Development of a Self-Management Program Using Decision Trees for Patients with Chronic Heart Failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/154752
Type:
Presentation
Title:
Development of a Self-Management Program Using Decision Trees for Patients with Chronic Heart Failure
Abstract:
Development of a Self-Management Program Using Decision Trees for Patients with Chronic Heart Failure
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Kim, Gi
P.I. Institution Name:Yonsei University
Objectives: The purposes of this study were 1) to develop a self-management program for patients with chronic heart failure (CHF) using health problem-based decision trees, 2) to validate the program using an expert group, and 3) to evaluate the clinical applicability of the program. Design: This study was a methodological study to develop a self-management program for patients with CHF. The self-management program used decision trees. Sample, Setting: In order to identify their health problems and self-care strategies and to draw up a preliminary self-management program, 1) medical records of 56 patients who were admitted with CHF to the Cardiovascular Hospital of Yonsei Medical Center in Seoul between September, 1999 and September, 2000 were randomly sampled, and 2) sixteen patients with CHF who either planned to be discharge after treatment or to be followed up at an outpatient clinic between January 15 and January 31, 2001 were selected as a convenience sampling. Clinical applicability test was done with six patients at the Cardiovascular Hospital of Yonsei Medical Center in Seoul between April 9 and May 30, 2001. Concept and variables : Self-Management Program : According to Riegel, et al(2000)and Nease, et al(1995), self-management is one component of self-care related to the cognitive decision-making process in response to symptoms of patients. The self-management program in this study was a program that included the cognitive decision-making in response to symptoms - dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea(PND), chest discomfort, edema, indigestion, and dizziness - of patients with CHF. In order to emphasize the cognitive decision-making in response to symptoms, decision trees were used in this study. Methods: 1) The first phase of this study was to determine the health problems of patients with CHF including their self-management strategies. This was done through a review of the literature, chart reviews and a survey of patients. 2) The second phase was to draw up a preliminary self-management program using decision trees based on the self-management stages developed by Riegel et al.(2000). In order to draw up a preliminary self-management program, seven major textbooks and several literature reports were utilized. 3) An expert team of three cardiologists, four professors of Nursing, and one nurse with expertise in cardiology examined the preliminary self-management program for validity. 4) And then a clinical applicability test was done using individualized patient education with the self-management program that had been developed. Patient interviews on the merits and possible revisions for the program were done in the outpatient clinic two weeks after discharge. The instrument for patient interview was a semi-structured questionnaire. Findings: The results of this study are summarized as follows : 1) The self-management program for patients with CHF was comprised of the following seven health problems: dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea(PND), chest discomfort(chest pain), edema, indigestion(epigastric discomfort, anorexia, and nausea), and dizziness. 2) The contents of the preliminary self-management program for these seven health problems were set up in the following order: identification of the health problem, confirmation of factors related to the problem, and suggestions for coping strategies. 3) As a results of the expert validity test, the framework for the preliminary self-management program was modified to the following order: identification of the health problem, presentation of immediate coping behaviors, reconfirmation of problem, confirmation of related factors, and suggestions for coping strategies. 4) As the results of the clinical applicability test using the self-management program showed that the most frequently using self-management program was the program related to dyspnea on exertion, and dizziness. On the other hand, the program related to orthopnea and PND were not used during the clinical applicability test period because these symptoms didn't occur. 5) The merits of this program were found to be ease of understanding the content and flow of the program, the ability to use the program for symptom relief when health problems arose, and improvement in self-confidence to manage health care after using the program. Conclusions & Implications: In conclusion, this study suggests that the self-management program using decision trees is an effective intervention method for patients with CHF. Utilizing the program improves self-efficacy and compliance with therapeutic regimen by patients with CHF. Therefore repeat admissions of CHF patient will be decrease.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDevelopment of a Self-Management Program Using Decision Trees for Patients with Chronic Heart Failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154752-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Development of a Self-Management Program Using Decision Trees for Patients with Chronic Heart Failure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kim, Gi</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Yonsei University</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">krumen@hanmail.net</td></tr><tr><td colspan="2" class="item-abstract">Objectives: The purposes of this study were 1) to develop a self-management program for patients with chronic heart failure (CHF) using health problem-based decision trees, 2) to validate the program using an expert group, and 3) to evaluate the clinical applicability of the program. Design: This study was a methodological study to develop a self-management program for patients with CHF. The self-management program used decision trees. Sample, Setting: In order to identify their health problems and self-care strategies and to draw up a preliminary self-management program, 1) medical records of 56 patients who were admitted with CHF to the Cardiovascular Hospital of Yonsei Medical Center in Seoul between September, 1999 and September, 2000 were randomly sampled, and 2) sixteen patients with CHF who either planned to be discharge after treatment or to be followed up at an outpatient clinic between January 15 and January 31, 2001 were selected as a convenience sampling. Clinical applicability test was done with six patients at the Cardiovascular Hospital of Yonsei Medical Center in Seoul between April 9 and May 30, 2001. Concept and variables : Self-Management Program : According to Riegel, et al(2000)and Nease, et al(1995), self-management is one component of self-care related to the cognitive decision-making process in response to symptoms of patients. The self-management program in this study was a program that included the cognitive decision-making in response to symptoms - dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea(PND), chest discomfort, edema, indigestion, and dizziness - of patients with CHF. In order to emphasize the cognitive decision-making in response to symptoms, decision trees were used in this study. Methods: 1) The first phase of this study was to determine the health problems of patients with CHF including their self-management strategies. This was done through a review of the literature, chart reviews and a survey of patients. 2) The second phase was to draw up a preliminary self-management program using decision trees based on the self-management stages developed by Riegel et al.(2000). In order to draw up a preliminary self-management program, seven major textbooks and several literature reports were utilized. 3) An expert team of three cardiologists, four professors of Nursing, and one nurse with expertise in cardiology examined the preliminary self-management program for validity. 4) And then a clinical applicability test was done using individualized patient education with the self-management program that had been developed. Patient interviews on the merits and possible revisions for the program were done in the outpatient clinic two weeks after discharge. The instrument for patient interview was a semi-structured questionnaire. Findings: The results of this study are summarized as follows : 1) The self-management program for patients with CHF was comprised of the following seven health problems: dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea(PND), chest discomfort(chest pain), edema, indigestion(epigastric discomfort, anorexia, and nausea), and dizziness. 2) The contents of the preliminary self-management program for these seven health problems were set up in the following order: identification of the health problem, confirmation of factors related to the problem, and suggestions for coping strategies. 3) As a results of the expert validity test, the framework for the preliminary self-management program was modified to the following order: identification of the health problem, presentation of immediate coping behaviors, reconfirmation of problem, confirmation of related factors, and suggestions for coping strategies. 4) As the results of the clinical applicability test using the self-management program showed that the most frequently using self-management program was the program related to dyspnea on exertion, and dizziness. On the other hand, the program related to orthopnea and PND were not used during the clinical applicability test period because these symptoms didn't occur. 5) The merits of this program were found to be ease of understanding the content and flow of the program, the ability to use the program for symptom relief when health problems arose, and improvement in self-confidence to manage health care after using the program. Conclusions &amp; Implications: In conclusion, this study suggests that the self-management program using decision trees is an effective intervention method for patients with CHF. Utilizing the program improves self-efficacy and compliance with therapeutic regimen by patients with CHF. Therefore repeat admissions of CHF patient will be decrease.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T13:14:58Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T13:14:58Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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