Tailoring consumer resources to enhance self-care in chronic heart failure
Section snippets
Background
Self-care in chronic heart failure (CHF) and health outcomes are closely linked. Mortality and hospitalisation rates remain high, particularly in the elderly. In Australia, approximately 40,000 patients were hospitalised with newly diagnosed CHF in 2003.1 Patients with CHF experience debilitating symptoms such as shortness of breath, increasing exercise intolerance and lethargy which impacts on their everyday day life. In an effort to reduce these symptoms and hospitalisations patients must
Self-care of heart failure
Self-care involves cognitive decision making, requiring the recognition of signs and symptoms that indicate a change in condition, which is based on knowledge and prior experiences of deterioration.3, 7 It also refers to the ability to engage in constructive behaviours to monitor and maintain health.3
Self-management of CHF depends on patient adoption of healthy behaviours and management strategies. Patients living with a chronic illness often find self-care decision making overwhelming.11
Adherence with self-care
Adherence with self-care is vital in chronic disease management and has been shown to reduce morbidity and mortality.14 The capacity to adhere with recommended treatment strategies is often suboptimal in individuals with CHF, especially in those who are recently diagnosed. A study by Michalsen et al.15 surveyed 179 patients admitted to hospital with an exacerbation of HF. All of the patients had a previous diagnosis of HF. No education about heart failure was given to patients prior to their
Knowledge of self-care
Knowledge and understanding are essential elements for patient empowerment and successful self-management. Information and resources used to provide this knowledge should be evidence-based to maximise opportunities for improving patient satisfaction and health outcomes.20
A lack of knowledge can lead to non-adherence with self-care practices such as following fluid restriction, low sodium diet and daily weighing routines.3 Ni et al.21 investigated 41 hospitalised heart failure patients and found
Health professional support of self-care practices
Health care providers can influence adherence to treatment.23 Simpson24 describes a constructive patient–provider relationship as one of trust that motivates patients to adhere to lifestyle changes and complex medication regimes. In spite of the importance of providing timely and relevant information, there is evidence to suggest that health care providers do not always use consumer resources within education opportunities. For example the results of a recent survey of 496 general practitioners
Health literacy in supporting self-care
Health literacy refers to an individual's ability to use and interpret information relating to health issues. Low health literacy can result in poor understanding of the information about CHF and is related to adverse health outcomes. Approximately 83% of Australians aged over 65 years have a health literacy level that is below the minimum required to meet the complex demands of everyday life.26 The elderly population also has the poorest health literacy skills27 and are the biggest users of
Living well with chronic heart failure
‘Living well with chronic heart failure’ consumer resource has been developed as a companion to the CHF guideline and as such communicates management strategies that are well known to optimise health outcomes.10 The consumer oriented approach to resource development ensures information is tailored to patient needs. Table 1 gives examples of how the clinical content and format and layout has been adapted for consumers.
One important component of the consumer resource is the action plan (Fig. 1).
Conclusion
Patients in contemporary health care systems, together with their health care provider, need to engage in partnerships to promote self-care strategies. In order to be effective partners, patients need and want accurate, practical information and advice; ‘Living well with chronic heart failure’ underpinned by a robust evidence-base on self-care, has been developed to address this need. In particular, this resource targets newly diagnosed or hospitalised people with heart failure. As a practical
Acknowledgements
“Living well with chronic heart failure” (2008) Members of the Heart Failure Consumer Resource Working Group: Roshmeen Azam, National Prescribing Service; Meredith Cameron, National Institute of Clinical Studies; Eleanor Clune, National Heart Foundation of Australia; James McVeigh, Prince of Wales Hospital, Sydney; Vilma Paguio, National Heart Foundation of Australia; Graeme Percival, Consumer; Sue Phillips, National Institute of Clinical Studies; Sepehr Shakib, Royal Adelaide Hospital; Agnes
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Cited by (32)
Multidisciplinary Management of Chronic Heart Failure: Principles and Future Trends
2015, Clinical TherapeuticsCitation Excerpt :CHF management programs focus on providing information and support to patients and their caregivers in self-management. Appropriate screening (eg, health literacy, cognition, depression) and negotiation of treatment goals is important in effective care planning, and the importance of tailoring and targeting self-care resources is increasingly being recognized.45 Counseling, home visits, 24-hour call centers, and reminder systems have been applied in various configurations to augment CHF management.
Psychoeducational support to post cardiac surgery heart failure patients and their partners-A randomised pilot study
2015, Intensive and Critical Care NursingCitation Excerpt :Our findings show increased health and better control, especially for the patients, when patient–partner had postoperative contacts and follow up with healthcare professionals. Fewer opportunities exist to provide necessary information and respond to patient concerns in hospital, and much of the process of wound healing and recovery that previously took place in hospital occurs after discharge (Driscoll et al., 2009). All surgical procedures affect the physical and mental conditions of patient–partner to some degree.
Implementing guideline based heart failure care in the northern territory: Challenges and solutions
2014, Heart Lung and CirculationCitation Excerpt :Realistic goals and timeframes, broad discussions, support that is ongoing, comprehensive, coordinated, accessible, user friendly; communication that is efficient and in real time; service delivery with cultural competence, sensitivity and evidence based, are at the heart of the discussions for urban and specialist outreach services. In addition, planning for projected population increases and meeting unmet clinical and investigational needs with staffing and infrastructure suggest a one-dimensional surge of resources may not address issues [1–25]. These issues are agenda items within the NT Cardiovascular reference group, which is open to feedback on the issues discussed in this paper.
AUStralian indigenous chronic disease optimisation study (AUSI-CDS) prospective observational cohort study to determine if an established chronic disease health care model can be used to deliver better heart failure care among remote indigenous Australians: Proof of concept-study rationale and protocol
2013, Heart Lung and CirculationCitation Excerpt :It is generally accepted that inadequate provision of usual therapies contributes to poorer outcomes. This picture of worse disease and poorer care delivery is particularly evident in the Northern Territory of Australia with a vast area serviced by two major public hospitals [1–13]. In excess of 70,000 Indigenous Australians live in the NT, 63% remotely, with 70 spoken languages.
Intelligent Medical Interactive Educational System for Cardiovascular Disease
2022, Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
- 1
On behalf of the National Heart Foundation Heart Failure Consumer Resource Working Group.
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