Bakgrund Hjärtsvikt har definierats som en global pandemi då det drabbar miljontals människor världen över. Samtidigt som prevalensen kommer öka dramatiskt med en växande äldre befolkning är prognosen för hjärtsvikt fortfarande dålig och ofta sämre än många cancerdiagnoser. Efterlevnad av egenvård vid hjärtsvikt är en viktig faktor för lyckad behandling, undvika försämring i sitt sjukdomstillstånd och minska dödligheten. Ändå är efterlevnaden av egenvård bland hjärtsviktspatienter låg. Syfte Syftet med studien var att undersöka faktorer som främjar egenvården hos patienter med hjärtsvikt. Metod Icke-systematisk litteraturöversikt som studiedesign med 15 vetenskapliga originalartiklar med kvalitativ och kvantitativ metodansats inkluderade från CINAHL och PubMed. Artiklarna granskades genom Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering samt kvalitet avseende studier med kvantitativ och kvalitativ metodansats. En integrerad dataanalys av resultatet gjordes i tre steg. Resultat Från de 15 vetenskapliga artiklarna som inkluderades hittades två huvudteman; Stöd och Personliga förmågor. Resultatet visade att kunskap om hjärtsvikt, socialt stöd från familj och vårdpersonal samt stärkande personliga egenskaper var de mest centrala faktorerna i det som främjade egenvård. Slutsats Den här litteraturöversikten visade att egenvård hos patienter med hjärtsvikt kan främjas genom att öka deras kunskap, ge stöd utifrån behov samt ta vara på varje individs personliga förmågor och stärka dessa. Den sammanställda kunskapen i den här litteraturöversikten är viktig för hälso- och sjukvården för att skapa sig en förståelse om svårigheterna med att utföra egenvård och på så sätt kunna implementera personcentrerade stödinsatser, vilka kan främja egenvård hos patienten. / Background Heart failure (HF) has been defined as a global pandemic since it affects millions of people over the world. While its prevalence is going to drastically increase over the next years due to a growing aging population the prognosis for heart failure is still poor and often worse than many forms of cancer. Adherence to self-care in HF is crucial for successful treatment, avoid impairment and reduce mortality. Yet adherence to self-care in HF patients remains poor. Aim The aim of this study was to examine factors that promote self-care in HF patients Method Non-systematic review as study design, 15 research articles with qualitative and quantative method were included from the databases CINAHL and PubMed. The articles were then reviewed through Sophiahemmet University assessment basis of scientific classification and quality. An integrated data analysis of the result was done in three steps. Results From the 15 research articles included two main themes emerged; Support and Personal capacities. The result showed that heart failure knowledge, social support from family and health care professionals and strengthening personal characteristics was the most central (main) factors in promoting self-care. Conclusions This literature review showed that self-care in HF patients can be promoted through enhanced knowledge, support based on individual needs, and to use the benefit of personal capacities within each individual and strengthen these. The compiled knowledge of this literature review is important for health care professionals, to create an understanding of the difficulties with perform self-care so they can implement person-centred support, which can promote self-care in patients.

No description available.

Hjärtsvikt är en vanligt förekommande sjukdom med ökad prevalens. Viktiga delar i behandlingen av hjärtsvikt är egenvård och följsamhet till behandling vilket innefattar att tolka och agera korrekt utifrån symtom och tecken till hjärtsvikt. Genom att tidigt upptäcka symtom på hjärtsvikt kan adekvata åtgärder sättas in som förhindrar en ytterligare försämring.  Syftet var att belysa hur personer med hjärtsvikt tolkar och agerar vid symtom och tecken på hjärtsvikt.  Metoden som användes var en litteraturöversikt med systematisk sökstrategi. De inklusionskriterier som användes var att artiklarna skulle handla om personer som var över 18 år med diagnosen hjärtsvikt. Artiklarna var av kvalitativ, kvantitativ och mixad metod och uppfyllde kriterierna för god eller mycket god kvalité enligt kvalitetsgranskningen. Artiklarna sammanställdes i en integrerad analys.  Resultatet som framkom består av två kategorier och sex underkategorier. Den första kategorin är “Tolkning av symtom” med underkategorierna “Symtom och hur de upplevs”, “Förståelse av symtom” och “Patientens bedömning av symtom”. Den andra kategorin som framkom var “Agerande på symtom” med underkategorierna “Strategier innan vårdsökande” och “Sökande av vård”. Resultatet lyfter olika aspekter som påverkar hur personer med hjärtsvikt tolkar och agerar vid symtom och tecken på hjärtsvikt.  Slutsatsen är att tolkning av och agerande vid symptom och tecken på hjärtsvikt är individuellt och verkar bero på kunskapsnivå, psykiska faktorer, anhörigas delaktighet, tidigare erfarenheter och relationen med vården. / Heart failure is a common disease with increased prevalence. Essential parts in the treatment of heart failure are self-care and compliance, which includes interpreting and acting correctly when experiencing signs and symptoms of heart failure. By detecting symptoms of the heart failure early, adequate measures can be put in place to prevent a further deterioration.  The aim was to highlight how people with heart failure interpret and act up on symptoms and signs of heart failure.  The method used was a literature review with a systematic search strategy. The inclusion criteria used were that the articles should be about people over 18 with a diagnosis of heart failure. The articles were of qualitative, quantitative and mixed methods and met the criteria for good or very good quality according to quality. The articles were compiled in an integrated analysis.  The result that emerged consists of two categories and six subcategories. The first category is “Interpretation of symptoms” with subcategories “Symptoms and how they are experienced”, “Understanding of symptoms” and “Patient's assessment of symptoms”. The second category that emerged is "Acting on symptoms" with subcategories "Strategies before seeking care" and "Seeking care". The result highlights different aspects that influence how people with heart failure interpret and act upon symptoms and signs of heart failure.  The conclusion is that the interpretation of and action in symptoms and signs of heart failure is individual and seems to depend on the level of knowledge, psychological factors, the participation of relatives, previous experiences and the relationship with the care.

Hjärtsvikt är ett kliniskt syndrom som kan innebära stor påverkan på den drabbades hälsorelaterade livskvalitet och livssituation genom funktionsnedsättande symtom och stort vårdbehov. Tillståndet har hög dödlighet och ökar med en åldrande befolkning även om behandlingen förbättrats. Telemedeicin implementeras i hjärtsviktsvården på flera håll i Sverige och kan med fördel integreras i vården enligt gällande internationella riktlinjer. Syftet var att undersöka hur patienter med hjärtsvikt påverkas vid användning av olika former av telemedicin avseende livskvalitet och patientens livssituation. Metoden var litteraturöversikt med ett systematiskt arbetssätt. Sökningar utfördes i databaserna PubMed och Cinahl. Artiklarna kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag. 15 artiklar publicerade 2013-2021 inkluderades från dessa sökningar. En integrerad analys av artiklarna utfördes. Resultatet visade att användning av telemedicin vid hjärtsvikt kan påverka livskvaliteten och patienternas livssituation. De kategorier som framträdde i resultatet var påverkan på livskvalitet utifrån hälsa, stöd till förändrat behov av sjukvård, support till egna handlingar och stöd tll förändringar i psykisk hälsa. Telemedicin påverkade den hälsorelaterade livskvaliteten positivt och kunde ge stöd till förändrat behov av sjukvård. Telemedicin kunde också ge support till egna handlingar och stöd till förändrad psykisk hälsa. Olika former av telemedicin hade använts enskilt eller som tillägg till andra interventioner. Slutsatsen är att telemedicin vid hjärtsvikt kan påverka patienternas hälsorelaterade livskvalitet och livssituation positivt. Vidare forskning kring vilka former av telemedicin som har positiv påverkan behövs samt vilka interventioner som med fördel kan kombineras. / Heart failure is a clinical syndrome that may have a major impact on the affected´s health related quality of life (HRqOL) and life in general through disabling symptoms and a substantial need for helathcare. Even though treatment has improved, the condition has high mortality rate and is increasing with an aging population. Telemedicine is implemented in heart failure care in several locations in Sweden and can advantageously be integrated into care according to international guidelines. The aim of this study was to scrutinize how patients with heart failure are affected when using various types of telemedicine regarding quality of life and life situation. The method was a literature review with a systematic approach. Literature search was conducted in the databases PubMed and Cinahl. The quality of the articles was reviewed according to Sophiahemmet University´s assessment documents. A total of 15 articles published between 2013-2021 were eventually included in the study. An integrated analysis of the articles was performed. The results showed that the use of telemedicine in heart failure can affect quality of life and the patient´s life situation. The categories that appeared in the results were impact on quality of life based on health, support for changing needs for healthcare, support for own actions and support for changes in mental health. Telemedicine had positive impact on HRqOL and supported changing needs for healthcare. Telemedicine could provide support for own actions and support for changed mental health. Various forms of telemedicine had been used alone or combined with other interventions.  The conclusion is that telemedicine in heart failure can positively affect the patients´ HRqOL and life situation. Further research on which forms of telemedicne have a positive impact is needed and which interventions can be advantageously combined.

Recent progress in treatment interventions has resulted in increased survival rates and longevity for diagnosed heart failure patients. However, heart failure still remains one of the leading causes of rehospitalization worldwide, where emergency readmissions continue to be a common occurrence. The multifactorial complexity of heart failure makes clinical judgment difficult and may lead to erroneous discharge prognoses and estimates in recovery trajectories. Recognizing emergency readmissions among heart failure patients who have been discharged is crucial within the critical six-month post-discharge period to proactively address additional support needs. To address the research question, “To what extent can machine learning models predict emergency readmissions in Chinese heart failure patients within six months post-discharge?”, this paper uses electronic health records obtained from a single healthcare center in China, containing 2,008 validated heart failure patients. This study adopts an experimental research methodology, where four machine learning models are developed to explore the research question. To ensure robustness, 10-fold cross-validation with stratified sampling and a two-step feature selection process is performed in addition to evaluation through metrics such as the area under the receiving operating curve and F1 Score. The findings indicate only modest predictive capability among the classifiers in the validation cohort. The best-achieved area under the receiving operating curve and F1 Score are obtained from separate classifiers with scores of 0.682 and 0.577, respectively. The findings provide valuable insights into future research on the effectiveness of ML-based prediction models for emergency readmission in Chinese heart failure patients.

Background: Patients with left ventricular ejection fractions between 40% and 49% either discovered de novo, having declined from ≥50%, or improved from <40% have been described as heart failure (HF) with mid-range ejection fraction (HFmrEF). Though clinical signs and symptoms are similar to other phenotypes, possible prognostic differences and therapeutic responses reinforce the need for further understanding of patients’ characteristics especially in a rural community based population. The purpose of this study is to evaluate the clinical characteristics, comorbidities and prognosis of a rural patient population with HFmrEF. Materials and Methods: We queried the electronic medical record from a community based university practice for all patients with a HF diagnosis. We included only those patients with >3 months follow-up and interpretable Doppler echocardiograms. We recorded demographic, Doppler-echo, and outcome variables (up to 2,083 days). Results: There were 633 HF patients: 42.4% with preserved ejection fraction (HFpEF, EF ≥50%), 36.4% with HFmrEF, and 21.0% with reduced ejection fraction (HFrEF, EF <40%). HFmrEF patients were older, had greater coronary disease prevalence, lower systolic blood pressure, elevated brain natriuretic peptide, lower hemoglobin, and higher creatinine than HFpEF. All-cause mortality was intermediate between HFrEF and HFpEF but was not significantly different. Landmark analysis revealed a trend toward greater second readmission in HFmrEF as compared to HFpEF (hazard ratio: 1.43 [0.96-2.14],P = 0.0767). Conclusions: Rural patients with HFmrEF without an ambulatory HF clinic represent a higher percentage of HF patients than previously reported with greater coronary disease prevalence with comparable readmission rates and nonsignificantly different all-cause mortality.

Bakgrund: Hjärtsvikt är en kronisk folksjukdom som globalt drabbar cirka 26 miljoner årligen med stigande incidens. Sjukdomens symptom påverkar patientens förmåga till att upprätthålla sin egenvård som resulterar i försämrad livskvalitet. Egenvård är en stor och viktig del av patientens behandling och vardag. Sjuksköterskans uppgift är att informera och stötta för att främja patientens egenvård. Därför är det relevant att sjuksköterskan har kunskap om patientens upplevelse av främjande egenvård. Syfte: Syftet var att beskriva hjärtsviktspatienters upplevelser av vad som främjar egenvård. Metod: En litteraturöversikt med kvalitativ design och induktiv ansats genomfördes. Tolv vetenskapliga artiklar analyserades med Fribergs fem steg. Resultat: Fem subteman formade två teman. Att ha socialt nätverk och att hitta motivation formade stöd och motivation. Att känna engagemang till behandling, att ha tillräckligt med information och att ha tillgång till hjälpmedel formade sjukdomsinsikt. Slutsats: Resultatet visade att det fanns främjande upplevelser av egenvård hos patienter. Stöd och motivation var centrala komponenter för att underhålla egenvård. För att främja egenvård framkom det också att sjukdomsinsikt hade en betydande roll. Engagemang till behandling, information och symtomövervakning med diverse hjälpmedel bidrog till ökad sjukdomsinsikt och goda upplevelser av egenvård. / Background: Heart failure is a chronic disease that globally affecting approximately 26 million yearly with increasing incidence. The symptoms of the disease affects the patient's ability to maintain their self-care, resulting in a reduced life quality. Self-care is a large and important part of the patient’s treatment and everyday life. The nurse’s job is to inform and support the patient to promote self-care. Therefore, it is relevant that the nurse has knowledge about the patient’s experience of self-care. Aim: The aim was to describe heart failure patients' experiences of what promotes self-care. Method: A literature review with qualitative design and inductive approach was conducted. Twelve scientific articles were analyzed with Friberg’s five-step. Results: Five subthemes formed two themes. To have social network and to find motivation, formed support and motivation. To feel committed to treatment, to have enough information and to have access to devices, formed disease awareness. Conclusion: The results showed that there were promoting experiences of self-care in patients. Support and motivation were central components for maintaining self-care. To promote self-care, it were also found that disease awareness played an important role. Commitment to treatment, information and monitoring of symptoms with different devices contributed to increased disease awareness and good experiences of self-care.

No description available.

No description available.

Background/Purpose: The American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines for management of heart failure were recently updated to include use of sacubitril/valsartan due to its ability to reduce mortality and hospitalizations over the current standard of therapy. Based on these guideline updates, a champion research team at East Tennessee State University (ETSU) Family Medicine Associates worked to create and implement a process that identified patients with systolic heart failure and provided access to medications with mortality and morbidity benefits. The objective of this study is to improve provider knowledge of evidence-based heart failure pharmacotherapy and to assess provider acceptability of a process implemented at ETSU Family Medicine Associates. Methodology: This study was approved by the Institutional Review Board. On December 21, 2016 the champion research team presented a didactic session to all providers at ETSU Family Medicine Associates. Immediately prior to the education session, providers completed a pre-education clinical knowledge assessment on heart failure pharmacotherapy. A one-hour didactic session then followed focusing on evidence-based medication management of systolic heart failure and introduction of the new process being implemented. Following the presentation, providers completed a post-education clinical knowledge assessment and a pre-implementation process acceptability survey. Providers were then scheduled to complete a post-implementation process acceptability survey at two months post-process implementation and quarterly thereafter. A McNemars Test will be used to determine if statistically significant differences exist among pre- and post-education clinical knowledge assessments and pre- and post-implementation process acceptability surveys. Presentation Objective: Discuss the process implemented to improve provider knowledge of heart failure pharmacotherapy and improve patient access to evidence-based pharmacotherapy options. Self-Assessment: Did the one-hour didactic session improve provider knowledge of heart failure pharmacotherapy?