Improving outcomes in heart failure : an interdisciplinary approach / edited by Debra K. Moser, Barbara Riegel.

Format:

Book

Contributor:

Moser, Debra K.

Riegel, Barbara, 1950-

Language:

English

Subjects (All):

Congestive heart failure.

Outcome assessment (Medical care).

Heart Failure--therapy.

Patient Care.

Treatment Outcome.

Medical Subjects:

Heart Failure--therapy.

Patient Care.

Treatment Outcome.

Physical Description:

xvi, 371 pages : illustrations ; 26 cm

Place of Publication:

Gaithersburg, Md. : Aspen Publishers, 2001.

Summary:

Recent advances have changed the way heart failure is treated and have resulted in substantial improvements in heart failure management. Improving Outcomes in Heart Failure addresses innovative ways of dealing with issues such as quality of life, treatment compliance, effective patient and family education and counseling, nonpharmacologic therapy, and new health care delivery models for improving the management of heart failure. With an interdisciplinary approach, this reference shows how heart failure outcomes and health care resource utilization can be improved significantly. Written by the editors of the distinguished Journal of Cardiovascular Nursing, Debra K. Moser, DNSc, RN and Barbara Riegel, DNSc, RN, CS, FAAN are well-known and nationally recognized experts in the field of cardiovascular nursing. Moser and Riegel have received numerous prestigious awards and honors and have contributed to many renowned journals on a wide variety of cardiovascular topics.

Contents:

Part I The Syndrome of Heart Failure: Personal and Societal Impact 1

Chapter 1 Epidemiology of Heart Failure / Marjorie Funk, Kerry A. Milner, Harlan M. Krumholz 3

Causes and Risk Factors 4

Incidence 7

Prevalence 8

Morbidity 12

Prognosis and Morality 12

Chapter 2 Health-Related Quality of Life Outcomes in Heart Failure: A Conceptual Model / Martha Shively, Ira B. Wilson 18

What Is Health-Related Quality of Life? 18

A Conceptual Model of HRQL for Clinicians 20

Understanding the HRQL Model in Heart Failure: Empirical Data 25

Conclusion and Implications 27

Chapter 3 Managing Heart Failure: Economic Impact and Outcomes / Kathleen M. McCauley, Mary D. Naylor 31

Economics of Heart Failure: Overview of Key Concepts 31

Incidence and Economic Impact 32

Cost-Effectiveness of Pharmacologic Therapy 33

Economic Outcomes Associated with Alternative Models of Care 35

Conclusion and Recommendations for Further Study 38

Part II Improving Outcomes by Influencing the Personal Impact of Heart Failure 41

Chapter 4 Impact of Pharmacologic Therapy on Health-Related Quality of Life in Heart Failure: Findings from Clinical Trials / Derek V. Exner, Eleanor B. Schron 43

Pathophysiology 43

Pharmacologic Therapy: Impact on Physiologic Parameters, Morbidity, and Morality 43

Pharmacologic Therapy: Impact on Quality of Life 44

Trials Evaluating Quality of Life in Heart Failure 44

Chapter 5 Impact of Surgical Therapy on Quality of Life in Heart Failure / Kathleen L. Grady, William Piccione, Jr., Rick J. Marcantonio 52

Methodologic Issues in Quality of Life Research 52

Surgical Revascularization in Heart Failure Patients 54

Mitral Valve Repair in Heart Failure Patients 56

Quality of Life after Surgical Revascularization and/or Mitral Valve Repair 58

Implantable Left Ventricular Assist Devices 60

Quality of Life after Ventricular Assist Device Implantation 63

Cardiac Transplantation 65

Quality of Life after Heart Transplantation 67

Recommendations for Future Research 71

Chapter 6 Impact of Nonpharmacologic Therapy on Quality of Life in Heart Failure / Debra K. Moser, Kathleen Dracup 77

Association between Quality of Life and Morbidity and Morality Outcomes 77

Interventions To Improve Quality of Life in Patients with Heart Failure 78

Biobehavioral Therapy 85

Exercise Training 86

An Integrated Theory To Explain Mechanism 92

Conclusion and Recommendations for Research and Practice 92

Part III Improving Outcomes with Nonpharmacologic Management 97

Chapter 7 Nutritional Management of the Patient with Heart Failure / Susan J. Bennett, Laurie Hackward, Sara A. Blackburn 99

Nutrition Assessment 99

Management of Malnutrition/Cachexia 112

Management of Symptoms 117

Management of Sodium Retention and Hypervolemia 118

Management of Hypovolemia and Dehydration 119

Compliance with Medical Nutrition Recommendations 120

Recommendations for Future Research 121

Chapter 8 Exercise in Heart Failure / John R. Wilson, Don B. Chomsky, Karen Dahle 124

Pathophysiology of Exercise Intolerance in Heart Failure 124

Exercise Training and Heart Failure 128

Exercise Prescriptions in Clinical Practice 131

Chapter 9 Risk Factor Modification in Heart Failure / Lynn V. Doering, Susan J. Bennett, Laurie Hackward, Sara A. Blackburn, Karol E. Watson 136

Behavioral Health Assessment in Heart Failure 136

Hypertension 138

Hyperlipidemia 142

Diabetes Mellitus and Insulin Resistance 143

Obesity 143

Smoking 144

Alcohol 146

Inactivity 146

Chapter 10 Biobehavioral Therapy in the Management of Patients with Heart Failure / Debra K. Moser, Lynne W. Stevenson 152

Biobehavioral Therapy: Biofeedback and Relaxation in Patients with Cardiovascular Disease 153

Biobehavioral Therapy: Biofeedback and Relaxation in Patients with Heart Failure 155

Part IV Improving Outcomes by Enhancing Treatment Compliance 163

Chapter 11 Extent of the Problem of Noncompliance in Patients with Heart Failure / Martha N. Hill 165

The Compliance Challenge 165

Impact of Noncompliance 165

Patient and Family Factors Contributing to Noncompliance 168

Provider Factors Contributing to Noncompliance 171

System Factors Contributing to Noncompliance 172

Research Recommendations To Enhance Compliance 173

Chapter 12 Heart Failure Patient and Family Education / Deborah Knox, Lisa Mischke, Randall E. Williams 178

Traditional Heart Failure Education 179

Appendix 12-A Monitoring and Educating Using Disease Management To Improve Compliance Instrument (MEDICI) 192

Appendix 12-B Consumer Information 197

Part V The Role of Family in Heart Management 199

Chapter 13 Supportive Resources for the Patient with Heart Failure / Linda S. Baas, Robin Trupp, William T. Abraham 201

Overview of Supportive Resources 201

A Theoretical Approach To Facilitating Supportive Resources 202

Supportive External Resources 205

Supportive Internal Resources 212

The Role of Health Care Providers in Enhancing Supportive Resources 214

Aims of Intervention 215

Chapter 14 Transitioning Heart Failure Care to the Family / Peggy M. O'Connor 219

Family Theory 219

Caring for the Caregiver 222

Part VI Improving Personal and Societal Outcomes with New Care Delivery Models 233

Chapter 15 Outcomes Measurement in Heart Failure / Christi Deaton, Derek V. Exner, Eleanor B. Schron, Barbara Riegel, Suzanne Prevost 235

Initial Considerations in Outcomes Measurement 235

Selecting Appropriate Instruments for Outcomes Measurement 239

Measuring Health-Related Quality of Life 241

Measuring Financial Outcomes 251

Measuring Processes That Influence Outcomes 254

Suggestions for Future Outcomes Measurement in Heart Failure 258

Chapter 16 Heart Failure Disease Management Models / Barbara Riegel, Barbara LePetri 267

Evolution of Disease Management 268

Designing a Disease Management Program 275

Chapter 17 Community Case Management Models of Heart Failure Care / Debra K. Moser, Marlene J. Macko, F. Kevin Hackett, Maggie Roush Hutchins 282

Rationale for Heart Failure Community Case Management 282

Tested Heart Failure Community Case Management Programs 284

An In-Depth View and Outcomes of One Heart Failure Community Case Management Program 290

Chapter 18 The Clinic Model of Heart Failure Care / Gregg C. Fonarow, Julie Walden Creaser, Nancy Livingston 301

Components of a Heart Failure Clinic 302

Heart Failure Patient Evaluation 307

Heart Failure Patient Management 307

The UCLA Heart Failure Program Experience 308

Patient Teaching 310

Evaluation of Outcomes 312

Analysis of Variables That May Influence Outcomes 313

Outcomes Measurement 314

Chapter 19 Telephonic Case Management Models of Heart Failure Care / Nancy Houston Miller, Jeffrey A. West 318

An Overview of Case Management Models 318

The Stanford Cardiac Rehabilitation Program Experience 322

Appendix 19-A Kaiser/Stanford Heart Failure Program Sodium Progress Report #2 329

Chapter 20 Multidisciplinary Disease Management Models of Heart Failure Care / Barbara Riegel, Michael W. Rich 331

An In-Depth Analysis of Existing Programs 331

Analysis and Directions for Future Research 337

Chapter 21 Summary and the Future of Heart Failure Care / Debra K. Moser, Barbara Riegel 343

Improving Outcomes 344

Are We Focusing on the Best Outcomes? 347

What Does the Future Hold? 350.

Notes:

Includes bibliographical references and index.

ISBN:

0834216442

OCLC:

44812286