Abstract
The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.
Highlights
Heart disease has a high rate of being cited as a health issue in elderly people aged 65 years or older [1] and, among them, the number of elderly people with dementia who are undergoing treatment for heart failure is expected to increase [2]
We obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function
Review of Documents Using previous studies, we extracted the characteristics of patients with reduced cognitive function who received treatment in the acute phase of heart failure such as “There is no awareness of deterioration of heart failure and the patient is put in an unfamiliar environment”, “Difficult to comprehend examination and treatment/patient is under stress and has subjective symptoms”, “Continuation of treatment becomes difficult and will be interrupted” and “Symptoms of deteriorating heart failure are not ameliorated and recovery is delayed”
Summary
Heart disease has a high rate of being cited as a health issue in elderly people aged 65 years or older [1] and, among them, the number of elderly people with dementia who are undergoing treatment for heart failure is expected to increase [2]. In the United States, soaring medical costs related to treatment and care of heart failure were a social problem [5], but disease management of dementia patients was not regarded as a problem. The background of discontinuation of treatment and symptomatic monitoring performed in the acute exacerbation phase of chronic heart failure in patients with impaired cognitive function became clear (Figure 1). A total of 22 people, including 7 certified chronic heart failure nurses and 15 nurses with dementia nursing care experience, were eligible. Age was 41.7 ± 7.8 years for chronic heart failure nurses and 42.7 ± 5.7 years for certified dementia nurses. Average years of experience as a nurse were 18.4 ± 8.6 for chronic heart failure nurses and 20.2 ± 5.7 years for certified dementia nurses. Sex in certified chronic heart failure nurses was 6 females and 1 male and for certified dementia nurses, it was 12 females and 3 males
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