Using vignettes to understand heart failure self‐care

Xu, Jiayun; Arruda, Sofia; Gallo, Joseph J.; Nolan, Marie T.; Flowers, D. Lynn; Szanton, Sarah L.; Himmelfarb, Cheryl Dennison; Han, Hae Ra

doi:10.1111/jocn.14581

Cited by 7 publications

(12 citation statements)

References 24 publications

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“…Manuscript types included 46 observational studies, 2, 7, 14, 21–63 27 qualitative studies, 4, 64–89 12 literature reviews, 16, 17,…”

Section: Resultsmentioning

confidence: 99%

“…115 Some of the 106 references related to more than one of the research questions. Twelve included references related to HF symptom perception definition, 1, 8, 17, 27, 34, 43, 54, 75, 80, 100, 102, 106 68 to description, 2–4, 7, 10, 16, 17, 21–42, 49, 64–74, 76–79, 81–87, 89…”

Section: Resultsmentioning

confidence: 99%

“…17, 71, 73, 74, 76, 80, 93, 102 Body analysing made patients uncertain, 89 as some patients find it challenging to determine whether a symptom is clinically meaningful 100 – particularly for vague or non-specific symptoms. 87 Patients are often uncertain in situations when symptoms require interpretation 30 when clinical status deteriorates warranting medical attention. 34, 72, 80, 90 Moreover, discrimination of HF symptoms from symptoms related to other comorbidities remains a challenge 66, 79, 92–94, 102 and many patients inaccurately attribute their symptoms to something other than HF 23, 81, 85 such as age, 16, 27, 31, 84, 89, 91, 96, 107 comorbidities, 4, 27, 31, 37, 38, 79, 93 medication, 76, 91, 93 stress, 102 fatigue 38 or the weather.…”

Section: Resultsmentioning

confidence: 99%

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Symptom perception in heart failure: a scoping review on definition, factors and instruments

Santos

Liljeroos

Dwyer

et al. 2019

European Journal of Cardiovascular Nursing

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2020). Symptom perception in heart failure: a scoping review on definition, factors and instruments.(2) AbstractBackground. Symptom perception in heart failure (HF) has been identified as crucial for effective self-care that is a modifiable factor related to decreased hospital readmission and improved survival. Aims. To systematically review the HF symptom perception literature and synthesise knowledge on definition, description, factors and instruments. Methods. We conducted a scoping review including studies reporting patient reported symptom perception in adults with HF. Structured searches were conducted in Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, JBI and grey literature. Two authors independently reviewed references for eligibility. Data were charted in tables and results narratively summarized. Results. The search yielded 3,057 references, of which 106 were included. The definition of HF symptom perception comprised body listening, monitoring signs, recognising, interpreting and labelling symptoms, and furthermore awareness of and assigning meaning to the change. Symptom monitoring, recognition and interpretation were identified as challenging. Symptom perception facilitators include prior HF hospitalisation, HF self-care maintenance, symptom perception confidence, illness uncertainty and social support. Barriers include knowledge deficits, symptom clusters and lack of tools/materials. Factors with inconsistent impact on symptom perception include age, sex, education, experiences of living with HF, comorbidities, cognitive impairment, depression and symptom progression. One instrument measuring all dimensions of HF symptom perception was identified. Conclusion. HF symptom perception definition and description have been elucidated. Several factors facilitating or hampering symptom perception are known. Further Symptom perception in heart failure: a scoping review on definition, factors and instruments 3 research is needed to determine a risk profile for poor symptom perception -which can then be taken into consideration when supporting HF self-care. (3) Keywords Heart failure Symptom perception Body observation Body analysis Facilitators Barriers Symptom perception in heart failure: a scoping review on definition, factors and instruments

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“…Manuscript types included 46 observational studies, 2, 7, 14, 21–63 27 qualitative studies, 4, 64–89 12 literature reviews, 16, 17,…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Symptom perception in heart failure: a scoping review on definition, factors and instruments

Santos

Liljeroos

Dwyer

et al. 2019

European Journal of Cardiovascular Nursing

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“…Vignettes "comprise stimuli that selectively portray elements of reality to which research participants are invited to respond" (p. 918) and can appear in different forms [70]. They represent a practical, ethical, and cost-effective method to generate data [71] and can be used to assess perceptions, attitudes, and behaviors [70], and were used in the context of self-care decisionmaking [72]. For the purpose of this study, three different vignettes (V1-3) in written form were developed by the principle investigator and the study coordinator taking into account the recommendations of Hughes and Huby [73].…”

Section: Capability and Sign-and-symptom Managementmentioning

confidence: 99%

A self-management support intervention for patients with atrial fibrillation: a randomized controlled pilot trial

Jobst¹,

Leppla²,

Köberich³

2020

Pilot Feasibility Stud

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Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Despite effective treatment, it is characterized by frequent recurrences. Optimal therapeutic management of AF requires active participation and self-management from patients. Two major components of self-management are self-monitoring and sign-andsymptom management. Pulse self-palpation (PSP) is a method of self-monitoring; however, not all AF patients are capable of successfully performing PSP. Due to a lack of interventions on this topic, a nurse-led intervention for patients with AF (PSPAF intervention) was developed to foster self-monitoring and to enhance self-management through PSP. The purpose of this pilot study was to test the acceptability, feasibility, and potential effects of this intervention on the capability of patients' PSP and sign-and-symptom management. Moreover, we aimed at gathering data on the feasibility of applied research methods to aid in the design of future studies. Methods: The pilot trial involved 20 adult patients with AF, randomized to an intervention or usual care group. At baseline and during a home visit 3-5 weeks later, we collected data using questionnaires, checklists, field notes, a mobile ECG device, and a diary. Acceptability and feasibility measures were validated through predefined cutoff points. Effect size estimates were expressed as relative risks (RR) and the number needed to treat (NNT). Results: The PSPAF intervention seemed feasible, but only partly acceptable. There were limitations in terms of potential effectiveness, suitability, addressing participants' willingness to implement its content in daily life, and adherence. Estimations of effect sizes suggest a large effect of the intervention on patients' PSP capability (RR = 6.0; 95% CI = [0.83, 43.3]; NNT = 2.4), but almost no effect on sign-and-symptom management (RR = 1.5; 95% CI = [0.7, 3.1]; NNT = 4.0). The feasibility of applied research methods showed minor limitations on recruitment and participant burden. Conclusions: Despite some limitations, the intervention seemed to be applicable and promising. Taking into account the suggestions and amendments we have made, we recommend conducting a full-scale trial to examine the efficacy of the PSPAF intervention.

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“…These patients often experience repeated and painful dyspnea and edema at night, which reminds patients to follow strictly medication instructions and control their diet properly, which helps to optimize their self-care behavior. A higher NYHA functional class is associated with more severe disease, which leads to more stringent restrictions on physical activities[32,33]. Slightly increased activity may cause dyspnea and fatigue, which also limits the patients’ normal self-care behavior.…”

Section: Discussionmentioning

confidence: 99%

Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

Sun¹,

Zhang²,

Ma³

et al. 2019

WJCC

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BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease, thus reducing the mortality and hospitalization rate. Although the previous regimen can effectively relieve symptoms in the early stage of treatment, long-term use may cause adverse events, such as arrhythmia, and even increase mortality. Therefore, conventional treatment cannot meet the actual health needs of patients, and scientific nursing intervention is very necessary. AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF). METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group ( n = 50) and control group ( n = 50) using a random number table. Routine nursing care was applied to the control group, and FCIHE was offered to the intervention group. The self-care behavior, 6-min walking distance (6MWD), and 36-item short form health survey (SF-36) scores were compared between the two groups. The influencing factors of the self-care were also analyzed. RESULTS The 6MWD was not significantly different between the two groups at admission ( P > 0.05); however, at 3 and 6 mo after discharge, 6MWD was significantly increased, and it was significantly longer in the intervention group ( P < 0.05). The scores for self-care behavior showed no significant difference at admission between the two groups ( P > 0.05); however, at 3 and 6 mo after discharge, the total scores for self-care maintenance, management, confidence, and behavior of the intervention group were significantly higher than those of the control group ( P < 0.05). There were no significant differences in the SF-36 scores at admission ( P > 0.05); however, at 3 mo and 6 mo after discharge, the scores for all eight subscales, including physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, vitality, social functioning, role-limitations due to emotional problems, and mental health, were significantly higher in the intervention group ( P < 0.05). As shown by logistic regression analysis, the influencing factors of self-care mainly included age, cardiac function class, and education background (odds ratio > 1; all P < 0.05). CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients. Age, cardiac function, and education level affected the implementation of self-care amon...

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Using vignettes to understand heart failure self‐care

Abstract: Vignettes may be a helpful tool to prompt patient-healthcare provider communication about self-care management and prompt discussions about appropriate self-care decisions in response to varying levels of symptom severity.

Cited by 7 publications

References 24 publications

Symptom perception in heart failure: a scoping review on definition, factors and instruments

Symptom perception in heart failure: a scoping review on definition, factors and instruments

A self-management support intervention for patients with atrial fibrillation: a randomized controlled pilot trial

Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

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