Factors Related to Disability in Instrumental Activities of Daily Living Among Persons With Heart Failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/161046
Type:
Presentation
Title:
Factors Related to Disability in Instrumental Activities of Daily Living Among Persons With Heart Failure
Abstract:
Factors Related to Disability in Instrumental Activities of Daily Living Among Persons With Heart Failure
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2007
Author:Seo, Yaewon, PhD
P.I. Institution Name:Case Western Reserve University
Contact Address:, Shaker Heights, OH, 44120, USA
Co-Authors:S.M. Moore, E. Madigan, and M. Dolansky, SON, Case Western Reserve University, Cleveland, OH; I.L. Pina, SOM, Case Western Reserve University, Cleveland, OH; and B.L. Roberts, College of Nursing , University of Florida, Gainesville, FL
Background: Heart failure (HF) causes activity intolerance and symptoms that interferes with physical incapacity necessary to maintain independence in activities of daily living (ADLs). These symptoms contribute to significant health care expenditures and increased burden in members of the social network to assist the person to live independently. Using Nagi's model of disability validated in community dwelling elders, we examined the sequential effects of pathology (co-morbidity condition), functional impairment (dyspnea, fatigue, muscle strength, & balance), and limitation (activity intolerance) on disability (modification: how people adapt to limitation). Methods and Results: Using a cross-sectional design and convenience sampling, 48 men and 54 women over 18 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) were recruited at a specialty outpatient HF clinic. More than 50% of patients were African American and were categorized as NYHA II. The mean activity intolerance measured by the 6-Minute Walk (6 MW) was 300.02 meters (range from 66.75 to 535.23). More than two-thirds of patients required pacing of or used assistive devices for performing Instrumental ADLs (IADLs). In multiple regressions, 49% of the variance in disability in IADLs was explained by the 6 MW after controlling for age, gender, depression, and social support. The shorter distance walked in 6 minutes was significantly related to greater disability in IADLs (beta = -.54). Only 6 MW had a large direct effect on disability (-.54). Among the covariates, greater depression predicted greater modifications in IADLs (beta = .30). Conclusion: The findings that only functional limitation measured by the 6 MW, and not pathology and physical impairment, significantly predicted disability provide support for the sequential ordering of effects described by Nagi's model of disability. The 6 MW is easily done in clinical practice and may provide the best indicator of the potential for disability while depression also contributes to disability. The 6 MW and depression should be assessed in persons with HF to identify those at greatest risk for disability. Interventions targeted to improve endurance (measured here as the 6 MW) and reduce depression may prevent or reduce 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.titleFactors Related to Disability in Instrumental Activities of Daily Living Among Persons With Heart Failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161046-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Factors Related to Disability in Instrumental Activities of Daily Living Among 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">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Seo, Yaewon, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Shaker Heights, OH, 44120, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">yxs9@po.cwru.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">S.M. Moore, E. Madigan, and M. Dolansky, SON, Case Western Reserve University, Cleveland, OH; I.L. Pina, SOM, Case Western Reserve University, Cleveland, OH; and B.L. Roberts, College of Nursing , University of Florida, Gainesville, FL</td></tr><tr><td colspan="2" class="item-abstract">Background: Heart failure (HF) causes activity intolerance and symptoms that interferes with physical incapacity necessary to maintain independence in activities of daily living (ADLs). These symptoms contribute to significant health care expenditures and increased burden in members of the social network to assist the person to live independently. Using Nagi's model of disability validated in community dwelling elders, we examined the sequential effects of pathology (co-morbidity condition), functional impairment (dyspnea, fatigue, muscle strength, &amp; balance), and limitation (activity intolerance) on disability (modification: how people adapt to limitation). Methods and Results: Using a cross-sectional design and convenience sampling, 48 men and 54 women over 18 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) were recruited at a specialty outpatient HF clinic. More than 50% of patients were African American and were categorized as NYHA II. The mean activity intolerance measured by the 6-Minute Walk (6 MW) was 300.02 meters (range from 66.75 to 535.23). More than two-thirds of patients required pacing of or used assistive devices for performing Instrumental ADLs (IADLs). In multiple regressions, 49% of the variance in disability in IADLs was explained by the 6 MW after controlling for age, gender, depression, and social support. The shorter distance walked in 6 minutes was significantly related to greater disability in IADLs (beta = -.54). Only 6 MW had a large direct effect on disability (-.54). Among the covariates, greater depression predicted greater modifications in IADLs (beta = .30). Conclusion: The findings that only functional limitation measured by the 6 MW, and not pathology and physical impairment, significantly predicted disability provide support for the sequential ordering of effects described by Nagi's model of disability. The 6 MW is easily done in clinical practice and may provide the best indicator of the potential for disability while depression also contributes to disability. The 6 MW and depression should be assessed in persons with HF to identify those at greatest risk for disability. Interventions targeted to improve endurance (measured here as the 6 MW) and reduce depression may prevent or reduce disability in HF patients.</td></tr></table>en_GB
dc.date.available2011-10-26T23:15:02Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:15:02Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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