scholarly journals Role of a multidisciplinary program in improving outcomes in cognitively impaired heart failure older patients

2015 ◽  
Vol 78 (1) ◽  
Author(s):  
Donatella Del Sindaco ◽  
Giovanni Pulignano ◽  
Andrea Di Lenarda ◽  
Luigi Tarantini ◽  
Giovanni Cioffi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cognitive Impairment ◽  
Relative Effectiveness ◽  
Intervention Group ◽  
Cognitive Status ◽  
High Risk Group ◽  
Mortality And Morbidity ◽  
Entire Cohort ◽  
Multidisciplinary Program ◽  
Significant Difference

Background: Cognitive impairment (CI) frequently complicates Heart failure (HF) and is associated with increased mortality and morbidity. Previous studies reported that nurse-lead home-based multidisciplinary program (MP) may not improve the prognosis of this high-risk group. In the present study, we analysed the relative effectiveness of an integrated hospital-based MP in patients with cognitive impairment. Methods: Consecutive (n=173) community-living outpatients aged >70 years (mean 77+6, 48% women) randomized to a MP (n=86) or usual care (UC) (n=87) were enrolled in stable clinical conditions. Cognitive status was assessed by means of Folstein Mini Mental State Examination (MMSE). Results: CI (MMSE<24) was present in 41.6% (42,5% UC vs 40.7% MP p=ns). The variables independently associated to CI were: older age, education level <5 years, anemia and severe renal dysfunction. During a 2-year follow-up, 59 patients died (31.4%) with no significant difference between intervention group. At multivariate analysis, in the entire cohort, CI was independently associated to death (HR 2,077[95%CI 1,097- 3,931]), HF admissions (2,133[1,346-3,381]), death/HF admissions (1,784[1,132-2,811]) and all-cause admissions (1,473[1,008-2,153]. When considered according to intervention groups, CI was independently associated to all-cause death (3,603 [1,553-8,358], death/HF admissions (2,029[1,200-3,432]) and HF admissions (2,474[1,406-4,353]) but not to all-cause admissions. The assignment of patients with CI to MP was associated to a significant reduction in HF admissions vs UC (0,503[0,253-0,999] (all interaction tests p=ns). Conclusions: This study suggests that CI is very common and associated to worse prognosis in heart failure and that hospital-based MP seems to improve outcomes in these patients through reduction of heart failure hospital admission.

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 The effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure: an experimental study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hossein Habibzadeh ◽  
Akram Shariati ◽  
Farshad Mohammadi ◽  
Salman Babayi
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Health Promotion ◽  
Intervention Group ◽  
Health Promotion Model ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
Health Promoting ◽  
Pender's Health Promotion Model

Abstract Background Heart failure is a common and chronic heart condition with high prevalence and mortality rates. This debilitating disease as an important predictor of health outcomes is directly related to patients' quality of life. Given that one of the main goals of heart failure treatment is to promote patients' quality of life and health status, conducting effective nursing interventions seems to be necessary in this regard. Therefore, the present study aimed to determine the effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure. Methods This is an experimental study in which a total of 80 patients with heart failure were recruited and randomly allocated to two groups of intervention and control (n = 40 in each group). The educational program was designed based on Pender's health promotion model and then provided for the patients in the intervention four subgroups (10 person in each group) during six sessions. Data were collected at three time-points of before, immediately after, and three months after the intervention using a demographic questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were then analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA) and p value less than 0.05 was taken as statistically significant. Results Based on the results of the present study, no statistically significant difference was shown in terms of demographic characteristics between the two groups. It was also indicated that there was a statistically significant difference in the mean scores of all dimensions of quality of life (except in the physical dimension) between the two groups so that the overall mean score of quality of life increased significantly in the intervention group after the intervention (p < .05). Moreover, there were significant increases in the mean scores of health-promoting behaviors (except in the domain of physical activity) in the intervention group compared to the control group (p < .05) after intervention. Conclusions This study demonstrates a trend that Pender's health promotion model is effective in improving the quality of life of patients with heart failure except of the physical dimension, and strengthening their health-promoting behaviors in all dimensions except of the physical activity dimension.

scholarly journals Perceptions of caregivers on immunization in Ntungamo district, Uganda

2021 ◽  
Vol 8 (12) ◽  
pp. 5729
Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas
Keyword(s):  
Risk Factor ◽  
Intervention Group ◽  
Cost Effective ◽  
Systematic Sampling ◽  
Control Group ◽  
Post Intervention ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Quasi Experimental ◽  
And Control

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 

Abstract 321: Impact Of Chronic Kidney Disease On Heart Failure Outcomes In A Minority Cohort

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
TAOPHEEQ MUSTAPHA ◽  
VARIJA BHOGIREDDY ◽  
HARTMAN MADU ◽  
ADU BOACHIE ◽  
ABDUL OSENI ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
African American ◽  
Kidney Disease ◽  
Prognostic Impact ◽  
Mortality And Morbidity ◽  
Ckd Stage ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

BACKGROUND: Heart failure (HF) and Chronic kidney disease (CKD) are major public health problems that often co-exist with a resultant high mortality and morbidity. Most of the studies evaluating their reciprocal prognostic impact have focused on mortality in majority populations. There is limited literature on the impact of CKD on HF morbidities in ethnic minorities. AIMS: Our study seeks to compare HF outcomes in patients with or without CKD in an African-American predominant cohort. METHODS: We obtained data from the NGH at Meharry Heart Failure Cohort; a comprehensive retrospective HF database comprised of patient care data (HF admissions, non-HF admissions, and emergency room visits) were assessed from January 2006 to December 2008. The study group consist of 306 subjects with a mean age of 65±15 years. 81% were African-American (AA), 19% Caucasian and 48.5% are females. Following the NKF KDOQI guidelines, 5 stages of CKD were outlined based on GFR. RESULTS: The overall prevalence of CKD in this population is 54.2%. CKD stage 1 was most prevalent with 45.8%, prevalence for stages 2-5 are 21.6%, 18.3%, 9.5% and 4.9% respectively. The comparison of the mean of ER visits, non HF hospitalizations and HF hospitalizations between normal and CKD patients was done using independent t-test and showed no significant difference in the mean number of ER visits (p=0.564), or HF hospitalizations(p=0.235). However, there is a statistically significant difference in the mean number of non -HF hospitalizations between normal and CKD patients (p=0.031). CONCLUSION: This study shows that the prevalence of CKD in this minority -predominant HF cohort is similar to prior studies in majority populations. However, only the non-HF hospitalizations were significantly increased in the CKD group. Future prospective studies will be needed to define the implications of this in the management of HF patients with CKD.

Impact of a Palliative Care Education Module in Patients With Heart Failure

2020 ◽  
Vol 37 (12) ◽  
pp. 1016-1021
Author(s):  
Shelley L. Thompson ◽  
Cary Ward ◽  
Anthony Galanos ◽  
Margaret Bowers
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Intervention Group ◽  
Care Group ◽  
Educational Module ◽  
Care Education ◽  
Levels Of Care ◽  
Palliative Care Education ◽  
Significant Difference ◽  
The Impact

Background: Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in HF therapy, but referrals are often delayed. Objective: Introduce PC to patients with HF and examine the impact on PC consults, readmission, mortality, and intensive care unit (ICU) transfers. Methods: Patients (n = 60) admitted with HF to an academic hospital were asked to view a PC educational module. A number of PC consults, re-admissions, mortality, and transfers to the ICU were compared among participants and those who declined. Results: Nine patients in the intervention group (n = 30) requested a PC consult ( P = .042) versus 2 in the usual care group (n = 30; P = .302). There was no statistically significant difference in readmissions, mortality, or ICU transfers between groups. Conclusions: Palliative care education increases the likelihood of PC utilization but in this short-term project was not found to statistically impact mortality, re-admissions, or transfers to higher levels of care.

scholarly journals Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Pär Wennberg ◽  
Margareta Möller ◽  
Johan Herlitz ◽  
Elisabeth Kenne Sarenmalm
Keyword(s):  
Cognitive Impairment ◽  
Hip Fractures ◽  
Controlled Trial ◽  
Intervention Group ◽  
Pain Medication ◽  
Cognitive Status ◽  
Preoperative Pain ◽  
Nerve Blocks ◽  
Double Blind ◽  
Fascia Iliaca Compartment Block

Abstract Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period. Methods One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire. Results Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures. Conclusion Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies. Trial registration EudraCT number 2008–004303-59 date of registration: 2008-10-24.

Repeated recall as an intervention to improve memory performance in heart failure patients

2017 ◽  
Vol 16 (8) ◽  
pp. 724-732 ◽  
Author(s):  
Jennifer Viveiros ◽  
Kristen Sethares ◽  
Amy Shapiro
Keyword(s):  
Heart Failure ◽  
Cognitive Impairment ◽  
Word Pair ◽  
Testing Effect ◽  
Memory Performance ◽  
Intervention Group ◽  
Memory Deficit ◽  
Controlled Clinical Trial ◽  
Repeated Testing ◽  
Heart Failure Patients

Background: Up to 50% of heart failure patients demonstrate aspects of cognitive impairment, including memory deficit. Novel interventions are needed to address memory deficit among heart failure patients. Aim: The goal of this study was to evaluate the testing effect as an intervention to improve memory performance in heart failure patients. Methods: This was a randomized controlled clinical trial ( N=84) comparing the memory performance of heart failure patients with and without mild cognitive impairment after a repeated testing intervention. Memory performance was measured by verbal word pair associates recall scores, between attention control and experimental subjects. Results: Patients had a mean age of 71.7 ± 13.3 years and similar baseline memory (immediate p=.79 and delayed p=.47). Overall, there were no significant differences in memory between experimental and control subjects, respectively (67.2±18.87 vs. 61.9±22.3, verbal word pair associates, t = −1.179, p=.24). In the final hierarchical regression model, age ( p=.018) and education ( p=.006) were significant predictors of memory performance, with the intervention approaching significance ( p=.079). Conclusions: Although not statistically significant, the intervention group reported better memory. Age and education continue to be significant contributors to memory performance in the heart failure population. Continued development of interventions to improve memory performance in heart failure patients is indicated.

scholarly journals Elevated Angiopoietin-1 Serum Levels in Patients with Alzheimer’s Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Brigitte Schreitmüller ◽  
Thomas Leyhe ◽  
Elke Stransky ◽  
Niklas Köhler ◽  
Christoph Laske
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Serum Levels ◽  
Cognitive Status ◽  
Potential Candidate ◽  
Healthy Controls ◽  
Healthy Elderly ◽  
Significant Difference ◽  
Angiopoietin 1

Background. Alzheimer's disease (AD) is the most common cause of dementia in the elderly. AD is characterized by the accumulation of amyloid plaques and neurofibrillary tangles and by massive neuronal loss in the brain. There is epidemiologic and pathologic evidence that AD is associated with vascular risk factors and vascular diseases, contributing to cerebral hypoperfusion with consecutive stimulation of angiogenesis and upregulation of proangiogenic factors such as Angiopoietin-1 (Ang-1).Methods. In the present study, we measured Ang-1 serum levels in 42 patients with AD, 20 patients with mild cognitive impairment (MCI), and in 40 healthy elderly controls by ELISA.Results. We found significantly increased Ang-1 serum levels in patients with AD compared to control subjects(P=0.003). There was no significant difference between MCI patients and healthy controls(P=0.553)or between AD and MCI patients(P=0.054). The degree of cognitive impairment as measured by the mini-mental status examination (MMSE) score was significantly correlated with the Ang-1 serum levels in all patients and healthy controls.Conclusions. We found significantly increased Ang-1 serum levels in AD patients. We could also show an association between Ang-1 serum levels and the cognitive status in all patients and healthy controls. Thus, serum Ang-1 could be a potential candidate for a biomarker panel for AD diagnosis.

scholarly journals The Effect of Teaching Palliative Care on the Self-Efficacy of Elderly Patients with Chronic Heart Failure

2020 ◽  
Vol 12 (3) ◽  
pp. 201-207
Author(s):  
Mahnaz Modanloo ◽  
Ameneh Tazikeh-Lemeski ◽  
Shohreh Kolagari
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
And Control

ABSTRACTObjetive: Determine the effect of teaching palliative care on the self-efficacy of elderly with Chronic Heart Failure. Material and Methods: This single-blind randomized clinical trial was done on patients with Chronic Heart Failure attending to the heart clinics of Golestan University of Medical Sciences in 2018. 48 eligible patients with class-III were selected via convenience sampling. Patients allocated into control and intervention group randomly (n=32). Palliative care training was done for intervention group for six weeks. Data was gathered through the Cardiac Self-Efficacy Scale (CSES) on three time points (before, immediately, and one month after intervention). Data were analyzed in SPSS-18 using independent t-test, chi-squared, Fisher's exact, and repeated-measures ANOVA with corrected Bonferroni post-hoc test. Results: Finding showed that before intervention the mean scores of self-efficacy in intervention and control group was 23.95±8.34 and 24.11±9.41, respectively. Immediate and one month after intervention it was 26.30±8.30 vs. 28.95±8.53 in intervention group and 24.68±9.32 vs. 25.53±10.39 in control group. In intervention group there was no significant difference between the mean scores of before with immediate and one month after intervention. However, there was a significant difference between the two time follow up in both intervention (p<0.0001) and control (p<0.003) groups. Conclusion: Although the education of palliative care has increased the ability to care in elderly, it seems that self-managing in complex conditions is required follow-up over time.

scholarly journals The effect of using smartphone applications on self-care in patients with heart failure

2020 ◽  
Author(s):  
Nahid Kiyarosta ◽  
Tahereh Najafi Ghezeljeh ◽  
Farah Naghashzadeh ◽  
Mahshid Feizi ◽  
Shima Haghani
Keyword(s):  
Heart Failure ◽  
Health Care Providers ◽  
Intervention Group ◽  
Self Care ◽  
Smartphone Application ◽  
Care Providers ◽  
Smartphone Applications ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
The Mean

Background & Aim: Due to the chronic nature of heart failure, it is necessary to observe and maintain self-care behaviors accordingly. Tele-monitoring using smartphone applications can be effective in this regard. This study aimed to determine the effect of using smartphone applications on self-care behaviors in patients with heart failure. Methods & Materials: This randomized controlled clinical trial was conducted between August and March in 2018. Using consecutive sampling, 120 patients were selected and were allocated to the two groups by a random quadruple block approach. The participants in both groups completed the European heart failure self-care questionnaire before and after the intervention. Patients in both groups received routine hospital care; however, patients in the intervention group used an Android smartphone application for three months daily as well. Via the application, there were ongoing interactions between patients and researchers, depending on the needs of patients and their conditions. The data were analyzed using SPSS V.16 software. Results: There was a statistically significant difference between groups in terms of the mean score of self-care after the intervention where the mean score in the intervention group was lower (p<0.001), which indicates better self-care. Based on the results, the intervention effect was reported at 0.787. Conclusion: The findings of this study showed that using a smartphone application can improve self-care in patients with heart failure. Therefore, it is recommended to health care providers to use this mobile application to care and monitor remote patients with HF.

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