Modeling Pathways to Pre-Disability in Instrumental Activities of Daily Living in Persons with Heart Failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/158391
Type:
Presentation
Title:
Modeling Pathways to Pre-Disability in Instrumental Activities of Daily Living in Persons with Heart Failure
Abstract:
Modeling Pathways to Pre-Disability in Instrumental Activities of Daily Living in Persons with Heart Failure
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Seo, Yaewon
P.I. Institution Name:University of Nebraska Medical Center
Title:College of Nursing
Contact Address:985330 Nebraska Medical Center, College of Nursing, Omaha, NE, 68198-5330, USA
Contact Telephone:1-402-559-6567
Co-Authors:Y. Seo, L. LaFramboise, B. Yates, College of Nursing, University of Nebraska Medical Center, Omaha, NE;
Background: Heart failure (HF) is the most common contributing factor for developing disability. Persons with HF modify their usual way of performing instrumental activities of daily living (IADLs) to maintain function until modification is no longer effective resulting in restriction of IADLs (disability). The theoretical framework guiding this study was modified from Nagi's (1965; 1991) model of disability. The purpose of the study was to evaluate the sequential effects of active pathology (co-morbid condition), functional impairment (dyspnea, fatigue, muscle strength), and functional limitation (activity tolerance) on pre-disability (modification). Methods and Results: In a cross-sectional design, 48 men and 54 women over 21 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) were recruited at an outpatient HF clinic. More than 80% of patients were categorized as NYHA II. Modification in performance of IADLs had an average rating of 2.08 (SD = 1.68) on a scale of 0-10; average dyspnea rating was 2.55 on a scale of 0-10 (SD = 1.97); average activity tolerance (6-Minute Walk [6 MW]) was 300.23 meters. Path analysis using Analysis of Moment Structures (AmosTM) revealed that 68% of the variance in modification in IADLs was significantly explained by the overall model. As expected, activity tolerance had direct effects whereas dyspnea had both direct- and indirect-effects through activity tolerance. Co-morbidity had an indirect effect through both dyspnea and activity tolerance. Fatigue and muscle strength had no effect on modification in IADLs. (See Figure 1) Conclusion: Clinical assessment of co-morbidity, activity tolerance, and dyspnea with activity may help identify patients at risk for disability. Interventions that target dyspnea and activity tolerance may improve pre-disability and prevent subsequent disability in HF patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleModeling Pathways to Pre-Disability in Instrumental Activities of Daily Living in Persons with Heart Failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158391-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Modeling Pathways to Pre-Disability in Instrumental Activities of Daily Living in Persons with Heart Failure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Seo, Yaewon</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Nebraska Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">College of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">985330 Nebraska Medical Center, College of Nursing, Omaha, NE, 68198-5330, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">1-402-559-6567</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">yaewonseo@unmc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Y. Seo, L. LaFramboise, B. Yates, College of Nursing, University of Nebraska Medical Center, Omaha, NE;</td></tr><tr><td colspan="2" class="item-abstract">Background: Heart failure (HF) is the most common contributing factor for developing disability. Persons with HF modify their usual way of performing instrumental activities of daily living (IADLs) to maintain function until modification is no longer effective resulting in restriction of IADLs (disability). The theoretical framework guiding this study was modified from Nagi's (1965; 1991) model of disability. The purpose of the study was to evaluate the sequential effects of active pathology (co-morbid condition), functional impairment (dyspnea, fatigue, muscle strength), and functional limitation (activity tolerance) on pre-disability (modification). Methods and Results: In a cross-sectional design, 48 men and 54 women over 21 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) were recruited at an outpatient HF clinic. More than 80% of patients were categorized as NYHA II. Modification in performance of IADLs had an average rating of 2.08 (SD = 1.68) on a scale of 0-10; average dyspnea rating was 2.55 on a scale of 0-10 (SD = 1.97); average activity tolerance (6-Minute Walk [6 MW]) was 300.23 meters. Path analysis using Analysis of Moment Structures (AmosTM) revealed that 68% of the variance in modification in IADLs was significantly explained by the overall model. As expected, activity tolerance had direct effects whereas dyspnea had both direct- and indirect-effects through activity tolerance. Co-morbidity had an indirect effect through both dyspnea and activity tolerance. Fatigue and muscle strength had no effect on modification in IADLs. (See Figure 1) Conclusion: Clinical assessment of co-morbidity, activity tolerance, and dyspnea with activity may help identify patients at risk for disability. Interventions that target dyspnea and activity tolerance may improve pre-disability and prevent subsequent disability in HF patients.</td></tr></table>en_GB
dc.date.available2011-10-26T21:00:14Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:00:14Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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