ quality of life (QoL) and disease experience, as revealed by the standardised PROMs (EQ-5D-5L global index=0.64 (0.36); Kansas City Cardiomyopathy Questionnaire total symptom score=71.56 (20.55)) and the in-depth interviews. Patients and caregivers often disagreed describing and evaluating perceived QoL, as patients downplayed their limitations and caregivers overemphasised the poor QoL of the patients. Patients related current QoL to distant life experiences or to critical moments in their disease, such as hospitalisations. Anxiety over the disease progression is apparent in both patients and caregivers, suggesting that caregiver-specific tools should be developed.ConclusionsPROMs are an effective way of assessing symptoms over the most recent time period. However, especially in chronic diseases such as HFrEF, PROM scores could be complemented with additional tools to gain a better understanding of the patient’s status. New PROMs designed to evaluate and compare specific points in the life of the patient could be clinically more useful to assess changes in health status.

scholarly journals Patient Adherence to a Mobile Phone–Based Heart Failure Telemonitoring Program: A Longitudinal Mixed-Methods Study (Preprint)

10.2196/13259 ◽  
2018 ◽  
Author(s):  
Patrick Ware ◽  
Mala Dorai ◽  
Heather J Ross ◽  
Joseph A Cafazzo ◽  
Audrey Laporte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Mobile Phone ◽  
Patient Adherence ◽  
Mixed Methods Study
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