| 1. |
- Strömberg, Anna, 1967-, et al.
(författare)
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Computer-based education for patients with chronic heart failure : A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life
- 2006
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Ingår i: Patient Education and Counseling. - Shannon, Ireland : Elsevier. - 0738-3991 .- 1873-5134. ; 7, s. 128-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effects of a single-session, interactive computer-based educational program on knowledge, compliance and quality of life in heart failure patients with special emphasis on gender differences.METHODS: One hundred and fifty-four patients, mean age 70 years, from five heart failure clinics were randomised to either receiving only standard education (n = 72) or standard education and additional computer-based education (n = 82).RESULTS: Knowledge was increased in both groups after 1 month with a trend towards higher knowledge (P = 0.07) in the computer-based group. The increase in knowledge was significantly higher in the computer-based group after 6 months (P = 0.03). No differences were found between the groups with regard to compliance with treatment and self-care or quality of life. The women had significantly lower quality of life and did not improve after 6 months as the men did (P = 0.0001).CONCLUSION: Computer-based education gave increased knowledge about heart failure. PRACTICE IMPLICATIONS: Computers can be a useful tool in heart failure education, but to improve compliance a single-session educational intervention is not sufficient. Gender differences in learning and quality of life should be further evaluated.
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| 2. |
- Broström, Anders, 1963-, et al.
(författare)
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Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure
- 2004
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Ingår i: Journal of Cardiovascular Nursing. - Philadelphia : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049 .- 1474-5151 .- 1873-1953. ; 19:4, s. 234-242
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Tidskriftsartikel (refereegranskat)abstract
- Background: Normal sleep changes with age in duration, fragmentation, and depth. The prevalence of insomnia is high in the elderly general population. In patients with chronic heart failure (HF) objective sleep assessments have shown disturbances such as a shorter total duration of sleep, frequent arousals, and sleep stage changes. Objective: To describe self- assessed sleep difficulties, daytime sleepiness, and their relation to health-related quality of life (HRQOL) in men and women with HF, as well as to make a comparison to data from a norm population. Methods: Cross-sectional design including 223 patients with HF, New York Heart Association classification II-IV, assessed using the Uppsala Sleep Inventory-Chronic Heart Failure, the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short Form Health Survey, and Minnesota Living With Heart Failure Questionnaire. Results: The most commonly reported sleep difficulties were initiating and maintaining sleep. The ratio of habitual sleep to the amount of estimated need for sleep was significantly shorter for women (P < .05), and the number of awakenings per night was significantly increased for men (P < .001). A total of 21% suffered from daytime sleepiness. Patients suffering from difficulties maintaining sleep, initiating sleep, and early morning awakenings reported significantly lower HRQOL in almost all dimensions of the SF-36 (P < .05-P < .001) compared to patients without sleeping difficulties, as well as to the normal population. The disease-specific Minnesota living With Heart Failure Questionnaire showed significantly reduced (P < .05-P < 001) HRQOL as measured by the total and subscale scores for patients suffering from sleeping difficulties compared to patients without sleeping difficulties. Conclusion: Patients with, HF have a reduced HRQOL especially if difficulties maintaining sleep, initiating sleep, and early morning awakenings are involved.
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| 3. |
- Johansson, Peter, et al.
(författare)
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Determinants of global preceived health in community-dwelling elderly screened for heart failure and sleep-disordered breathing.
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - : Wolters Kluwer. - 1474-5151 .- 1873-1953 .- 0889-4655 .- 1550-5049. ; 25:5, s. 16-26
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Tidskriftsartikel (refereegranskat)abstract
- The relationships between heart failure (HF), sleep-disordered breathing (SDB), insomnia, depressive symptoms, and excessive daytime sleepiness (EDS), as well as their relationship to Global Perceived Health (GPH) in an elderly community-dwelling population, have not been explored. Data from 331 community-dwelling elderly (71-87 years old) were collected by echocardiography, polygraphy, and specific questionnaires. Factor analyses and structural equation modeling were used to explore the relationships between HF, SDB, sleep, psychosocial factors, and GPH. Exploratory and confirmatory factor analyses derived a 5-factor model representing SDB, insomnia, systolic function, breathlessness/physical function, and psychosocial function. Structural equation modeling analyses were used to explore the relationships between the 5 factors and to GPH. Sleep-disordered breathing had a weak effect on systolic function, but no effects on any of the other factors or GPH were found. Psychosocial function and breathlessness/physical function directly affected GPH. Indirect effects on GPH, mediated by psychosocial function, were found for breathlessness/physical function and insomnia. Systolic function also had an indirect effect on GPH. The fact that SDB in the elderly has no obvious negative associations to sleep complaints or GPH does not exclude them from being adequately treated for SDB. However, the present study has shown that SDB, by means of self-rated sleep complaints and health-related quality of life, can be problematic to detect. Psychosocial function was the most important factor for perceived GPH as it had a direct effect, as well as mediated the factors breathlessness/physical function and insomnia effects, on GPH. This study indicates that interventions in clinical practice targeting psychosocial dysfunction, such as depressive symptoms, could help to improve GPH in the elderly with or without HF.
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| 4. |
- Johansson, Peter, 1962-, et al.
(författare)
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Factors and interventions influencing health-related quality of life in patients with heart failure : A review of the literature
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Because of the lack of a cure for patients with chronic heart failure (HF), there has been a progressive interest in the use of health-related quality of life (Hr-QoL) as complementary end-point to mortality and morbidity. Aim: The aim of this review was from a nursing perspective to describe Hr-QoL and the influencing factors of Hr-QoL, as well as to identify interventions aimed at influencing Hr-QoL in HF patients. Method: Medline, Cinahl and PsycInfo databases were searched from 1995 to 2004. A total of 58 papers were included. Results: HF symptoms and activity status influence Hr-QoL negatively. However, several individual characteristics such as personality, gender and age must also be taken into consideration because different values might exist regarding what constitutes a good Hr-QoL. Nurse led interventions based on education, support and exercise can influence Hr-QoL positively. There is also a need of more studies about the effects of depression, sleep disturbances, support as well as education on Hr-QoL. There is also a need of exercise studies with larger sample sizes and older patients in higher NYHA classes. Conclusion: Several individual factors impact Hr-QoL, therefore, must nursing interventions are individually adapted to the patient's resources. © 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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| 5. |
- Johansson, Peter, 1962-, et al.
(författare)
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Global perceived health and health-related quality of life in elderly primary care patients with symptoms of heart failure
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 7:4, s. 269-276
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to examine whether a single question about global perceived health (GPH) is associated with the domains of health-related quality of life (HR-QoL) as assessed by the SF-36, and whether the scores in these domains differ from the different scores of the GPH in relation to left ventricular ejection fraction (LVEF). Method: The study included 412 elderly outpatients with symptoms of heart failure (HF). Echocardiography was used to determine their LVEF, and GPH was assessed by the first question on the SF-36. Results: The correlations between GPH and the different domains in SF-36 ranged from 0.33 to 0.64 in patients with LVEF ≥ 50% and was between 0.29 and 0.59 in patients with LVEF < 40%. Regression analyses revealed GPH to be the strongest predictor of HR-QoL. Patients with LVEF < 40% rating poor GPH differed significantly (p < 0.05) from those with good or moderate GPH in six of the eight HR-QoL domains. Conclusion: One question about GPH gives a good general description of HR-QoL and may therefore be used as a simple tool to assess HR-QoL in elderly outpatients with clinical symptoms of HF.
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| 6. |
- Johansson, Peter, 1962-, et al.
(författare)
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Measurement of health-related quality of life in chronic heart failure, from a nursing perspective - A review of the literature
- 2004
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Living with chronic heart failure (CHF) is distressful and affects daily life. Because of the lack of a cure for CHF, there has been a progressive interest in using health-related quality of life (Hr-QoL) as an outcome measurement of the treatment in patients with CHF. Objective: The aim of this review was to describe the instruments/questionnaires used in different studies in the measurement of Hr-QoL in patients with CHF, and how they were put into operation as seen from a nursing perspective. Method: MEDLINE and CINAHL databases were searched from January 1995 to June 2002, by using the keywords CHF, heart failure, QoL and Hr-QoL. A total of 33 articles were analysed. Results: Thirty-two different Hr-QoL questionnaires were found. Generic, disease-specific and battery approaches were different ways used to measure Hr-QoL. To assess/describe Hr-QoL, evaluate the impact of interventions and examine relations/predictors were three main objectives. However, different aspects of the concept Hr-QoL, influencing factors, how to implement the questionnaires and a lack of unified CHF criteria existed. Conclusions: To create a guideline for the measurement of Hr-QoL in CHF patients is of great importance for nurses and might generate homogeneity in the measurement methods and promote the scientific approach in the nursing care process. © 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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| 7. |
- Johansson, Peter, et al.
(författare)
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Sleep disordered breathing, insomnia, and health related quality of life - A comparison between age and gender matched elderly with heart failure or without cardiovascular disease
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier Science B.V., Amsterdam.. - 1474-5151 .- 1873-1953. ; 9:2, s. 108-117
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL). Methods: Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36). Results: The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, pless than0.001). Moderate/severe SDB was found in 42% of those with HF vs. 8% in those without CVD (p=0.001). Those with HF had more difficulties maintaining sleep (DMS) (72% vs. 50%, p=0.05) and excessive daytime sleepiness (EDS) (25% vs. 8%, p=0.05) and scored worse Hr-QoL in five of eight SF-36 domains. In regression analysis SDB had no association to Hr-QoL. DMS associated to the physical-, and non restorative sleep to the mental domain of Hr-QoL. SDB had no correlations to insomnia or EDS. Conclusions: SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly.
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| 8. |
- Mårtensson, Jan, et al.
(författare)
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Nurse-led heart failure follow-up in primary care in Sweden
- 2009
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Ingår i: EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:2, s. 119-124
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little or no knowledge is available about which service is offered to patients with heart failure in primary care. Aims: To describe nurse-led follow-up of patients with heart failure in primary care in Sweden. Methods and results: A questionnaire was sent to all primary health care centres in Sweden and 6 10 of 939 centres returned the questionnaire. Special nurses had designated time for follow-up of heart failure patients at 18% (n = 111) of the centres, compared to 93% and 78% for diabetes and obstructive lung disease. Centres with nurse-led follow-up of heart failure patients more frequently provided heart failure information (pandlt;0.001), had more doctors interested in heart failure (pandlt;0.001), more often had special care programmes (Pandlt;0.001) and had more co-operation with the hospitals around patients with heart failure (pandlt;0.01), compared to centres without such follow-up (n = 499). Conclusion: In primary care in Sweden, nurse-led follow-up is uncommon for patients with heart failure, despite being common for patients with diabetes and obstructive pulmonary disease. To improve this situation in primary care, an increased number of specially trained nurses is needed, together with further research to ensure a high quality follow-up in primary care.
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