Barbara Riegel

..Case management is believed to promote continuity of care and decrease hospitalization rates, although few controlled trials have tested this approach...

..Recommendations are provided for a stepped approach to patient education and counseling that uses these findings in practice...

..Researchers have questioned whether LHFQ is sensitive to subtle differences and sufficiently responsive to clinical interventions because the instrument has demonstrated variable performance in clinical trials...

..This study sought to identify characteristics that distinguish men from women with both conditions...

..In a previous, small, mixed-methods study, heart failure patients were described as novice, expert, or inconsistent in self-care. In that study, self-care types differed in experience, confidence, attitudes, and skill...

..04). Only sleep quality was associated with fatigue (p < .001). Sleep-disordered breathing was not significantly associated with EDS or with fatigue. These factors may be amenable to intervention...

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..Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work...

..The Self-Regulation Model of Illness guided this study as it acknowledges the dynamic nature of illness and influence of contextual factors and social environment on the interpretation and response to symptoms...

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..Assumptions and propositions of the theory are specified. Factors influencing self-care including experience, skill, motivation, culture, confidence, habits, function, cognition, support from others, and access to care are described...

..Few such comparisons have been performed in persons with heart failure. The purpose of this study was to compare HRQL in non-Hispanic white, black, and Hispanic adults with heart failure...

..Rapid arrival to the hospital for treatment of acute myocardial infarction (AMI) improves long-term outcomes. Whether prehospital delay time is associated with short-term, in-hospital complications remains unknown...

..Clusters occurred more frequently in older patients, but caused less impact...

..Scale scores were significantly correlated but without evidence of multicolinearity. Initial tests of reliability and validity support further testing of this new instrument...

..860, p = .001; IRR = 0.914, p = .043, respectively). DM self-care maintenance and management influence health outcomes but in different ways. These data provide evidence that both elements are needed in the education of patients about DM...

..We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease...

..We sought to identify which ACS symptoms are related-symptom clusters-and to determine if sample characteristics, response times, and outcomes differ among symptom cluster groups...

..9, df = 9.56, P < .0001). CONCLUSIONS: Elderly men and those with fewer comorbid illnesses were most successful at HF self-care...

..Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors...

..Further exploration of this naturally occurring phenomenon may provide insight into how HRQL can be improved in the general heart failure population...

..Aging is associated with losses in hearing and vision. The objective of this study was to assess whether aging also is associated with less ability to detect and interpret afferent physiological information...

..Evidence of health disparities between urban and rural populations usually favors urban dwellers. The impact of rurality on heart failure (HF) outcomes is unknown...

..The purpose of this study was to determine if frailty explains variability in health related quality of life (HRQOL) in older adults with HF over and above known correlates...

..The purpose of this article is to propose a conceptual model describing how poor sleep may contribute to inadequate self-care and untoward outcomes in persons with HF...

..Because these mechanisms are hypothetical, research findings are required to establish their validity. Several strategic research questions are proposed...

..03). Those who successfully managed heart failure and work described strategies to incorporate self-care into their workdays, self-efficacy in managing symptoms while at work, and favorable attitudes toward employment...

..Self-care is vital for successful heart failure (HF) management. Mastering self-care is challenging; few patients develop sufficient expertise to avoid repeated hospitalization...

..The 12-item self-report Heart Failure Somatic Awareness Scale (HFSAS) was developed to measure awareness of and distress secondary to heart failure symptoms. The purpose of this study was to test the psychometric properties of the HFSAS...

..Small group meetings may be less intrusive and more desirable for this patient population...

..Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging...

..Patients are being followed for 2 years from the time of enrollment. The purpose of this article is to describe the intervention and its theoretical framework, and to outline the design of this randomized controlled trial...

..These propositions were tested and supported using data obtained in previous research. Support of these propositions provides early evidence for this situation-specific theory of heart failure self-care...

..Our study offers policymakers and health plan administrators important guideposts for developing an evidence base on which to build effective policy and programmatic initiatives for chronic care management...

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..We hypothesized that medication adherence would be poorer in adults with heart failure (HF) and EDS and that cognitive status would be the mechanism of effect...

..CONCLUSION: Research on which to base advice for HF patients is greatly needed...

..Correlates of cognitive impairment require further study...

..Self-care of heart failure has been described as a naturalistic decision-making process, but the data available to defend this description are anecdotal...

..Most heart failure patients have multiple comorbidities...

..Thus, it is difficult to determine whether measured health disparities are the result of actual differences or due to measurement error resulting from translation or conceptual differences...

..Of the 7 somatic complaints assessed, improvements were noted in 5 (sleep disturbances, hot flashes, night sweats, vaginal dryness, and appetite). A prospective clinical trial is needed to confirm these results...

..Social support can influence treatment adherence of patients with chronic illnesses, which may explain the positive effects of social support on heart failure (HF) outcomes...

..Telemonitoring, the use of communication technology to remotely monitor health status, is an appealing strategy for improving disease management...

..Although disease management is effective in the mainstream HF patient population, in Hispanics this ill, elderly, and poorly educated, a different approach may be needed...

..The psychometric properties of the LHFQ after deleting these items were improved. These results could provide researchers and clinicians a more useful measure of HRQOL...

..Objective variables proposed by WCM to drive the model were not significant predictors. Mediator effects hypothesized in the WCM were not fully demonstrated in this sample. Thus modification of the WCM is warranted...

..Even though various cultures were represented in this study, culture itself did not account for variations in anxiety after AMI. It appears that anxiety after AMI is a universal phenomenon...

..Men and women differ in anxiety, which is one of the most stressful outcomes of an acute myocardial infarction (AMI). This anxiety may be moderated by coping styles of preference for information and control...

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..Critical care nurses reported numerous and distinctive anxiety indicators and management strategies. Further research is needed to examine exactly how appropriate and effective these assessment indicators and management strategies are...

..CONCLUSION: Quality of life is similar in men and women with heart failure when functional status, age, ejection fraction, and marital status differences are controlled...

..The reliability and validity of the SCHFI are sufficient to support its use in clinical research...

..In particular, research testing the safety, efficacy, and acceptability of therapies in the oldest old is greatly needed...

..If acquiescence causes failure to participate in care, it could potentially exacerbate chronic conditions unnecessarily...

..Self-care was defined as an active, cognitive process in which persons engage for the purpose of maintaining their health (maintenance) and managing symptoms (management)...

..We examined the utility of an index of clinical exacerbations of heart failure (HF) as a surrogate measure of outcome for use in modestly sized clinical trials and observational studies...

..To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs...

..We examined patients' ability to self-monitor adherence to an LSD and medications by comparing self-reported adherence with objective evidence of adherence...

..Creative approaches to achieving a true partnership between providers and patients are needed if clinical outcomes are to improve...

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