How to care for patients with heart failure – A systematic review of nursing interventions

Abstract

Background: Heart Failure (HF) is a highly dysfunctional disease, with impact on the biopsychosocial dimensions of the patients. The worldwide progressive growth of HF incidence, caused by longer life expectancy, results in higher HF rehospitalization rates. HF patients’ rehospitalization is mostly a result of avoidable causes, including limitations in knowledge regarding HF self-care and impaired therapeutic adherence; therefore, the intervention of nurses is essential. Goals: To identify nursing interventions to address alterations in Basic Human Needs (BHN) and to promote relief of symptoms for HF patients as they transition from hospital to home, including follow-up care. Method: A systematic review in CINAHL and MEDLINE databases to answer the study question: In patients with HF, what nursing interventions help to improve BHN, promote relief of symptoms and aid the transition from hospital to home? Results: Nine studies were included. Nursing interventions focused on relief of symptoms during hospitalization to promote well-being and the individual’s health status. Preparing the patient’s transition from hospital to home earlier in their admission allows for the identification and adequate response to patient needs. Language adaptation during health education and a periodic follow-up were effective measures to promote independence in HF self-care and to reduce mortality and rehospitalization rates. Even though these interventions show positive results, they are not frequently used in clinical practice given a lack of specialized education about HF among healthcare professionals and empowerment culture, as well as an incapacity for adequate patient follow-up. Final Considerations: The nurse is responsible for helping the patient to develop skills to manage their symptoms (e.g., recognize relevant symptoms) and the therapeutic regimen; if successfully achieved, this promotes empowerment, thus reducing readmissions and promoting well-being.