Self-care behaviors among patients with heart failure.
ABSTRACT One way to prevent frequent hospitalizations and promote positive health outcomes among patients with heart failure (HF) is to ensure that the amount and quality of self-care used is appropriate to the patient's situation.
The following are the purposes of this study: (a) examine the frequency of performance of self-care behaviors, (b) describe personal and environmental factors (basic conditioning factors [BCFs]) that affect self-care behaviors, and (c) describe the relationship between the level of knowledge patients have to empower their performance of self-care and the actual performance of self-care behaviors.
This descriptive correlational study was guided by Orem's theory of self-care. One hundred ten participants, predominantly African Americans, who were outpatients or inpatients ready for hospital discharge, 18 years or older, and diagnosed with HF that was confirmed by an ejection fraction of 40% or less were conveniently selected from 1 of 2 sites. Data were collected with 2 investigator-developed instruments: the Revised Heart Failure Self-Care Behavior Scale and the Heart Failure Knowledge Test. Descriptive statistics, correlational analyses, and t tests for independent samples were used to analyze the data.
Three of the top 5 most frequently performed self-care behaviors were related to taking prescribed medications, and the 5 least frequently performed self-care behaviors were concerned with symptom monitoring or management. There were no significant relationships between the total self-care behavior score and any of the BCFs; however, a number of significant relationships between BCFs and individual self-care behaviors were observed. There was a significant relationship between the mean total knowledge score and the total mean self-care score (r = 0.21, P =.026).
Detailed information about the influence of BCFs on the performance of specific HF self-care behaviors can help nurses tailor interventions to the patient's situation.
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ABSTRACT: Weight monitoring is an important element of HF self-care, yet the most clinically meaningful way to evaluate weight monitoring adherence is uncertain. We conducted this study to evaluate the association of (1) self-reported recall and (2) daily diary-recorded weight monitoring adherence with heart failure-related (HF-related) hospitalization. We conducted a prospective cohort study among 216 patients within a randomized trial of HF self-care training. All patients had an initial self-care training session followed by 15 calls (median) to reinforce educational material; patients were also given digital scales, instructed to weigh daily, record weights in a diary, and mail diaries back monthly. Weight monitoring adherence was assessed with a self-reported recall question administered at 12 months and dichotomized into at least daily versus less frequent weighing. Diary-recorded weight monitoring was evaluated over 12 months and dichotomized into >=80% and <80% adherence. HF-related hospitalizations were ascertained through patient report and confirmed through record review. Over 12 months in 216 patients, we identified 50 HF-related hospitalizations. Patients self-reporting daily or more frequent weight monitoring had an incidence rate ratio 1.34 (95% CI 0.24-7.32) for HF-related hospitalizations with self-reported recall of at least daily weight monitoring compared to those reporting less frequent weight monitoring. Patients who completed >=80% of weight diaries had an IRR of 0.37 (95% CI 0.18-0.75) for HF-related hospitalizations compared to patients who completed <80% of weight diaries. Self-reported recall of weight monitoring adherence was not associated with fewer HF hospitalizations. In contrast, diary-recorded adherence >=80% of days was associated with fewer HF-related hospitalizations. Incorporating diary-based measures of weight monitoring adherence into HF self-care training programs may help to identify patients at risk for HF-related hospitalizations.BMC Cardiovascular Disorders 01/2014; 14(1):12. · 1.46 Impact Factor
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ABSTRACT: This study describes knowledge tests in patient education through a systematic review of the Medline, Cinahl, PsycINFO, and ERIC databases with the guidance of the PRISMA Statement. Forty-nine knowledge tests were identified. The contents were health-problem related, focusing on biophysiological and functional knowledge. The mean number of items was 20, with true-false or multiple-choice scales. Most of the tests were purposely designed for the studies included in the review. The most frequently reported quality assessments of knowledge tests were content validity and internal consistency. The outcome measurements for patient-education needs were comprehensive, validating knowledge tests that cover multidimensional aspects of knowledge. Besides the measurement of the outcomes of patient education, knowledge tests could be used for several purposes in patient education: to guide the content of education as checklists, to monitor the learning process, and as educational tools. There is a need for more efficient content and health problem-specific knowledge-test assessments.Nursing and Health Sciences 11/2013; · 0.71 Impact Factor
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ABSTRACT: Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (Na) intake and medication adherence (MA). HF patient and family member (FM) dyads (n = 117) were randomized to: usual care (UC), patient-FM education (PFE), or family partnership intervention (FPI). Dietary Na (3-day food record), urinary Na (24-hour urine), and MA (Medication Events Monitoring System) were measured at baseline (BL) before randomization, and at 4 and 8 months. FPI and PFE reduced urinary Na at 4 months, and FPI differed from UC at 8 months (P = .016). Dietary Na decreased from BL to 4 months, with both PFE (P = .04) and FPI (P = .018) lower than UC. The proportion of subjects adherent to Na intake (≤2,500 mg/d) was higher at 8 months in PFE and FPI than in UC (χ(2)(2) = 7.076; P = .029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention. Dietary Na intake, but not MA, was improved by PFE and FPI compared with UC. The UC group was less likely to be adherent with dietary Na. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted.Journal of cardiac failure 12/2013; 19(12):829-841. · 3.25 Impact Factor