Characteristics of Patients with Decreased Cognitive Function Undergoing Treatment for Acute Exacerbation of Chronic Heart Failure—Basic Survey for Standardization of Nursing to Prevent Discontinuation of Treatment

Abstract

The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, "cognitive function at hospitalization", "characteristics at hospitalization, "characteristics when receiving examinations, procedures or treatment", "characteristics of course of treatment", "characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration", "characteristics when using diuretics", "characteristics concerning compliance with dietary restrictions" and "support required for discharge from hospital" concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.

Development of a Nursing Protocol for Hospitalized Patients with Reduced Cognitive Function in the Process of Recovery from Acute Exacerbation of Chronic Heart Failure

“…In the basic survey [26], we revealed issues in nursing care which make it difficult for patients with impaired cognitive function to continue treatments for acute exacerbation of chronic heart failure or to go through monitoring of symptoms.…”

“…A draft of the nursing protocol was prepared based on the basic survey [26] and the guidelines for treatments of acute heart failure [27] in order to prepare a nursing protocol for treatments frequently performed for acute exacerbation phase of chronic heart failure in patients with impaired cognitive function. In the basic survey [26], we revealed issues in nursing care which make it difficult for patients with impaired cognitive function to continue treatments for acute exacerbation of chronic heart failure or to go through monitoring of symptoms.…”

“…For the second stage, semi-structured interviews were conducted with 4 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure the content validity of the draft protocol. In the interviews, we asked their opinions on characteristics of patients with impaired cognitive function with acute exacerbation of chronic heart failure [26] as well as on the draft of the protocol. Then we revised the draft according to their opinions.…”

“…For the first step of the research, a draft of the nursing protocol was prepared based on a basic survey [26] for patients with chronic heart failure with impaired cognitive function. For the second stage, semi-structured interviews were conducted with 4 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure the content validity of the draft protocol.…”

“…Based on the evidence from the previous study (original draft) [26] and opinions of certified nurses specialized in chronic heart failure and/or dementia care, we prepared a revised draft of the nursing protocol using a mail survey on nurses working in clinical settings for the effects of assessment items and specific nursing care practice. The nursing protocol was considered useful by 90.1% of these nurses, suggesting that it is valid to a certain level.…”