Development of a scale to gain insight into the experience of living with chronic heart failure: The UNAV-Experience of Living with Chronic Heart Failure Scale.

BACKGROUND: To date, there are no tools for the nursing staff to gain systematic insight on the experience lived by patients with chronic heart failure. The objective of this study was to develop a scale for this purpose. METHODS: The study was conducted between January 2018 and December 2020 in three Spanish hospitals. The process described by DeVellis was used for the development of the scale. The items were built based on a phenomenological study and a systematic review of the literature. Next, feedback from a panel of experts was obtained, the scale was administered to a sample of patients with chronic heart failure, and a cognitive interview and an observational study were conducted to create the final version of the scale. RESULTS: The first version of the scale had in seven domains and 76 items. After its evaluation by a panel of experts, it was reduced to a second version with six domains and 55 items. Following the administration of Version 2 to 17 patients (58.8% male, mean age 59.53, 70.6% classified as NYHA functional class II), five items were modified and two eliminated. Thus, the third version of the UNAV-CHF Experience Scale was composed of six domains and 53 items. CONCLUSIONS: This study presents the development of the UNAV-experience of living with chronic heart failure scale. It is an original and novel instrument that allows systematically explore this experience. A larger-scale study is necessary to confirm the validity of our scale.

Interventions on the social dimension of people with chronic heart failure: a systematic review of randomized controlled trials.

AIMS: The symptom burden of patients with chronic heart failure (CHF), together with social determinants and psychosocial factors, results in limitations to maintain adequate social life and roles, participate in social events and maintain relationships. This situation's impact on health outcomes makes it of utmost importance to develop meaningful social networks for these patients. The primary objective aimed to identify randomized controlled trials that impact the social dimension of people with CHF. The secondary objectives were to analyze the methodological quality of these interventions, establish their components, and synthesize their results. METHODS AND RESULTS: A systematic review following PRISMA guidelines was conducted in Pubmed, Scopus, Cochrane CENTRAL, PsychINFO, and CINAHL databases between 2010 and February 2022. The Revised Cochrane risk-of-bias tool for randomized trials was used. The protocol was registered in PROSPERO. Eight randomized controlled trials were identified, among which two were at 'high risk of bias.' Interventions were synthesized according to the following categories: delivery format, providers and recipients, and the intervention content domains. Half of the studies showed statistical superiority in improving the intervention group's social support in people with CHF. CONCLUSION: This review has highlighted the scarcity of interventions targeting the social dimension of people with CHF. Interventions have been heterogeneous, which limits the statistical combination of studies. Based on narrative review and vote counting, such interventions could potentially improve social support and self-care, which are important patient reported outcomes, thus warrant further research. Future studies should be co-created with patients and families to be adequately targeted. REGISTRATION: PROSPERO CRD42021256199.

Family Narratives About Providing End-of-Life Care at Home.

Currently, the dying process in Spain is moving to the home environment where responsibility for care falls largely on the family, thereby challenging and testing the stability of the family. Previous research has focused on the impact of illness on the primary caregiver; therefore, a knowledge gap exists. This study aimed to understand families' unitary experiences of providing home care to terminally ill family member. Using the "Model of Interpersonal Relationship Between the Nurse and the Person/Family Cared For," narrative research included family and individual interviews with nine families (9 groups/23 individuals). Thematic narrative analysis was used to interpret the interviews. The results highlight the impact of illness on family well-being as a whole. Family members often felt abandoned while caring for an ill family member and wished to be cared for themselves. However, their immediate community and the nurses caring for their ill family member neglected them. A paradigm shift is required by society and in home care at the end of life to better support the family.

Experiencing the possibility of near death on a daily basis: A phenomenological study of patients with chronic heart failure.

BACKGROUND: Chronic heart failure (CHF) is a syndrome that greatly impacts people's lives. Due to the poor prognosis of CHF, together with the frequent exacerbations of symptoms, death is a topic that is very present in the lives of patients with CHF. OBJECTIVE: To explore thoughts about death experienced by patients with chronic heart failure in their daily lives. METHODS: A hermeneutic phenomenological study was carried out. Conversational interviews were conducted with 20 outpatients with chronic heart failure. Analysis of the responses was based on the method proposed by van Manen. RESULTS: From the analysis, four main themes emerged: (1) Feeling afraid of the possibility of dying; (2) Acceptance of the possibility of death; (3) Desiring death for relief from suffering; and (4) Striving to continue living to enjoy family. CONCLUSIONS: This study presents, as a novel finding, that people with CHF experience the possibility of near death on a daily basis. This experience, which they must encounter on their own, makes them afraid. In addition, some of them, in view of the discomfort they are living, wish to die, with some even considering committing suicide.

Causes, experiences and consequences of the impact of chronic heart failure on the person´s social dimension: A scoping review.

Chronic heart failure (CHF) is a progressive and disabling condition that significantly impacts patients' daily lives. One of its effects is decreased opportunities to participate in social life, leading to reduced social interaction, loneliness, social isolation and lack of social support to continue with their daily life activities. This study aimed to explore the causes, experiences, and consequences of the impact of CHF on the social dimension of the person. According to the Arksey & O'Malley method, a scoping review of the literature was conducted to examine existing knowledge in the area, summarise existing evidence and identify gaps in the literature. The search was conducted in the PubMed, CINAHL, PsychINFO, Scopus, and Web of Science databases from January 2010 to November 2021. Twenty-six articles were identified. The reasons why CHF influences the social dimension of the person were multifactorial and related to physical aspects, sociodemographics, lifestyle changes and the feelings experienced by these patients. Social relationships play a key role, and the benefits of good social relationships and the impact of poor or inadequate social support were identified. Furthermore, the influence of alterations in the social dimension on the CHF patient's clinical outcomes was described. This approach will help to detect and better understand the bidirectional influence that exists in each person between social isolation, relationships, and support life experiences, self-care activities, and morbi-mortality rates. These findings have shown the importance of detecting higher-risk groups and systematically assessing factors related to the social dimension in all patients with CHF.

Unexplored Aspects of the Meaning of Living with Chronic Heart Failure: A Phenomenological Study within the Framework of the Model of Interpersonal Relationship between the Nurse and the Person/Family Cared for.

The complicated situation experienced by chronic heart failure (CHF) patients affects their entire well-being but clinical practice continues to fail to adequately respond to their demands. The aim of this study was to understand the meaning of living with CHF from the patient's perspective. A hermeneutic phenomenological study was conducted according to Van Manen's phenomenology of practice method. Individual conversational interviews were held with 20 outpatients with CHF. Six main themes emerged from the analysis: (1) Living with CHF involves a profound change in the person; (2) The person living with CHF has to accept their situation; (3) The person with CHF needs to feel that their life is normal and demonstrate it to others; (4) The person with CHF needs to have hope; (5) Having CHF makes the person continuously aware of the possibility of dying; (6) The person with CHF feels that it negatively influences their close environment.

Redefining a 'new normality': A hermeneutic phenomenological study of the experiences of patients with chronic heart failure.

AIM: To explore the perception of normality in life experienced by patients with chronic heart failure. DESIGN: A hermeneutic phenomenological study was conducted. METHODS: Individual conversational interviews were held with 20 outpatients with chronic heart failure between March 2014-July 2015. Van Manen's phenomenology of practice method was used for data analysis. RESULTS: From the analysis, four main themes emerged: (a) Accepting my new situation; (b) Experiencing satisfaction with life; (c) Continuing with my family, social and work roles; and (d) Hiding my illness from others. CONCLUSIONS: The present study makes a novel contribution to understanding the importance of the perception of normality in the lives of patients with chronic heart failure. It was found that patients need to incorporate this health experience into their lives and reach a 'new normal', thus achieving well-being. Several factors were identified that can help promote this perception in their lives; therefore, nursing interventions should be designed to help develop scenarios encouraging this normalization process. IMPACT: Although the implications of having a sense of normality or experiencing 'normalization' of the illness process in life have been studied in other chronic patient populations, no studies to date have examined how patients with chronic heart failure experience this phenomenon in their lives. For the first time, the results of this research prove that the perception of normality is a key aspect in the experience of living with chronic heart failure.

Beneficios del ejercicio físico en la tercera edad / Benefits of physical exercise for "The elderlyenot"

Se indican algunos aspectos del beneficio que aporta el ejercicio físico a pacientes de la tercera edad. Fueron censados 100 abuelos del círculo de abuelos del consultorio No. 13 del policlínico docente "Dr. Carlos J. Finlay" y se les palicó una necuesta que analizaba: edad, sexo, tiempo y frecuencia del ejercicio físico, utilidad y satisfacción que reporta el mismo, y se obtuvieron resultados que se expresan en el trabajo. Se plantea que existe una notable mejoría en el estado de salud de los ancianos, el 52 por ciento refieren sentirse bien y el 48 por ciento regular. En cuanto a los síntomas, el 100 por ciento presentaba dolores articulares; en el 89 por ciento se notaba mejoría con el ejercicio físico. Del total que tomaban medicamentos para diversos síntomas y enfermedades el 36 por ciento dejó de hacerlo y redujeron la dosis al 47 por ciento . El apoyo y la atención del médico y la enfermera de la familia ocupan en el 100 por ciento de los abuelos un aspecto importante para el desarrollo de estos círculos (AU)

Beneficios del ejercicio físico en la tercera edad / Benefits of physical exercise for \"The elderlyenot\"

Se indican algunos aspectos del beneficio que aporta el ejercicio físico a pacientes de la tercera edad. Fueron censados 100 abuelos del círculo de abuelos del consultorio No. 13 del policlínico docente "Dr. Carlos J. Finlay" y se les palicó una necuesta que analizaba: edad, sexo, tiempo y frecuencia del ejercicio físico, utilidad y satisfacción que reporta el mismo, y se obtuvieron resultados que se expresan en el trabajo. Se plantea que existe una notable mejoría en el estado de salud de los ancianos, el 52 por ciento refieren sentirse bien y el 48 por ciento regular. En cuanto a los síntomas, el 100 por ciento presentaba dolores articulares; en el 89 por ciento se notaba mejoría con el ejercicio físico. Del total que tomaban medicamentos para diversos síntomas y enfermedades el 36 por ciento dejó de hacerlo y redujeron la dosis al 47 por ciento . El apoyo y la atención del médico y la enfermera de la familia ocupan en el 100 por ciento de los abuelos un aspecto importante para el desarrollo de estos círculos