Self-management in chronic heart failure

The syndrome of chronic heart failure is regarded as an epidemic in western societies due to an increase in lifespan and due to therapeutic developments in the management of coronary arteries disease. The rapid increase in the prevalence of the syndrome, its poor prognosis, frequent hospital readmissions, low quality of life and the increase in hospital cost have made the researchers focus their interest in the last 20 years at the investigation of pharmacological and nonpharmacological factors that could help in the reduction of its repercussions. Following multicenter clinical trials national and international scientific societies as American Heart Association (AHA) and the European Cardiology Society (ESC) have published guidelines for the management of chronic heart failure. Developments also have been made in the area of mechanic support as well as in the area of artificial heart. Regarding the non-pharmacological management and follow-up of these patients there are still questions to be answered. Many countries recently adapted follow-up programs for patients with chronic heart failure. The main components of these programs were education and consultation, both components of the autonomous nursing role. These interventions were taking place in various times and a form in heart failure clinics or home-based programs mainly as nurse-led activities although there are programs that used doctors or interdisciplinary team. The majority of these programs showed a decrease in readmissions, improvement in patients’ quality of life and in some instances a reduction in cost independent from their particular structure. In 2002 Stewar et al announced a reduction in mortality rates in the longest to-date study with an average follow up time of 4.2 years. The first positive results from the education of patients with chronic heart failure were soon included in the guidelines of AHA and ECS with reference in the content of education. The education of patients with chronic heart failure is only the way to achieve the target of self-care. The significance of self-care and its components, which are self-maintenance and self-management, constitute a challenge for research and clinical practice. In recent years nursing deals particularly with the concept of self-care in chronic illness as this can be influenced by nursing interventions. Thus were recently created scales of measurement for self-care, which have been checked with good results. The two more common scales are described in this article, the European Heart Failure SelfCare Behavior Scale (EHFScBS) and the Self-Care of Heart Failure Index (SCHFI).

Category: Volume 45, N 1
Hits: 25 Hits
Created Date: 15-03-2006
Authors: Dimitris Dimitrelis , Georgia Angeli-Kranidiotou