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
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