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Bakgrund   Hjärtsvikt är ett allvarligt medicinskt tillstånd som påverkar miljontals människor över hela världen. Det är inte bara en sjukdom i sig själv, utan snarare ett komplex syndrom som uppstår när hjärtats pumpförmåga är nedsatt, vilket leder till otillräcklig blodcirkulation till kroppens vävnader. Symtomen på hjärtsvikt är varierande och inkluderar tryck över bröstet, andfåddhet, trötthet och ödem. Egenvård spelar en avgörande roll i hanteringen av kronisk hjärtsvikt. Genom att ge patienter kunskap och verktyg att ta hand om sig själva kan deras livskvalitet förbättras och risken för sjukhusinläggningar minskas. Dorothea Orem teori om egenvård ger en ram för att förstå patientens roll i sin egna vård och betonar vikten av att anpassa vården efter patientens individuella behov och förmågor. Syfte Att belysa patienters upplevelser av egenvård vid kronisk hjärtsvikt. Metod En icke-systematisk litteraturöversikt baserad på 13 vetenskapliga artiklar med kvalitativa ansatser, hämtade från databaserna CINAHL och PubMed genom olika sökkombinationer. Artiklarna har kvalitetsgranskats utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet och resultatet analyserades med integrerad dataanalys. Resultat Resultatet sammanställdes i två huvudkategorier och fem underkategorier. Den första huvudkategorin “En utmanande upplevelse” inkluderar underkategorierna “Emotionella reaktioner” “Att hantera symtom” och “Egenvårdsstrategier”. Den andra huvudkategorin “Upprätthålla egen hälsa” omfattar underkategorierna “Sociala stödets roll” och “Informationsbehov”. Resultatet från litteraturöversikten visade att patienter med hjärtsvikt står inför betydande utmaningar i sin egenvård, där en av de mest framträdande aspekterna var hanterandet av symtomen och den emotionella påverkan. Slutsats Denna litteraturöversikt visar att upplevelsen av egenvård vid hjärtsvikt är en utmaning som kräver anpassning till en ny livssituation. Utförandet av egenvård kan väcka starka emotionella reaktioner hos den enskilde. Genom att förstå hur dessa patienter påverkas av sin sjukdom, kan sjuksköterskan på ett professionellt sätt möta individens behov. / Background Heart failure is a serious medical condition that affects millions of people worldwide. It is not merely a disease in itself but rather a complex syndrome that occurs when the heart's pumping capacity is impaired, leading to insufficient blood circulation to the body's tissues. The symptoms of heart failure vary and include chest pressure, shortness of breath, fatigue, and edema. Self-care plays a crucial role in the management of chronic heart failure. By providing patients with the knowledge and tools to care for themselves, their quality of life can be improved, and the risk of hospital admissions can be reduced. Dorothea Orem's theory of self-care offers a framework for understanding the patient's role in their own care and emphasizes the importance of tailoring care to the patient's individual needs and capabilities Aim To describe patients' experience of self-care in chronic heart failure. Method A non-systematic literature review based on 13 scientific articles with qualitative approaches, retrieved from the databases CINAHL and PubMed through different search combinations. The articles have been quality-checked based on Sophiahemmet University's assessment tool for scientific classification and quality, and the results were analyzed with integrated data analysis. Results The results were compiled into two main categories and five subcategories. The first main category “A challenging experience” includes the subcategories “Emotional reactions”, “To manage symptoms” and “Self-care strategies”. The second main category "Maintaining one's own health" includes the subcategories "The role of social support" and "Information needs”. The results from the literature review showed that patients with heart failure face significant challenges in their self-care, where one of the most prominent aspects was managing the symptoms and the emotional impact. Conclusions This literature review shows that the experience of self-care in heart failure is a challenge that requires adaptation to a new life situation. The performance of self-care can arouse strong emotional reactions in the individual. By understanding how these patients are affected by their illness, nurses can meet the individual's needs in a professional manner.

Aims: The overall aims of the study were to identify the information needs of Chinese HF population and to examine the effectiveness of a heart failure disease management programme (HFDMP) on patients' clinical outcomes, health-related quality of life (HRQoL), and psychological status. / Background: Heart failure (HF) is a major and increasing public health problem globally. In China, there were approximately 4,000,000 patients with HF in the year 2000 and the number is continuously increasing due to the aging population. HF greatly influences patients' lives in all aspects. Programmes are therefore in imperative need to manage the disease and increase patients' sense of well-being. / Conclusion: Findings of the study provide further evidence that the simple combination of education and telephone follow-up could improve patients' medication adherence, HRQoL, and psychological status among Chinese HF population. Moreover, booklet developed in the study, to a certain extent, can be used as the tool for clinical HF education in China. The study also provides clues and direction for health professionals to develop interventions under the situation of busy clinical work and limited resources in Chinese health care practice. / Methods: First of all, a questionnaire survey (phase I, n=347), of which the questionnaire validation (n=247) was also included, and qualitative interviews with 26 patients and 24 health professionals (phase II) were consecutively conducted to know the information needs of patients with HF. According to the results of phase I and phase II studies, a booklet was developed to address the information needs of patients. Then a prospective controlled trial (phase III, n=160) was undertaken to examine the effectiveness of a HFDMP, including the components of two-session inpatient booklet education and weekly telephone follow-up for 4 weeks after discharge, on patients' performance of 6-minute walking test (6-MWT), clinical outcomes [death, cardiac-related admission (CRA) and length of stay (LoS) in hospital], medication adherence, HRQoL, and psychological status (depression and anxiety). Data collection was carried out at baseline, at 4 weeks (programme end) and 3 months (study end) after hospital discharge. Inferential statistics including independent t-test, paired t-test, Chi-square test, Fisher's exact test, the Mann-Whitney U test, and the Generalized Estimating Equation model, were used to compare the baseline and various outcome variables within and between groups. / Results: According to the results of phase I, the questionnaire entitled "Heart Failure Patient Learning Needs Inventory" is valid and reliable to measure learning needs among Chinese HF population. Based on the information needs identified in phase I and II, infonnation about HF regarding definition, symptoms, risk factors, classification, treatment strategies, and self-management strategies such as weight and symptoms monitoring, low-salt diet, medication compliance, exercise, and emotion management was included in the booklet. The accuracy, readability, and applicability of the booklet were established by an expert panel and potential users. / With regard to the effectiveness of the HFDMP on patients' outcomes, patients in the experimental group showed greater improvement through the study period than those in control group in the following aspects: a significantly better medication adherence (p < 0.001) as measured by the Chinese version of the Morisky Medication Adherence Scale, a significantly better HRQoL (p < 0.001) as assessed by the Chinese version of the Minnesota Living with Heart Failure Questionnaire, and a significantly greater reduction in depression and anxiety (p < 0.001) as assessed by the Chinese version of the Hospital Anxiety and Depression Scale. However, effectiveness of the programme on patients' 6-MWT, death, CRA, and LoS were not confirmed in the present study. / Yu, Mingming. / Adviser: Sek Ying Chair. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 267-310). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendix also in Chinese.

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Han, Jinghao. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 182-204). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese.

Cardiac Resynchronization Therapy (CRT) is a treatment option for heart failure patients with ventricular dyssynchrony. CRT corrects for dyssynchrony by electrically stimulating the septal and lateral walls of the left ventricle (LV), forcing synchronous con- traction and improving cardiac output. Current selection criteria for CRT rely upon the QRS duration, measured from a surface electrocardiogram, as a marker of electrical dyssynchrony. Unfortunately, 30-40% of patients undergoing CRT fail to benefit from the treatment. A multitude of studies have shown that presence of mechanical dyssynchrony in the LV is an important factor in determining if a patient will benefit from CRT. Furthermore, recent evidence suggests that patient response can be improved by placing the LV pacing lead in the most dyssynchronous or latest contracting segment. The overall goal of this project was to develop methods that allow for accurate assessment and display of regional mechanical dyssynchrony throughout the LV and at the site of the LV pacing lead. To accomplish this goal, we developed a method for quantifying regional dyssynchrony from standard short-axis cine magnetic resonance (MR) images. To assess the effects of LV lead placement, we developed a registration method that allows us to project the LV lead location from dual-plane fluoroscopy onto MR measurements of cardiac function. By applying these techniques in patients undergoing CRT, we were able to investigate the relationship between regional dyssynchrony, LV pacing lead location, and CRT response.

Appendum consists of last two leaves. / Copies of author's previously published articles inserted. / Bibliography: leaves 241-283. / xviii, 284 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / The studies described were designed to identify and address (through the application of relatively novel and potentially useful adjunctive therapeutic strategies) some of the determinants of sub-optimal therapeutic response in intermediate coronary syndrome and chronic congestive heart failure; especially when targeted towards those patients who fail to gain the maximal benefit from pre-existing modalities of pharmacological treatment. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 4 uppsatser.

Allt fler personer drabbas av hjärt- och kärlsjukdomar, vilket på sikt kan leda till kronisk hjärtsvikt. För att förbättra omvårdnadsåtgärder för hjärtsviktspatienter har Socialstyrelsen 2004 givit ut nationella riktlinjer för hjärtsjukvård där vikten av en individuell handlingsplan betonas. Syftet med litteraturstudien är att undersöka på vilket sätt sjuksköterskor utför omvårdnadsåtgärder avseende fysisk aktivitet, egenvård, nutrition och rökstopp för patienter med hjärtsvikt och om dessa överrensstämmer med gällande riktlinjer samt om hänsyn måste tas till genusskillnader. Metoden är en litteraturstudie i databaserna PubMed och Elin@Malmö vilket resulterade i 14 artiklar som användes för att söka svaret på syftet. Som teoretisk referensram har Antonovskys KASAM modell använts. Resultatet visar att det är viktigt att patienten får rätt information, förstår informationen och kan omsätta den i sin vardag. Det är framförallt viktigt att fokusera på egenvård för att minska behovet av sjukhusinläggningar och att hjärtsviktsmottagningar prioriteras samt att vården ska individanpassas. / More and more people suffer from cardiac and vascular diseases that eventually can result in congestive heart failure. Socialstyrelsen has 2004 issued national guidelines for cardiac care in order to improve caring possibilities for patient with heart failure where an individual action plan is emphasised. The aim with the literature review is to look into in what way caring measures for patients with heart failure are performed with respect to physical activities, self-care, nutrition and smoking and if gender differences need to be considered. The method is a literature review in the databases PubMed and Elin@Malmö that resulted in 14 articles that were used in order to fulfil the aim. Antonovskys KASAM model has been used as the theoretical reference frame. The result shows that it is essential that the patient receives the correct information, understand it and is able to put into practise. It is especially important to focus on self-caring in order to reduce the number of hospital admissions and that heart failure clinics are prioritised together with an individual care.