Epidemiology and Management of Heart Failure in Nepal

Koirala, Binu; Himmelfarb, Cheryl Dennison; Koirala, Bibhu; Budhathoki, Chakra; Davidson, Patricia M.

doi:10.1016/j.cardfail.2019.08.019

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…HF is considered a final common pathway for many cardiovascular diseases [3] and the burden of HF is increasing in low-and middle-income countries [4], including Nepal. Although national data on HF in Nepal is undocumented [5], globally, 26 million people are living with HF, with the prevalence of HF in Asian countries being approximately 1.26%-6.7% [6]. In neighboring countries, China and India, it is estimated that there are 4.2 million and up to 23 million people with HF, respectively [2].…”

Section: Introductionmentioning

confidence: 99%

“…Having information on the sociodemographic and clinical factors influencing selfcare and the relationship between self-care and HRQOL may be useful to develop, tailor and target appropriate self-care strategies for patients living with HF in Nepal. We have provided a commentary on the epidemiology and profile of HF in Nepal, which identifies inadequate self-care among most of the participants and recommends a study exploring factors influencing self-care [5]. This study seeks to describe the context of self-care, examine sociodemographic and clinical factors affecting self-care, and to explore the relationship between self-care and HRQOL.…”

Section: Introductionmentioning

confidence: 99%

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Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

Koirala

Himmelfarb

Budhathoki

et al. 2020

Heliyon

Self Cite

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Background: Self-care helps maintain health, prevents complications and improves the quality of life of patients living with heart failure (HF). Self-care is critical to HF management but has received limited attention in Nepal. Identification of the sociodemographic and clinical characteristics associated with self-care is crucial to tailoring appropriate self-care programs to improve health outcomes including patients' quality of life. Aims: The aims of this study were to describe self-care including the factors influencing self-care and the relationship between self-care and health-related quality of life in patients living with HF in Kathmandu, Nepal. Methods: We used a cross-sectional observational study design to measure self-care maintenance, self-care management, and self-care confidence using the Nepali Self-Care of Heart Failure Index. To analyze data, we used descriptive statistics, bivariate associations and regression modeling. Results: We recruited 221 patients with HF: mean age 57.5 AE 15.76 years, 62% male. The results in this sample indicated poor self-care maintenance (38.5 AE 11.56), management (45.7 AE 15.14), and confidence (40.9 AE 16.31). Patients with higher education were associated with higher self-care maintenance and management. Living alone and a better New York Heart Association functional classification for HF were related to higher selfcare confidence. Higher social support was associated with better self-care. Self-care confidence was an independent predictor of self-care maintenance, management and health-related quality of life on adjusted analyses. Conclusion: Self-care was limited among patients living with HF in Nepal yet was associated with better quality of life. The study identified various sociodemographic and clinical factors related to self-care, which could be crucial while developing self-care interventions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

Koirala

Himmelfarb

Budhathoki

et al. 2020

Heliyon

Self Cite

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“…Consequently, HF is a global clinical and public health problem associated with substantial mortality and morbidity and subsequent increased healthcare expenditure. This phenomenon is an increasing concern in low-and middle-income countries, particularly when models of care do not follow a traditional Western paradigm (Koirala et al, 2019). Epidemiological studies evaluating the prevalence of HF and associated mortality in the Middle East and North Africa (MENA) region, including Lebanon, are lacking.…”

Section: Introductionmentioning

confidence: 99%

Heart Failure in Lebanon: A Review of the Literature

Deek

Massouh²,

Davidson³

2022

Jurnal Keperawatan Indonesia

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This research aimed to provide a comprehensive overview of the current literature on heart failure (HF) management in Lebanon and identify the implications for policy, practice, education, and research. The design of this research was a systematic review following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Databases were searched using the search terms “heart failure” and “Lebanon” and associated MeSH terms. The abstracts of the selected articles were examined independently by two researchers; the sample characteristics, HF indices, and results of the included studies were extracted. Key findings and trends were synthesized. Eleven papers were reviewed with 2,774 participants (mean age = 57.98, SD = 13.09 years, and the majority [n = 1,494, 53.85%] were male). Over one-third reported having coronary artery disease, and half had hypertension. The mean ejection fraction was 47.28% (SD = 10.44), and the mean length of hospital stay was 7.97 days (SD = 10.28). Self-care was a common theme showing varying but low scores, especially in the self-management subscale. The findings of this study outline the unique characteristics of the population with HF in a Middle Eastern country. These characteristics should be considered when planning interventions in countries facing geopolitical instability in the context of population aging and the rise of noncommunicable diseases. AbstrakTinjauan Pustaka tentang Gagal Jantung di Lebanon. Penelitian ini bertujuan untuk menyajikan rangkuman kajian pustaka terkait manajemen gagal jantung di Lebanon dan mengidentifikasi implikasinya terhadap kebijakan, praktik, pendidikan, dan riset di bidang tersebut. Metode tinjauan sistematis digunakan pada penelitian ini dengan mengacu pada preferred reporting items for systematic reviews and meta-analyses (PRISMA). Beberapa istilah, seperti “gagal jantung” dan “Lebanon” serta istilah dalam medical subject headings (MeHS) lainnya digunakan dalam pencarian pada basis data. Kumpulan abstrak terpilih ditinjau dan diteliti dalam hal: karakteristik sampelnya, indeks gagal jantung, dan hasil penelitiannya. Poin utama temuan dan tren dipadukan. Pada sebelas manuskrip yang telah ditelaah, terdapat 2.774 partisipan (rerata umur = 57,98, SD = 13,09 tahun, dan mayoritas partisipan adalah laki-laki (n = 1.494, 53,85%). Lebih dari sepertiganya mengalami jantung coroner dan setengahnya mengalami hipertensi. Nilai mean untuk pecahan ejeksi sebesar 47,28% (SD = 10,44), dan nilai mean untuk lama rawat inap yang dijalani ialah 7,97 hari (SD = 10,28). Perawatan mandiri adalah tema yang paling sering muncul tetapi dengan variasi skor rendah, khususnya pada subskala manajemen mandiri. Temuan pada penelitian ini menggarisbawahi karakteristik unik pada populasi gagal jantung di negara-negara Timur Tengah. Karakteristik ini diharapkan dapat menjadi acuan dalam merencanakan intervensi pada negara yang menghadapi ketidakstabilan geopolitik, khususnya dalam konteks populasi lansia dan meningkatnya kasus penyakit tidak menular.Kata Kunci: gagal jantung, keperawatan, Lebanon, literasi, MENA region, perawatan mandiri

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The Self‐Care of Heart Failure Index: A psychometric study

Koirala

Budhathoki

Himmelfarb

et al. 2019

Journal of Clinical Nursing

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BackgroundThe Self‐Care of Heart Failure Index is an empirically tested instrument to measure self‐care of heart failure patients across different populations and cultures.AimsTo develop and evaluate the psychometric properties of the Nepali Self‐Care of Heart Failure Index.DesignThis psychometric study used a cross‐sectional, observational, study design to collect data. The study was guided and reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline.MethodsTo develop and culturally validate Nepali Self‐Care of Heart Failure Index, a combination of the recommended methods for cross‐cultural validation studies were applied such as translation, back translation, expert committee review of the translated version and validity/reliability testing. Face and content validity were ensured using expert review. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. Composite reliability scores were calculated for each sub‐scale of the Nepali Self‐Care of Heart Failure Index.ResultsA total of 221 heart failure patients in Nepal were enrolled in the study. Adequate face and content validity were ensured through expert review. Exploratory factor analysis and confirmatory factor analysis supported the original three‐factor model. Although the three factors explained only 41% of the variance, confirmatory factor analysis fit indexes and error measures were found reasonable. The composite reliability coefficients for self‐care maintenance, management and confidence scale were 0.6, 0.7 and 0.8, respectively.ConclusionsThe Nepali Self‐Care of Heart Failure Index is a theoretically based, culturally acceptable and appropriate instrument for use among Nepali heart failure patients. However, further studies are needed to refine its psychometric properties.Relevance to clinical practiceAccess to reliable, valid and culturally appropriate instruments is crucial in describing the state of the problem as well as for developing and evaluating tailored and targeted self‐care practice interventions for Nepali patients living with heart failure.

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Epidemiology and Management of Heart Failure in Nepal

Cited by 3 publications

References 7 publications

Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

Heart Failure in Lebanon: A Review of the Literature

The Self‐Care of Heart Failure Index: A psychometric study

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