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1.
Br J Community Nurs ; 25(4): 206, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32267763
2.
Nurs Older People ; 31(6): 28-32, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31778064

RESUMO

The role of the community matron in supporting patients with long-term conditions through holistic case management is well established, as is learning through critical reflection and using case studies for continuing professional development. This article draws on a case study to provide a critical analysis of the community matron service, which offers intervention and case management for a patient who had been diagnosed with heart failure.


Assuntos
Administração de Caso/organização & administração , Enfermagem em Saúde Comunitária , Insuficiência Cardíaca/enfermagem , Papel do Profissional de Enfermagem , Idoso , Humanos , Masculino
3.
Medicine (Baltimore) ; 98(41): e17351, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593085

RESUMO

BACKGROUND: This study will assess the effects of high quality nursing care (HQNC) on psychological outcomes (PCO) in patients with chronic heart failure (CHF). METHODS: We will carry out a through search in 7 databases: PUBMED, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WANGFANG, and China National Knowledge Infrastructure. Eligibility criteria will be randomized controlled trials on assessing effects of HQNC on PCO in patients with CHF. Cochrane risk of bias evaluation will be utilized for methodological quality. RESULTS: This proposed study will summarize a rational synthesis of current evidence for HQNC on PCO in patients with CHF. CONCLUSION: The results of this study will provide convinced evidence for judging the effects of HQNC on PCO in patients with CHF.


Assuntos
Insuficiência Cardíaca/enfermagem , Insuficiência Cardíaca/psicologia , Cuidados de Enfermagem/psicologia , Cuidados de Enfermagem/normas , Qualidade da Assistência à Saúde , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1340-1346, out.-dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022135

RESUMO

Objective: The study's purpose has been to assess the main limitations reported by heart failure bearing patients. Methods: It is a secondary analysis of an exploratory study with a qualitative approach. This study was performed with 15 patients with heart failure, out of the 167 undergoing ambulatory care, and over the period from March to July 2011. The collection of primary data was based on semi-structured interviews with subsequent analysis according to the Bardin's perspective. The secondary analysis was performed according to the retrospective interpretation strategy. Results: There were female predominance (73.3%); incomplete elementary school (80.2%); hypertensive patients (80.2%); dyslipidemic patients (53.4%); and diabetics patients (33.3%). Concerning the daily limitations, the following stand out: impaired walking, precarious sleep pattern, fatigue, dyspnea, loss of autonomy, dependence on others, poor sleep pattern, low sexual activity. Conclusion: By taking into consideration the heart failure, a chronic disease, it is fundamental for nurses to look for guidelines and strategies that are able to develop the capacity for self-care, prevention and health promotion


Objetivo: Analisar as principais limitações relatadas por pacientes com insuficiência cardíaca. Método: análise secundária de um estudo exploratório, de abordagem qualitativa, realizado com 15 pacientes portadores de insuficiência cardíaca no período de março a julho de 2011, dentre os 167 em atendimento ambulatorial. A coleta de dados primários deu-se a partir de uma entrevista semi-estruturada, com posterior análise de Bardin, e para presente análise secundária foi utilizada como estratégia a interpretação retrospectiva. Resultados: predominância do sexo feminino (73,3%); ensino fundamental incompleto (80,2%); hipertensos (80,2%); dislipidêmicos (53,4%); diabéticos (33,3%). Quanto às limitações no cotidiano, destacam-se: deambulação prejudicada, padrão de sono precário, fadiga, dispneia, perda de autonomia, dependência de terceiros, padrão de sono precário, baixa frequência da atividade sexual. Conclusão: na insuficiência cardíaca, uma doença crônica, é fundamental que o enfermeiro busque por orientações e estratégias, as quais possam desenvolver a capacidade de autocuidado, prevenção e promoção da saúde


Objetivo: Analizar las principales limitaciones relatadas por pacientes con insuficiencia cardiaca. Método: análisis secundario de un estudio exploratorio, de abordaje cualitativo, realizado con 15 pacientes portadores de insuficiencia cardíaca en el período de marzo a julio de 2011, entre los 167 en atención ambulatoria. La recolección de datos primarios se dio a partir de una entrevista semiestructurada, con posterior análisis de Bardin, y para el presente análisis secundario se utilizó como estrategia la interpretación retrospectiva. Resultados: predominio del sexo femenino (73,3%); educación básica incompleta (80,2%); hipertensos (80,2%); dislipidémicos (53,4%); diabéticos (33,3%). En cuanto a las limitaciones en el cotidiano, se destacan: deambulación perjudicada, patrón de sueño precario, fatiga, disnea, pérdida de autonomía, dependencia de terceros, patrón de sueño precario, baja frecuencia de la actividad sexual. Conclusión: en la insuficiencia cardíaca, una enfermedad crónica, es fundamental que el enfermero busque orientaciones y estrategias, que puedan desarrollar la capacidad de autocuidado, prevención y promoción de la salud


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Autocuidado/instrumentação , Insuficiência Cardíaca/enfermagem , Insuficiência Cardíaca/prevenção & controle , Promoção da Saúde
5.
Metas enferm ; 22(7): 65-71, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184101

RESUMO

La función cardiaca y la función renal están íntimamente asociadas, ya que el corazón y los riñones llevan a cabo la regulación hemodinámica del organismo. Cuando se producen alteraciones de forma bidireccional en ambos órganos se activa una serie de mecanismos compensadores que provocan un efecto nocivo de uno de ellos sobre el otro. Es lo que se conoce como síndrome cardiorrenal. Actualmente se dispone de protocolos de Enfermería estandarizados para el manejo de la insuficiencia cardiaca y para la insuficiencia renal; no obstante, es necesario ampliar la información para entender de forma óptima la relación cardiorrenal y aplicar la mejor evidencia científica a los cuidados. Por ello se expone un caso clínico abordado desde Atención Primaria, con el desarrollo de un plan de cuidados elaborado una vez identificados los diagnósticos de Enfermería que se han derivado de la valoración enfermera siguiendo el modelo de las 14 necesidades básicas de Virginia Henderson


Cardiac function and renal function are closely related, because the heart and the kidneys carry out the hemodynamic regulation of the body. When there are bidirectional alterations in both organs, a series of compensating mechanisms are activated, which cause harmful effects of one over the other. This is known as Cardiorenal Syndrome. There are current standard Nursing protocols available for the management of heart failure and renal impairment; however, it is necessary to increase information for an optimal understanding of the cardiorenal interaction, and to apply the best scientific evidence into care. To this aim, we present a case record addressed at Primary Care, with the development of a plan of care prepared after the Nursing diagnoses were identified, derived from nursing assessment following the model of the 14 Basic Needs of Virginia Henderson


Assuntos
Humanos , Feminino , Idoso , Cuidados de Enfermagem , Atenção Primária à Saúde/métodos , Síndrome Cardiorrenal/complicações , Síndrome Cardiorrenal/enfermagem , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/enfermagem , Padrão de Cuidado/normas , Nível de Saúde , Atenção Primária à Saúde , Nefropatias/complicações , Cardiopatias/complicações , Implementação de Plano de Saúde/normas , Insuficiência Cardíaca/enfermagem
6.
Transplant Proc ; 51(7): 2492-2494, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31405741

RESUMO

Heart transplantation, one of the treatment options for end-stage heart failure, is still regarded as the gold standard treatment to improve quality and length of life. However, the rapid increase in the number of patients waiting for heart transplantation and the inadequate number of donors makes heart transplantation a less feasible option and increases the need for ventricular assist devices as an alternative. The success of ventricular assist device implantation requires the collaboration of a multidisciplinary team consisting of cardiac surgeons, nurses, ventricular assist device coordinators, cardiologist, cardiac anesthesia specialists, perfusionists, and physiotherapists. Nurses working in different fields such as intensive care units, operating rooms, outpatient clinics, and ventricular assist device coordination units have important responsibilities in multidisciplinary teams. In this study, national and international studies on the responsibilities of nurses for the management and care of ventricular assist devices were reviewed. Nurses undertake many tasks, especially in the postoperative care of patients and in preparing them for discharge. Important responsibilities of nurses in the care of patients with ventricular assist devices include monitoring complications, managing equipment and emergency situations, establishing dressing change protocols, organizing daily life activities, determining rehabilitation needs, ensuring use of medicines, and providing comprehensive discharge education. Organizational and communication skills of nurses working with multidisciplinary teams are very important for the success of the ventricular assist device implantation process.


Assuntos
Insuficiência Cardíaca/enfermagem , Insuficiência Cardíaca/cirurgia , Coração Auxiliar , Equipe de Assistência ao Paciente/organização & administração , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/enfermagem
7.
Home Healthc Now ; 37(4): 190-197, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31274581

RESUMO

The prevalence of chronic heart failure is increasing in the United States due to the increase in the number of older adults and because many people are surviving acute cardiac events and living longer with chronic heart disease. In end-stage heart failure, heart transplant was once the gold standard of treatment and patients had to wait for a matching heart donor. In the past, the left ventricular assist device (LVAD) was a mechanical circulatory support treatment used temporarily for those awaiting heart transplant. However, the LVAD is increasingly becoming the chosen treatment of patients in lieu of heart transplant. Home healthcare nurses and clinicians need to be familiar with LVADs in order to care for patients in end-stage heart failure who are using these devices. This article explains the mechanism, potential complications, and nursing implications of caring for the patient who is using an LVAD.


Assuntos
Insuficiência Cardíaca/terapia , Coração Auxiliar , Doença Crônica/enfermagem , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/enfermagem , Coração Auxiliar/efeitos adversos , Enfermagem Domiciliar , Humanos , Implantação de Prótese/enfermagem
8.
Hu Li Za Zhi ; 66(4): 87-94, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342505

RESUMO

Heart failure is a complicated chronic disease. Although numerous new medications are used to treat and improve the quality of life of patients with heart failure, the final treatment for terminal heart failure still relies heavily on heart transplants. However, as the number of heart donations is limited, many health institutions implant mechanical assist devices to perform heart functions temporarily. These implanted ventricular assist devices help reduce heart failure symptoms and enhance quality of life. However, driveline infection is one of the more severe complications associated with these devices. If this infection is not controlled, another heart surgery will be necessary to replace the device. Severe driveline infection may even lead to patient death. An approach to care that includes driveline wound care standardization and immobilization of the driveline has been shown to effectively decrease the incidence of driveline infections and to increase the survival rate. As Taiwan still lacks the relevant clinical care standards for implantable ventricular assist device support and driveline wound care, this study introduces the relevant Western literature and the author's clinical experience related to driveline wound management. We hope that this article serves as a useful reference for related nursing care.


Assuntos
Insuficiência Cardíaca/terapia , Coração Auxiliar , Infecções Relacionadas à Prótese/prevenção & controle , Desenho de Equipamento , Insuficiência Cardíaca/enfermagem , Coração Auxiliar/efeitos adversos , Humanos , Infecções Relacionadas à Prótese/etiologia , Qualidade de Vida , Taiwan , Fatores de Tempo
9.
J Biol Regul Homeost Agents ; 33(3): 905-910, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31165607

RESUMO

Children with severe pneumonia often have heart failure. This study explored the clinical effect of high quality nursing intervention on children with pneumonia complicated with heart failure. In the study, 96 children with pneumonia complicated with heart failure were selected and randomly divided into a conventional nursing group (n=48) and a high quality nursing group (n=48). Based on the conventional nursing, the children in one group were given high quality nursing, and comprehensive nursing was carried out in aspects such as respiratory tract, medication, psychology and diet. Then, the heart rate, respiratory rate, heart failure correction time, hospitalization time, cost and nursing satisfaction were compared between the two groups. The results showed that the heart rate of the high quality nursing group was 145.37±8.72 times/min and the respiratory rate was 45.65±6.08 times/min, which were significantly lower than those of the conventional nursing group (P less than 0.05). The correction time of heart failure was about 32 h in the high quality nursing group, and the length and cost of hospitalization were significantly lower than those in the conventional nursing group (P less than 0.05). The nursing satisfaction of the patients' family members in the high quality nursing group was also higher (P less than 0.05). This study shows that high quality nursing can promote the recovery of children with pneumonia complicated with heart failure, and is worth popularizing widely in clinics.


Assuntos
Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/enfermagem , Pneumonia/complicações , Pneumonia/enfermagem , Criança , Hospitalização , Humanos
10.
Rev Gaucha Enferm ; 40: e20180057, 2019 Jun 10.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31188982

RESUMO

AIMS: Identify the occurrence of depressive symptoms in family caregivers of patients with heart failure and the correlation of other variables with depressive symptoms. DESIGN/METHOD: The literature review was conducted in the Web of Science, Medline, LILACS and PubMed databases in March 2017. Papers published between 2004 and 2016, written in English, Spanish or Portuguese were included. The descriptors used were health, heart failure, depression, caregivers, and family. RESULTS: 26 papers were selected. 6% to 64% reported depressive symptoms. Depressive symptoms were associated with patients' and caregivers' characteristics. In most cases, depressive symptoms were greater among family caregivers than in the general population and were mainly associated with care burden and quality of life. CONCLUSIONS: The studies report depressive symptoms in caregivers of patients with heart failure.


Assuntos
Cuidadores/psicologia , Depressão/diagnóstico , Família/psicologia , Insuficiência Cardíaca/enfermagem , Adulto , Idoso , Lista de Checagem , Efeitos Psicossociais da Doença , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Jpn J Nurs Sci ; 16(4): 459-467, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31161722

RESUMO

AIM: Heart failure is a progressive, debilitating disease with exacerbated physical and psychological symptoms that reduces the quality of life of patients. Nursing intervention based on nursing theories could help in the adaptation of patients to the disease and improving quality of life. The aim of this study was to determine the effect of an educational program based on Roy's adaptation model on the quality of life of patients with heart failure. METHODS AND MATERIAL: In this randomized controlled trial, 76 patients with heart failure were allocated to either the intervention or control group through a blocked randomization method. The data were collected between May and October 2017. The intervention group received oral and written educational programs for 4 weeks. Minnesota quality-of-life questionnaire and Roy's adaptation model-based evaluation form was completed at the beginning of the trial, and 1 month after the completion of the study. RESULTS: Intervention patients showed statistically significantly improved scores on the physiologic, role function, independence-interdependence dimensions and the total score of Roy's adaptation model over time compared with control patients (p < .05). The mean score of all of the three quality-of-life dimensions and total score of quality of life increased significantly (p < .05). CONCLUSION: The study results help nursing staff detect the stimuli and the behaviors of patients with heart failure. Roy's adaptation model can be used as a standard practice to increase adaptation to the disease and improving quality of life.


Assuntos
Adaptação Psicológica , Insuficiência Cardíaca/fisiopatologia , Educação de Pacientes como Assunto , Qualidade de Vida , Feminino , Insuficiência Cardíaca/enfermagem , Humanos , Masculino , Relações Enfermeiro-Paciente , Inquéritos e Questionários
12.
Med. clín (Ed. impr.) ; 152(11): 431-437, jun. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-183903

RESUMO

Background and objective: Several trials have evaluated the effect of disease management programs in heart failure (HF) with diverse results. The aim of this study was to develop a simple nurse-led clinic intervention program for patients with HF and assess whether this intervention positively affects the prognosis of patients, their care costs and perceived quality of life (QoL). Methods: Between 2011 and 2013, 127 patients with reduced ejection fraction were prospectively randomly allocated (1:2) to standard care or intervention program. Primary composite endpoint was all-cause mortality and hospital readmissions. Secondary endpoints were all-cause mortality, all-cause hospital readmissions, readmissions for HF, time to first readmission and QoL improvements assessed by "Minnesota Living with Heart Failure Questionnaire" (MLHFQ). An intention-to-treat analysis was performed. Results: After a median follow-up of 2-years, no differences were found in the primary composite endpoint. Likewise, there were no differences between groups in the predefined secondary endpoints of mortality and readmissions from any cause. However, in the intervention group, readmissions for HF were significantly reduced (35% vs. 18%; p=0.04) and QoL significantly improved (MLHFQ±SD: 2.29±14 vs. 10.9±14.75; p=0.04). Conclusions: In patients with HF, the use of a nurse-led intervention program significantly improves perceived QoL and reduce HF hospital readmissions


Introducción y objetivos: Se han publicado múltiples ensayos sobre programas de gestión de enfermedades en la insuficiencia cardiaca (IC) con resultados muy heterogéneos. El objetivo de este estudio fue desarrollar un sencillo programa de intervención clínica dirigido por enfermería en pacientes con IC y evaluar si dicha intervención afecta positivamente sobre el pronóstico de los pacientes, sus costes de atención y la calidad de vida percibida. Métodos: Entre 2011 y 2013, 127 pacientes con fracción de eyección reducida fueron aleatorizados (1:2) a manejo estándar o al programa de intervención. El objetivo primario compuesto fue mortalidad y reingresos hospitalarios por cualquier causa. Los criterios de valoración secundarios fueron mortalidad por cualquier causa, reingresos hospitalarios por cualquier causa, reingresos hospitalarios por IC, tiempo hasta el primer ingreso y mejoría de la calidad de vida evaluado por el Minnesota Living with Heart Failure Questionnaire (MLHFQ). Resultados: Tras un seguimiento medio de 2 años, no se encontraron diferencias en el criterio de valoración compuesto primario. Igualmente, no hubo diferencias en la mortalidad o los reingresos por cualquier causa. Sin embargo, en el grupo de intervención, los reingresos por IC se redujeron (35 vs. 18%; p=0,04) y la calidad de vida percibida mejoró de forma significativa (MLHFQ±DE: 2,29±14 vs. 10,9±14,75; p=0,04). Conclusiones: En los pacientes con IC, el empleo de un programa de intervención dirigido por enfermería mejora significativamente la calidad de vida percibida y reduce los reingresos hospitalarios por IC


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/enfermagem , Qualidade de Vida , Prognóstico , Seguimentos
13.
Home Healthc Now ; 37(3): 152-157, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31058733

RESUMO

The purpose of this study was to determine if the timing of home care visits post hospitalization for heart failure influenced hospital readmission rates. Using a randomized control study design, hospital readmission data were collected from 67 recently discharged patients with heart failure. The control group (n = 32) received the usual care, whereas the intervention group (n = 35) received an altered scheduling of home care visits. Seven study participants were readmitted during the study time frame (control group n = 3; intervention group n = 4). Emergency room visits occurred three times (control group n = 1; intervention group n = 2). The timing of the home healthcare visit did not affect hospital readmission. Adherence to weight monitoring, fluid restriction, and medication administration improved with the home care visits. Greater attention to these activities should be the focus of home healthcare visits as they may decrease hospital readmissions.


Assuntos
Insuficiência Cardíaca/enfermagem , Serviços de Assistência Domiciliar , Readmissão do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
14.
Rural Remote Health ; 19(2): 5270, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31113205

RESUMO

INTRODUCTION: Patient self-management skills are an important part of heart failure (HF) management. However, there is a lack of knowledge about the effectiveness of nurse-led education on patient self-management and the associated clinical outcomes of rural Chinese patients with chronic heart failure (CHF). As such, this study was designed to evaluate the impact of a nurse-led education program on patient self-management and hospital readmissions in rural Chinese patients with CHF. METHODS: Ninety-six patients in the eastern Chinese province of Shandong with CHF were randomly divided into intervention and control groups. A structured education program was delivered to the intervention group during hospitalization and after discharge. Control group patients were managed as per clinical guidelines without structured education. Medication adherence, dietary modifications, social support, and symptom control were assessed 12 months after the educational intervention. RESULTS: The mean score of medication adherence, dietary modifications, social support and symptom control in the intervention group was higher than in the control group at the end of the study (p<0.01). The readmission rates for HF in the intervention and control group were 10.4% and 27.1%, respectively (p=0.036). CONCLUSIONS: This study has demonstrated that a structured education program was associated with a significant improvement in medication adherence, dietary modifications, social support, and symptom control in rural CHF patients. Furthermore, this program was associated with a significant reduction in hospital readmission. This study indicates that implementation of a nurse-led education program improves self-management and clinical outcomes of rural CHF patients, who may not have regular access to cardiac management services as per metropolitan populations.


Assuntos
Insuficiência Cardíaca/enfermagem , Educação de Pacientes como Assunto/métodos , Readmissão do Paciente/estatística & dados numéricos , Autogestão/métodos , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente
15.
Rev Gaucha Enferm ; 40(spe): e20180344, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31038607

RESUMO

OBJECTIVE: To report the role of multiprofessional teams in the effective communication and safe care of patients with left ventricular assist device. METHODS: This is an experience report about the use of effective communication for patients with ventricular assist device in a university hospital in southern Brazil. Care based on individualized action and centered on the patients started in 2017. RESULTS: At the institution, the multiprofessional teams attended training sessions and care protocols were established. The patients and caregivers attended systematic educational sessions and home visits were made to arrange patient discharge and urgency plans. Also, the hospital teams located near the patients' homes received basic training. CONCLUSION: Effective communication between multiprofessional teams, patients, and their families when planning care plays a pivotal role in the early identification of possible complications and their prevention, resulting in a greater survival rate and a better quality of life.


Assuntos
Coração Auxiliar , Comunicação Interdisciplinar , Assistência Ambulatorial , Brasil , Cuidadores/educação , Feminino , Pessoal de Saúde/educação , Insuficiência Cardíaca/enfermagem , Insuficiência Cardíaca/psicologia , Insuficiência Cardíaca/terapia , Hospitais Universitários , Visita Domiciliar , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Educação de Pacientes como Assunto , Assistência Centrada no Paciente , Relações Profissional-Família , Relações Profissional-Paciente , Qualidade de Vida
16.
Rev Lat Am Enfermagem ; 27: e3137, 2019 Apr 29.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31038631

RESUMO

OBJECTIVE: to identify which clinical features of heart failure are associated with a greater chance of functional dependence for the basic activities of daily living in hospitalized elderly. METHOD: cross-sectional study conducted with elderly hospitalized patients. The clinical characteristics of heart failure were assessed by self-report, medical records and scales. Dependency was assessed by the Katz Index. The Fisher's Exact Test was used to analyze associations between the nominal variables, and logistic regression to identify factors associated with dependence. RESULTS: the sample consisted of 191 cases. The prevalence of functional dependence was 70.2%. Most of the elderly were partially dependent (66.6%). Clinical characteristics associated with dependence at admission were dyspnea (Odds Ratio 8.5, Confidence Interval 95% 2.668-27.664, p <0.001), lower limb edema (Odds Ratio 5.7, 95% Confidence Interval 2.148-15.571, p <0.001); cough (Odds Ratio 9.0, 95% confidence interval 1.053-76.938, p <0.045); precordial pain (Odds Ratio 4.5, 95% confidence interval 1.125-18.023, p <0.033), and pulmonary crackling (Odds Ratio 4.9, 95% Confidence Interval 1.704-14.094, p <0.003). CONCLUSION: functional dependence in admitted elderly patients with heart failure is more associated with congestive signs and symptoms.


Assuntos
Atividades Cotidianas , Insuficiência Cardíaca/terapia , Hospitalização/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Dispneia , Feminino , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
17.
Br J Nurs ; 28(10): 653, 2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31116600

RESUMO

Aysha Mendes, Editor, British Journal of Cardiac Nursing, begins a series on cardiology with a look at attitudes to and guidelines on providing end-of-life care for people with heart failure.


Assuntos
Insuficiência Cardíaca/enfermagem , Assistência Terminal , Atitude Frente a Saúde , Acesso aos Serviços de Saúde , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Humanos , Pesquisa em Avaliação de Enfermagem , Guias de Prática Clínica como Assunto
18.
Crit Care Nurse ; 39(2): 15-28, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30936128

RESUMO

INTRODUCTION: Only a few cases of biventricular cardiogenic shock have been treated with Impella circulatory assist devices in the United States. CLINICAL FINDINGS: A 29-year-old man came to the emergency department because of cough, shortness of breath, fever, and chills. Initial assessment revealed hypotension; an elevated creatinine level of 2.1 mg/dL; and markedly elevated results on liver function tests, with alanine transaminase 5228 IU/L and aspartate aminotransferase 6200 IU/L. The patient's signs and symptoms met criteria for New York Heart Association class IV heart failure and associated poor prognosis for recovery. DIAGNOSIS: Echocardiography revealed dilated cardiomyopathy and biventricular failure with an ejection fraction of 15%. Results of an endomyocardial biopsy confirmed the diagnosis of myocarditis. INTERVENTIONS: After unsuccessful treatment with inotropes, biventricular support was started with an Impella CP device in the left ventricle and an Impella RP device in the pulmonary artery. OUTCOMES: The patient was maintained on support for 8 days and was discharged to home from the hospital after 27 days. Repeat echocardiography 90 days after discharge indicated improvement in ejection fraction to 40%. At follow-up 16 weeks after discharge, all signs and symptoms of heart failure had resolved. The patient has not had any inpatient readmissions to the hospital to date. CONCLUSION: This case presents an opportunity for analysis of care activities and role responsibilities of bedside nurses in caring for this patient. Discussion of this case expands the literature describing nursing activities associated with caring for patients with Impella devices.


Assuntos
Dispositivos de Terapia de Ressincronização Cardíaca , Enfermagem de Cuidados Críticos/normas , Insuficiência Cardíaca/enfermagem , Ventrículos do Coração/fisiopatologia , Guias de Prática Clínica como Assunto , Artéria Pulmonar/fisiopatologia , Choque Cardiogênico/enfermagem , Administração Cutânea , Adulto , Educação Continuada em Enfermagem , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos
19.
Crit Care Nurse ; 39(2): 45-52, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30936130

RESUMO

Transplant cardiologists in our hospital have performed the percutaneously placed axillary-subclavian intra-aortic balloon pump procedure since 2007. This procedure allows patients to mobilize and walk while they wait for a heart transplant, rather than remaining on bed rest as they would with a traditional femoral intra-aortic balloon pump. This procedure has presented challenges to the nursing staff. A 2007 literature search revealed no precedent or published nursing articles on this subject. This article reviews heart failure, medical treatments, complications of bed rest associated with the femoral intra-aortic balloon pump, the nursing challenges and unique problems of caring for patients with percutaneously placed axillary-subclavian intra-aortic balloon pumps, and our solutions for those challenges.


Assuntos
Assistência Ambulatorial/normas , Enfermagem de Cuidados Críticos/normas , Insuficiência Cardíaca/enfermagem , Transplante de Coração/normas , Balão Intra-Aórtico/enfermagem , Guias de Prática Clínica como Assunto , Cuidados Pré-Operatórios/normas , Coração Auxiliar , Humanos
20.
Crit Care Nurse ; 39(2): 85-93, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30936132

RESUMO

Despite improvements in heart failure therapies, hospitalization readmission rates remain high. Nationally, increasing attention has been directed toward reducing readmission rates and thus identifying patients with the highest risk for readmission. This article summarizes the evidence related to decreasing readmission for patients with heart failure within 30 days after discharge, focusing on the acute setting. Each patient requires an individualized plan for successful transition from hospital to home and preventing readmission. Nurses must review the patient's current plan of care and adherence to it and look for clues to failure of the plan that could lead to readmission to the hospital. In addition, nurses must reassess the current plan with the patient and family to ensure that the plan continues to meet the patient's needs. Finally, nurses must continually reeducate patients about their plan of care, their plan for self-management, and strategies to prevent hospital readmission for heart failure.


Assuntos
Enfermagem de Cuidados Críticos/normas , Insuficiência Cardíaca/enfermagem , Alta do Paciente/normas , Educação de Pacientes como Assunto , Readmissão do Paciente/normas , Medição de Risco/normas , Autogestão/educação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Medição de Risco/estatística & dados numéricos
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