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Westland H, Van Rijn MM, Page S, Wiebe DJ, Freedland KE, Lee C, Vellone E, Aryal S, Stromberg A, Jaarsma T, Riegel B. Self-care recommended by clinicians in patients with heart failure or type 2 diabetes: a Delphi study. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Australian Catholic University, Australia
Background
Patients with heart failure or type 2 diabetes often experience bothersome symptoms (e.g., swelling, dizziness) and need clinical support with symptom management to reduce the impact of these symptoms. Knowledge about recommended self-care management behaviors by experienced clinicians can help to guide the development of more effective self-care interventions.
Purpose
To develop a list of common bothersome symptoms of heart failure and type 2 diabetes and of self-care management behaviors that clinicians recommend to patients to reduce the impact of these symptoms.
Methods
A two-round Delphi study among a panel of 37 nurses and physicians (heart failure only n=14; type 2 diabetes only n=11 and both heart failure and type 2 diabetes n=12) from Italy, the Netherlands, Sweden and the US was performed. Online surveys were used to identify common and bothersome symptoms and related self-care management behaviors that they recommend to patients with heart failure or type 2 diabetes. Self-care management behaviors that received at least 75% agreement were retained and similar self-care management behaviors were discussed and merged to reduce redundancy.
Results
For heart failure, the final list included 12 common bothersome symptoms (e.g., fatigue/tiredness, shortness of breath) and 51 related self-care management behaviors (e.g., balance rest & activity, check body weight & swelling). For type 2 diabetes, 11 common bothersome symptoms (e.g., hypo- and hyperglycemia symptom clusters, foot wounds) and 25 related self-care management behaviors (e.g., check blood sugar, take insulin, contact podiatrist) were included in the final list. Consensus was reached on the vast majority (70%) of recommended behaviors.
Conclusion
The lists of common bothersome symptoms and self-care management behaviors reflect consensus but also discrepancies between clinicians’ recommendations and current guidelines. Efforts to enhance and align the use of proven effective self-care management behaviors to reduce symptom impact in routine care by clinicians should be considered.
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Affiliation(s)
- H Westland
- University Medical Center Utrecht, Julius Center for health Sciences and Primary Care , Utrecht , Netherlands (The)
| | - M M Van Rijn
- University Medical Center Utrecht, Division Heart and Lungs , Utrecht , Netherlands (The)
| | - S Page
- University of Pennsylvania, School of Nursing , Philadelphia , United States of America
| | - D J Wiebe
- University of Pennsylvania, School of Nursing , Philadelphia , United States of America
| | - K E Freedland
- Washington University School of Medicine , St Louis , United States of America
| | - C Lee
- Boston College - William F. Connell School of Nursing , Boston , United States of America
| | - E Vellone
- Tor Vergata University Hospital Polyclinic , Rome , Italy
| | - S Aryal
- University of Pennsylvania, School of Nursing , Philadelphia , United States of America
| | | | - T Jaarsma
- Linkoping University , Linkoping , Sweden
| | - B Riegel
- University of Pennsylvania, School of Nursing , Philadelphia , United States of America
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