Effects of a Weight and Symptom Diary on Elderly Heart Failure Clients in Home Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/163715
Category:
Abstract
Type:
Presentation
Title:
Effects of a Weight and Symptom Diary on Elderly Heart Failure Clients in Home Care
Author(s):
Redeker, Nancy
Author Details:
Nancy Redeker, PhD, Professor, Yale University, West Haven, Connecticut, USA, email: nancy.redeker@yale.edu
Abstract:
Heart failure is a major cause of morbidity, reduced quality of life and a frequent reason for admission of elderly HF patients to home health care agencies. Weight and symptom diaries (WSD) are often used to monitor fluid status and exacerbation of HF. However, WSD may also be useful in assisting HF patients to understand their symptoms and serve as a stimulus for behavioral change. The purpose of this pilot study was to examine the effects of a WSD and ongoing self-management instruction by a home care nurse on self-efficacy for managing symptoms and disease: shortness of breath; communication with the home care nurse and physician; symptom distress; and physical function and emotional wellbeing. The study used a 2-group pre-test/post-test design. Twenty-five Medicare-insured HF clients who were 65 years of age or older and receiving home health care nursing services (M age = 77.2, SD = 11.18 years, 16 women, 9 men) were randomized to either control (n = 15) or intervention (n = 10) groups at the time of admission to a home health agency after hospital discharge for HF. The control group received routine home health care nursing. The intervention group completed a daily WSD with structured instruction on self-management during, in addition to routine home health care. Self-efficacy for managing symptoms, disease, and communicating with the physician and home care nurse (Instruments developed by Lorig); symptom distress (McCorkle's symptom distress scale); and physical and emotional wellbeing (MOS SF-36) were measured at baseline and at the conclusion of time on home care. Levels of functional status were low com-pared to published norms, and approximately 50% of the available population of home care clients with HF were ineligible for the study due to cognitive status deficits, renal failure, and other health issues. Participants used a mean of 8.9 prescription medications and had 2.5 co-morbid conditions. There were no significant changes in symptom distress or self-efficacy, but there were improvements in role-physical, vitality, social functioning, and mental health scores of the SF-36 from baseline to follow-up in the entire group. The intervention group had significantly higher levels of self-efficacy in managing shortness of breath, t (23) = -2.48, p =.02, which persisted when controlling for baseline self-efficacy, F(1,21) = 5.19, p = .035. There were no significant differences between the control and intervention groups on symptom distress, functional status, the other self-efficacy variables, demographics, or home care utilization. Weight and symptom diaries may improve self-efficacy to manage shortness of breath in a carefully selected group of home care patients. Further study is needed to identify HF clients who are most likely to participate in and benefit from self-management strategies. The effects of the WSD on health care utilization and functional status, as well as morbidity and mortality, should also be further examined in a larger study.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
ENRS 13th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Atlantic City, New Jersey, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEffects of a Weight and Symptom Diary on Elderly Heart Failure Clients in Home Careen_GB
dc.contributor.authorRedeker, Nancyen_US
dc.author.detailsNancy Redeker, PhD, Professor, Yale University, West Haven, Connecticut, USA, email: nancy.redeker@yale.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163715-
dc.description.abstractHeart failure is a major cause of morbidity, reduced quality of life and a frequent reason for admission of elderly HF patients to home health care agencies. Weight and symptom diaries (WSD) are often used to monitor fluid status and exacerbation of HF. However, WSD may also be useful in assisting HF patients to understand their symptoms and serve as a stimulus for behavioral change. The purpose of this pilot study was to examine the effects of a WSD and ongoing self-management instruction by a home care nurse on self-efficacy for managing symptoms and disease: shortness of breath; communication with the home care nurse and physician; symptom distress; and physical function and emotional wellbeing. The study used a 2-group pre-test/post-test design. Twenty-five Medicare-insured HF clients who were 65 years of age or older and receiving home health care nursing services (M age = 77.2, SD = 11.18 years, 16 women, 9 men) were randomized to either control (n = 15) or intervention (n = 10) groups at the time of admission to a home health agency after hospital discharge for HF. The control group received routine home health care nursing. The intervention group completed a daily WSD with structured instruction on self-management during, in addition to routine home health care. Self-efficacy for managing symptoms, disease, and communicating with the physician and home care nurse (Instruments developed by Lorig); symptom distress (McCorkle's symptom distress scale); and physical and emotional wellbeing (MOS SF-36) were measured at baseline and at the conclusion of time on home care. Levels of functional status were low com-pared to published norms, and approximately 50% of the available population of home care clients with HF were ineligible for the study due to cognitive status deficits, renal failure, and other health issues. Participants used a mean of 8.9 prescription medications and had 2.5 co-morbid conditions. There were no significant changes in symptom distress or self-efficacy, but there were improvements in role-physical, vitality, social functioning, and mental health scores of the SF-36 from baseline to follow-up in the entire group. The intervention group had significantly higher levels of self-efficacy in managing shortness of breath, t (23) = -2.48, p =.02, which persisted when controlling for baseline self-efficacy, F(1,21) = 5.19, p = .035. There were no significant differences between the control and intervention groups on symptom distress, functional status, the other self-efficacy variables, demographics, or home care utilization. Weight and symptom diaries may improve self-efficacy to manage shortness of breath in a carefully selected group of home care patients. Further study is needed to identify HF clients who are most likely to participate in and benefit from self-management strategies. The effects of the WSD on health care utilization and functional status, as well as morbidity and mortality, should also be further examined in a larger study.en_GB
dc.date.available2011-10-27T11:12:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:12:33Z-
dc.conference.date2001en_US
dc.conference.nameENRS 13th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationAtlantic City, New Jersey, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.