Limits...
Patient participation in patients with heart failure receiving structured home care--a prospective longitudinal study.

Näsström L, Jaarsma T, Idvall E, Årestedt K, Strömberg A - BMC Health Serv Res (2014)

Bottom Line: Better self-care behavior was associated with all four scales measuring different aspects of participation.Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation.Higher level of patient participation was consistently associated with better self-care behavior.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, 581 85, Sweden. lena.nasstrom@liu.se.

ABSTRACT

Background: Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care.

Methods: The study had a prospective pre-post longitudinal design evaluating the influence of structured home care on participation in patients at four different home care units. Patient participation was measured using 3 scales and 1 single item. Self-care behavior, knowledge, symptoms of depression, socio- demographic and clinical characteristics were measured to explore factors associated with patient participation. Repeated measure ANOVA was used to describe change over time, and stepwise regression analyses were used to explore factors associated with patient participation.

Results: One hundred patients receiving structured heart failure home care were included. Mean age was 82 years, 38 were women and 80 were in New York Heart Association functional class III. One aspect of participation, received information, showed a significant change over time and had increased at both six and twelve months. Better self-care behavior was associated with all four scales measuring different aspects of participation. Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation.

Conclusion: Patients experienced a fairly high level of satisfaction with participation in care at baseline, and there was a significant improvement over time for participation with regard to received information after being admitted to structured home care. Higher level of patient participation was consistently associated with better self-care behavior. This study shows that patient participation may need to be further focused upon, and that the association with self-care may be interesting to target in future interventions.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the participants in the study. Study enrollment, follow-up and analysis of different views of participation over time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4279700&req=5

Fig1: Flow chart of the participants in the study. Study enrollment, follow-up and analysis of different views of participation over time.

Mentions: During the inclusion period 274 patients were eligible, resulting in 100 consecutively included patients at baseline, with 49 patients remaining at the fourth data collection point 12 months later (Figure 1). There were 62 men and the mean age was 82 years. Eighty of the participants were classified in NYHA class III and had a high prevalence of co-morbidities (4.0 ± 2.2) (Table 1). During the study period, 55 of 100 patients were hospitalized at some point and 42 died. Eighty-seven were prescribed beta-blockers, 95 loop-diuretics and 72 angiotensin –converting enzyme inhibitor/angiotensin receptor blockers. There were no significant differences regarding age and sex between the included patients and those eligible who did not want to participate.Figure 1


Patient participation in patients with heart failure receiving structured home care--a prospective longitudinal study.

Näsström L, Jaarsma T, Idvall E, Årestedt K, Strömberg A - BMC Health Serv Res (2014)

Flow chart of the participants in the study. Study enrollment, follow-up and analysis of different views of participation over time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4279700&req=5

Fig1: Flow chart of the participants in the study. Study enrollment, follow-up and analysis of different views of participation over time.
Mentions: During the inclusion period 274 patients were eligible, resulting in 100 consecutively included patients at baseline, with 49 patients remaining at the fourth data collection point 12 months later (Figure 1). There were 62 men and the mean age was 82 years. Eighty of the participants were classified in NYHA class III and had a high prevalence of co-morbidities (4.0 ± 2.2) (Table 1). During the study period, 55 of 100 patients were hospitalized at some point and 42 died. Eighty-seven were prescribed beta-blockers, 95 loop-diuretics and 72 angiotensin –converting enzyme inhibitor/angiotensin receptor blockers. There were no significant differences regarding age and sex between the included patients and those eligible who did not want to participate.Figure 1

Bottom Line: Better self-care behavior was associated with all four scales measuring different aspects of participation.Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation.Higher level of patient participation was consistently associated with better self-care behavior.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, 581 85, Sweden. lena.nasstrom@liu.se.

ABSTRACT

Background: Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care.

Methods: The study had a prospective pre-post longitudinal design evaluating the influence of structured home care on participation in patients at four different home care units. Patient participation was measured using 3 scales and 1 single item. Self-care behavior, knowledge, symptoms of depression, socio- demographic and clinical characteristics were measured to explore factors associated with patient participation. Repeated measure ANOVA was used to describe change over time, and stepwise regression analyses were used to explore factors associated with patient participation.

Results: One hundred patients receiving structured heart failure home care were included. Mean age was 82 years, 38 were women and 80 were in New York Heart Association functional class III. One aspect of participation, received information, showed a significant change over time and had increased at both six and twelve months. Better self-care behavior was associated with all four scales measuring different aspects of participation. Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation.

Conclusion: Patients experienced a fairly high level of satisfaction with participation in care at baseline, and there was a significant improvement over time for participation with regard to received information after being admitted to structured home care. Higher level of patient participation was consistently associated with better self-care behavior. This study shows that patient participation may need to be further focused upon, and that the association with self-care may be interesting to target in future interventions.

No MeSH data available.


Related in: MedlinePlus