Effects of education, self-care instruction and physical exercise on patients with chronic heart failure

Miche, E; Herrmann, G; Wirtz, U; Laki, H; Barth, Maria Angeles; Radzewitz, Andrea

doi:10.1007/s00392-003-1009-1

Cited by 17 publications

(10 citation statements)

References 58 publications

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“…Although these results were not unexpected findings (Field et al 2006), it elucidated and supported many other studies that considered knowledge a critical foundation for self-care in patients with CHF (Toman et al 2001; Artinian et al 2002; Bushnell 1992; Wright et al 2003; Miche et al 2003). Insufficient information not only directly prohibited patients from understanding and applying instructions, but also introduced other barriers to self-care in patients with CHF (Kaholokula et al 2008; Clark et al 2009; Dickson et al 2012).…”

Section: Discussionsupporting

confidence: 84%

Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies

2013

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Chronic heart failure (CHF) is a costly condition that places large demands on self-care. Failure to adhere with self-care recommendations is common and associated with frequent hospitalization. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. This qualitative review was conducted to address the research question, "What are the barriers and facilitators to self-care among patients with CHF?” Electronic databases including Medline, EMBASE, CINAHL, Web of Science, Scopus and Google scholar were searched. Articles were included if they were peer reviewed (1995 to 2012), in English language and investigated at least one contextual or individual factor impacting on self-care in CHF patients > 18years. The criteria defined by Kuper et al. including clarity and appropriateness of sampling, data collection and data analysis were used to appraise the quality of articles. Twenty-three articles met the inclusion criteria. Factors impacting on self-care were included factors related to symptoms of CHF and the self-care process; factors related to personal characteristics; and factors related to environment and self-care system. Important factors such as socioeconomic situation and education level have not been explored extensively and there were minimal data on the influence of age, gender, self-confidence and duration of disease. Although there is an emerging literature, further research is required to address the barriers and facilitators to self-care in patients with CHF in order to provide an appropriate guide for intervention strategies to improve self-care in CHF.

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Section: Discussionsupporting

confidence: 84%

Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies

2013

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“…En effet, ce serait dans les suites immédiates d'un accident de santé majeur que les risques futurs seraient perçus de la façon la plus réaliste par les individus qui seraient ainsi davantage réceptifs aux interventions visant un changement de comportement. De leur côté, Miche et al [19] démontrent l'efficacité d'un programme éducatif sur les paramètres cardio-pulmonaires et sur le sentiment de bien-être physique des patients, mais pas sur les mesures de dépression et d'anxiété. L'absence d'effet constaté sur l'humeur des patients suggère l'utilité d'associer à l'approche éducative, des techniques cognitives qui ciblent spécifiquement les pensées négatives.…”

Section: Les Troubles Anxieux Après Un Accident Vasculaire Cérébralunclassified

Prise en charge des troubles anxieux dans le cadre d'atteintes neurologiques

Bruggimann¹,

Annoni²

2004

Swiss Arch Neurol Psychiatr

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Summary Bruggimann L, Annoni J-M. [Management of anxious disorders in neurological diseases.] Schweiz Arch Neurol Psychiatr 2004;155:407-13.Neuropsychiatric sequelae are a significant cause of morbidity in neurological patients. Current studies suggest that anxiety is frequent (about 20 to 30%) in all these conditions. Neurobiological, environmental and dispositional factors may be implicated in the development of anxiety suggesting that several ways of intervention are worth to be considered, e.g. pharmacological, socio-educative or psychotherapeutic interventions. Anxiety disorders following medical problems are often undiagnosed or inadequately treated. This may reflect difficulties with the diagnosis of affective disorders among people with neurological affections, but may also reflect uncertainty about the effectiveness of interventions in this setting.This review addresses the emergence of anxiety disorders in three classical neurological conditions, namely stroke, dementia and multiple sclerosis. Prevalence of anxiety, characteristics, contributing factors and associated cerebral lesions are discussed for each of these neurological conditions. Existing research literature on psychological and psychotherapeutic interventions to manage anxiety is then reported. Pharmacological therapy is not considered.Any psychotherapeutic treatment is necessarily limited by the cognitive and the behavioural disorders characterising each neurological condition. Consequently, usefulness of the intervention should always be evaluated in the context of a specific disease. The paucity of research and the methodological limitations in existing studies prevent a conclusion as any psychological intervention has empirical support for its effectiveness. However, different approaches seem to be worthy of further investigation.Cognitive behaviour therapy (CBT) is an appropriate treatment for some anxious or depressed patients with cerebrovascular disease or multiple sclerosis. This approach includes identification and modification of unhelpful thoughts and beliefs, activity scheduling and graded task assignment. There are very few controlled studies, but they suggest that this kind of therapy may have the same effect as pharmacological treatments. Mood, anxiety, adherence to medications and appraisal of self-control are susceptible to improvement after cognitive behaviour therapy. Interesting results may also be obtained using educative programmes. Preliminary results indicate that a brief intervention designed to change patients' illness perceptions can result in improved functional outcome after severe medical affection. Combined with cognitive behaviour therapy, such an approach is promising. Therapy has to be adapted particularly in dementia, where cognitive and behavioural disorders are the most pronounced. Group interventions based on verbal or non verbal (e.g. painting) interactions reveal interesting therapeutic effects such as the dissolution of anxiety into the group, the acceptance of aging or the reaffirmation of oneself ...

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“…Patientenwissen ist insbesondere vor dem Hintergrund von Studien bedeutsam, die einen positiven Effekt von Trainingsprogrammen zum Selbstmanagement [3] bei Herzinsuffizienz auf Lebensqualität, kardiopulmonale Parameter [4] und Mortalität [5] zeigen konnten. Dabei spielt nicht nur das Wissen um Lebensstilmaßnahmen [6] eine Rolle, sondern auch die Kenntnis typischer Symptome -als Basis für ein lückenloses Selbstmonitoring.…”

Section: Introductionunclassified

“…Letztlich ist die richtige Einordnung von Herzinsuffizienzsymptomen durch die Betroffenen entscheidend zur Verhinderung, bzw. Früherkennung schwerwiegender Komplikationen [4,8,9]. Über den Informationsstand von Patienten mit Herzinsuffizienz existieren derzeit aber noch wenige Daten.…”

Section: Introductionunclassified

Kennen Patientinnen und Patienten mit Herzinsuffizienz die Symptome ihrer Erkrankung?

et al. 2006

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ZusammenfassungHintergrund und Fragestellung: Patienteninformation und Aufklärung sind essenziell für das Selbstmanagement bei Herzinsuffizienz. Über den Informationsstand von Patientinnen und Patienten mit Herzinsuffizienz existieren aber bislang wenige Daten. Unsere Studie sollte die Kenntnis von Herzinsuffizienz-Symptomen ein Jahr nach Hospitalisation und deren Zusammenhang mit der Inanspruchnahme ärztlicher Leistungen untersuchen. Patienten und Methodik: 74 Patientinnen und Patienten wurden im Universitätsklinikum Göttingen rekrutiert und ein Jahr nach Hospitalisation durch ein standardisiertes Interview über mögliche Symptome bei Herzinsuffizienz befragt. Zudem wurden Re-Hospitalisation, Konsultationsfrequenz und die Inanspruchnahme diagnostischer Leistungen erfragt. Ergebnisse: Ein Jahr nach Hospitalisation kannten etwa 40 % der Patienten die Symptome Müdig-keit, Leistungsschwäche und Atemnot, weniger als 10 % konnten die Symptome "dicke Beine", Schwellungen oder Ödeme nennen. Durch multiple lineare Regression konnte unter gleichzeitigem Einschluss von Alter, Geschlecht sowie Konsultations-, Einweisungsraten und diagnostischen Leistungen 25,9 % des Informationsstands der Patienten erklärt werden (signifikant für weibliches Geschlecht [p = 0,05] und Konsultation von Kardiologen [p = 0,02]). Schlussfolgerungen: Nur wenige Patienten mit Herzinsuffizienz kennen die Symptome ihrer Erkrankung. Die Gründe hierfür sind letztlich unklar, wenngleich sie in der Verdrängung oder in der Verwechslung mit Symptomen anderer, gleichzeitig bestehender Erkrankungen liegen könnten. Weitere Studien müssten zeigen, ob die gezielte Erläuterung kausaler Zusammenhänge die Wahrnehmung der Erkrankung verbessern kann. Schlüsselwörter Herzinsuffizienz · Selbstmanagement · Information · AufklärungAbstract Background: Patients' information is essential for the self-management of heart failure (HF). However, few data is available about disease specific patients' competence. The aim of our study was to analyse patients' knowledge on HF-symptoms one year after hospitalisation. Methods: In 74 patients with HF recruited in the university hospital of Göttingen, knowledge of HF symptoms was assessed by standardised interviews one year after hospitalisation. Additionally, patients were also asked about rehospitalisation, consultation frequency and use of diagnostics. Results: One year after hospitalisation, about 40 % of the patients knew the symptoms fatigue, loss of power and dyspnea. Less than 10 % of the patients mentioned "plump legs", swelling or oedema. Using regression analysis, 25.9 % of patients' knowledge could be explained by age, sex and consultation-as well as re-hospitalisation frequencies and use of diagnostics (significant for female gender [p = 0.05] and consultation of a cardiologist [p = 0.02]). Conclusions: Only few HF-patients know the symptoms of their disease. The reasons for that phenomenon are unclear. However, denial of HF symptoms or mixing-up with symptoms of comborbidities might influence patient's knowlegde. Furthe...

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Effects of education, self-care instruction and physical exercise on patients with chronic heart failure

Abstract: A specialized in hospital rehabilitation program including education, patient self management and training has a sustained positive effect on cardiopulmonary parameters and physical well-being.

Cited by 17 publications

References 58 publications

Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies

Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies

Prise en charge des troubles anxieux dans le cadre d'atteintes neurologiques

Kennen Patientinnen und Patienten mit Herzinsuffizienz die Symptome ihrer Erkrankung?

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