Contenuto dell'articolo principale
Abstract
Aim: Heart failure is a chronic disease with a complex regimen treatment. Patients must have to enroll in a disease management program to engage in self-care. However, symptom recognition is a difficult step to manage by patients, as they tend to wait for the symptoms to disappear. The aim of this study is to verify if patients with heart failure can recognize early signs of the disease.
Methods: A systematic review will be carried out to analyze the effectiveness of patient education in detecting heart failure symptoms.
Results: The systematic review will provide data to understand if patient education on heart failure symptom recognition is effective on reducing hospital admissions.
Conclusion: Patients with heart failure struggle daily in balancing self-care. If not taught about what symptoms to expect, patients will sit and wait at home, resulting in severe hospital admissions. Previous systematic reviews and meta-analysis focused on associations among symptoms in individuals with heart failure, or on a multicomponent Heart failure management programs, with several teaching topics. This protocol for a new review, which will focus on symptom monitoring by patients with heart failure, and the development of this skill positively interferes with self-care and avoids hospital readmissions. Keywords: Heart failure, Symptom assessment, self-care, self-management.
L'efficacia dell'istruzione sul riconoscimento dei sintomi in pazienti affetti da insufficienza cardiaca ai fini del self-care: un protocollo di revisione sistematica
Scopo: L'insufficienza cardiaca è una malattia cronica caratterizzata da un complesso regime di trattamento. I pazienti devono registrarsi a un programma di gestione del trattamento della patologia anche ai fini del self care. Tuttavia, il riconoscimento dei sintomi è una fase difficilmente gestibile dai pazienti, poiché essi tendono ad attenderne la scomparsa. Lo scopo di questo studio è verificare se i pazienti affetti da insufficienza cardiaca sappiano riconoscere i primi segnali della malattia.
Metodo: Sarí effettuata una revisione sistematica al fine di analizzare l'efficacia dell'istruzione dei pazienti nel rilevamento dei sintomi legati all'insufficienza cardiaca.
Risultati: La revisione sistematica fornirí dati atti a comprendere se l'istruzione dei pazienti in materia di insufficienza cardiaca sia efficace nella riduzione dei ricoveri ospedalieri.
Conclusioni: I pazienti affetti da insufficienza cardiaca lottano quotidianamente per trovare un equilibrio in merito all'automedicazione. Se non istruiti sui sintomi da attendersi, i pazienti resterebbero a casa ad aspettarli, determinando cosí¬ ricoveri ospedalieri gravi. Le precedenti revisioni sistematiche e meta-analisi si sono concentrate sulle associazioni tra i sintomi nei pazienti affetti da insufficienza cardiaca o su programmi di gestione dell'insufficienza cardiaca caratterizzati da più componenti, con diversi argomenti didattici. Il presente protocollo di revisione è incentrato sul monitoraggio dei sintomi da parte dei pazienti affetti da insufficienza cardiaca, e lo sviluppo di questa abilití interferirí positivamente con l'automedicazione, evitando più ricoveri ospedalieri.
Parole Chiave: Scompenso cardiaco, gestione dei sintomi, self-care, self-management.
Dettagli dell'articolo
Riferimenti
- Altice N.F., & Madigan E.A. (2012). Factors associated with delayed care-seeking in hospitalized patients with heart failure. Heart & Lung: The Journal of Acute and Critical Care, 41 (3), 244-254. https://doi.org/10.1016/j.hrtlng.2011.09.007
- Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M. (2017). Heart Disease and Stroke Statistics"”2017 Update. American Heart Association. https://doi.org/10.1161/CIR. 0000000000000485
- Cohen J. (1960). A Coefficient of Agreement for Nominal Scales. Educational and Psychological Measurement, 20 (1), 37-46. https://doi.org/10.1177/001316446002000104
- Evangelista L.S., Dracup K., & Doering L.V. (2000). Treatment-seeking delays in heart failure patients. The Journal of Heart and Lung Transplantation, 19 (10), 932-938. https://doi.org/10.1016/S1053-2498(00)00186-8
- Gallagher, R. (2010). Self Management, Symptom monitoring and associated factors in people with heart failure living in the community. European Journal of Cardiovascular Nursing, 9 (3), 153-160. https://doi.org/10.1016/ j.ejcnurse.2009.12.006
- Herr J.K., Salyer J., Lyon D.E., Goodloe L., Schubert C., & Clement D.G. (2014). Heart failure symptom relationships: a systematic review. Journal of Cardiovascular Nursing, 29 (5), 416-422. https://doi.org/10.1097/JCN.0b013e31829b675e
- Jaarsma T., Halfens R., Huijer Abu-Saad H., Dracup K., Gorgels T., van Ree, J. & Stappers J. (1999). Effects of education and support on self-care and resource utilization in patients with heart failure. European Heart Journal, 20 (9), 673-682. https://doi.org/10.1053/euhj.1998.1341
- Jaarsma T., Strí¶mberg A., Mí¥rtensson J., & Dracup K. (2003). Development and testing of the European Heart Failure Self-Care Behaviour Scale. The European Journal of Heart Failure, 5, 363-370. https://doi.org/10.1016/S1388-9842(02)00253-2
- Jaarsma T., Nikolova-Simons M., & van der Wal M. (2012). Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: An in-depth look. Heart & Lung: The Journal of Acute and Critical Care, 41 (6), 583-593. https://doi.org/10.1016/ j.hrtlng.2012.03.003
- JBI – Joanna Briggs Institute (2014). Joanna Briggs Institute Reviewers' Manual: 2014 edition. https://joannabriggs.org/
- assets/docs/sumari/reviewersmanual-2014.pdf; consulted on 15-09-2017
- Jurgens C. (2009). Somatic awareness, uncertainty, and delay in care-seeking in acute heart failures. Research in Nursing & Health, 29, 74- 86. https://doi.org/10.1002/nur.20118
- Jurgens C.Y., Hoke L., Byrnes J., & Riegel B. (2009). Why Do Elders Delay Responding to Heart Failure Symptoms? Nursing research, 58 (4), 274. https://doi.org/10.1097 /NNR.0b013e3181ac1581
- McMurray, J., Adamopoulos, S., Anker, S., et al. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal, 33 (14). https://doi.org/10.1093/eurheartj/ehs104
- Moola S, Munn Z., Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Mu P. (2017). Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual, 2017. https://reviewersmanual.joannabriggs.org/ consulted on 15-09-2017.
- Moser D.K., Frazier S.K., Worrall-Carter L., Biddle M.J., Chung M.L., Lee K., & Lennie T.A. (2011). Symptom variability, not severity, predicts rehospitalization and mortality in patients with heart failure. European Journal of Cardiovascular Nursing, 10 (2), 124-129. https://doi.org/10.1016 /j.ejcnurse.2010.05.006
- Nieuwenhuis M., Jaarsma T., van Veldhuisen D.J., & van der Wal M. (2011). Factors associated with patient delay in seeking care after worsening symptoms in heart failure patients. Journal of Cardiology Failure, 17 (8), 657-663. https://doi.org/10.1016/j.cardfail.2011.04.004
- Oosterom-Calo R., van Ballegooijen A.J., Terwee C.B., te Velde S.J., Brouwer I.A., Jaarsma T., & Brug J. (2012). Determinants of heart failure self-care: a systematic literature review. Heart Failure Review, 17 (3), 367-385. https://doi.org/10.1007 /s10741-011-9292-9
- Ponikowski P., Voors A.A., Anker S.D., et al. (2016) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Hearth Journal. 37 (27), 2129-2200m. https://doi.org/10.1161/CIR.0000000000000485
- Riegel B., Moser D.K., Anker S.D., et al (2009a). State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 120(12), 1141-1163. https://doi.org/10.1161/ CIRCULATIONAHA.109.192628
- Riegel B., Lee C., Dickson V., & Carlson B. (2009b). An Update on the Self-Care of Heart Failure Index. Journal of Cardiovascular Nursing, 24 (6), 485-497. https://10.1097 /JCN.0b013e3181b4baa0
- Riegel B., Dickson V., Cameron J., Johnson J.C., Bunker S., Page K., & Worrall- Carter L. (2010). Symptom Recognition in Elders With Heart Failure. Journal of Nursing Scholarship, 42 (1), 92-100. https://doi.org/10.1111/j.15475069.2010. 01333.x
- Riegel B., Lee C.S., & Dickson V. (2011). Self care in patients with chronic heart failure. Nature reviews Cardiology, 8 (11), 644-654. https://doi.org/10.1038/nrcardio.2011.95
- Riegel B, Vaughan Dickson V, Lee CS, et al. (2017). A mixed methods study of symptom perception in patients with chronic heart failure. Heart & Lung Journal of Acute Critical Care. 47 (2),107-114. https://doi.org/10.1016/ j.hrtlng.2017.11.002
- Smeulders E.S., van Haastregt J C., Ambergen T., Janssen-Boyne J.J., van Eijk J.T., & Kempen G.I. (2009). The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients. European Journal of Heart Failure, 11 (6), 609-616. https://doi.org/10.1093/eurjhf/hfp047
- Tufanaru C, Munn. Z., Aromataris E, Campbell J, Hopp L. (2017). Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual, 2017. https://reviewersmanual.joannabriggs.org/ consulted on 15-09-2017
- Vellone E., Riegel B., Cocchieri A., et al. (2013). Psychometric Testing of the Self-Care of Heart Failure Index Version 6.2. Research in Nursing & Health, 36, 500-511. https://doi.org/10.1002/nur.21554
- Wakefield B.J., Boren S.A., Groves P.S., & Conn V.S. (2013). Heart Failure Care Management Programs: A Review of Study Interventions and Meta-Analysis of Outcomes. Journal of Cardiovascular Nursing, 28 (1), 8-19. https://doi.org/ 10.1097/JCN.0b013e318239f9e1
- Wright S.P., Walsh H., Ingley K.M., et al. (2003). Uptake of self-management strategies in a heart failure management programme. European Journal of Heart Failure, 5 (3), 371-380. https://doi.org/10.1016/S1388-9842(03)00039-4
Riferimenti
Altice N.F., & Madigan E.A. (2012). Factors associated with delayed care-seeking in hospitalized patients with heart failure. Heart & Lung: The Journal of Acute and Critical Care, 41 (3), 244-254. https://doi.org/10.1016/j.hrtlng.2011.09.007
Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M. (2017). Heart Disease and Stroke Statistics"”2017 Update. American Heart Association. https://doi.org/10.1161/CIR. 0000000000000485
Cohen J. (1960). A Coefficient of Agreement for Nominal Scales. Educational and Psychological Measurement, 20 (1), 37-46. https://doi.org/10.1177/001316446002000104
Evangelista L.S., Dracup K., & Doering L.V. (2000). Treatment-seeking delays in heart failure patients. The Journal of Heart and Lung Transplantation, 19 (10), 932-938. https://doi.org/10.1016/S1053-2498(00)00186-8
Gallagher, R. (2010). Self Management, Symptom monitoring and associated factors in people with heart failure living in the community. European Journal of Cardiovascular Nursing, 9 (3), 153-160. https://doi.org/10.1016/ j.ejcnurse.2009.12.006
Herr J.K., Salyer J., Lyon D.E., Goodloe L., Schubert C., & Clement D.G. (2014). Heart failure symptom relationships: a systematic review. Journal of Cardiovascular Nursing, 29 (5), 416-422. https://doi.org/10.1097/JCN.0b013e31829b675e
Jaarsma T., Halfens R., Huijer Abu-Saad H., Dracup K., Gorgels T., van Ree, J. & Stappers J. (1999). Effects of education and support on self-care and resource utilization in patients with heart failure. European Heart Journal, 20 (9), 673-682. https://doi.org/10.1053/euhj.1998.1341
Jaarsma T., Strí¶mberg A., Mí¥rtensson J., & Dracup K. (2003). Development and testing of the European Heart Failure Self-Care Behaviour Scale. The European Journal of Heart Failure, 5, 363-370. https://doi.org/10.1016/S1388-9842(02)00253-2
Jaarsma T., Nikolova-Simons M., & van der Wal M. (2012). Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: An in-depth look. Heart & Lung: The Journal of Acute and Critical Care, 41 (6), 583-593. https://doi.org/10.1016/ j.hrtlng.2012.03.003
JBI – Joanna Briggs Institute (2014). Joanna Briggs Institute Reviewers' Manual: 2014 edition. https://joannabriggs.org/
assets/docs/sumari/reviewersmanual-2014.pdf; consulted on 15-09-2017
Jurgens C. (2009). Somatic awareness, uncertainty, and delay in care-seeking in acute heart failures. Research in Nursing & Health, 29, 74- 86. https://doi.org/10.1002/nur.20118
Jurgens C.Y., Hoke L., Byrnes J., & Riegel B. (2009). Why Do Elders Delay Responding to Heart Failure Symptoms? Nursing research, 58 (4), 274. https://doi.org/10.1097 /NNR.0b013e3181ac1581
McMurray, J., Adamopoulos, S., Anker, S., et al. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal, 33 (14). https://doi.org/10.1093/eurheartj/ehs104
Moola S, Munn Z., Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Mu P. (2017). Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual, 2017. https://reviewersmanual.joannabriggs.org/ consulted on 15-09-2017.
Moser D.K., Frazier S.K., Worrall-Carter L., Biddle M.J., Chung M.L., Lee K., & Lennie T.A. (2011). Symptom variability, not severity, predicts rehospitalization and mortality in patients with heart failure. European Journal of Cardiovascular Nursing, 10 (2), 124-129. https://doi.org/10.1016 /j.ejcnurse.2010.05.006
Nieuwenhuis M., Jaarsma T., van Veldhuisen D.J., & van der Wal M. (2011). Factors associated with patient delay in seeking care after worsening symptoms in heart failure patients. Journal of Cardiology Failure, 17 (8), 657-663. https://doi.org/10.1016/j.cardfail.2011.04.004
Oosterom-Calo R., van Ballegooijen A.J., Terwee C.B., te Velde S.J., Brouwer I.A., Jaarsma T., & Brug J. (2012). Determinants of heart failure self-care: a systematic literature review. Heart Failure Review, 17 (3), 367-385. https://doi.org/10.1007 /s10741-011-9292-9
Ponikowski P., Voors A.A., Anker S.D., et al. (2016) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Hearth Journal. 37 (27), 2129-2200m. https://doi.org/10.1161/CIR.0000000000000485
Riegel B., Moser D.K., Anker S.D., et al (2009a). State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 120(12), 1141-1163. https://doi.org/10.1161/ CIRCULATIONAHA.109.192628
Riegel B., Lee C., Dickson V., & Carlson B. (2009b). An Update on the Self-Care of Heart Failure Index. Journal of Cardiovascular Nursing, 24 (6), 485-497. https://10.1097 /JCN.0b013e3181b4baa0
Riegel B., Dickson V., Cameron J., Johnson J.C., Bunker S., Page K., & Worrall- Carter L. (2010). Symptom Recognition in Elders With Heart Failure. Journal of Nursing Scholarship, 42 (1), 92-100. https://doi.org/10.1111/j.15475069.2010. 01333.x
Riegel B., Lee C.S., & Dickson V. (2011). Self care in patients with chronic heart failure. Nature reviews Cardiology, 8 (11), 644-654. https://doi.org/10.1038/nrcardio.2011.95
Riegel B, Vaughan Dickson V, Lee CS, et al. (2017). A mixed methods study of symptom perception in patients with chronic heart failure. Heart & Lung Journal of Acute Critical Care. 47 (2),107-114. https://doi.org/10.1016/ j.hrtlng.2017.11.002
Smeulders E.S., van Haastregt J C., Ambergen T., Janssen-Boyne J.J., van Eijk J.T., & Kempen G.I. (2009). The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients. European Journal of Heart Failure, 11 (6), 609-616. https://doi.org/10.1093/eurjhf/hfp047
Tufanaru C, Munn. Z., Aromataris E, Campbell J, Hopp L. (2017). Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual, 2017. https://reviewersmanual.joannabriggs.org/ consulted on 15-09-2017
Vellone E., Riegel B., Cocchieri A., et al. (2013). Psychometric Testing of the Self-Care of Heart Failure Index Version 6.2. Research in Nursing & Health, 36, 500-511. https://doi.org/10.1002/nur.21554
Wakefield B.J., Boren S.A., Groves P.S., & Conn V.S. (2013). Heart Failure Care Management Programs: A Review of Study Interventions and Meta-Analysis of Outcomes. Journal of Cardiovascular Nursing, 28 (1), 8-19. https://doi.org/ 10.1097/JCN.0b013e318239f9e1
Wright S.P., Walsh H., Ingley K.M., et al. (2003). Uptake of self-management strategies in a heart failure management programme. European Journal of Heart Failure, 5 (3), 371-380. https://doi.org/10.1016/S1388-9842(03)00039-4