Educação e monitorização por telefone de pacientes com insuficiência cardíaca: ensaio clínico randomizado

Abstract

Background: Nursing approaches to manage patients with heart failure (HF) showed benefits in reducing the morbidity and mortality. However, combining intra-hospital education with telephone contact after hospital discharge has been little explored.

Knowledge, barriers and attitudes toward dietary sodium in patients with decompensated heart failure

“…[3,8] A randomized clinical trial conducted in Brazil showed that the hospitalization period is the optimal time to start the health education process, as patients who received educational nursing interventions during their hospital stays exhibited improvement both in knowledge of disease and in self-care measures, including adherence to a low-sodium diet and to prescribed medications. [34] Although discussions are currently underway as to the role that a more sodium-permissive diet might play in disease management, it is well known that many patients with HF consume daily amounts of sodium well in excess of any recommendation. [28] This means that difficulty adhering to treatment -including nonpharmacological measures -is one of the main hindrances in the search for better outcomes.…”

“…Regardless of the cause of decompensation, unplanned admissions are always associated with poorer patient outcomes, as they signal a change in the natural course of HF progression. [28] Therefore, hospitalizations due to preventable causes -such as treatment nonadherence -lead to worse prognoses, and multidisciplinary teams should be aware of this to enable implementation of follow-up measures during admission, telephone follow-up, [34] and other strategies, such as a house call shortly after hospital discharge. [35,36] A limitation of the study was that, simply because patients primary cause for admission was other than nonadherence, does not mean those patients were adherent.…”

The knowledge of patients with heart failure in the homecare context: an experimental study

“…by improving their knowledge, whether done through the home visits, by telephone contact or by group orientation. A study of patients with IC who had been hospitalized and were then followed by telephone contact for three months showed significant improvement in knowledge and self-care scores (9) .…”

Contato telefônico: ferramenta clínica útil?

“…This line of investigation uses two types of methodologies: i) observational studies, when the purpose is to describe the effectiveness of a treatment or to identify determinants of this effectiveness; or ii) interventional studies (clinical trials) used to test strategies for the implementation of medical treatments. Domingues et al's article 4 published in the current edition of Arquivos represents a randomized clinical trial testing the benefit of an outpatient management program in patients hospitalized for HF 4 .…”

“…Finally, we should point out that the type of methodological discussion generated by Domingues et al's study 4 is useful to stress the importance of outcomes research studies. Domingues et al's example 4 should be followed, so that further studies evaluate the benefit of management programs in samples of patients with HF, with the purpose of identifying means of increasing the effectiveness, in our midst, of strategies proven efficient.…”