Life In Heart Failure Patients Research Articles

Influence of Comprehensive Nursing Care on Heart Failure Patient Management: A Systematic Review and Meta-Analysis.

Heart failure is a common chronic illness associated with high readmission rates and death. Comprehensive nursing care, management of symptoms, and psychological support are increasingly seen as critical components of successful heart failure therapy. This systematic review and meta-analysis aimed to determine the effect of comprehensive nursing care on clinical outcomes and quality of life in heart failure patients. We searched electronic databases (Pubmed, PROSPERO, and Web of Science) for randomised controlled trials and observational studies on comprehensive nursing care treatments for heart failure patients. Data on readmission rates, mortality rates and quality of life were obtained and examined. 693 studies satisfied the inclusion criteria. A meta-analysis found that comprehensive nursing care reduced heart failure-related readmissions considerably when compared to conventional therapy (odds ratio (OR) 0.77 (95% CI 0.66-0.88, P =.0002). There was a significant difference in all-cause mortality (OR 0.76 (95% CI: 0.60-0.97, P=.03), but comprehensive treatment enhanced quality of life and functional status (Standardised Mean Difference -0.05, 95% CI -0.21 to 0.10, P =.49). Comprehensive nursing care improves clinical outcomes and quality of life for heart failure patients. This study stresses the need to add comprehensive nurse interventions in normal heart failure treatment programmes.

Psychometric properties of the KCCQ-12 in an european cohort of patients with heart failure

Abstract Background Despite medical advances, patients with heart failure continue to suffer from poor quality of life due to worsening symptoms and functional limitations. Therefore, it is important to understand the multidimensional facets of quality of life in these patients. The Kansas City Cardiomyopathy Questionnaire is a commonly used quality of life assessment tool worldwide. However, However, there is still a lack of knowledge about its psychometric properties. Purpose The aim of this study was to investigate the psychometric properties of the KCCQ-12 and its measurement invariance in a cohort of European patients with heart failure. Methods Participants (n=510, median age=72, IQR=18, 58% males) completed the KCCQ-12 alongside measures of clinical psychosocial severity. A confirmatory factor analysis was used to establish factorial validity; internal consistency was determined using the Omega coefficient and the model-based internal consistency coefficient. Zero-order correlations between the KCCQ-12 scores and clinical and psychosocial measures were performed to test convergent validity. Multigroup confirmatory factor analysis was conducted to test measurement invariance across patients with preserved vs reduced ejection fraction. Results Confirmatory factor analysis confirmed a four-factor solution, with the domains of physical limitations, symptom frequency, quality of life, and social interference. Internal consistency was excellent (Omega coefficients ranging from 0.83 and 0.90, and internal consistency index of 0.94). The KCCQ-12 scores significantly correlated with ejection fraction, New York Heart Association class, quality of life, anxiety, depression, symptom burden, and the KCCQ-23 Overall Summary score, which adequately supported the convergent validity of the KCCQ-12. Measurement invariance was confirmed at the partial scalar and strict level. Conclusions These findings support the validity and reliability of the KCCQ-12, both in patients with reduced and preserved ejection fraction. Hence, this version can be confidently used both in research and clinical practice to measure quality of life of heart failure patients.

PSYCHOMETRIC PROPERTIES OF THE KCCQ–12 IN A EUROPEAN COHORT OF PATIENTS WITH HEART FAILURE

Abstract Background Despite medical advances, patients with heart failure continue to suffer from poor quality of life due to worsening symptoms and functional limitations. Therefore, it is important to understand the multidimensional facets of quality of life in these patients. The Kansas City Cardiomyopathy Questionnaire is a commonly used quality of life assessment tool worldwide. However, However, there is still a lack of knowledge about its psychometric properties. Purpose The aim of this study was to investigate the psychometric properties of the KCCQ–12 and its measurement invariance in a cohort of European patients with heart failure. Methods Participants (n=510, median age=72, IQR=18, 58% males) completed the KCCQ–12 alongside measures of clinical psychosocial severity. A confirmatory factor analysis was used to establish factorial validity; internal consistency was determined using the Omega coefficient and the model–based internal consistency coefficient. Zero–order correlations between the KCCQ–12 scores and clinical and psychosocial measures were performed to test convergent validity. Multigroup confirmatory factor analysis was conducted to test measurement invariance across patients with preserved vs reduced ejection fraction. Results Confirmatory factor analysis confirmed a four–factor solution, with the domains of physical limitations, symptom frequency, quality of life, and social interference. Internal consistency was excellent (Omega coefficients ranging from 0.83 and 0.90, and internal consistency index of 0.94). The KCCQ–12 scores significantly correlated with ejection fraction, New York Heart Association class, quality of life, anxiety, depression, symptom burden, and the KCCQ–23 Overall Summary score, which adequately supported the convergent validity of the KCCQ–12. Measurement invariance was confirmed at the partial scalar and strict level. Conclusions These findings support the validity and reliability of the KCCQ–12, both in patients with reduced and preserved ejection fraction. Hence, this version can be confidently used both in research and clinical practice to measure quality of life of heart failure patients.

Spiritual Well-Being to the Quality of Life of Heart Failure Patients

Heart failure is caused by the heart being unable to maintain normal blood flow. Some patients with heart failure expressed that they needed nurses' help with their physical, psychological, and spiritual problems. Spiritual Well-Being and its components play an important role in a person's declining quality of life and have been linked to various other health factors. This research aims to determine the relationship between spiritual well-being and the quality of life of heart failure patients. The sample for this research was 100 respondents taken using the accidental sampling technique. Data analysis uses the chi-square correlation test if the test conditions are met. If the test requirements are not met, use the alternative Fisher exact test. The instruments used in this research were the Spiritual Needs Questionnaire (SpNQ) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The results of this study illustrate that there is no relationship between quality of life scores and all aspects of the spiritual needs of heart failure patients (p> 0.05). The results of the analysis carried out showed that NYHA functional status (p= 0.044) and ejection fraction (r= -0.205, p= 0.041) influenced the spiritual needs of heart failure patients. The results of this study indicate that the patient's spiritual needs are not related to the general quality of life score, but have a significant relationship with the physiological dimensions of quality of life, ejection fraction, and NYHA functional status.

The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study

BackgroundWhile palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran.MethodsThis single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits.ResultsWe recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference.ConclusionThis nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran.Trial registrationThe study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform.IRCT registration number: IRCT20100725004443N29.

The Six-Minute Walk as A Safety Exercise in Improving the Health-Related Quality of Life Among Heart Failure Patients: A Preliminary Research

The prevalence of heart failure patients is steadily increasing worldwide. The quality of life among them was also shown to be decreasing day by day. Inadequate health-related quality of life in heart failure patients leads to an increase in mortality rate. Thus, effective management of heart failure patients is essential. The present study was to examine the intervention based on the six-minute walk test to improve health-related quality of life for patients with heart failure. A quasi-experimental study was conducted in the cardiovascular center of the acute care setting. The Six-minute Walk Test (6MWT), in accordance with the American Thoracic Society guideline, was implemented as the intervention procedure. The Minnesota Living with Heart Failure (MLWHF) was used to measure the health-related quality of life of patients. Fifteen heart failure patients enrolled in the study for a month; 73.3% were male with a mean age of 57.47 (SD 14.32). Overall, the health-related quality of life in heart failure patients was poor at the baseline of the study, then their quality of life significantly increased to good quality after implementing the 6MWT. An improvement in the functional performance was also found among them. This study indicates that the 6MWT was suitable, safe, and simply performed in heart failure patients, which can effectively improve the health-related quality of life of patients with heart failure.

Abstract 14176: Cardiac Structure and Function in Relation to Health-Related Quality of Life in Heart Failure Patients With Preserved Ejection Fraction: Results From the PARAGON-HF Study

Background: Health-related quality of life (HRQL) is reduced in patients with heart failure with preserved ejection fraction (HFpEF). However, the extent to which HRQL outcomes are related to cardiac structure and function in patients with HFpEF is not well understood. Methods: We examined the association between baseline echocardiographic measures and longitudinal Kansas City Cardiomyopathy Questionnaire (KCCQ) measures in patients with HFpEF in the PARAGON-HF trial using longitudinal regression models adjusted for age, sex, baseline KCCQ score, randomization, and other important clinical confounders. Results: Among 1,094 patients with baseline KCCQ data at randomization and a baseline echocardiogram within 6 months of enrollment, the mean age was 74 years and 53% were women. Over 3 years, 78% completed KCCQ measures at baseline, 12, 24, and 36 months. Missing values for non-survivors (n=116) were imputed as zero to avoid survival bias. Posterior wall thickness, septal E/e’, and right ventricular (RV) end diastolic area were negatively associated with the KCCQ Overall Summary Score, and a similar pattern of associations was observed for the KCCQ Clinical Summary Score (Table). Pulmonary artery systolic pressure was additionally negatively associated with the KCCQ Total Symptom Score. Notably, left ventricular (LV) size, septal wall thickness, LV ejection fraction, LV strain, and left atrial size were not significantly associated with longitudinal changes in KCCQ. Conclusion: In patients with HFpEF, increased LV posterior wall thickness, elevated LV filling pressure, elevated pulmonary pressure, and RV enlargement - together suggestive of more advanced diastolic dysfunction - are associated with a decline in KCCQ scores and may influence future worsening of quality of life.

Development and validation of heart failure-specific quality-of-life measurement tool in India

ObjectiveTo develop and validate a sensitive tool for assessment of quality of life (QoL) in heart failure (HF) patients in Indian settings. MethodsThe authors conducted literature review, in depth interviews, clinical observations and designed the first draft of the QoL tool. The tool was validated using content and face validity by a panel of experts. For internal consistency reliability, the questionnaire was administered among 270 HF patients. Test-retest reliability was assessed in 20 HF patients. Principal component factor analysis with varimax rotation was employed to assess the dimensionality and to reduce the number of items. Cronbach's alpha, and Intra-class correlation coefficients (ICCs) were employed to investigate reliability of questionnaire. The responsiveness data were collected 6 months after the baseline data collection from 30 HF patients. IBM® SPSS® Statistics Version 21 was used for statistical analysis. ResultsThe principal component factor analysis revealed mainly 5 domains. The final tool included 25 items. Cronbach's alpha (α) for the overall tool was 0.915. Intra-class correlation coefficients (ICCs) based on test-retest was 0.734. The final tool showed good responsiveness to changes with a mean ± SD of the change in response of 46 ± 12.4 and a standardized mean response of 3.7 within six-months. ConclusionThe HF specific QoL tool developed for Indian patients is a valid and reliable instrument and it can be applied in daily clinical practice, and research. Short summaryWe had developed and validated a quality-of-life tool for heart failure patients in India. This is the first ever attempt to develop a measure for heart failure patients in India. We had used a mixed methodology approach to identify all the domains in the tool. The newly developed tool is a valid, reliable, sensitive and responsive tool to measure quality of life in HF patients in India. This tool can be applied in daily clinical practice, research and health system for patients with HF in India.

Knowledge, treatment adherence, and quality of life of heart failure patients at Nhan Dan Gia Dinh Hospital

Heart failure (HF) is one of the most common diseases worldwide, with a high prevalence and mortality, creating a significant cost burden on patients, society, and the healthcare system. As a result, extensive research has been conducted to investigate advanced treatment methods for heart failure, and patient adherence plays a crucial role in optimizing treatment effectiveness. This study aims to describe the current status of patients’ knowledge, treatment adherence, and quality of life among outpatients with heart failure visiting for routine treatment at Nhan Dan Gia Dinh Hospital. A descriptive cross-sectional survey was conducted on 330 outpatients with heart failure who were visited for routine treatment at Nhan Dan Gia Dinh Hospital. All data were collected through face-to-face interviews using constructed questionnaires. The study showed the limit of heart failure knowledge among patients, with a mean score of 5.2 ± 2.3. Only 4.8% of patients were adequate overall heart failure knowledge. The treatment adherence was limited, with an overall adherence rate of 20.9%. The patient’s quality of life was generally stable at a high level, with a mean of 0.871 for the descriptive system score and 0.697 for the standardized VAS score. The adherence rate of patients with HF was low, particularly among those with non-drug adherence. Very few patients with heart failure have adequate knowledge of heart failure. More support and health education programs on heart failure treatment adherence are needed for patients to increase their knowledge, adherence and improve their quality of life.

The Relationship between Coping Strategies and Quality of Life in Patients with Heart Failure

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Heart failure is one of the most common cardiovascular diseases, causing high mortality and morbidity worldwide. Heart failure is a chronic disease that causes functional damage to the heart due to many symptoms that affect quality of life. The aim of this study was to clarify the relationship between coping strategies and quality of life in heart failure patients. This type of research is a quantitative study with a cross-sectional approach. This research was conducted on heart failure patients at the Cardiac Polyclinic at Sebelas Maret University Hospital in March-April 2023. The population of this study was all heart failure patients at the Cardiac Polyclinic at Sebelas Maret University Hospital as many as 1</em><em>.</em><em>114 patients. The sampling technique in this study was purposive sampling with a total sample of 294 patients. Data collection in this study used the Brief Cope Inventory questionnaire to measure coping strategies and the Minnesota Living Heart Failure Questionnaire (MLHFQ) to measure the quality of life in heart failure patients. Data analysis with pearson product moment correlation test. The results showed that there was a relationship between coping strategies and quality of life in heart failure patients (p-value 0.000) with a correlation coefficient (r) = 0.625, there was a very strong correlation between the two variables. It is recommended for health workers to educate, support, and motivate patients with heart failure who are undergoing routine treatment to pay attention to self-coping and improve the quality of life, and it is recommended that the patient's family provide support and treatment assistance to patients in carrying out treatment in order to improve the patient's quality of life</em><em>.</em><em></em></p><p><em> </em></p></td></tr></tbody></table></div><p><strong><em>Keyword: Coping Strategies, Heart Failure, Quality of Life</em></strong></p>

Fatigue Berhubungan dengan Kualitas Hidup pada Pasien Gagal Jantung

This study aims to determine the relationship between fatigue and quality of life in heart failure patients. This study uses a correlative descriptive method utilizing a cross-sectional approach. Based on the study's results, most respondents were in the age range of 56-65 years with 39.6% and male sex as much as 61.3%. Most respondents are in the category of severe fatigue 77.4% and poor quality of life as much as 70.8%. Data analysis used the Chi-Square test, which produced a p-value of 0.001. In conclusion, a relationship exists between fatigue and quality of life in heart failure patients.
 Keywords: Heart Failure, Fatigue, Quality of Life

The implantable cardiac monitor in heart failure patient: a possible new indication?

Implantable cardiac monitors (ICMs) have found increasing use in clinical practice over the years, proving, when used in high-risk populations, to facilitate the diagnosis of bradyarrhythmias and tachyarrhythmias requiring treatment. Experience with heart failure patients undergoing pacemaker (PMK) or implantable defibrillator (ICD) implantation, which allow for continuous electrocardiographic monitoring and transthoracic impedance assessment, has made it possible to identify predictors of heart failure flare-ups. In this context, the use of telemonitoring has been shown to ensure better management of patients with heart failure. These benefits cannot be assessed to date in patients with heart failure and left ventricular ejection fraction (LVEF) > 35% who have no indication for PMK or ICD implantation. This population has been shown to have a significant incidence of ventricular arrhythmias and bradyarrhythmias. In addition, a significant number of cerebrovascular events are observed in this population, largely attributable to the high incidence of atrial fibrillation (AF). In this population, the occurrence of AF has also been shown to have a negative impact on patients' prognosis; at the same time, a rhythm control strategy has been shown to be more beneficial in this area than a rate control strategy. Studies also suggest arrhythmias have a negative impact on the cognitive status and quality of life of heart failure patients. These reasons could justify the implantation of ICMs equipped with telemonitoring systems in heart failure patients. The information provided by the monitoring system, if properly managed, could bring benefits in terms of prognosis and quality of life along with a reduction in economic costs. We will try here, by answering a few questions, to assess whether there is an indication for ICM in heart failure, which patients should be candidates and how these patients should be managed.

The feasibility and acceptability of an early tele-palliative care intervention to improve quality of life in heart failure patients in Iran: A protocol for a randomized controlled trial

BackgroundHeart failure (HF) has become a global health problem that has affected the quality of life of millions of people. One approach to improving patients’ quality of life (QoL) with chronic diseases such as HF is palliative care. In Iran, the bulk of palliative care research is directed to patients with cancer, with the primary focus on the physical aspect rather than the psychosocial and spiritual aspects of palliative care. To address this gap, this study aims to determine the feasibility and acceptability of this early tele-palliative care intervention to improve quality of life in heart failure patients in Iran. MethodsThe early tele-palliative care versus usual care study is designed as a single-centre, randomised, feasibility trial of 50 patients with heart failure aged 18 to 65 and clinician-determined New York Heart Association class II/III or American College of Cardiology stage B/C HF, recruited in Imam Khomeini Hospital Complex, Tehran, Iran. This intervention contains 6 weekly educational webinars and concurrent WhatsApp® group activities. Program feasibility and acceptability will be assessed by measuring the recruitment, attrition, and questionnaire completion rates; satisfaction and attitudes about the intervention will be measured via a telephone-based interviews. Secondary outcomes of Qol, mood status and number of emergency department visits will be measured with validated instruments. Participants in both groups will be followed up for 6 weeks, and the measures will be re-administered. Appropriate statistical tests will be used to analyse the data. ConclusionThis is the first early tele-palliative care intervention designed for heart failure patients in Iran. The intervention has been developed by a multidisciplinary team of academic and clinical professionals with patient stakeholder input to create a rigorous and culturally responsive approach for palliative care delivery for heart failure patients in Iran. Trial registrationIRCT registration number - IRCT20100725004443N29.

The Influence of Informal Caregivers' Preparedness on Psychological Symptoms and Quality of Life Among Patients With Heart Failure And Insufficient Self-care.

Most patients with heart failure find self-care difficult to perform and rely on family caregivers for support. Informal caregivers, however, often face insufficient psychological preparation and challenges in providing long-term care. Insufficient caregiver preparedness not only results in psychological burden for the informal caregivers but may also lead to a decline in caregiver contributions to patient self-care that affects patient outcomes. Our objective was to test (1) the association of baseline informal caregivers' preparedness with psychological symptoms (anxiety and depression) and quality of life 3 months after baseline among patients with insufficient self-care and (2) the mediating effects of caregivers' contributions to self-care of heart failure (CC-SCHF) on the relationship of caregivers' preparedness with patients' outcomes at 3 months. A longitudinal design was used to collect data between September 2020 and January 2022 in China. Data analyses were conducted using descriptive statistics, correlations, and linear mixed models. We used model 4 of the PROCESS program in SPSS with bootstrap testing to evaluate the mediating effect of CC-SCHF of informal caregivers' preparedness at baseline with psychological symptoms or quality of life among patients with HF 3 months later. Caregiver preparedness was positively associated with CC-SCHF maintenance ( r = 0.685, P < .01), CC-SCHF management ( r = 0.403, P < .01), and CC-SCHF confidence ( r = 0.600, P < .01). Good caregiver preparedness directly predicted lower psychological symptoms (anxiety and depression) and higher quality of life for patients with insufficient self-care. The associations of caregiver preparedness with short-term quality of life and depression of patients with HF with insufficient self-care were mediated by CC-SCHF management. Enhancing the preparedness of informal caregivers may improve psychological symptoms and quality of life of heart failure patients with insufficient self-care.

Model of spiritual nursing care in enhancing quality of life of patients with heart failure

To develop a spiritual nursing care model to improve the quality of life of heart failure patients. The cross-sectional study was conducted at two government hospitals in East Java, Indonesia, from August to November 2019, and comprised patients of either gender aged 30 years or above having classic heart failure symptoms of weariness, ankle swelling and dyspnoea. Standardised questionnaires were used to collect data regarding disease, psychosocial, spiritual, demographic and environmental factors as well as stressors, formation of meaning, coping strategy, spiritual wellbeing, and quality of life. Data was analysed using partial least squares structural equation modelling. Of the 222 patients, 124(55.9%) were males and 98(44.1%) were females. The overall mean age was 57.7±9.96 years. Overall, 33(14.9) patients were suffering from heart failure for >5 years, 36(16.2) had been hospitalised >5 times, and 8(3.6%) had no health insurance cover. Psychosocial (T=2.110), spiritual (T=1,998) and environmental (T=2,019) factors had an effect on the ability to assess stressors. Disease (T=5.497), spiritual (T=3.596) and environmental (T=3.172) factors had an effect on spiritual wellbeing. Disease (T=7.553), psychosocial (T=2.230) and environmental (T=2.625) factors affected the quality of life. The ability to assess stressors affected meaning formation (T=3.293), which had an effect on coping strategies (T=3.863), which, in turn, had an effect on spiritual wellbeing (T=9.776), and that affected the quality of life (T=2.669). The spiritual nursing care model was found to be influenced by disease, psychosocial and environmental factors as well as by spiritual wellbeing.

Investigating Occupation, Ejection Fraction, and Comorbidity Factors with Quality of Life in Heart Failure Patients: A Cross-sectional Study in Indonesia

Background: Heart disease causes functional disorders that can cause the sufferer to experience fatigue and dyspnea, leading to low quality of life. Various factors related to the quality of life of heart failure patients include occupation and ejection fraction. The number of heart failure patients treated at Aceh government hospital is still high in 2021, as well as the incidence of recurrent hospitalization. Objectives: This study aimed to determine the relationship between occupation, ejection fraction, and heart failure patients' quality of life. Methods: The study used a quantitative research approach with a cross-sectional design. The sample was 154 heart failure patients who visited the Cardiac Polyclinic of a provincial hospital in Banda Aceh, Indonesia. Data on patient occupation, ejection fraction, and comorbidity factors were obtained from the sociodemographic and clinical characteristics of the respondents. Then, the patient’s quality of life was measured by the Minnesota Living with Heart Failure (MLHF) questionnaire. The chi-square test and logistic regression (with a significance level α = 0.05) were used in data analysis in this study. Results: The results of the study found a significant direct correlation between patient occupation (P = 0.001), ejection fraction (P = 0,001), and an inverse correlation of comorbidity factors (P = 0.001) with quality of life (α = 0.05). The multivariate analysis using logistic regression found that the dominant factor, ejection fraction, was associated with the quality of life of heart failure patients with OR: 12.033, followed by comorbidity factors (OR: 3.565) and occupation (OR: 1.819). Conclusions: The quality of life of heart failure patients is strongly associated with the ejection fraction in heart failure patients; therefore, maintaining the ejection fraction is needed to improve the quality of life.

Heart Failure Clinic: A Practical Guide for Health Practitioners in Hospitals

Heart failure is still the leading cause of mortality and morbidity in healthcare in the world. Although the development of the latest drugs and therapeutic devices for heart failure is growing, the life expectancy of patients with heart failure is still low. This is because the hospital has not developed a special heart failure clinic consisting of cross-sectional experts. This heart failure clinic will provide therapy according to heart failure guidelines and will discuss with the patient what therapy is suitable for his condition. This clinic is expected to be a link with advances in technology and medical therapy to improve the quality of life of heart failure patients.

Effect of Advance Care Planning on Heart Failure Patients: An Evidence Based Case Report

Despite the advances in medical therapy, heart failure remains a disease that requires attention due to the course of the illness; it can lead to unpredictable, progressive, and fatal conditions. Existing therapy aims to improve the condition and prevent disease progression, with a balanced secondary therapy for various conditions that can trigger acute decompensated heart failure. Advances in technology and therapy may increase the prevalence of patients with heart failure, including prolonging the refractory phase of the disease. There are recommendations for advance care planning to support patient therapy and improve the quality of life of patients with heart failure. This evidence-based case report aims to investigate the benefits of advance care planning in heart failure patients. A heart failure patient is referred to the palliative care team for advance care planning. Literature searches were conducted on ProQuest, PubMed, Scopus, and Cochrane according to the clinical questions. The studies were selected based on the inclusion and exclusion criteria, then a critical review was conducted. One study showed significant results regarding the effectiveness of advance care planning on the quality of life of heart failure patients. Another study showed a significant improvement in depression among patients engaged in advance care planning. However, it showed no difference in the quality of life compared to usual care because the sample size was relatively small, and the quality of evidence was low. Therefore, it can be concluded that advance care planning can improve heart failure patients’ psychological symptoms and quality of life.

Psychosocial factors partially explain gender differences in health-related quality of life in heart failure patients.

There is little information about the influence of gender on quality of life (QoL) in heart failure. The purpose of this study was to evaluate whether the health-related QoL gap between men and women can be explained by the interaction between psychosocial factors and clinical determinants in a real-word cohort of patients with chronic heart failure. We conducted a single-centre, observational, prospective cohort study of 1236 consecutive patients diagnosed with chronic heart failure recruited between 2004 and 2014. To assess QoL, we used the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Female gender was associated with worse global QoL compared to male gender (MLHFQ overall summary score: 49±23 vs. 43±24; P value <0.001, respectively) and similarly had poorer scores in physical and emotional dimensions but scored better on social dimension. In univariate models and in models adjusted for clinical determinants, female gender behaved as a predictor of worse global, physical and emotional QoL, and better social QoL compared with men. In models only including psychosocial determinants and in comprehensive models including all psychosocial and clinical factors, these differences according to gender were no longer significant. In this study, we have shown that the gap in health-related QoL between men and women with chronic heart failure can be partially explained by the interaction between biological and psychosocial factors. Biological factors are the main drivers of QoL in HF patients. However, the contribution of psychosocial factors is essential to definitively understand the role of gender in this field.

The Relationship of Social Support and Severity of Disease with Quality of Life in Heart Failure Patients

Amaç: Bu çalışmada kalp yetersizliği hastalarında sosyal destek ve hastalık şiddeti ile yaşam kalitesi arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntem: Tanımlayıcı korelasyonel kesitsel bir çalışmada kalp yetmezliği olan hastalar değerlendirildi. Yaşam kalitesini değerlendirmek için Minnesota'nın Yaşayan Kalp Yetmezliği Anketi (MLHFQ) kullanıldı. Fleming tarafından geliştirilen sosyal destek anketi de kullanılmıştır. Hastalığın şiddeti New York Kalp Derneği'nin (NYHA) rehberliğine göre sınıflandırıldı. İstatistiksel olarak p&lt;0.05 anlamlı kabul edildi. Bulgular: Yaşam kalitesinin fiziksel (29.68), sosyoekonomik (11.03), duygusal (89.6) ve toplam yaşam kalitesi (46.2) gibi farklı boyutları çoğunlukla düşük ve orta düzeydeydi. Kalp yetersizliği olan hastalarda algılanan sosyal desteğin tüm boyutları ağırlıklı olarak düşüktü. Algılanan sosyal desteğin tüm boyutları yaşam kalitesi ile anlamlı ve pozitif olarak ilişkiliydi (p&lt;0,001). Sosyal desteği yüksek olan hastalar, hastalıklarının şiddetine rağmen daha iyi bir yaşam kalitesine sahipti. (p&lt;0.01). Sonuç ve Öneriler: Bu çalışmanın sonuçları kalp yetersizliği hastalarında algılanan sosyal desteğin ve yaşam kalitesinin düşük olduğunu ve sosyal destek ile yaşam kalitesi arasında pozitif bir ilişki olduğunu göstermiştir. Ayrıca, daha yüksek sosyal desteğe sahip hastaların, hastalıklarının ciddiyetine rağmen daha iyi bir yaşam kalitesine sahip olduklarını bulduk. Bu nedenle hemşirelerin bu hastaların duygusal boyutuna özellikle dikkat etmeleri, yaşam kalitelerini artırmaları için uygun sosyal desteği tanıtmaları ve sağlamaları önerilmektedir