Dietary Approaches for Patients with Heart Failure and Diabetes

This case study discusses the importance of effective dietary patterns for patients with heart failure and diabetes. It explores the Mediterranean diet and its benefits in managing hypertension and reducing the risk of heart disorders. The study also highlights the role of exercise-based rehabilitation and psychological interventions in improving health outcomes for patients with chronic heart failure.

Running head: CASE STUDY
CASE STUDY
Name of the student:
Name of the university:
Author note:

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CASE STUDY
Butler, T., Georgousopoulou, E. N., & Mellor, D. (2018). Dietary approaches for patients
with heart failure and diabetes. Practical Diabetes, 35(4), 127-130a. https://doi-
org.libraryproxy.griffith.edu.au/10.1002/pdi.2179
Butler, Georgousopoulou and Mellor (2018) had conducted a research where they had
discussed the importance of effective dietary patterns among people suffering from
cardiovascular disorders along with diabetes. It has been found that the Mediterranean diet also
called the DASH diet pattern helps the patients with heart disorders by not only preventing the
disorder but also effectively managing hypertension and reducing the risk of heart disorders
among vulnerable patients. The researchers are of the opinion that that this form of diet helps by
sodium restriction as well as fluid restriction which help the patients in getting relief from the
symptoms. Diet that consists of low carbohydrates should be consumed by this set of patients.
the diets should include different dairy products like that of yogurt and cheese and also limit the
inclusion of processed meat and shifting towards white meat and fish help in ensuring positive
health outcomes in the patient. Moderating the intake of alcohol and undertaking physical
activities along with intake of proper diet can help the affected individuals in effective
management of heart disorders and diabetes successfully.
Sagar, V. A., Davies, E. J., Briscoe, S., Coates, A. J. S., Dalal, H. M., Lough, F., … Taylor,
R. S. (2015). Exercise-based rehabilitation for heart failure: Systematic review and meta-
analysis. Open Heart, 2, 1-12. Retrieved
from http://openheart.bmj.com/content/openhrt/2/1/e000163.full.pdf

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As per the work of Sagar et al. (2015), comparisons between that of the no-exercise
control group and that of the experimental groups have shown that exercise interventions that are
conducted single-handedly as well as being a component of comprehensive cardiac rehabilitation
programs can contribute to in reduction of not only the rates of hospitalization but also in the
improvements of the health-related quality of lives. Moreover, the authors have also concluded
that the benefits of the exercise based cardiac rehabilitation were indeed independent of the
different types of exercises that were included in the cardiac rehabilitation. This can help in
showing that the benefits of the exercises were not controlled by whether the interventions were
only exercises based or formed part of the comprehensive cardiac rehabilitation program. It also
did not matter whether the interventions were any aerobic exercise only or aerobic and resistance
exercises, average dose of the exercise interventions and many others. Further, the authors have
been also seen to form the opinion that exercise based cardiac rehabilitation programs mainly
contribute in the development of the health-related as well as quality of lives. It had been also
found by the authors that magnitude of the reduction in rate of hospitalization and development
of health related quality of life showed better outcomes when they were conducted in the
settings of the homes rather than any form of hospital settings.
Jiang, Y., Shorey, S., Seah, B., Chan, W. X., San Tam, W. W., & Wang, W. (2018). The
effectiveness of psychological interventions on self-care, psychological and health outcomes
in patients with chronic heart failure—A systematic review and meta-
analysis. International journal of nursing studies, 78, 16-25.
doi:10.1016/j.ijnurstu.2017.08.006
Jiang et al (2018) had provided an interesting insight in the study. They are of the opinion
that professionals caring for patients with heart disorders undertake patient education sessions to

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help the patients develop their health literacy mainly during discharge phase. The professionals
are seen to focus on the development of physical health of the patients along with self-
management education strategies but they completely ignore the fact that the patients need to be
motivated to follow the interventions. This approach may also fail for people suffering from
depression, stress and anxiety. Hence, the researchers have tried to review various randomized
control trials so that they can understand the efficiency of psychological interventions that are
believed to help in the development of motivation and even self-management abilities among the
patients. It has been found that these interventions actually help in getting positive health
outcomes of the service users and make them more dedicated to betterment of health. Patients are
seen to become more empowered as well as encouraged in undertaking self-management abilities
successfully. The different psychological approaches that had been found to be successfully are
cognitive behavioral therapies as well as motivational interviewing of the patients. Therefore, the
study showed that psychological interventions can help in developing self-care as well as
psychological and health outcomes like better quality health and increased physical functions in
patients with CHF.
Part 2:
Nursing professionals have the responsibility in educating patients about the significance
of the modifying the different lifestyle factors and other health behaviors so that the symptoms of
the patients are effectively managed and to prevent recurrences (Pandey et al, 2015). It has been
seen that professionals often provide medication prescriptions and also educate patients with
proper lifestyle behaviors that needs to be taken but very few of the professionals try to identify
whether the patient are motivates for the change or not (Haykowsky et al., 2018). It has been
seen in the case study that William had already suffered from heart disorders in 2017 and gain in

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the year 2019; he is seen to have the same disorders. Therefore, it can be stated that the patient is
not enough motivated to follow the advices provided by the healthcare professionals regarding
diet and physical exercises. In such scenario, the paper of Jiang et al, (2018) would be found to
be helpful where it had been stated that patients who are less motivated or are suffering from
depression, anxiety and stress might not be able to develop self-coping abilities. The authors
have thereby put forward important psychological techniques that can prove to be efficient in
developing motivation among patients to adopt healthy lifestyle choices. These techniques would
be helpful in increasing the adherence of the patient to the different medications and the lifestyle
change advices (Deek et al., 2016). These would make them feel empowered and would help to
develop self-management and self-coping abilities. Hence the paper would help the nurse to
tackle the issues that are faced by William.
The patient named Williams is suffering from obesity. This health concern is in turn one
of the most important risk factors for heart disorders. Moreover, high blood pressure is also
found to be present among patients who are suffering from overweight issues and obesity. High
blood pressure can result in formation of plaques in the arteries and may expose them in
rupturing that might lead to occurrence of heart attack among different individuals (Budd et al.,
2015). Studies are of the opinion that obesity and overweight are linked with many types of
factors that cause increase in the chance of heart disorders. These factors are high blood lipids
and high levels of triglycerides. They may even lead to glucose intolerance as well as different
metabolic syndromes (Kitzman et al., 2016). William was also seen to suffer from hypertension
and is also found to be overweight. Therefore, it becomes important for the nursing professionals
to help William manage his diet guiding him through effective calorie management along with
the reduction in chances of the further deterioration of the condition. Therefore, diet management

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is indeed an important action that William needs to take. Butler, Georgousopoulou and Mellor
(2018) had published an important paper that shows how effective management of diet like that
of the Dash diet can help in controlling weight and reducing calorie intake. The paper contains
detailed information about the different food items that William would need to include in his diet
which would help him in managing his disorder of hypertension as well as other health disorders.
The Dash diet is extremely helpful in managing weight of patients by reduced calorie intake and
increasing nutrition in the body and would be helpful for treating hypertensions and heart
disorder in .William.
The paper of Sagar et al. (2018) has mainly talked about the efficiency of undertaking
exercise based rehabilitation techniques in case of different heart disorders. The paper had
clearly shown the ways by which how exercise based interventions have helped in providing
positive health outcomes in people who have suffered from heart disorders. In the case study as
well, it us found that William is suffering from heart disorders and hence nurses can use this
evidence to develop a cardiac rehabilitation program for William for helping him to overcome
the symptoms of heart disorders. It has been found that exercises help individuals in
strengthening their hearts and lowering their blood pressure. Exercises also help in developing a
healthy body weight and also burning of stress with the boosting of mood and self-esteem.
Exercises also help in reduction of inflammation. In this way, the paper by Sagar et al. (2018),
had successfully helped in providing evidences for it and helped in assigning this intervention for
William.

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Part 3:
Nursing professionals need to develop care plans for patients with heart disorders that
should comprise of developing healthy behaviors as well as lifestyle modification of the patients
making them lead better quality lives (Danaei et al., 2016). Lifestyle modifications like taking
proper diets comprising of fruits and vegetables along with high quality fiber containing foods
and undertaking physical activities can help the patient in developing from heart disorders.
Weight of the patients needs to be managed primarily as obesity or overweight conditions can
increase chances of hypertension, high blood glucose levels, osteoarthritis and high cholesterol.
Most of them also contribute to development of heart disorders (Creber et al., 2015). Therefore,
weight needs to be managed successfully to reduce the chances of occurrences of chronic
ailments. This can be achieved by the nursing professionals by effectively educating the patients
about the importance of proper diets and undertaking exercises successfully. Another important
aspect that nurses should also try to understand is the motivation level of the patients (Carrara et
al., 2016). This is because patients who are not motivated to undertake lifestyle modifications
may not show positive outcomes even when they are educated about benefits of the lifestyles
interventions. Hence, nurses need to assess the motivation level of the patients. In order to
develop the motivation, nurses would need to use different psychological interventions like that
motivational interviewing and cognitive behavioral therapy for developing the motivation among
the patients and undertake self-management abilities successfully to lead better quality lives
(Clark et al., 2015).

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References:
Budd, G. M., & Peterson, J. A. (2015). CE: The Obesity Epidemic, Part 2 Nursing Assessment
and Intervention. AJN The American Journal of Nursing, 115(1), 38-46. doi:
10.1097/01.NAJ.0000459630.15292.d5
Butler, T., Georgousopoulou, E. N., & Mellor, D. (2018). Dietary approaches for patients with
heart failure and diabetes. Practical Diabetes, 35(4), 127-130a. https://doi-
org.libraryproxy.griffith.edu.au/10.1002/pdi.2179
Carrara, F. S. A., Zanei, S. S. V., Cremasco, M. F., & Whitaker, I. Y. (2016). Outcomes and
nursing workload related to obese patients in the intensive care unit. Intensive and Critical Care
Nursing, 35, 45-51. https://doi.org/10.1016/j.iccn.2015.12.003
Clark, A. P., McDougall, G., Riegel, B., Joiner-Rogers, G., Innerarity, S., Meraviglia, M., ... &
Davila, A. (2015). Health status and self-care outcomes following an education-support
intervention for people with chronic heart failure. The Journal of cardiovascular nursing, 30(4 0
1), S3. doi: 10.1097/JCN.0000000000000169
Creber, R. M., Patey, M., Dickson, V. V., DeCesaris, M., & Riegel, B. (2015). Motivational
interviewing tailored interventions for heart failure (MITI-HF): study design and
methods. Contemporary clinical trials, 41, 62-68. https://doi.org/10.1016/j.cct.2014.12.019
Danaei, G., Robins, J. M., Young, J. G., Hu, F. B., Manson, J. E., & Hernán, M. A. (2016).
Weight loss and coronary heart disease: sensitivity analysis for unmeasured confounding by
undiagnosed disease. Epidemiology (Cambridge, Mass.), 27(2), 302-310.
https://doi.org/10.1016/j.cct.2014.12.019

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Deek, H., Noureddine, S., Newton, P. J., Inglis, S. C., MacDonald, P. S., & Davidson, P. M.
(2016). A family‐focused intervention for heart failure self‐care: conceptual underpinnings of a
culturally appropriate intervention. Journal of advanced nursing, 72(2), 434-450.
https://doi.org/10.1111/jan.12768
Haykowsky, M. J., Nicklas, B. J., Brubaker, P. H., Hundley, W. G., Brinkley, T. E., Upadhya,
B., ... & Kitzman, D. W. (2018). Regional adipose distribution and its relationship to exercise
intolerance in older obese patients who have heart failure with preserved ejection
fraction. JACC: Heart Failure, 6(8), 640-649. DOI: 10.1016/j.jchf.2018.06.002
Jiang, Y., Shorey, S., Seah, B., Chan, W. X., San Tam, W. W., & Wang, W. (2018). The
effectiveness of psychological interventions on self-care, psychological and health outcomes in
patients with chronic heart failure—A systematic review and meta-analysis. International
journal of nursing studies, 78, 16-25. doi:10.1016/j.ijnurstu.2017.08.006
Kitzman, D. W., Brubaker, P., Morgan, T., Haykowsky, M., Hundley, G., Kraus, W. E., ... &
Nicklas, B. J. (2016). Effect of caloric restriction or aerobic exercise training on peak oxygen
consumption and quality of life in obese older patients with heart failure with preserved ejection
fraction: a randomized clinical trial. Jama, 315(1), 36-46. doi:10.1001/jama.2015.17346
Pandey, A., Parashar, A., Kumbhani, D. J., Agarwal, S., Garg, J., Kitzman, D., ... & Berry, J. D.
(2015). Exercise training in patients with heart failure and preserved ejection fraction: meta-
analysis of randomized control trials. Circulation: Heart Failure, 8(1), 33-40.
https://doi.org/10.1161/CIRCHEARTFAILURE.114.001615

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Sagar, V. A., Davies, E. J., Briscoe, S., Coates, A. J. S., Dalal, H. M., Lough, F., … Taylor, R. S.
(2015). Exercise-based rehabilitation for heart failure: Systematic review and meta-analysis.
Open Heart, 2, 1-12. Retrieved
from http://openheart.bmj.com/content/openhrt/2/1/e000163.full.pdf