Home-based rehabilitation of patients with heart failure
Evidence, Self-care and Health Status
by
Home-based rehabilitation of patients with heart failure
Evidence, Self-care and Health Status
Palle Larsen
Background
Living with heart failure is serious disease and call for long term
rehabilitation care. Rehabilitation elements for patients with heart failure
are based on the recommendations from the European Society of
Cardiology and focuses on self-care and adherence in general. The aim of
this study was to develop and test a protocol for rehabilitation of patients
with Heart Failure, after completing rehabilitation in the outpatient clinic.
Method
The study design is quasi-experimental. Patients in the control group
follow the conventional rehabilitation. For the patients in the intervention
group an individual rehabilitation plan was prepared and followed up by
telephone after 4 and 12 weeks. For all patients Health Status were
measured with Short Form 36 and EQ5D. A systematic review on
effectiveness of reducing dietary sodium intake in patients with heart
failure on reducing readmission rate and mortality was carried out in order
to add to the pool of existing evidence.
Ph.D. lecture
by
Palle Larsen
Monday 11 May 2015
Results
162 patients are included in the study of which 137 (84.6%) consented. No
differences were measured in Health status. There were a significant
increase in total scores in self-care behavior after 12 weeks.(p=0.007). A
reduction in dietary sodium intake in patients with HF in diuretic treatment
increased the risk for readmission with OR 2.53 (2.12-3.03)
EQ5D measurements of Health Status showed a significant reduction in
anxiety/depression in the intervention group with a within-group increase
from 34.4 percent at baseline to 51.4 percent after 12 weeks (p=.0002).
Conclusion
Systematic intervention conducted by a clinical nurse specialist based on
patient self-care behaviors and telephone follow-up 4 and 12 weeks after
initial contact leads to a significant increase in the total self-care behavior
in patients with heart failure. Analyses showed a significant reduction in
anxiety in the intervention group .
This thesis is based on
Palle Larsen’s research work at:
A meta-analysis show that heart failure patients on diuretics have a higher
risk of being readmitted as well as a higher risk of mortality if they reduce
their daily salt intake. Further studies are needed.
Department of Health Science and Technology
Aalborg University, Denmark
To fulfil the requirements for the Ph.D. degree, Palle Larsen has
submitted his thesis: Home-based rehabilitation of patients with
heart failure: Evidence, Self-care and Health Status
to the Faculty Council of Medicine at Aalborg University.
Program for Ph.D. lecture
by
Palle Larsen
The Faculty Council has appointed the following adjudication
committee to evaluate the thesis and the associated lecture:
Associate Professor Vibeke Zoffmann
Center of Womens and Children’s Health
Copenhagen University Hospital
Denmark
Professor João Luis Alves Apóstolo
Escola Superior de Enfermagern de Coimbra
University of Coimbra
Portugal
Chairman:
Associate Professor Lisbeth Uhrenfeldt
Department of Health Science and Technology
Aalborg University
Denmark
Moderator:
Associate Professor Erik Elgaard Sørensen
Department of Clinical Medicine
Aalborg University
Denmark
The Ph.D. lecture is public and will take place on:
Monday 11 May 2015 at 13:00
Aalborg University – Niels Jernes Vej 14, room 4-111
9220 Aalborg East
Monday 11 May 2015
Home-based rehabilitation of patients with heart failure
Evidence, Self-care and Health Status
Chairman:
Moderator:
Associate Professor Lisbeth Uhrenfeldt
Associate Professor Erik Elgaard Sørensen
13.00
Opening by the Moderator
13.05
Ph.D. lecture by Palle Larsen
13.50
Break
14.00
Questions and comments from the Committee
Questions and comments from the audience at the Moderator’s
discretion
16.00
Conclusion of the session by the Moderator
After the session a reception will be arranged in the Foyer
at Niels Jernes Vej 14