Effect of Clinical Nurses Specialists intervention on rehabilitation outcomes in patients with heart failure

Abstract

Introduction: Living with heart failure is serious and call for long term rehabilitation care. Rehabilitation elements for patients with Heart Failure are based on the recommendations from the European Society of Cardiology and focuses on self-care and adherence in general. The aim of this study was, therefore, to test a protocol for rehabilitation of patients after completing rehabilitation in the outpatient clinic. Method:The study design is quasi-experimental. Patients in the control group follow the conventional rehabilitation. For the patients in the intervention group an individual rehabilitation plan was prepared and followed up by telephone after 4 and 12 weeks. For all patients Health Status were measured with Short Form 36 and EQ5D.Results: One hundred and sixty-two patients are included in the study of which 137 (84.6%) consented. There were no differences in total self-care behavior between the groups at baseline and at follow-up after 4 and 12 weeks. Within the control group no changes in the self-care score from baseline to follow-up were observed. Total EQ5D scores showed no significant differences between the groups at baseline. Subgroup analyses showed a significant difference in usual activities and decrease in anxiety/depression in the intervention group with a within-group increase from 34.4 percent at baseline to 51.4 percent after 12 weeks (p = .0002). No between-groups differences at 4 weeks or 12 weeks were observed.Conclusion: No significant increase in Health Status between groups were found. Subgroup analysis showed a significant within-group decrease in development of anxiety in the intervention group from baseline to twelve weeks. There may be a correlation between the increase in self-care behavior in patients in the intervention group after 12 weeks and a reduction in anxiety.

Supporting patients in reducing postoperative constipation: fundamental nursing care – a quasi‐experimental study

“…Three previous studies have tested active involvement in the same frame of reference, where the goal was to enable patients to handle health issues by themselves at home. Those interventions showed positive effects in all cases . One study tested active involvement in energy and protein intake among patients that underwent orthopaedic surgeries, including patients with hip fractures.…”

“…Actively involving patients in their care, through individualised care and support, during the postoperative period increased energy and protein intakes, (28) reduced patients' time to reach habitual levels in three of eight areas of health status, (29) and increased usual activities and a decreased anxiety/depression (30). Based on those findings, we reasoned that active involvement through individually planned care, support and counselling during a hospital stay for patients with hip fractures may be important in preventing postsurgical constipation.…”

The centrality of the nurse–patient relationship: A Scandinavian perspective

“…Pedersen's interpretation of Larsen's and Green's models has so far been tested in three doctoral theses in 2010–2017 dealing with issues of fundamentals of care: Hørdam et al. in on mobilising patients, Larsen, Thomsen, and Pedersen in on patients’ self‐care when it comes to heart failure and Trads, Deutch, and Pedersen in on prevention of postoperative obstipation.…”