Improvement of self-care behaviors in patients with heart failure
DOI:
https://doi.org/10.17533/udea.iee.12591Keywords:
Heart failure; self-care; education, nursing.Abstract
Objective. To evaluate the improvement in self-care behaviors after a nursing educational intervention in patients with heart failure.
Methodology. The study had the participation of 29 patients over 30 years of age, who attended in 2010 the cardiovascular healthcare program of a hospital institution in Medellín (Colombia) and who signed the informed consent and received for nine months a nursing educational intervention consisting of group educational meetings, telenursing sessions, home visits, and support leaflet. The study applied Artinian’s Self-care scale validated in the field, composed of 28 items distributed in four dimensions (request for help, adaptation to disease, and adherence to pharmacological and non-pharmacological treatments). To evaluate changes in these behaviors, the scale was applied at the beginning and end of the study.
Results. Bearing in mind that the maximum possible score in the scale is 84, the patients had initial and final median scores of 40 and 53 (p < 0.05). The dimensions in which the most positive changes were observed were: request for help, adaptation to the disease, and adherence to the pharmacological treatment; regarding adherence to the non-pharmacological treatment, two behaviors did not obtain favorable changes (reduction in salt intake and measurement of the amount of urine eliminated).
Conclusion. The nursing educational intervention conducted in our study had beneficial effects on most of the self-care behaviors assessed in individuals with HF.
Downloads
References
(1) Albert N. Evidence-based nursing care for patients with heart failure. AACN Adv Crit Care. 2006;17(2):170-83.
(2) Achury D. Adherencia al tratamiento en el paciente con falla cardiaca. In: Rincón F, Díaz E, editors. Enfermería cardiovascular. Bogotá: Sociedad Colombiana de Cardiología; 2008. p. 342-68.
(3) Scott L, Setter-Kliner K, Britton A. The effects of nursing interventions to enhance mental health and quality of life among individuals with heart failure. Appl Nurs Res. 2004;17(4):248-56.
(4) Orem DE, Taylor SG, McLaughlin K, editors. Nursing: Concepts of Practice. St Louis, MO: Mosby; 2001.
(5) Renpenning K, Taylor S. Self-care t theory of nursing: Selected Papers of Dorothea Orem. New York: Springer Pub Co; 2003.
(6) Deaton C. Outcome measurement. J Cardiovasc Nurs. 2000;14(1):116-8.
(7) Jiang HE, Ogden LG, Bazzano LA, Vupputuri S, Loria C, Whelton P. Risk factors for congestive heart failure in US men and women: NHANES I Epidemiologic Follow-up Study. Arch Intern Med. 2001;161(7):996-1002.
(8) Evangelista L, Doering L, Dracup K, Hamilton M. Compliance behaviors of elderly patients with advanced heart failure. J Cardiovasc Nurs. 2003;18(3):197-206.
(9) Gheorghiade M, Zannad F. Modern management of acute heart failure syndrome. Eur Heart J. 2005;7(suppl B:):B7.
(10) Chui M, Deer MBS, Tu W, Oury S, Brater D, Murray M. Association between adherence to diuretic therapy and health care utilization in patients with heart failure. Pharmacother. 2003;23(3):326-32.
(11) Benatar D, Bondmass M, Ghitelman J, Avitall B. Outcomes of chronic heart failure. Arch Intern Med. 2003;163(3):347-52.
(12) Baker DW, Asch SM, Keesey JW, Brown JA, Chan KS, Joyce G, et al. Differences in education, knowledge, self-management activities, and health outcomes for patients with heart failure cared for under the chronic disease model: the improving chronic illness care evaluation. J Card Fail. 2005;11(6):405-13.
(13) Blue L, Lang E, McMurray J. Randomised controlled trial of specialist nurse intervention in heart failure. BMJ. 2001;323(7315):715-8.
(14) McAlister F, S. S, Ferrua S, 2004 MJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission. A systematic review of randomized trials. J Am Coll Cardiol. 2004;44(4):810-9.
(15) Artinian N, Morris M, Sloan M, Lange P. Self-care behaviors among patients with heart failure. Issues in Cardiovascular Nursing. Heart Lung. 2002;31(3):161-72.
(16) Arredondo-Holguin E, Rodríguez-Gázquez M. Validez y confiabilidad de una escala de valoración de comportamientos de autocuidado en personas con falla cardiaca. Aquichan. 2012;12(1):23-31
(17) Jovicic A, Holroyd-Leduc J, Straus S. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC Cardiovasc Disord. 2006;6:43.
(18) Leslie WS, Urie A, Hooper J, Morrison CE. Delay in calling for help during myocardial infarction: reasons for the delay and subsequent pattern of accessing care. Heart. 2000;84(2):137-41.
(19) Penny WJ. Patient delay in calling for help: the weakest link in the chain of survival? Heart. 20011;85(2):121-2.
(20) An K, De Jong M, Riegel B, McKinley S, Garvin B. A cross-sectional examination of changes in anxiety early after acute myocardial infarction Heart Lung. 2004;33(2):75-82.
(21) Buetow S, Goodyear F, Coster G. Coping strategies in the self-management of chronic hearth failure. Fam Pract. 2001;18:117-22.
(22) Mahoney JS. An ethnographic approach to understanding the illness experiences of patients with congestive heart failure and their family members. Heart Lung. 2001;30(6):429-36.
(23) Pattenden JF, Roberts H, Lewin RJ. Living with heart failure; patient and carer perspectives. Eur J Cardiovasc Nurs. 2007;6(4):273-9.
(24) Costello JA, Boblin S. What is the experience of men and women with congestive heart failure? Can J Cardiovasc Nurs. 2004;14(3):9-20.
(25) Welstand J, Carson A, Rutherford PJ. Living with heart failure: an integrative review. Int Nurs Stud. 2009;46(10):1374-85.
(26) Strömberg A, Mårtensson J, Fridlund B, Levin LA, Karlsson JE. Dahlström, U. Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective randomised trial. Eur Heart J. 2003;24:1014-23.
(27) González B, Lupón J, Herreros J, Urrutia A, Altimir S, Coll R, et al. Patient's education by nurse: what we really do achieve? Eur J Cardiovasc Nurs. 2005;4(2):107-11.
(28) Clark AP, Stuifbergen A, Gottlieb NH, Voelmeck W, Darby D, Delville C. Health promotion in heart failure--a paradigm shift. Holist Nurs Pract. 2006;20(2):73-9.
(29) Barrera L, Galvis C, Moreno M, Pinto N, Pinzón M, Romero E, et al. La habilidad de cuidado de los cuidadores familiares de personas con enfermedad crónica. Un estudio comparativo de tres unidades académicas de enfermería. Invest Educ Enferm. 2006;24(1):36-46.
(30) Hearth Failure Society of America. Comprehensive heart failure practice guideline. J Card Failure. 2010;16:e1-e194.
(31) González B, Lupón J, Herreros J, Urrutia A, Altimir S, Coll R, et al. Patient's education by nurse: what we really do achieve? Eur J Cardiovasc Nurs 2005;4(2):107-11.
(32) Martje HL, Van der Wal M, Jaarsma T, Moser D, Veeger N, van Gilst W, et al. Compliance in heart failure patients: the importance of knowledge and beliefs. Eur Heart J. 2006;27(4):434-40.
(33) Colín E, Castillo L, Orea A, Montaño P, Dorantes J. Impacto de una dieta con restricción de sodio y líquidos sobre el estado clínico de pacientes con insuficiente cardiaca. Rev Chil Nutr. 2010;37(4):427-37.
(34) Bentley B, De Jong MJ, Moser DK, Peden AR. Factors related to nonadherence to low sodium diet recommendations in heart failure patients. Eur J Cardiovasc Nurs. 2005;4(4):331-6.
(35) Ajzan I. Attitudes, personality and behavior New York: Open University Press; 2005.
(36) Achury D. Contexto clínico de la falla cardiaca. En: Adherencia al tratamiento en el paciente con falla cardiaca. Bogotá: Editorial Universidad Nacional; 2007.
(37) Rich MW. Heart failure in the elderly: strategies to optimize outpatient control and reduce hospitalizations. Am J Geriatr Cardiol. 2003;12(1):19-24.
(38) Koelling TM, Johnson ML, Cody RJ, Aaronson KD. Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005;111(2):179-85.
(39) Rankin S, Stallings K. Patient education, principles and practice. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2001.
(40) Gattis W, Hasselblad V, Whellan D, O'Connor C. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team. Arch Intern Med. 1999;159(16):1939-45.
(41) Holst M, Willenheimer R, Martenson J, Lindholm M, Strömberg ATf-uos-cbaasseopwhfiphc. Telephone follow-up of self-care behaviour alter a single sesión education of patients with heart failure in primary health care. Eur J Cardiovasc Nurs. 2007;6(2):153-9.
(42) López M, Rus C, Martínez MM, Cortez GA, Delgado M. Aplicación de un plan de cuidados de enfermería en un programa de insuficiencia cardiaca. Enferm Cardiol. 2007;14(41):25-32.
(43) Whellan DJ, Gaulden L, Gattis WA, Granger B, Russell SD, Blazing MA, et al. The benefit of implementing a heart failure disease management program. Arch Intern Med. 2001;161(18):2223-8.
Downloads
Published
How to Cite
Issue
Section
License
Derechos de propiedad / Direitos de Propriedade
English: If the article is accepted for publication, all copyright will be of exclusive property of Investigación y Educación en Enfermería. The text and the graphics included in the publication are exclusive responsibility of the authors and not necessarily reflect the thought of the Editorial Committee.
Español: Si el artículo es aprobado para publicación, todos los derechos son de propiedad de Investigación y Educación en Enfermería. El texto y las gráficas incluidas en la publicación son de exclusiva responsabilidad de los autores y no necesariamente refleja el pensamiento del Comité Editorial.
Português: Se o artigo for aceito para publicação, todos os direitos autorais serão de propriedade exclusiva de Investigación y Educación en Enfermería. O texto e os gráficos incluídos na publicação são de responsabilidade exclusiva dos autores e não refletem necessariamente o pensamento do Comitê Editorial.
