Factors Influencing Knowledge of and Adherence to Self-care Among Patients With Heart Failure

Ni, Hanyu; Nauman, Deirdre; Burgess, Donna; Wise, Kendra; Crispell, Kathy; Hershberger, Ray E.

doi:10.1001/archinte.159.14.1613

Cited by 322 publications

(317 citation statements)

References 12 publications

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“…With regard to gender differences, our study indicates that women are more likely to improve their self-care behaviour compared to men. This confirms by Ni et al [26] who found a difference in favour of women, whereas Artinian et al [35] found no gender differences. Although the present study is small and one should be careful to draw general conclusions, our results indicate that education about self-care behaviour maybe should be different for men and women.…”

Section: Discussionsupporting

confidence: 82%

“…There were no significant gender differences regarding quality of life. Self-care behaviour did not change significantly from baseline (31, [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]) to 12 month (29 [22,). There were no gender differences in self-care behaviour measured by the EHFScBS between baseline and 12 months.…”

Section: Study Patientsmentioning

confidence: 99%

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Telephone Follow-Up of Self-Care Behaviour after a Single Session Education of Patients with Heart Failure in Primary Health Care

Holst

Willenheimer

Mårtensson

et al. 2007

European Journal of Cardiovascular Nursing

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Background: Improved self-care behaviour is a goal in educational programmes for patients with heart failure, especially in regard to daily self-weighing and salt and fluid restriction. Aims: The objectives of the present study were to: (1) describe self-care with special regard to daily self-weighing and salt and fluid restriction in patients with heart failure in primary health care, during one year of monthly telephone follow-up after a single session education, (2) to describe gender differences in regard to self-care and (3) to investigate if self-care was associated with health-related quality of life. Methods: The present analysis is a subgroup analysis of a larger randomised trial. After one intensive educational session, a primary health care nurse evaluated 60 patients (mean age 79 years, 52% males, 60% in New York Heart Association class III–IV) by monthly telephone follow-up during 12 months. Results: The intervention had no effect on quality of life measured by EuroQol 5D and no significant associations were found between quality of life and self-care behaviour. Self-care behaviour measured by The European Self-care Behaviour Scale remained unchanged throughout the study period. No significant gender differences were shown but women had a tendency to improve adherence to daily weight control between 3- and 12 months. Conclusion: The self-care behaviour and quality of life in patients with heart failure did not change during one year of monthly telephone follow-up after a single session education and this indicates a need for more extensive interventions to obtain improved self-care behaviour in these patients.

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Section: Discussionsupporting

confidence: 82%

Section: Study Patientsmentioning

confidence: 99%

Telephone Follow-Up of Self-Care Behaviour after a Single Session Education of Patients with Heart Failure in Primary Health Care

Holst

Willenheimer

Mårtensson

et al. 2007

European Journal of Cardiovascular Nursing

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“…Important physician factors that may contribute to CHF exacerbations are under-utilization of established therapy such as ACE inhibitors that can reduce morbidity and mortality, and suboptimal education, including low rates of general and dietary counseling (Smith et al, 1998;CONSENSUS, 1987;SOLVD, 1991;IPRO, 1996). Medication and dietary nonadherence (with sodium restriction), inadequate discharge planning and follow-up, lack of social support and not seeking medical attention promptly when symptoms recur also increase the risk of CHF exacerbations (Ni et al, 1999;Ghali, Kadakia, Cooper, & Ferlinz, 1988;Chin & Goldman, 1997;Vinson, Rich, Sperry, Atul, & McNamara, 1990, Tsuyuki et al, 2001Michalsen, Konig, & Thimme, 1998).…”

Section: Introductionmentioning

confidence: 99%

A story of maladies, misconceptions and mishaps: effective management of heart failure

Horowitz¹,

Rein²,

Leventhal³

2004

Social Science & Medicine

240

283

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Congestive heart failure (CHF) is a common chronic disease with effective therapy, yet interventions to improve outcomes have met with limited success. Though problems in selfmanagement are suspected causes for deterioration, few efforts have been made to understand how self-management could be improved to enhance the lives of affected patients. We conducted semistructured interviews of 19 patients with CHF treated at an urban United States hospital to elucidate their knowledge and beliefs about CHF and to understand what underlies their self-care routines. A comparison of the themes generated from these interviews with the common-sense model for self-management of illness threats, clarifies how patients' perceptions and understanding of CHF affected their behaviors. Patients had an acute model of CHF. They did not connect chronic symptoms with a chronic disease, CHF, and did not recognize that these symptoms worsened over time from their baseline of moderate, chronic distress, to a severe state that required urgent care. As a consequence, they often did not manage symptoms on a routine basis and did not, therefore, prevent or minimize exacerbations. When they worsened, many patients reported barriers to reaching their physicians and most reported seeking care primarily in an emergency room.These in depth responses elucidate how the interplay between acute and chronic models of a chronic illness effect self-management behaviors. These factors play a previously not understood role in patient's efforts to understand and manage the ever-present but symptomatically variable chronic illness that is CHF. These new concepts illustrate the tools that may be needed to effectively manage this serious and disabling illness, and suggest possible ways to enhance the self-management process and ultimately improve patients' lives.

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“…However, compliance with weighing remained high during follow-up in the intervention groups, while compliance decreased in the care as usual group. Although knowledge alone does not ensure compliance 16 , it has nevertheless been confirmed as an important determinant of compliance in the HF literature. [17][18][19][20] An explanation for low compliance with weighing could be that many HF patients do not recognize the importance of daily weighing to check for fluid retention.…”

mentioning

confidence: 99%

“…[17][18][19][20] An explanation for low compliance with weighing could be that many HF patients do not recognize the importance of daily weighing to check for fluid retention. 16 Also, having a stable weight over a longer period of time is another reason why patients weigh themselves less often. 21 Our study showed that providing adequate education on the importance of daily weighing is effective on increasing and maintaining compliance.…”

mentioning

confidence: 99%

Long-Term Compliance With Nonpharmacologic Treatment of Patients With Heart Failure

Nieuwenhuis

Jaarsma

Veldhuisen

et al. 2012

The American Journal of Cardiology

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The aim of this study was to examine long-term compliance with non-pharmacological treatment of patients with heart failure (HF) and its associated variables. Data of 648 hospitalized HF patients (mean age 69±12 years; 38% female; mean left ventricular ejection fraction [LVEF] 33±14%) were analyzed. Compliance was assessed by means of self-report at baseline and 1, 6, 12, and 18 months after discharge. Patients completed questionnaires on depressive symptoms, HF knowledge, and physical functioning at baseline. Logistic regression analyses were performed to examine independent associations with low long-term compliance. From baseline to 18 months at follow-up, long-term compliance with diet and fluid restriction ranged from 77%-91% and 72%-89% respectively. In contrast, compliance with daily weighing (34%-85%) and exercise (48%-64%) was lower. Patients who were in New York Heart Association (OR 3.55,), and less physical functioning (OR 0.99, were associated with low compliance with exercise. In conclusion, long-term compliance with exercise and daily weighing was lower than long-term compliance with advice on diet and fluid restriction. Although knowledge on HF and being offered educational support positively affected compliance with weighing and fluid restriction, these variables were not related to compliance with exercise. Therefore, new approaches to help HF patients stay physically active are needed. Key-words:Adherence; Compliance; Heart Failure; Non-Pharmacological Treatment. 3Although it has been well established, most studies on determinants of compliance in patients with heart failure (HF) are cross-sectional, or focus solely on compliance with 1 specific non-pharmacological recommendation. Data on temporal trends in compliance with cardiovascular medication have been reported previously 1 , but little is known about long-term compliance with non-pharmacological treatment (i.e., sodium-restricted diet, fluid restriction, daily weighing, and exercise) and its determinants. Noncompliance with non-pharmacological treatment is related to adverse outcomes 2 and lower quality of life. 3 It is therefore vital to identify those patients who are at risk for noncompliance over a longer period of time, especially since studies have shown that noncompliance is a problem in the HF population. 4 It has been suggested that compliance with a specific recommendation might be a marker for compliance with other recommendations or lifestyle changes. 5 Unfortunately, direct comparisons of compliance with different recommendations in the same study population are not available. The present study aims to address this gap by examining long-term compliance with nonpharmacological recommendations and by assessing variables associated with long-term compliance. MethodsThe study employed a descriptive, prospective design and used data from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study.COACH was a randomized, multi-center, controlled study in which 1023 HF patient...

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Factors Influencing Knowledge of and Adherence to Self-care Among Patients With Heart Failure

Abstract: We observed a gap between patients receiving and absorbing or retaining information on self-care for congestive heart failure supplied by health care providers. Self-care education needs to be directed to outpatients in addition to inpatients.

Cited by 322 publications

References 12 publications

Telephone Follow-Up of Self-Care Behaviour after a Single Session Education of Patients with Heart Failure in Primary Health Care

Telephone Follow-Up of Self-Care Behaviour after a Single Session Education of Patients with Heart Failure in Primary Health Care

A story of maladies, misconceptions and mishaps: effective management of heart failure

Long-Term Compliance With Nonpharmacologic Treatment of Patients With Heart Failure

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