Educational level and self-care behaviour in patients with heart failure before and after nurse educational intervention.

BACKGROUND: Self-care is important for heart failure (HF) management and may be influenced by the patient's educational level. AIM: We assessed the relationship of educational level with baseline self-care behaviour and changes one year after a nursing intervention in HF outpatients attending a HF unit. PATIENTS AND METHOD: Three hundred and thirty-five HF patients were studied, with a median age of 67 years (P(25-75) 57-75) and a median HF duration of six months (P(25-75) 1-36). HF aetiology was mainly ischaemic heart disease (53.4%). Median ejection fraction was 30% (P(25-75) 24-37%). The functional class was mainly II (66.3%) and III (25.7%). Educational levels were: very low 17.3%; low 62.1%; medium-high 20.6%. Patients were evaluated at the first visit (baseline) and one year after the educational intervention with the nine-item European Heart Failure Self-care Behaviour Scale. RESULTS: Median patient scores differed in the baseline (19 (P(25-75) 15-26) vs. 16 (P(25-75) 13-21) vs. 15 (P(25-75) 12.5-15.5)) and the one-year evaluation (15 (P(25-75) 13-17) vs. 13 (P(25-75) 11-15) vs. 12 (P(25-75) 10-14)) for the three educational levels, respectively, with statistically significant differences between levels (p=0.007 to p<0.001) except between low and medium-high education at one year (p=0.057). In the one-year evaluation, self-care behaviour significantly improved in the three educational groups (p<0.001), with a similar, albeit not statistically significant, magnitude of improvement in all groups. CONCLUSIONS: Self-care behaviour at baseline and one year after a nursing intervention was better in patients with a higher education, although the improvement with the intervention was similar irrespective of the educational level.

Isolated congenital nail candidiasis: report of 6 cases.

Congenital candidal infection usually presents as skin rash but it can also affect skin appendages. Nail involvement in congenital candidiasis is rare and has been usually associated with cutaneous lesions. We report 6 cases of congenital candidiasis limited to nail plates that had favorable outcome.

Patients' self-care improvement with nurse education intervention in Spain assessed by the European Heart Failure Self-Care Behaviour Scale.

UNLABELLED: The European Heart Failure Self-care Behaviour Scale (EHFScBS) has been developed for assessing patients' self-care level. We used it to assess our patients' self-care progress after a medium-term period of nurse education intervention. PATIENTS AND METHOD: We prospectively studied 151 patients (111 men and 40 women, mean age 65.4+/-11.9 years). All patients were evaluated twice with the EHFScBS: during the first visit to the Unit and after 1 year of nurse educational intervention. RESULTS: Mean score obtained by our patients in the initial evaluation was 24.8+/-7.6. In the second evaluation patients showed a significant (p<0.001) improvement in self-care behaviour (mean score 19.9+/-5.7). Analyzing item by item of the scale, patients show improvement in all items except in four: "If I am short of breath, I take it easy", "I take a rest during the day", "I eat a low salt diet" and "I take my medication as prescribed". CONCLUSIONS: Improvement in self-care behaviour, assessed with the EHFScBS, was achieved with nurse educational intervention in patients without previous heart failure education. However, in our population, this improvement was not obtained in one important aspect such is low salt diet compliance, although punctuation in this item was quite acceptable already initially.