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1.
Medicine (Baltimore) ; 100(10): e25052, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725890

RESUMEN

ABSTRACT: The nurse-led program is associated with a short-term improvement of mental health status (MHS) and quality of life (QOL) in patients with chronic heart failure (CHF). Nonetheless, the long-term effect of this program is undetermined. The aims of the current study were to evaluate the 1-year effects of the nurse-led program on MHS, QOL, and heart failure (HF) rehospitalization among patients with CHF.CHF patients in the control group received standard care, and patients in the treatment group received standard care plus telehealth intervention including inquiring patients' medical condition, providing feedbacks, counseling and providing positive and emotional talk with the patients. At the third, sixth, and twelfth month's follow-up, patients were called by registered nurses to assess the Mental Health Inventory-5 (MHI-5) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. HF rehospitalization was also assessed.A total of 300 patients were included and 46% (n = 138) of the patients were in the treatment group. There were no significant between-group differences in the MHI-5 and KCCQ scores at baseline. In the control group, the MHI-5 score was gradually decreased with follow-up and the score was significantly lower than that in the treatment group since the third month's follow-up (63.5 ±â€Š10.6 vs 73.6 ±â€Š10.3). Compared with the treatment group, KCCQ score was lower in the control group from the third month's follow-up (64.3 ±â€Š10.6 vs 73.5 ±â€Š12.3) until the end of the twelfth months' follow-up (45.3 ±â€Š11.2 vs 60.8 ±â€Š11.1). During 12 months' follow-up, the proportion of patients who experienced HF rehospitalization was lower in the treatment group (19.6% vs 24.1%). After adjusting for covariates, the utilization of the nurse-led program, and increase of MHI-5 and KCCQ scores were associated with reduced risk of HF rehospitalization.The nurse-led program is beneficial for the improvement of MHS and QOL for CHF patients, which might contribute to the reduction of HF rehospitalization.


Asunto(s)
Estado de Salud , Insuficiencia Cardíaca/terapia , Salud Mental/estadística & datos numéricos , Pautas de la Práctica en Enfermería/organización & administración , Consulta Remota/organización & administración , Adulto , Anciano , Enfermedad Crónica/terapia , Femenino , Estudios de Seguimiento , Insuficiencia Cardíaca/psicología , Humanos , Masculino , Persona de Mediana Edad , Readmisión del Paciente/estadística & datos numéricos , Pautas de la Práctica en Enfermería/estadística & datos numéricos , Estudios Prospectivos , Calidad de Vida , Nivel de Atención/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Resultado del Tratamiento
2.
JMIR Mhealth Uhealth ; 9(1): e19465, 2021 01 20.
Artículo en Inglés | MEDLINE | ID: mdl-33470941

RESUMEN

BACKGROUND: Due to the complexity and chronicity of heart failure, engaging yet simple patient self-management tools are needed. OBJECTIVE: This study aimed to assess the feasibility and patient engagement with a smartphone app designed for heart failure. METHODS: Patients with heart failure were randomized to intervention (smartphone with the Habits Heart App installed and Bluetooth-linked scale) or control (paper education material) groups. All intervention group patients were interviewed and monitored closely for app feasibility while receiving standard of care heart failure management by cardiologists. The Atlanta Heart Failure Knowledge Test, a quality of life survey (Kansas City Cardiomyopathy Questionnaire), and weight were assessed at baseline and final visits. RESULTS: Patients (N=28 patients; intervention: n=15; control: n=13) with heart failure (with reduced ejection fraction: 15/28, 54%; male: 20/28, 71%, female: 8/28, 29%; median age 63 years) were enrolled, and 82% of patients (N=23; intervention: 12/15, 80%; control: 11/13, 85%) completed both baseline and final visits (median follow up 60 days). In the intervention group, 2 out of the 12 patients who completed the study did not use the app after study onboarding due to illnesses and hospitalizations. Of the remaining 10 patients who used the app, 5 patients logged ≥1 interaction with the app per day on average, and 2 patients logged an interaction with the app every other day on average. The intervention group averaged 403 screen views (per patient) in 56 distinct sessions, 5-minute session durations, and 22 weight entries per patient. There was a direct correlation between duration of app use and improvement in heart failure knowledge (Atlanta Heart Failure Knowledge Test score; ρ=0.59, P=.04) and quality of life (Kansas City Cardiomyopathy Questionnaire score; ρ=0.63, P=.03). The correlation between app use and weight change was ρ=-0.40 (P=.19). Only 1 out of 11 patients in the control group retained education material by the follow-up visit. CONCLUSIONS: The Habits Heart App with a Bluetooth-linked scale is a feasible way to engage patients in heart failure management, and barriers to app engagement were identified. A larger multicenter study may be warranted to evaluate the effectiveness of the app. TRIAL REGISTRATION: ClinicalTrials.gov NCT03238729; http://clinicaltrials.gov/ct2/show/NCT03238729.


Asunto(s)
Insuficiencia Cardíaca/terapia , Aplicaciones Móviles , Participación del Paciente , Calidad de Vida/psicología , Estudios de Factibilidad , Femenino , Hábitos , Insuficiencia Cardíaca/psicología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Volumen Sistólico
3.
Curr Probl Cardiol ; 46(4): 100737, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33412349

RESUMEN

BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown. AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries. METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms. RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms. CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Diabetes Mellitus/epidemiología , Síndrome Metabólico/epidemiología , Adulto , Anciano , Enfermedades Cardiovasculares/psicología , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/psicología , Depresión/psicología , Trastorno Depresivo Mayor/psicología , Diabetes Mellitus/psicología , Dieta/estadística & datos numéricos , Dislipidemias/epidemiología , Dislipidemias/psicología , Ingestión de Alimentos , Ejercicio Físico/psicología , Femenino , Frutas , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/psicología , Humanos , Hipertensión/epidemiología , Hipertensión/psicología , América Latina/epidemiología , Masculino , Salud Mental , Síndrome Metabólico/psicología , Persona de Mediana Edad , Factores Sexuales , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/psicología , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento/psicología , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Verduras
4.
ESC Heart Fail ; 8(2): 1324-1332, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33463044

RESUMEN

AIMS: The coronavirus disease 2019 (COVID-19) pandemic has created significant challenges to healthcare globally, necessitating rapid restructuring of service provision. This questionnaire survey was conducted amongst adult heart failure (HF) patients in the United Kingdom (UK), to understand the impact of COVID-19 upon HF services. METHODS AND RESULTS: The survey was conducted by the Pumping Marvellous Foundation, a UK HF patient charity. 'Survey Monkey' was used to disseminate the questionnaire in the Pumping Marvellous Foundation 's online patient group and in 10 UK hospitals (outpatient hospital and community HF clinics). There were 1050 responses collected (693/1050-66% women); 55% (579/1050) were aged over 60 years. Anxiety level was significantly higher regarding COVID-19 (mean 7 ± 2.5 on anxiety scale of 0 to 10) compared with anxiety regarding HF (6.1 ± 2.4; P < 0.001). Anxiety was higher amongst patients aged ≤60 years about HF (6.3 ± 2.2 vs. 5.9 ± 2.5 in those aged >60 years; P = 0.005) and COVID-19 (7.3 ± 2.3 vs. 6.7 ± 2.6 those aged >60 years; P < 0.001). Sixty-five per cent of respondents (686/1050) reported disruption to HF appointments (cancellation or postponement) during the lockdown period. Thirty-seven per cent reported disruption to medication prescription services, and Thirty-four per cent reported inability to access their HF teams promptly. Thirty-two per cent expressed reluctance to attend hospital (25% stated they would only attend hospital if there was no alternative, and 7% stated that they would not attend hospital at all). CONCLUSIONS: The COVID-19 pandemic has caused significant anxiety amongst HF patients regarding COVID-19 and HF. Cancellation or postponement of scheduled clinic appointments, investigations, procedures, prescription, and monitoring services were implicated as sources of anxiety.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/terapia , Telemedicina/organización & administración , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prioridad del Paciente , Encuestas y Cuestionarios , Reino Unido , Adulto Joven
5.
Medicine (Baltimore) ; 99(52): e23901, 2020 Dec 24.
Artículo en Inglés | MEDLINE | ID: mdl-33350788

RESUMEN

BACKGROUND: Qishen granules (QSG) is a famous traditional Chinese Medicine (TCM) formula used to treat chronic heart failure (CHF). The objective of this protocol is to clarify the efficacy and safety of QSG for treating CHF. METHODS: Six databases will be electronically searched up to November 1, 2020 for randomized controlled trials (RCTs) in English and Chinese languages. Two independent reviewers will complete tasks of literature retrieval and data extraction. After that, the Cochrane Collaboration risk of bias tool will be utilized to assess methodological quality. The primary outcomes are left ventricular ejection fraction, left ventricular fractional shortening, and N-terminal B-type natriuretic peptide. The secondary outcomes consist of composite cardiac events, adverse effects, and quality of life. Meta-analysis will be performed using the Revman version 5.3. RESULTS: This study will provide a high-quality synthesis of current evidence of QSG for CHF from primary and secondary outcomes. CONCLUSION: This study will provide evidence for the effectiveness and safety of QSG in the treatment of CHF. PROSPERO REGISTRATION NUMBER: CRD42020150442.


Asunto(s)
Medicamentos Herbarios Chinos/farmacología , Insuficiencia Cardíaca/tratamiento farmacológico , Fármacos Cardiovasculares/farmacología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/psicología , Humanos , Medicina China Tradicional/métodos , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
6.
BMC Cardiovasc Disord ; 20(1): 522, 2020 12 12.
Artículo en Inglés | MEDLINE | ID: mdl-33308152

RESUMEN

BACKGROUND: The The Roadmap Using Story Telling project used a narrative medicine (NM) framework to assess the perspectives of people with heart failure (HF), their informal caregivers and HF specialists of the impact of HF on the daily life of patients and their carers. METHODS: Italian HF specialists participated on a voluntary basis, completing their own narratives, and inviting patients and their caregivers to write anonymously about their experiences, all on a dedicated online platform. The narratives were analyzed according to standard NM methodology. RESULTS: 82 narratives were collected from patients, 61 from caregivers, and 104 from HF specialists. Analysis of the three points of view revealed the extent of the burden of illness on the entire family, particularly that of the caregiver. The impact was mainly experienced as emotional and social limitations in patients' and their caregivers' daily lives. The analysis of all three points of view highlighted a strong difference between how HF is perceived by patients, caregivers, and HF specialists. CONCLUSIONS: This NM project illustrates the complex issues of living with HF and gave insights to integrate three different perspectives into the HF pathway of care.


Asunto(s)
Actitud del Personal de Salud , Cardiólogos/psicología , Cuidadores/psicología , Costo de Enfermedad , Emociones , Insuficiencia Cardíaca/psicología , Medicina Narrativa , Pacientes/psicología , Conducta Social , Actividades Cotidianas , Anciano , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/terapia , Humanos , Italia , Masculino , Persona de Mediana Edad , Relaciones Médico-Paciente , Calidad de Vida
7.
PLoS One ; 15(12): e0243974, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315935

RESUMEN

INTRODUCTION: Information about how patients with advanced heart failure (HF) live and cope with their disease remains scarce. The objective of this study was to explore, from phenomenological and holistic perspectives, the experiences of patients suffering from advanced HF, attended at home in the primary care setting in 2018. MATERIALS AND METHODS: Qualitative study conducted in 4 primary healthcare centers in Barcelona (Spain). Twelve in-depth interviews were conducted in advanced HF patients, aged over 65 and visited regularly at home. We developed a purposeful sampling, accounting for variability in gender, age, and socioeconomic level. Leventhal's framework was used to analyze the interviews. RESULTS: Participants received insufficient and contradictory information about HF. They talked about their cognitive representation and claimed a better communication with healthcare professionals. Due to their advanced age, subjects considered their daily living limitations to be normal rather than as a consequence of HF. Gender differences in emotional representation were clearly observed. Women considered themselves the keystone of correct family "functioning" and thought that they were not useful if they could not correspond to gendered societal expectations. Cognitive coping strategies included specific diets, taking medication, and registering weight and blood pressure. Nevertheless, they perceived the locus of control as external and felt unable to manage HF progression. Their emotional coping strategies included some activities at home such as watching television and reading. Social support was perceived crucial to the whole process. CONCLUSIONS: Locus of control in advanced HF was perceived as external. Healthcare professionals should adapt emotional health interventions in patients with advanced HF based on a gender perspective. Social support was found to be crucial in facing the disease. Patients reported poor communication with healthcare professionals.


Asunto(s)
Adaptación Psicológica , Insuficiencia Cardíaca/psicología , Calidad de Vida , Anciano , Femenino , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/rehabilitación , Humanos , Masculino , Apoyo Social , España , Encuestas y Cuestionarios
8.
Medicine (Baltimore) ; 99(50): e23621, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327336

RESUMEN

OBJECTIVE: The objective of our research is to explore the efficiency of self-care education on the life quality in chronic heart failure (CHF) patients. METHODS: The experiment will be implemented from July 2021 to July 2022 and was granted through the Research Ethics Committee of Shengjing Hospital of China Medical University (423507-037). Eighty patients are included in the study. The recruitment criteria of patients includes: the patients have been diagnosed with CHF by physician on the basis of echocardiography; being stabilized in the acute disease state; in accordance with medical record, the patients have no sensory-cognitive problems. Any reason for not participating in education course (such as not wishing to continue taking part in our experiment or discharge from hospital) is regarded as the exclusion criterion. The primary outcome is the patients' life quality, which is evaluated with Iranian heart failure quality of life questionnaire. Other outcomes include the incidence of hospitalization and total medical cost. RESULTS: Table 1 suggests the comparison of patients' life quality between control group and study group after receiving the education of self-care. CONCLUSION: The program of self-care education can be regarded as the proper method to improve the life quality in CHF patients. TRIAL REGISTRATION: The protocol was registered in Research Registry (researchregistry6225).


Asunto(s)
Insuficiencia Cardíaca/psicología , Educación del Paciente como Asunto , Calidad de Vida , Autocuidado , Femenino , Humanos , Masculino
9.
Enferm. clín. (Ed. impr.) ; 30(6): 386-397, nov.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-197668

RESUMEN

OBJETIVO: Validar las definiciones conceptuales y operacionales de los indicadores de Control de síntomas (1608) para pacientes con enfermedades cardíacas en cuidados paliativos. MÉTODO: Las definiciones fueron establecidas por medio de revisión bibliográfica y fueron validadas por consenso entre enfermeros expertos. Se realizaron 2rondas de la metodología Delphi y un encuentro con expertos con el propósito de validar las definiciones de los indicadores y de la magnitud de respuesta para cada indicador. RESULTADOS: Las definiciones conceptuales y operacionales para los indicadores de Control de síntomas (1608) y para la magnitud de respuesta de cada indicador fueron validadas. CONCLUSIONES: Todas las definiciones conceptuales y operacionales de los 11 indicadores del resultado de enfermería Control de síntomas (1608) fueron validados por expertos. Se necesitan estudios de validación de contenido y clínica de este resultado de enfermería para verificar la capacidad de estos indicadores en medir la efectividad de las intervenciones de enfermería en la práctica clínica y pesquisa


OBJECTIVE: To validate conceptual and operational definitions of Symptom control (1608) indicators for patients with cardiac diseases in palliative care. METHOD: Definitions were established through a literature review and were validated by consensus among expert nurses. Two rounds of the Delphi method and a meeting with experts were carried out in order to validate the definitions for the indicators and for the magnitude of response for each indicator. RESULTS: Conceptual and operational definitions for Symptom control (1608) indicators and for the magnitude of response for each indicator were validated. CONCLUSIONS: All conceptual and operational definitions of 11 indicators of the nursing outcome Symptom control (1608) were validated by experts. Content and clinical validation studies remain necessary to verify the capacity of the indicators to measure the effectiveness of nursing interventions in clinical practice and research


Asunto(s)
Humanos , Evaluación de Síntomas/estadística & datos numéricos , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/terapia , Cuidados Paliativos/métodos , Evaluación de Síntomas/instrumentación , Técnica Delfos , Evaluación de Resultados de Intervenciones Terapéuticas
10.
Rech Soins Infirm ; (141): 38-48, 2020 06.
Artículo en Francés | MEDLINE | ID: mdl-32988188

RESUMEN

Heart failure is one of the most common reasons for hospitalization in older people, and the hospital-to-home transition can be unsuccessful for these patients. Existing care programs focus primarily on the physiological aspects of the disease and are rarely based on theory. Using Roy's adaptation model (1), the aim of this study was to develop a thorough understanding of the adaptation difficulties and factors that influence how well elderly patients with chronic heart failure cope with the hospital-to-home transition, in order to develop a nursing interventions program. Based on the process proposed by Sidani and Braden (2011), this qualitative descriptive study adopted a deductive approach, with the use of intermediary theories and empirical data, as well as an inductive approach, where older people with chronic heart failure (n=7), caregivers (n=6), and healthcare professionals (n=14) participated in semi-structured individual interviews. The triangulation of data highlights the difficulties and factors influencing adaptation at the physical, psychological, and social levels. Gaining a better understanding of the experience of older people with heart failure when it comes to their transition from hospital to home, and doing so with a holistic vision, provides information for interventions that can contribute to better management of chronic disease and a better quality of life for these elderly patients.


Asunto(s)
Adaptación Psicológica , Insuficiencia Cardíaca/enfermería , Insuficiencia Cardíaca/psicología , Transferencia de Pacientes , Anciano , Enfermedad Crónica , Humanos , Teoría Psicológica
11.
G Ital Cardiol (Rome) ; 21(10): 750-756, 2020 Oct.
Artículo en Italiano | MEDLINE | ID: mdl-32968307

RESUMEN

BACKGROUND: During the COVID-19 pandemic, non-urgent outpatient activities were temporarily suspended. The aim of this study was to assess the impact of this measure on the management of the heart failure outpatient clinic at our institution. METHODS: We analyzed the clinical outcome of 110 chronic heart failure patients (mean age 73 ± 9 years) whose follow-up visit had been delayed. RESULTS: At their last visit before the lockdown, 80.9% was in NYHA class II, had an ejection fraction of 37 ± 7%, and B-type natriuretic peptide level was moderately elevated (266 ± 138 pg/ml). All patients received loop diuretics, 97.2% beta-blockers, 64.9% an aldosterone antagonist, 60.9% sacubitril/valsartan (S/V), and 72.2% of the remaining patients were on angiotensin-converting enzyme inhibitor or valsartan therapy. Patients were contacted by phone during and at the end of the lockdown period to fix a new appointment and underwent a structured interview to assess their clinical conditions and ongoing therapy and to verify whether they had contracted SARS-CoV-2 infection. Twelve patients (13.2%) contracted COVID-19. None was hospitalized for worsening heart failure or reported defibrillator shocks and none changed autonomously the prescribed therapy. Overall, 75% of patients reported stable or improved general well-being from the last in-person visit, while 25% described subjective worsening due to the social effect of the pandemic. Unchanged body weight and blood pressure values were reported by 86% and 78.4% of patients, respectively. Lower blood pressure values compared to baseline were recorded in 15.2% of patients on conventional renin-angiotensin system inhibition vs 21% of those on S/V, one of whom had to down-titrate S/V for persistent but asymptomatic hypotension; 4 patients up-titrated S/V to 200 mg/day following phone indications. CONCLUSIONS: Cancellation of scheduled follow-up visits during 3 months did not have significant negative effects in a cohort of stable patients with chronic heart failure on optimized medical therapy. Telephone support was effective in keeping connections with the patients during the lockdown, allowing appropriate management and implementation of drug therapy. In particular, patients who received S/V were not affected by delays in scheduled visits, confirming the tolerability and safety of this novel therapy in terms of both clinical and biohumoral parameters.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Insuficiencia Cardíaca/tratamiento farmacológico , Neumonía Viral/epidemiología , Cuarentena , Antagonistas Adrenérgicos beta/uso terapéutico , Anciano , Instituciones de Atención Ambulatoria , Aminobutiratos/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Enfermedad Crónica , Continuidad de la Atención al Paciente/organización & administración , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/psicología , Prestación de Atención de Salud , Progresión de la Enfermedad , Combinación de Medicamentos , Femenino , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/psicología , Humanos , Italia/epidemiología , Masculino , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Péptido Natriurético Encefálico/sangre , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/psicología , Recurrencia , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/uso terapéutico , Volumen Sistólico , Teléfono , Tetrazoles/uso terapéutico , Privación de Tratamiento
12.
Medicine (Baltimore) ; 99(33): e21746, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-32872064

RESUMEN

Current study was to evaluate the effectiveness of nurse-led program in improving mental health status (MHS) and quality of life (QOL) in chronic heart failure (CHF) patients after an acute exacerbation. CHF patients were enrolled after informed consent was obtained and were assigned into the control and treatment group. Patients in the control group received standard care. In the treatment group, patients received standard care plus telehealth intervention including inquiring patients medical condition, providing feedbacks, counseling patients, and having positive and emotional talk with patients. At the third and sixth month after discharge, participants were called by registered nurses to assess Mental Health Inventory-5 (MHI-5) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. Compared to the treatment group, patients in the control group were less likely to have educational attainment ≥ high school degree and have a married status, but were more likely to have diabetes. No significant differences in MHI-5 (68.5 ±â€Š12.7 vs 66.9 ±â€Š10.4) and KCCQ (70.6 ±â€Š12.2 vs 68.7 ±â€Š10.9) scores at baseline between the control and treatment groups were observed. There were significantly differences in MHI-5 (72.7 ±â€Š15.6 vs 65.2 ±â€Š11.4) and KCCQ score (74.2 ±â€Š14.9 vs 66.4 ±â€Š12.1) at 3 months follow-up between control and treatment groups. Nonetheless, at 6 months follow-up, although MHI-5 and KCCQ scores remained higher in the treatment group, there were no statistically significant differences (MHI-5: 65.4 ±â€Š12.8 vs 61.4 ±â€Š10.0; KCCQ: 65.1 ±â€Š12.3 vs 61.9 ±â€Š10.3). After multivariate regression analysis, not receiving nurse-led program were significantly associated with reduced MHI-5 (odds ratio [OR] 1.25% and 95% confidence interval [CI]: 1.14-1.60) and KCCQ (OR: 1.20% and 95% CI:1.11-1.54) scores. Nurse-led program is helpful to improve MHS and QOL in CHF patients after an acute exacerbation. However, these achievements are attenuated quickly after the nurse-led intervention discontinuation.


Asunto(s)
Insuficiencia Cardíaca/enfermería , Servicios de Salud Mental/estadística & datos numéricos , Adulto , Anciano , Enfermedad Crónica , Progresión de la Enfermedad , Femenino , Insuficiencia Cardíaca/psicología , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Calidad de Vida
14.
Health Qual Life Outcomes ; 18(1): 262, 2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32746842

RESUMEN

BACKGROUND: Empirical identification of the direct impact of hospitalisation in the change in utility could provide an interpretation for some of the unexplained variance in quality of life responses in clinical practice and clinical trials and provide assistance to researchers in assessing the impact of a hospitalisation in the context of economic evaluations. This study had the goal of determining the impact of nonfatal hospitalisations on the quality of life of a cohort of patients previously diagnosed with heart failure by using their quality of life measurements before and after hospitalisation. METHODS: The impact of hospitalisation on health-related quality of life was estimated by calculating the difference in utility measured using the EQ-5D-3L in patients that were hospitalised and had records of utility before and after hospitalisation. The variation in differences between the utilities pre and post hospitalisation was explained through two multiple linear regression models using (1) the individual patient characteristics and (2) the hospitalisation characteristics as explanatory variables. RESULTS: The mean difference between health-related quality of life measurement pre and post hospitalisation was found to be 0.020 [95% CI: - 0.020, 0.059] when measured with the EQ-5D index, while there was a mean decrease of - 0.012 [95% CI: - 0.043, 0.020] in the utility measured with the visual analogue scale. Differences in utility variation according to the primary cause for hospitalisation were found. Regression models showed a statistically significant impact of body mass index and serum creatinine in the index utility differences and of serum creatinine for utilities measured with the visual analogue scale. CONCLUSIONS: Knowing the impact of hospitalisation on health-related quality of life is particularly relevant for informing cost-effectiveness studies designed to assess health technologies aimed at reducing hospital admissions. Through using patient-level data it was possible to estimate the variation in utilities before and after the average hospitalisation and for hospitalisations due to the most common causes for hospital admission. These estimates for (dis) utility could be used in the calculations of effectiveness on economic evaluations, especially when discrete event simulations are the employed modelling technique.


Asunto(s)
Insuficiencia Cardíaca/psicología , Hospitalización , Calidad de Vida , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Análisis Costo-Beneficio/métodos , Femenino , Insuficiencia Cardíaca/economía , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
15.
Medicine (Baltimore) ; 99(27): e21062, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32629734

RESUMEN

BACKGROUND: The benefits of high-intensity interval training (HIIT) are well-known, there is insufficient evidence about the effects of HIIT on heart failure with preserved ejection fraction (HFpEF). METHOD: Multiple databases include MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, PEDro, Cochrane Library, and Google Scholar are used to search for randomized controlled trials investigating the effects of HIIT on HFpEF. All related articles published with the English language with no time limitation will be included. Two reviews independently conducted the selection, data extraction, and quality assessment. The primary outcome is exercise capacity. The secondary outcomes include quality of life (QoL), blood pressure (BP), ventricular function, and left ventricular diastolic function, symptom improvement, endothelial function, and arterial stiffness. Data analysis is performed with Review Manager Software (Version 5.3). RESULT: This systematic review and meta-analysis aim to evaluate the efficacy of HIIT on HFpEF, its outcome will provide reliable evidence for future studies. CONCLUSION: The findings of this study will be published in a related peer-reviewed journal. REGISTRATION NUMBER: INPLASY202050097.


Asunto(s)
Insuficiencia Cardíaca/rehabilitación , Entrenamiento de Intervalos de Alta Intensidad/métodos , Volumen Sistólico/fisiología , Presión Sanguínea/fisiología , Diástole/fisiología , Endotelio Vascular/fisiología , Estudios de Evaluación como Asunto , Tolerancia al Ejercicio/fisiología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/psicología , Humanos , Calidad de Vida/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto , Rigidez Vascular/fisiología , Función Ventricular Izquierda/fisiología
18.
Internist (Berl) ; 61(9): 929-938, 2020 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-32666209

RESUMEN

Approximately 40% of patients with heart failure show cognitive deficits, such as concentration difficulties, attention deficits, and memory impairment. Affected patients have a higher rate of rehospitalization and an increased mortality. This could be due to low adherence mediated by a lack of disease-specific knowledge and strategies to deal with symptom exacerbation. The pathogenesis of cognitive deficits in heart failure is multifactorial. In this respect the heart failure itself as well as cardiovascular risk factors and comorbidities play a role. Orientating neuropsychological screening tests can show a first indication of the presence of cognitive impairment. When identified, the causes can be specifically treated and care can be optimized through certain measures, such as the involvement of caregivers and healthcare providers.


Asunto(s)
Trastornos del Conocimiento/etiología , Disfunción Cognitiva/etiología , Insuficiencia Cardíaca/complicaciones , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/psicología , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Comorbilidad , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/psicología , Humanos , Cumplimiento de la Medicación , Pruebas Neuropsicológicas
19.
Health Qual Life Outcomes ; 18(1): 238, 2020 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-32682424

RESUMEN

BACKGROUND: Persons identifying as Black, Chinese, or South Asian make up the largest minority groups in Canada. Individuals with chronic heart failure (CHF) from these groups experience a greater rate of re-hospitalization and poorer quality of life. Although experts agree that culture can shape the experience of CHF, little is known about how patients from these minority populations define a good quality of life with CHF and what barriers they experience when carrying out self-care behaviours. The aim of this qualitative study was to examine cultural and gender-based influences on quality of life in patients with CHF. METHODS: Purposive sampling included 30 patients (67% male), 18 to 75 years of age, who self-identified as Black (n = 8), Chinese (n = 9), or South Asian (n = 6). Caucasians (n = 7) were included as a comparison group. Semi-structured interviews (see the online appendix), lasting approximately 60 min, were conducted, which focused on personal understanding of CHF and living with the disease, including impact on lifestyle and quality of life. An inductive qualitative approach with thematic content analysis was used to develop key insights into individual experience of CHF, as well as cultural and gender-based influences on self-care and quality of life. Descriptive statistics were generated from questionnaire responses. RESULTS: Five key themes emerged from the narrative analysis of participant interviews: (i) CHF as an emergent reality, (ii) quality of life and disruption of lifecourse milestones, (iii) the challenge to accept CHF and re-evaluation of quality of life; (iv) impact on social activities essential to quality of life, and (v) life with CHF as a commitment to culturally tailored self-care. Participants described the unique impact of CHF on their quality of life, including life trajectory milestones such as dating, parenting, and retirement planning, as well as the importance of accepting their diagnosis, and the reframing goals for living well with heart failure. Positive and negative impacts on social relationships were noted, including sexual intimacy and interactions with spouses, other family members, and co-workers. CONCLUSIONS: Study findings highlight important lifespan, cultural, and gender considerations that can inform the improvement of patient care and quality of life for patients and their families.


Asunto(s)
Adaptación Fisiológica , Insuficiencia Cardíaca/psicología , Canadá , Enfermedad Crónica/psicología , Asistencia Sanitaria Culturalmente Competente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Autocuidado/psicología , Factores Sexuales
20.
Health Qual Life Outcomes ; 18(1): 236, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32680513

RESUMEN

BACKGROUND: Heart failure is a worldwide health problem that significantly affects patients' physical function and health state. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a disease-specific patient-reported outcome measure commonly used for the assessment of health states of patients with heart failure. This study aimed to evaluate the psychometric properties of the Japanese version of the KCCQ. METHODS: Using pooled data of 141 Japanese patients with chronic heart failure from three clinical trials, the Japanese version of the KCCQ was evaluated for validity and reliability, with a focus on the clinical summary score (CSS) and its component domains. For construct validity, the associations of baseline KCCQ scores with New York Heart Association (NYHA) class and the EuroQol five-dimension, three-level (EQ-5D-3L) scores at baseline were analyzed. For reliability, internal consistency was assessed using Cronbach's α, and test-retest reliability (reproducibility) was assessed among stable patients. Responsiveness to changes in patients' clinical status was assessed by analyzing score changes between two timepoints among patients whose health states improved. RESULTS: Among 141 patients (mean age, 73.7 ± 10.9 years), 76.6% were NYHA class II at baseline. For CSS and its component domains (physical limitations, symptom frequency, and symptom severity), baseline scores were all significantly lower in patients with a higher NYHA class (p <  0.001 for all, Jonckheere-Terpstra test). The physical limitations domain and CSS showed a moderate correlation (Spearman's ρ = - 0.40 to - 0.54) with three functional status-related EQ-5D dimensions (mobility, self-care, and usual activities). The Cronbach's standardized α was high (> 0.70) for all KCCQ domain/summary scores. In the test-retest analysis among 58 stable patients, all domain/summary scores minimally changed by 0.3-4.2 points with intraclass correlation coefficients of 0.65-0.84, demonstrating moderate to good reproducibility, except for the symptom stability domain. Among 44 patients with improved health states, all domain/summary scores except for the symptom stability and self-efficacy domains substantially improved from baseline with a medium to large effect size of 0.62-0.88. CONCLUSIONS: The Japanese version of the KCCQ was demonstrated to be a valid and reliable tool for the assessment of symptoms and physical function of Japanese patients with chronic heart failure.


Asunto(s)
Insuficiencia Cardíaca/psicología , Calidad de Vida , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/psicología , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Reproducibilidad de los Resultados
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