The average score of the MLWHFQ was high, and this reflects the poor quality of life of patients. Higher scores in specific patient groups show the negative influence of these factors in quality of life. The holistic care of patients with heart failure by a multidisciplinary team of healthcare professionals could improve their quality of life.
Context: Many nursing educational approaches have been applied on patients with heart failure (HF) to improve their outcomes. The results of these approaches on outcomes of patients with HF remain controversial.Evidence Acquisition: The aim of this study was to highlight the importance of nursing education to improve the outcomes of patients with HF, such as self-care behaviour, quality of life, mortality, readmission and hospitalization rates. A systematic review was conducted in the MEDLINE database on investigations punished from 2000 to 2012. The search terms used were self-care, heart failure, nursing, and education. A total of 22 studies complied with the eligibility criteria for this review.
Results:The findings of the reviewed studies showed that self-care behaviour of patients who received nursing education improved significantly. No significant improvement was noticed in the health-related quality of life. Additionally, there was no significant reduction in readmission, hospitalization and mortality rates of patients after implementing this educational process.
Conclusions:The effectiveness of nursing education on self-care behaviour of HF patients was clearly demonstrated. Methodological differences in development and implementation of education programs, made the comparison between the results of the studies difficult.
Ten clinical studies were identified. The majority of studies reported beneficial effect of nursing intervention on treatment adherence in hypertensive patients. Telephone contacts and home visits were found to be the most effective educational approaches. Although comorbidities are considered to be an important barrier to adherence, there was not enough evidence to elucidate this aspect. Identifying specific factors that affect behavioral change in the setting of a successful intervention was difficult due to high heterogeneity among studies regarding materials and methods. Nursing interventions were shown to alleviate non-adherence to medication in patients with hypertension. Large well designed clinical trials are needed to evaluate specific factors that are associated with effective interventions.
Background Coronary artery disease (CAD) is known to impact on patients' physical and mental health. The relationship between performance on treadmill exercise tolerance test (ETT) and health-related quality of life (HRQL)has never been specifically investigated in the setting of CAD. Methods Consecutive patients undergoing an ETT with the Bruce protocol during a diagnostic workup for CAD (n = 1,631, age 55 ± 12 years) were evaluated. Exercise-related indices were recorded. Detailed information on cardiovascular risk factors and past medical history were obtained. HRQLwas assessed with the use of the validated 36-Item Short Form Survey (SF-36) questionnaire. Results Increasing age and the presence of cardiovascular risk factors and comorbidities correlated with lower scores on the physical and mental health component of SF-36(all P < 0.05). Subjects with arrhythmias during exercise and slow recovery of systolic blood pressure had lower scores on the physical health indices or the Social Role Functioning component (P < 0.05). Achieved target heart rate and good exercise tolerance were independently associated with better scores of the physical and mental health domains of SF-36 and overall HRQLscores (β = 0.05 for target HR and PCS-36, β = 1.86 and β = 1.66 per increasing stage of exercise tolerance and PCS-36 and MCS-36, respectively, P < 0.001 for all associations). Ischemic ECG changes were associated with worse scores on Physical Functioning (β = − 3.2, P = 0.02) and Bodily Pain (β = − 4.55, P = 0.026). Conclusion ETT parameters are associated with HRQL indices in patients evaluated for possible CAD. Physical conditioning may increase patient well-being and could serve as a complementary target in conjunction with cardiovascular drug therapy.
KeywordsTreadmill exercise tolerance test • Coronary heart disease • Quality of life • Physical health • Mental health Vasiliki Katsi and Georgios Georgiopoulos have contributed equally for this study.
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