Browsing by Author "Pestana, Sandra"
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- Do heart failure inpatients present a suitable self-management of their disease?Publication . Delgado, Bruno; Lopes, Ivo; Gomes, Bárbara; Pestana, Sandra; Correia, Ana Luísa; Novo, AndréHeart failure (HF) is a syndrome that conduct patients to high levels of impairment. Knowing the symptoms of the disease and being aware about the most important aspects related to a good selfmanagement is very important. The first step to improve knowledge is to know what patients really understand about HF and what are they capable of doing, in order to control the disease. Purpose To characterize the level of selfmanagement of the disease on patients admitted due to decompensated HF Methods Using the Self Care Heart Failure Index (SCHFI), 92 inpatients were evaluated in order to understand their level of awareness about selfcare in HF and what are the main strategies used when they identify symptoms of decompensation. Variables like age, gender and functional status (Barthel index (BI) and LCADL) at admission were used to made some correlations. Descriptive statistics was used to identify the most common strategies used by patients and to analyze the selfcare items of the scale. Results The mean age was 70 (±9,4) years and patients were mainly male (66,7%). They presented high levels of functional impairment with 32 points on LCADL and 73 on BI and a mean of 4 cardiovascular risk factors. Regarding section A, the three most frequent instructions performed by patients was: 1) Avoid getting sick, 2) keep doctor or nurse appointments and 3) Don´t forget to take the medicines. The most notfollowed instructions were: 1) Do some physical activity or Exercise for 30 minutes, 2) Weight themselves and 3) check ankles for swelling. Regarding section B only 7,6% of the patients immediately recognized the symptom of HF decompensation and 57,6% did not. 64,1% of the patients refers Very likely to Call the doctor or nurse for attendance. Section C refers to confidence of patients in selfmanagement, 53% of the patients refer to be not confident about any of the items of the list. The mean score of the scale was 43 (±10) points. Regarding correlations, patients who refer to perform same physical activity or exercise at least 30 minutes show a negative correlation with number of CVRF and LCADL at admission and a positive correlation with BI at admission. Conclusions Patients demonstrate high confidence on their health team providers, however they do not perform correctly the instructions given and showed difficulties in identifying symptoms of decompensation. Self management and knowledge must be improved to these patients. Other study must be devolved in order to understand the causes for this results. Conclusions Patients demonstrate high confidence on their health team providers, however they do not perform correctly the instructions given and showed difficulties in identifying symptoms of decompensation. Self management and knowledge must be improved to these patients. Other study must be devolved in order to understand the causes for this results.
- Do heart failure inpatients present a suitable selfmanagement of their disease?Publication . Delgado, Bruno; Lopes, Ivo; Pestana, Sandra; Correia, Ana Luísa; Gomes, Bárbara; Novo, AndréHeart failure (HF) is a syndrome that conduct patients to high levels of impairment. Knowing the symptoms of the disease and being aware about the most important aspects related to a good selfmanagement is very important. The first step to improve knowledge is to know what patients really understand about HF and what are they capable of doing, in order to control the disease. Purpose To characterize the level of selfmanagement of the disease on patients admitted due to decompensated HF Methods Using the Self Care Heart Failure Index (SCHFI), 92 inpatients were evaluated in order to understand their level of awareness about selfcare in HF and what are the main strategies used when they identify symptoms of decompensation. Variables like age, gender and functional status (Barthel index (BI) and LCADL) at admission were used to made some correlations. Descriptive statistics was used to identify the most common strategies used by patients and to analyze the selfcare items of the scale. Results The mean age was 70 (±9,4) years and patients were mainly male (66,7%). They presented high levels of functional impairment with 32 points on LCADL and 73 on BI and a mean of 4 cardiovascular risk factors. Regarding section A, the three most frequent instructions performed by patients was: 1) Avoid getting sick, 2) keep doctor or nurse appointments and 3) Don´t forget to take the medicines. The most notfollowed instructions were: 1) Do some physical activity or Exercise for 30 minutes, 2) Weight themselves and 3) check ankles for swelling. Regarding section B only 7,6% of the patients immediately recognized the symptom of HF decompensation and 57,6% did not. 64,1% of the patients refers Very likely to Call the doctor or nurse for attendance. Section C refers to confidence of patients in selfmanagement, 53% of the patients refer to be not confident about any of the items of the list. The mean score of the scale was 43 (±10) points. Regarding correlations, patients who refer to perform same physical activity or exercise at least 30 minutes show a negative correlation with number of CVRF and LCADL at admission and a positive correlation with BI at admission. Conclusions Patients demonstrate high confidence on their health team providers, however they do not perform correctly the instructions given and showed difficulties in identifying symptoms of decompensation. Self management and knowledge must be improved to these patients. Other study must be devolved in order to understand the causes for this results. Conclusions Patients demonstrate high confidence on their health team providers, however they do not perform correctly the instructions given and showed difficulties in identifying symptoms of decompensation. Self management and knowledge must be improved to these patients. Other study must be devolved in order to understand the causes for this results.
- The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients: results of a multicenter randomized controlled trial (ERIC-HF study)Publication . Delgado, Bruno; Novo, André; Lopes, Ivo; Rebelo, Carina; Almeida, Cecília; Pestana, Sandra; Gomes, Bárbara; Froelicher, Erika; Klompstra, LeonieTo analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design A randomized controlled clinical trial with follow-up at discharge. Settings Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome Functional exercise tolerance was measured with a 6-min walking test at discharge. Results In total 257 patients with DHF were included, with a mean age of 67 ± 11 years, 84% (n = 205) had a reduced ejection fraction and the hospital stay was 16 ± 10 days. At discharge, patients in the intervention group walked further compared to the control group (278 ± 117m vs 219 ± 115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96 ± 7 vs 93 ± 12, p = 0.02) and dyspnea associated to ADL (13 ± 5 vs 17 ± 7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p = 0.02). Conclusion The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.