Adequate adherence to treatment is indispensable in preventing adverse consequences in heart failure patients. Such adherence can be managed through heart failure clinics and various methods of follow-up. In recent years, the use of telemonitoring has shown promising benefits in supporting clinicians' follow-up, as well as contributing to patients' self-care. This article presents the development and evaluation of a telemonitoring application for heart failure, through a Web-based interface for clinicians and a mobile application for patients. The application was evaluated through a 6-month pilot observational descriptive study in 20 outpatients with reduced ejection fraction and two nurses, in the context of a heart failure clinic. A technological acceptance questionnaire was applied to all patients and nurses at the end of the study period. In use, the application generated 64 real-time alerts for early decision-making to prevent complications, and 91% of patients did not present hospital readmissions. Such results, along with high user acceptance, show potential utility of the application as an effective complementary strategy for follow-up of patients with heart failure.

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Introduction:The family of the terminal patient is an essential therapeutic element while relieving the patient's suffering; and thus, nursing professionals should promote that families are prepared, and willing, to provide the necessary companionship to the terminal patient. Objective: To identify the importance of the communication between the nursing professionals and the family of the terminal patient. Development: Caring patients and their families requires that nursing professionals develop and strengthen emotional competencies to understand the process of therapeutic communication and implement it in their daily practice. Conclusion: Nursing professionals should acknowledge that the therapeutic communications in care must develop transversally, and that this process is founded on knowledge, supporting relationship, and active listening. This particular form of listening is essential because it has the purpose to re-establish the family's emotional stability so that this is re-directed as a therapeutic element which can contribute to relieving the suffering of the terminal patient in his/her last moments. With the above, it will be achieved an improvement in professional skills and communication quality.

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Universidad de Santander. Este es un artículo de acceso abierto, distribuido bajo los términos de la licencia Creative CommonsAttribution , que permite el uso ilimitado, distribución y reproducción en cualquier medio, siempre que el autor original y la fuente sean debidamente citados.http: //dx.doi.org/10.15649/cuidarte.v8i3.407 Resumen Introducción: El cuidador familiar es la fuente más importante de apoyo social y requiere desarrollar habilidades para reforzar las conductas de autocuidado en su familiar. El objetivo de este estudio fue determinar la competencia de cuidado de los cuidadores familiares de los pacientes con falla cardiaca (FC) en una institución de cuarto nivel de complejidad. Materiales y Métodos: Estudio descriptivo de corte transversal. Con un tamaño de muestra de 41 cuidadores familiares de personas con FC que asisten al programa de FC en una institución de salud de cuarto nivel, durante el segundo semestre del 2016. Para la recolección de la información se utilizó el instrumento "CUIDAR" que cuenta con pruebas de validez de constructo y consistencia interna con un alfa de Cronbach de 0.93. Se realizó un análisis descriptivo con distribución de frecuencias absolutas y relativas. Resultados: El nivel de competencia global para el cuidado en el hogar de los cuidadores familiares de los pacientes con FC fue medio y alto. Las dimensiones que alcanzaron un nivel más alto de competencia fueron Disfrutar e Instrumental y Procedimental. Discusión: Una adecuada competencia para el cuidado en los cuidadores se convierte en un factor que puede influir de manera positiva en el manejo de la persona. Conclusiones: Una adecuada competencia del cuidador familiar va a permitir una mejor adaptación a los nuevos requerimientos de la vida del paciente con su enfermedad y pueden ayudar a prevenir las descompensaciones. Palabras clave: Cuidadores; Insuficiencia Cardíaca; Competencia Clínica; Pacientes. Abstract Introduction: The family caretaker is the most important source of social support and requires developing skills to reinforce self-care conducts in their relatives. The aim of this study was to determine the care skills of family caretakers of patients with heart failure (HF) in an institution with tier IV level of complexity. Materials and Methods: This was a cross-sectional descriptive study, with a sample size of 41 family caretakers of people with HF attending the HF program in a tier IV health institution, during the second semester of 2016. The 'CUIDAR' instrument was used to collect information. Said instrument has construct validity and internal consistency tests with Cronbach's alpha of 0.93. A descriptive analysis was performed with absolute and relative distribution frequencies. Results: The global skill level for homecare of family caretakers of patients with HF was medium and high. The dimensions reaching the highest level of skills were enjoyment, instrumental, and procedural. Discussion: An adequate care skill in caretakers becomes a factor that can positively influence upon managing a per...