Hospital readmissions for heart failure are a major clinical problem and associated financial burden. However, readmission rate in heart failure remains high. This study aimed to test a model ...explaining the factors influencing readmission in people with heart failure. In total, 204 patients with heart failure were recruited at four regional hospitals in Thailand. All research instruments used showed acceptable validity and reliability. The data were analyzed using version 8.72 of Linear Structural Relationship. The results showed that the hypothetical model matched the empirical data. The severity of symptoms was the factor that had the most impact on readmission and had a direct positive effect on readmission, followed by quality of life and depression. An intervention study to prevent readmission in heart failure patients should be developed and tested as well. It should incorporate the promotion of social support and quality of life to reduce readmission in heart failure patients.
Purpose To survey the characteristics and differences of discharge support that heart failure patients and physical therapists consider necessary. Participants and Methods The subjects were 16 ...patients with heart failure who were 65 years of age or older and 7 physical therapists (PT). The Q-sort method was used to survey the values relating to discharge support needed by heart failure patients. Results The discharge support item considered highly necessary by both groups was “response at times of recurrence.” Differences between the two groups were found in “purpose of exercise” and “explanation of exercise risk”, with the patient group expressing lower need than the PT group. Conclusion Both groups were conscious of the need for effective management of salt and water intake, and body weight for prevention of recurrence. The need for “exercise” was lower in the patient group than in the PT group. This suggests that there is a problem with guidance related to exercise.
Background: The incidence of heart failure as well as its treatment costs and rehospitalization rates are increasing worldwide. Physical assessment of elderly patients with heart failure living in ...their homes is challenging for community nurses. Pocket-sized echocardiographs will be useful for assessing the condition of the patients with heart failure during home-visit care. Objectives: This pilot study aimed to examine the feasibility of measuring the inferior vena cava (IVC) diameter using a pocket-sized ultrasound device. Methods: Nursing students were trained to use the pocket-sized ultrasound device (PUSD) for measuring the inferior vena cava diameter of a healthy subject. We evaluated the accuracy and rapidity of the nursing students’ measurements compared with those of an expert sonographer. Results: In total, 83.3% of the participants accurately visualized the IVC using the PSUD. There was no significant difference in the mean IVC diameter between that measured by the students and the sonographer. In total, 25% of the participants accurately measured the IVC diameter. The mean measurement time was 201 seconds. Conclusion: Our training program allowed the participants to accurately visualize the IVC using the PSUD. However, these results on accuracy and measurement time still need to be improved before community nurses can use the PSUD during home visits.
Introduction Although the management and planning of infectious diseases such as AIDS -Human immunodeficiency virus (HIV) infection is considered pandemic by the World Health Organization (Rabirad et ...al., 2013, Mohammadnejad et al., 2010), hepatitis B - one of the most prevalent infectious diseases in the world (Mohammadnejad et al., 2011) and emerging diseases such as coronavirus (Abdollahi, 2020) is very important, proper planning for non-communicable and chronic diseases must be done at the same time. Materials and Methods This ongoing semi experimental was conducted to investigate the effects of peer education on quality of life in patients with congestive heart failure. Inclusion criteria were no history of participation in training programs in the field of heart failure during the past six months, literacy, ability to speak Persian, no cognitive problems, physical disability and medical or related education and the possibility of making phone calls directly with patients. Data collection tool consisted of two questionnaires, including demographic profile (age, gender, marital status, educational level, occupational status, duration of illness, history of comorbidities such as diabetes and hypertension, and educational history) and Cardiac Self-Efficacy Questionnaire developed by Sullivan in 1998 (Sullivan et al., 1998).This questionnaire consists of 16 statements that are rated on a five-point Likert scale from 0 (not at all) to 4 (completely confident), indicating the mean scores of 33-64 as high self-efficacy, the mean scores of 23-32 as moderate self-efficacy and the mean scores of 0-22 as low self-efficacy.
Abstract Elderly patients with heart failure (HF) may be troubled by thirst, despite the fact that elderly have an impaired ability to sense thirst. The present study was undertaken to compare the ...intensity of thirst in patients with and without HF and to evaluate how this symptom relates to the health-related quality of life and indices of the fluid balance. Forty-eight patients (mean age 80 years) admitted to hospital with worsening HF ( n = 23) or with other acute illness ( n = 25) graded their thirst and estimated their health-related quality of life (HRQoL). Serum sodium was measured and urine samples were assessed for color and electrolyte content. The HF patients reported significantly more intensive thirst (median = 75 mm) compared with those in the control group (median = 25 mm; p < 0.0001). There was no statistically significant relationship between thirst and HRQoL, which was low overall. Serum sodium and urine color did not differ significantly between the groups, but the urine of the HF patients had a lower sodium concentration and osmolality. We conclude that elderly patients with worsening HF have considerably increased thirst and, hence, intense thirst should be regarded as a symptom of HF.
Measurements of oxidative stress biomarkers in patients with heart failure (HF) have yielded controversial results. This study aimed at testing the hypothesis that circulating levels of the lipid ...peroxidation product 4-hydroxynonenal bound to thiol proteins (4HNE-P) are strongly associated with those of its potential precursors, namely n-6 polyunsaturated fatty acids (PUFA).
Circulating levels of 4HNE-P were evaluated by gas chromatography-mass spectrometry in 71 control subjects and 61 ambulatory symptomatic HF patients along with various other clinically- and biochemically-relevant parameters, including other oxidative stress markers, and total levels of fatty acids from all classes, which reflect both free and bound to cholesterol, phospholipids and triglycerides. All HF patients had severe systolic functional impairment despite receiving optimal evidence-based therapies. Compared to controls, HF patients displayed markedly lower circulating levels of HDL- and LDL-cholesterol, which are major PUFA carriers, as well as of PUFA of the n-6 series, specifically linoleic acid (LA; P=0.001). Circulating 4HNE-P in HF patients was similar to controls, albeit multiple regression analysis revealed that LA was the only factor that was significantly associated with circulating 4HNE-P in the entire population (R (2)=0.086; P=0.02). In HF patients only, 4HNE-P was even more strongly associated with LA (P=0.003) and HDL-cholesterol (p<0.0002). Our results demonstrate that 4HNE-P levels, expressed relative to HDL-cholesterol, increase as HDL-cholesterol plasma levels decrease in the HF group only.
Results from this study emphasize the importance of considering changes in lipids and lipoproteins in the interpretation of measurements of lipid peroxidation products. Further studies appear warranted to explore the possibility that HDL-cholesterol particles may be a carrier of 4HNE adducts.
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