The Efficacy Of Self Management Education

Nearly 5.1 million people in the United States have been diagnosed with heart failure. Yet so many people don’t have a clue what it is until they have been diagnosed with it. Congestive Heart Failure, or CHF, is a disease that has many symptoms, can be tested and treated, has several causes, and can be avoided.

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

(Heart Failure Society of America, 2010). HF is accountable for 25% of all readmission within 30 days in the United States and represents an estimated $17 million dollars in healthcare spending (Desai, 2012). HF is most commonly seen in person’s age 65 or greater with common clinical presentations of dyspnea with exertion, orthopnea, edema in lower extremities and weight gain Patients often experience frequent exacerbations and decompensations (Anderson, 2014). The Heart Failure Society of America (2010) published the Comprehensive Heart Failure Practice Guidelines with the underlying goal to improve symptoms and to optimize the patient’s volume status. These guidelines include evidence based recommendations for “prevention, evaluation, disease management, and pharmacologic and device therapy” (Heart Failure Society of America, 2010, p 476). The Institute for Healthcare Improvement (n.d.) supports the balance of evidence based treatment during acute admission but asserts that it is equally as important to assess and provide patient education for self-management after

One of the main causes of mortality and morbidity is congestive heart failure (CHF). The major causes of CHF are coronary artery disease and hypertension. Other risk factors are occurrence of left ventricular hypertrophy (LVH), valvular heart disease, diabetes, smoking, obesity and dyslipidemia [46, 47]. Diabetes mellitus as an anticipated factor of CHF was explained in some studies [44, 47]. Diabetes is considered as a risk factor for CHF but yet, its relationship with CHF has not been completely understood [47, 48]. Alterations of left ventricular function and structure that are associated with diabetes mellitus or diminished glucose regulation have been described in recent studies [42, 49]. It has been reported that insulin resistance

Heart failure is term that is used to describe the heart’s inability to work efficiently as a pump. In order to decipher if an individual is likely to have heart failure is through their health history. Common backgrounds associated are diabetes mellitus, kidney dysfunction, hypertension, chronic lung disease, angina, myocardial infarction, and ischemic heart disease (Kirk, 2011). It is accompanied by shortness of breath on exertion, decreased exercise tolerance, paroxysmal nocturnal dyspnea, orthopnea, ankle swelling, sudden weight gain, lack of appetite or nausea and difficulty concentrating (Kirk, 2011). In worsening conditions it could progress to fluid buildup, rapid or irregular heartbeat, chest pains , and sudden

Heart failure (HF) is a chronic, progressive condition defined as the hearts inability to efficiently pump an adequate amount of blood to meet the demands of the body (Naab, 2011). Heart failure may be the result of the heart chambers not adequately filling, also known as diastolic HF or the decreased contractility of the valves to perfuse blood to the body, also known as systolic HF. “Heart Failure is a progressive disease which arises as a consequence of an abnormality in cardiac structure, function, rhythm or conduction” (Naab, 2011).

More than 1.5% of the population are currently affected with CHF and is associated with excess mortality and morbidity. It is one of the major cardiovascular disease that has an increasing incidence and prevalence, due to relatively ineffective treatment, a decrease in acute cardiovascular morbidity and the aging population. It has emerged as the top reason for hospitalization in patients who are over 65 years of age.

Heart failure (HF) is a complex syndrome in which structural or functional cardiac disorders impair the ability of one or both ventricles to fill with or eject blood. HF is considered to be a chronic condition with periods of worsening symptoms that may require medical attention. It may present acutely within just 24 hours in the form of pulmonary edema or even cardiogenic shock. To diagnose HF, three criteria need to be present: including shortness of breath at rest or during exertion and/or fatigue, signs of fluid retention such as pulmonary congestion and/or ankle swelling, and objective evidence of a decrease in myocardial performance at rest which is demonstrated using echocardiography.(1)

There are many causes of heart failure. Among them is a reduction in the contractile ability of the heart due to mechanical problems or any problem that limits the filling capacity of the heart chambers with blood due to any form of cardiomyopathy. Whatever the cause, the patient’s tissues are compromised because they cannot receive an adequate amount of oxygen necessary to perform optimally (Bui, Horwich, & Fonarow, 2010).

The pathophysiology of congestive heart failure is that the heart has a loss of contractibility. This causes a lack of cardiac output which can’t meet the demands of the body. CHF can be caused by multiple different factors such as loss of muscle, abnormal rhythm or volume overload. CHF often occurs in patients who have multiple comorbidities such as hypertension or diabetes

CHF is prevalent in those who are 65 and older and the factors that contribute to heart failure in adults are ischemic and hypertensive heart disease. Aging is associated with impaired left ventricular filling that is due to changes in the myocardial relaxation. A progressive increase in systolic blood pressure with aging contributes to the development of left ventricular hypertrophy and altered diastolic filling. Another reason for heart failure with aging is that the heart becomes stiffer and less compliant with age. Clinical manifestations of heart failure are nocturia, nocturnal incontinence, edema, impaired perfusion, and exertional dyspnea, orthopnea, and impaired exercise intolerance. Diagnosis of CHF are based on history, physical examination, chest radiograph, and electrocardiographic findings. The treatments include Ace inhibitors, exercise programs, sodium restriction, and sometimes bed rest (Grossman & Porth, 2014). Room 582 is currently taking Lasix for his heart failure.

The literature shows that the heart failure is most prevalent in the African Americans when compared with other racial groups (Alspach, 2014). The African American also tends to have hypertension, and this is what physicians tell us is the link between heart failure and the African American ("Heart Failure," 2017). The elderly in general also tend to be the most likely of the age groups to develop heart failure.

Approximately 20 million people around the world have a diagnosis of heart failure (HF) (Hobbs, Escutia, Harrison, Moore, & Sarpong, 2016). HF is the most frequent reason that cardiac patients are rehospitalized. As outlined in the Affordable Care Act,

In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.

Heart failure is a common cardiovascular condition affecting over 5 million individuals in USA. About 400,000 to 700,000 new cases of heart failure are diagnosed each year and carry a mortality of up to 250,000 per year (1). The current treatment options for managing heart