| 1. |
- Jaarsma, Tiny, et al.
(författare)
-
Self-care and quality of life in patients with advanced heart failure : the effect of a supportive educational intervention
- 2000
-
Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 29:5, s. 319-330
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure. DESIGN: The study design was an experimental, random assignment. SETTING: The study was located at the University Hospital in Maastricht, The Netherlands. PATIENTS: The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure. OUTCOME MEASURES: Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril's ladder of life). INTERVENTION: The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care. RESULTS: Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up. CONCLUSION: A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life.
|
|
| 2. |
- Mårtensson, Jan, et al.
(författare)
-
Decisive situations influencing spouses' support of patients with heart failure : A critical incident technique analysis
- 2001
-
Ingår i: Heart & Lung. - Amsterdam : Elsevier. - 0147-9563 .- 1527-3288. ; 30:5, s. 341-350
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:The aim of this study was to describe decisive situations experienced by spouses of patients with heart failure that could potentially affect their ability to provide social support to the patient.METHODS:A qualitative descriptive design with a critical incident technique was used. Twenty-three informants, 15 women and 8 men, who were spouses of patients with severe heart failure were strategically chosen to ensure maximal variation in sociodemographic data and experiences as a spouse.RESULTS:Decisive situations influenced the experience of spouses of patients with heart failure in a manner that was either positive (involvement with others) or negative (feeling like an outsider). When spouses were given attention and treated like persons of value, they experienced involvement with others. In these cases, spouses had someone to turn to and were included in the physical care. In contrast, when spouses were kept at a distance by the patient, were socially isolated, and received insufficient support from children, friends, and health care professionals, they experienced feeling like an outsider.CONCLUSIONS:By identifying spouses' experiences, health care professionals can assess which kind of specific interventions should be used to improve the life situation of the patient with heart failure and his or her spouse.
|
|
| 3. |
- Ågård, Anders, et al.
(författare)
-
When is a patient with heart failure adequately informed? A study of patients' knowledge of and attitudes toward medical information
- 2004
-
Ingår i: Heart Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 33:4, s. 219-26
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim was to explore patients' knowledge of heart failure and their attitudes toward medical information (prognostic information in particular) and to assess different patient-related factors that might hamper the improvement of patients' knowledge. Moreover, taking the data obtained into account, we analyzed ethical aspects of information disclosure to patients with heart failure. SETTING: The study was performed at Sahlgren's University Hospital in Gothenburg, Sweden. DESIGN: The study was a qualitative analysis of semistructured interviews. PATIENTS: The sample included 40 patients with various stages of chronic heart failure. RESULTS: Many patients had only a limited understanding of their disease, but they still claimed that they were satisfied with the information they received. Some of them seemed to accept, to be indifferent to, or to be unaware of their low level of knowledge. The majority did not request prognostic information. CONCLUSION: We argue that patients with heart failure are adequately informed when they have reached the level of knowledge that enables them to be managed as effectively and securely as possible while being satisfied with the information provided. To give adequate information, health care providers should determine the patients' level of knowledge and explore why those patients who have a limited understanding do not assimilate or request information.
|
|
| 4. |
- Ekman, Inger, 1952, et al.
(författare)
-
Can treatment with ACE-inhibitors in elderly patients with moderate to severe heart failure be improved by a nurse-monitored structured care program?
- 2003
-
Ingår i: Heart & Lung. - 0147-9563. ; 32:1, s. 3-9
-
Tidskriftsartikel (refereegranskat)abstract
- Can treatment with angiotensin-converting enzyme inhibitors in elderly patients with moderate to severe chronic heart failure be improved by a nurse-monitored structured care program? A randomized controlled trial. OBJECTIVE: The purpose of this study was to examine whether a nurse-monitored structured care program resulted in a more effective use of angiotensin-converting enzyme (ACE) inhibitors in elderly patients compared with standard care in patients with chronic heart failure (CHF). METHODS: Hospitalized patients were screened to identify individuals with CHF, age more than 65 years, New York Heart Association classification III to IV, and no contraindications to ACE inhibitor treatment. One hundred forty-five patients were randomized to a nurse-monitored structured care program that included uptitration of enalapril to a target dose of 10 mg twice a day or to standard care. Six-month follow-up data were collected. RESULTS: The mean age of the randomized patients was 81 years. Although the proportion of patients treated with an ACE inhibitor did not differ between structured care (70%) and standard care (64%), the number of patients with the target ACE inhibitor dose was significantly higher in the structured care group (26% versus 11% in the standard care group; P <.018). Treatment had to be discontinued in 26% of the patients because of adverse effects. CONCLUSION: The patients in this study were older than in previous intervention studies and had considerable comorbidity and reduced tolerance for ACE inhibitors. ACE inhibitor treatment was underused but improved with the structured care program, although achieved treatment levels were below those in the large intervention trials in patients with CHF.
|
|
| 5. |
- Ekman, Inger, 1952, et al.
(författare)
-
Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls
- 2002
-
Ingår i: Heart & Lung. - 0147-9563. ; 31:2, s. 94-101
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe health-related quality of life (QoL) and sense of coherence (SOC) in a group of elderly people with moderate to severe chronic heart failure and to make comparisons with a healthy sex- and age-matched control group. METHODS: Patients (n = 94), with a mean age of 81 years, hospitalized for chronic heart failure with New York Heart Association functional classification III to IV were age- and sex-matched to a healthy control group. The instruments used were the 36-Item Short Form Health Survey (SF-36) and SOC. RESULTS: The patients had lower levels of health-related QoL scores (SF-36) but high and similar scores of SOC compared with the controls. There were, however, significant positive correlations between the SOC scores and the emotional dimensions in the SF-36 instrument. CONCLUSION: The findings from this study indicate that old age and severe chronic heart failure were associated with limited functional abilities and impaired health-related QoL but also with internal resources such as SOC.
|
|
| 6. |
|
|
| 7. |
- Johansson, Ingela, et al.
(författare)
-
Factors related to delay times in patients with suspected acute myocardial infarction
- 2004
-
Ingår i: Heart & Lung: The Journal of Acute and Critical Care. - : Elsevier BV. - 0147-9563. ; 33:5, s. 291-300
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The study’s objective was to describe symptoms, symptom management, and patient delay times in patients seeking treatment for suspected acute myocardial infarction (AMI), and to find explanatory factors influencing the decision time. Method This is a descriptive survey study including 403 Swedish patients with a median age of 64 years with suspected AMI. Results Altogether, 84% of the patients suspected that the symptoms emanated from the heart. Despite this fact, 59% delayed going to the hospital more than 1 hour after the onset of symptoms. In the multiple regression analysis, a “dull pain,” the patients’ belief that it was nothing serious, and contact with the general practitioner were associated with prolonged delay. The decision to contact the emergency service shortened the delay time. Conclusions The patient’s subjective feeling of the severity of symptoms is an important predictor for delay times. There is still a need for public awareness of the appropriate responses to AMI symptoms, that is, to call for an ambulance instead of contacting the general practitioner.
|
|
