Griffith University: 1203NRS Evidence-Based Heart Failure Management
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Project
AI Summary
This project provides an overview of current evidence-based practices for the management of heart failure (HF). The project highlights the importance of effective HF management to mitigate HF exacerbation, reduce medical costs, and improve the quality of life for patients, particularly those aged 65 and above. The key findings emphasize the effectiveness of self-care skills, patient education, and symptom monitoring. Interventions such as structured phone support, telemonitoring, and incorporating physical exercises are also discussed as beneficial strategies. The project underscores the importance of consistent symptom assessment, medication management, exercise training, and patient education in nursing practice. Furthermore, the project offers recommendations for practice, education, and future research, including the need to consider patients with exacerbated HF over 80 years of age and those with comorbidities. The project analyzes various research papers and studies, including systematic reviews, randomized control trials, and meta-syntheses, to support its findings and recommendations. This project is a comprehensive review of the current state of evidence-based HF management strategies.
Heart failure is an illness arising from high blood pressure and coronary heart
disease that is predominantly common among individuals who are 65
years and above. Research strongly recommends that effective HF
management is critical given the associated HF exacerbation, rising medical
costsand poor quality of life. Self-care skills learnt through patient education
coupled with monitoring and interpreting symptoms have been found to be
effective HF management practices. Aside from patient education, structured
phone support and tele-monitoring are other interventions that are gar-
nering prominence given their effectiveness in reducing hospitalization rates.
Incorporating physical exercises has also been found to improve patient
outcomes through improved quality of life and reduction in hospital
readmission. It is further recommended that nursing practice should be guided
by consistent symptoms assessment, medication management, exercise
training and patient education. Education is reliant on available knowledge
and tools such as HF symptoms monitoring and follow-up call times. Finally
future studies need to take into consideration patients with exacerbated
HF above the age of 80 as well as other associated comorbidities such as
dementia and their implications on patient outcomes.
Abstract
disease that is predominantly common among individuals who are 65
years and above. Research strongly recommends that effective HF
management is critical given the associated HF exacerbation, rising medical
costsand poor quality of life. Self-care skills learnt through patient education
coupled with monitoring and interpreting symptoms have been found to be
effective HF management practices. Aside from patient education, structured
phone support and tele-monitoring are other interventions that are gar-
nering prominence given their effectiveness in reducing hospitalization rates.
Incorporating physical exercises has also been found to improve patient
outcomes through improved quality of life and reduction in hospital
readmission. It is further recommended that nursing practice should be guided
by consistent symptoms assessment, medication management, exercise
training and patient education. Education is reliant on available knowledge
and tools such as HF symptoms monitoring and follow-up call times. Finally
future studies need to take into consideration patients with exacerbated
HF above the age of 80 as well as other associated comorbidities such as
dementia and their implications on patient outcomes.
Abstract
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Current Evidence for the Management of
Heart Failure Law Chian Ying S5129091
Outline
1.Introduction
2.Main Findings
3.Methodology
4.Limitation of Findings
5.Recommendations
IntroductionIntroductionIntroduction
HHHF is a complex condition characterized by impairment of ventricle fillingsF is a complex condition characterized by impairment of ventricle fillingsF is a complex condition characterized by impairment of ventricle fillings
caused by structural cardiac abnormalities (Jurgens et al., 2015).caused by structural cardiac abnormalities (Jurgens et al., 2015).caused by structural cardiac abnormalities (Jurgens et al., 2015).
AAAmong women, hypertension is the most common causal factor while coronarymong women, hypertension is the most common causal factor while coronarymong women, hypertension is the most common causal factor while coronary
artery disease will likely lead to HF among men (Riegel et al., 2017).artery disease will likely lead to HF among men (Riegel et al., 2017).artery disease will likely lead to HF among men (Riegel et al., 2017).
OOOther effects associated with HF include; poor prognosis, high medication coststher effects associated with HF include; poor prognosis, high medication coststher effects associated with HF include; poor prognosis, high medication costs
and generally poor quality of life (Liu et al., 2018).and generally poor quality of life (Liu et al., 2018).and generally poor quality of life (Liu et al., 2018).
EEEvidence thus indicates that patients should look to adopt effective HF manage-vidence thus indicates that patients should look to adopt effective HF manage-vidence thus indicates that patients should look to adopt effective HF manage-
ment which can be done by learning selfment which can be done by learning selfment which can be done by learning self---care skills such as monitoring symp-care skills such as monitoring symp-care skills such as monitoring symp-
toms, interpreting symptoms and informed decision making (Dinh et al., 2019).toms, interpreting symptoms and informed decision making (Dinh et al., 2019).toms, interpreting symptoms and informed decision making (Dinh et al., 2019).
Main Findings
Videoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce theVideoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce theVideoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce the
chances of rechances of rechances of re---hospitalization according to (Bauce et al, 2018).hospitalization according to (Bauce et al, 2018).hospitalization according to (Bauce et al, 2018).
A patientA patientA patient---based educational program that focuses on HF selfbased educational program that focuses on HF selfbased educational program that focuses on HF self---care conducted by the usecare conducted by the usecare conducted by the use
of teachof teachof teach---back increase patient knowledge on HF skills (Dinh et al, 2019).back increase patient knowledge on HF skills (Dinh et al, 2019).back increase patient knowledge on HF skills (Dinh et al, 2019).
Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-
proach with incorporation of physical training for HF patients (Liu et al, 2018).proach with incorporation of physical training for HF patients (Liu et al, 2018).proach with incorporation of physical training for HF patients (Liu et al, 2018).
Shao, Shao & Chen (2018) revealed that HF selfShao, Shao & Chen (2018) revealed that HF selfShao, Shao & Chen (2018) revealed that HF self---management program with assistancemanagement program with assistancemanagement program with assistance
from nurses improves high level symptoms associated with HF.from nurses improves high level symptoms associated with HF.from nurses improves high level symptoms associated with HF.
Herber et al., (2018) further suggests that selfHerber et al., (2018) further suggests that selfHerber et al., (2018) further suggests that self---care should be supplemented with modi-care should be supplemented with modi-care should be supplemented with modi-
fied behavior change interventions to enhance positive outcomes.fied behavior change interventions to enhance positive outcomes.fied behavior change interventions to enhance positive outcomes.
Jürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere toJürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere toJürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere to
pharmacological interventions can help alleviate HF symptoms.pharmacological interventions can help alleviate HF symptoms.pharmacological interventions can help alleviate HF symptoms.
Lycholip et al., (2018) articulates that teleLycholip et al., (2018) articulates that teleLycholip et al., (2018) articulates that tele---monitoring (TM) has an advantage in selfmonitoring (TM) has an advantage in selfmonitoring (TM) has an advantage in self---
care because it improves selfcare because it improves selfcare because it improves self---care behaviors among outpatients.care behaviors among outpatients.care behaviors among outpatients.
Toukhsati, Driscoll and Hare (2015) reveal that selfToukhsati, Driscoll and Hare (2015) reveal that selfToukhsati, Driscoll and Hare (2015) reveal that self---management practices such as ad-management practices such as ad-management practices such as ad-
herence to medication and monitoring symptomsherence to medication and monitoring symptomsherence to medication and monitoring symptoms
Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.
MethodologyMethodologyMethodology
Systematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presentsSystematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presentsSystematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presents
first level of evidence. The two studies are thus valid to guide evidencefirst level of evidence. The two studies are thus valid to guide evidencefirst level of evidence. The two studies are thus valid to guide evidence---based practice.based practice.based practice.
Randomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) andRandomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) andRandomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) and
Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.
Jürgens et al., (2015) put forth literature review based on multiple comprehensiveJürgens et al., (2015) put forth literature review based on multiple comprehensiveJürgens et al., (2015) put forth literature review based on multiple comprehensive
guideline statements on HF management and as such, a second level of evidence.guideline statements on HF management and as such, a second level of evidence.guideline statements on HF management and as such, a second level of evidence.
Lycholip et al., (2018) conducts an RCT comprising of 177 patients.Lycholip et al., (2018) conducts an RCT comprising of 177 patients.Lycholip et al., (2018) conducts an RCT comprising of 177 patients.
Study by Toukhsati, Driscoll and Hare (2015) is a metaStudy by Toukhsati, Driscoll and Hare (2015) is a metaStudy by Toukhsati, Driscoll and Hare (2015) is a meta---synthesis of previous RCT stud-synthesis of previous RCT stud-synthesis of previous RCT stud-
ies on CHF management.ies on CHF management.ies on CHF management.
LimitationsLimitationsLimitations
Bauce et al., (2018) fails to identify clearBauce et al., (2018) fails to identify clearBauce et al., (2018) fails to identify clear---cut goals of the VC intervention and the influ-cut goals of the VC intervention and the influ-cut goals of the VC intervention and the influ-
ence of this mechanism on HF.ence of this mechanism on HF.ence of this mechanism on HF.
The overall outcomes of the teachThe overall outcomes of the teachThe overall outcomes of the teach---back methodologies on patients were not establishedback methodologies on patients were not establishedback methodologies on patients were not established
by Dinh et al., (2019).by Dinh et al., (2019).by Dinh et al., (2019).
Findings of Liu et al., (2018) need to be backed up by succeeding metaFindings of Liu et al., (2018) need to be backed up by succeeding metaFindings of Liu et al., (2018) need to be backed up by succeeding meta---analysis that ad-analysis that ad-analysis that ad-
dress issues such as level of physical exercises recommended for HF patients.dress issues such as level of physical exercises recommended for HF patients.dress issues such as level of physical exercises recommended for HF patients.
The findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program onThe findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program onThe findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program on
patients with and without caregivers.patients with and without caregivers.patients with and without caregivers.
Also, patients find it difficult to adhere to such comprehensive selfAlso, patients find it difficult to adhere to such comprehensive selfAlso, patients find it difficult to adhere to such comprehensive self---care managementcare managementcare management
programs.programs.programs.
Recommendations
Practice: Nursing management of HF patients should include symptoms assess-
ment, exercise training, medication management and patient education.
Education: Patient education by nursing staff should be consistent prior to patient
discharge including; handling medications and appropriate time to call healthcare
providers.
Research: Research and clinical trials need to include residents in skilled nursing
facilities and involve patients above the age of 80.
In summary, patient education, regular exercise and follow-up care are essential HF man-
agement and promoting self-care behaviors.
Heart Failure Law Chian Ying S5129091
Outline
1.Introduction
2.Main Findings
3.Methodology
4.Limitation of Findings
5.Recommendations
IntroductionIntroductionIntroduction
HHHF is a complex condition characterized by impairment of ventricle fillingsF is a complex condition characterized by impairment of ventricle fillingsF is a complex condition characterized by impairment of ventricle fillings
caused by structural cardiac abnormalities (Jurgens et al., 2015).caused by structural cardiac abnormalities (Jurgens et al., 2015).caused by structural cardiac abnormalities (Jurgens et al., 2015).
AAAmong women, hypertension is the most common causal factor while coronarymong women, hypertension is the most common causal factor while coronarymong women, hypertension is the most common causal factor while coronary
artery disease will likely lead to HF among men (Riegel et al., 2017).artery disease will likely lead to HF among men (Riegel et al., 2017).artery disease will likely lead to HF among men (Riegel et al., 2017).
OOOther effects associated with HF include; poor prognosis, high medication coststher effects associated with HF include; poor prognosis, high medication coststher effects associated with HF include; poor prognosis, high medication costs
and generally poor quality of life (Liu et al., 2018).and generally poor quality of life (Liu et al., 2018).and generally poor quality of life (Liu et al., 2018).
EEEvidence thus indicates that patients should look to adopt effective HF manage-vidence thus indicates that patients should look to adopt effective HF manage-vidence thus indicates that patients should look to adopt effective HF manage-
ment which can be done by learning selfment which can be done by learning selfment which can be done by learning self---care skills such as monitoring symp-care skills such as monitoring symp-care skills such as monitoring symp-
toms, interpreting symptoms and informed decision making (Dinh et al., 2019).toms, interpreting symptoms and informed decision making (Dinh et al., 2019).toms, interpreting symptoms and informed decision making (Dinh et al., 2019).
Main Findings
Videoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce theVideoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce theVideoconferencing (VC) reduces worsening of HF symptoms and ultimately reduce the
chances of rechances of rechances of re---hospitalization according to (Bauce et al, 2018).hospitalization according to (Bauce et al, 2018).hospitalization according to (Bauce et al, 2018).
A patientA patientA patient---based educational program that focuses on HF selfbased educational program that focuses on HF selfbased educational program that focuses on HF self---care conducted by the usecare conducted by the usecare conducted by the use
of teachof teachof teach---back increase patient knowledge on HF skills (Dinh et al, 2019).back increase patient knowledge on HF skills (Dinh et al, 2019).back increase patient knowledge on HF skills (Dinh et al, 2019).
Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-Study by Liu et al., (2018) has suggested a multidisciplinary disease management ap-
proach with incorporation of physical training for HF patients (Liu et al, 2018).proach with incorporation of physical training for HF patients (Liu et al, 2018).proach with incorporation of physical training for HF patients (Liu et al, 2018).
Shao, Shao & Chen (2018) revealed that HF selfShao, Shao & Chen (2018) revealed that HF selfShao, Shao & Chen (2018) revealed that HF self---management program with assistancemanagement program with assistancemanagement program with assistance
from nurses improves high level symptoms associated with HF.from nurses improves high level symptoms associated with HF.from nurses improves high level symptoms associated with HF.
Herber et al., (2018) further suggests that selfHerber et al., (2018) further suggests that selfHerber et al., (2018) further suggests that self---care should be supplemented with modi-care should be supplemented with modi-care should be supplemented with modi-
fied behavior change interventions to enhance positive outcomes.fied behavior change interventions to enhance positive outcomes.fied behavior change interventions to enhance positive outcomes.
Jürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere toJürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere toJürgens' et al., (2015) recommends that consistency from the nurses’ part to adhere to
pharmacological interventions can help alleviate HF symptoms.pharmacological interventions can help alleviate HF symptoms.pharmacological interventions can help alleviate HF symptoms.
Lycholip et al., (2018) articulates that teleLycholip et al., (2018) articulates that teleLycholip et al., (2018) articulates that tele---monitoring (TM) has an advantage in selfmonitoring (TM) has an advantage in selfmonitoring (TM) has an advantage in self---
care because it improves selfcare because it improves selfcare because it improves self---care behaviors among outpatients.care behaviors among outpatients.care behaviors among outpatients.
Toukhsati, Driscoll and Hare (2015) reveal that selfToukhsati, Driscoll and Hare (2015) reveal that selfToukhsati, Driscoll and Hare (2015) reveal that self---management practices such as ad-management practices such as ad-management practices such as ad-
herence to medication and monitoring symptomsherence to medication and monitoring symptomsherence to medication and monitoring symptoms
Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.Riegel et al., (2017) emphasizes on healthy diet and exercises in HF management.
MethodologyMethodologyMethodology
Systematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presentsSystematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presentsSystematic review conducted by Bauce et al., (2018) and Herber et al., (2018) presents
first level of evidence. The two studies are thus valid to guide evidencefirst level of evidence. The two studies are thus valid to guide evidencefirst level of evidence. The two studies are thus valid to guide evidence---based practice.based practice.based practice.
Randomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) andRandomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) andRandomized control trial used by Dinh et al., (2019), Shao, Shao & Chen (2019) and
Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.Liu et al., (2018) entail third level of evidence. Hence, they are applicable in patient care.
Jürgens et al., (2015) put forth literature review based on multiple comprehensiveJürgens et al., (2015) put forth literature review based on multiple comprehensiveJürgens et al., (2015) put forth literature review based on multiple comprehensive
guideline statements on HF management and as such, a second level of evidence.guideline statements on HF management and as such, a second level of evidence.guideline statements on HF management and as such, a second level of evidence.
Lycholip et al., (2018) conducts an RCT comprising of 177 patients.Lycholip et al., (2018) conducts an RCT comprising of 177 patients.Lycholip et al., (2018) conducts an RCT comprising of 177 patients.
Study by Toukhsati, Driscoll and Hare (2015) is a metaStudy by Toukhsati, Driscoll and Hare (2015) is a metaStudy by Toukhsati, Driscoll and Hare (2015) is a meta---synthesis of previous RCT stud-synthesis of previous RCT stud-synthesis of previous RCT stud-
ies on CHF management.ies on CHF management.ies on CHF management.
LimitationsLimitationsLimitations
Bauce et al., (2018) fails to identify clearBauce et al., (2018) fails to identify clearBauce et al., (2018) fails to identify clear---cut goals of the VC intervention and the influ-cut goals of the VC intervention and the influ-cut goals of the VC intervention and the influ-
ence of this mechanism on HF.ence of this mechanism on HF.ence of this mechanism on HF.
The overall outcomes of the teachThe overall outcomes of the teachThe overall outcomes of the teach---back methodologies on patients were not establishedback methodologies on patients were not establishedback methodologies on patients were not established
by Dinh et al., (2019).by Dinh et al., (2019).by Dinh et al., (2019).
Findings of Liu et al., (2018) need to be backed up by succeeding metaFindings of Liu et al., (2018) need to be backed up by succeeding metaFindings of Liu et al., (2018) need to be backed up by succeeding meta---analysis that ad-analysis that ad-analysis that ad-
dress issues such as level of physical exercises recommended for HF patients.dress issues such as level of physical exercises recommended for HF patients.dress issues such as level of physical exercises recommended for HF patients.
The findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program onThe findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program onThe findings of Shao, Shao & Chen (2018) do not reveal the efficacy of the program on
patients with and without caregivers.patients with and without caregivers.patients with and without caregivers.
Also, patients find it difficult to adhere to such comprehensive selfAlso, patients find it difficult to adhere to such comprehensive selfAlso, patients find it difficult to adhere to such comprehensive self---care managementcare managementcare management
programs.programs.programs.
Recommendations
Practice: Nursing management of HF patients should include symptoms assess-
ment, exercise training, medication management and patient education.
Education: Patient education by nursing staff should be consistent prior to patient
discharge including; handling medications and appropriate time to call healthcare
providers.
Research: Research and clinical trials need to include residents in skilled nursing
facilities and involve patients above the age of 80.
In summary, patient education, regular exercise and follow-up care are essential HF man-
agement and promoting self-care behaviors.
References
Bauce, K., Fahs, D. B., Batten, J., & Whittemore, R. (2018). Videoconferencing for
Management of Heart Failure: An Integrative Review. Journal of Gerontological
Nursing, 44(4), 45-52. Doi:10.3928/00989134-20180207-01
Dinh, H. T. T., Bonner, A., Ramsbotham, J., & Clark, R. (2019). Cluster Randomized
Controlled Trial Testing the Effectiveness of a Self-Management Intervention us
ing the Teach-Back Method for People with Heart Failure. Nursing & Health
Sciences, 2019; 1-9. doi:10.1111/nhs.12616
Herber, O. R., Atkins, L., Stork, S., & Wilm, S. (2018). Enhancing Self-Care Adherence
in Patients with Heart Failure: A Study Protocol for Developing a Theory-
Based Behaviour Change Intervention Using the COM-B Behaviour Model. BMJ
Open. Retrieved from https://bmjopen.bmj.com/content/8/9/e025907
Jurgens, C. Y., Goodlin, S., Dolansky, M., Ahmed, A., Fonarow, G. C., Boxer, R., &
Cranner, K. (2015). Heart Failure Management in Skilled Nursing Facilities. Cir
culation: Heart Failure, 8(3). Retrieved from
https://www.ahajournals.org/doi/10.1161/HHF.0000000000000005
Liu, M., Wang, C., Tung, T., Kuo, L., & Chiou, A. (2018). Effects of a
Multidisciplinary Disease Management Programme with or without Exercise Training
for Heart
Failure Patients: Secondary Analysis of a Randomized Controlled Trial.
International Journal of Nursing Studies, 87, 94-102.
doi:10.1016/j.ijnurstu.2018.06.010Lycholip, E., Aamodt, I. T., Lie, I., Simbelyte, T., Puronait, R., Hillege, H., De Vries,
A., … Krai, I. (2018). The Dynamics of Self-Care in the Course of Heart Failure
Management: Data from the TOUCH Study. Patient Preference and Adherence,
12, 1113-1122. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC6027682/
Riegel, B., Moser, D. K., Buck, G. C., Dickson, V. V., Dunbar, S. B., & Lindenfeld, J.
(2017). Self-Care for the Prevention and Management of Cardiovascular Disease
and Stroke. Journal of the American Heart Association, 6(9). Retrieved from
https://www.ahajournals.org/doi/10.1161/JAHA.117.006997
Shao, J. H., Shao, J., & Chen, S. H. (2019). Randomized Control Trial of a Self-
Management Intervention for Heart Failure Older Adults in Northern Taiwan. The Aus
tralian Journal of Nursing, Scholarship & Research, 26(2), 288-294. Retrieved
from https://www.collegianjournal.com/article/S1322-7696(18)30122-7/fulltext
Toukhsati, S. R., Driscoll, A., & Hare, D. L. (2015). Patient Self-Management in
Chronic Heart Failure: Establishing Concordance between Guidelines and Practice.
Cardiac Failure Review, 1(2), 128-131. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490946/
Bauce, K., Fahs, D. B., Batten, J., & Whittemore, R. (2018). Videoconferencing for
Management of Heart Failure: An Integrative Review. Journal of Gerontological
Nursing, 44(4), 45-52. Doi:10.3928/00989134-20180207-01
Dinh, H. T. T., Bonner, A., Ramsbotham, J., & Clark, R. (2019). Cluster Randomized
Controlled Trial Testing the Effectiveness of a Self-Management Intervention us
ing the Teach-Back Method for People with Heart Failure. Nursing & Health
Sciences, 2019; 1-9. doi:10.1111/nhs.12616
Herber, O. R., Atkins, L., Stork, S., & Wilm, S. (2018). Enhancing Self-Care Adherence
in Patients with Heart Failure: A Study Protocol for Developing a Theory-
Based Behaviour Change Intervention Using the COM-B Behaviour Model. BMJ
Open. Retrieved from https://bmjopen.bmj.com/content/8/9/e025907
Jurgens, C. Y., Goodlin, S., Dolansky, M., Ahmed, A., Fonarow, G. C., Boxer, R., &
Cranner, K. (2015). Heart Failure Management in Skilled Nursing Facilities. Cir
culation: Heart Failure, 8(3). Retrieved from
https://www.ahajournals.org/doi/10.1161/HHF.0000000000000005
Liu, M., Wang, C., Tung, T., Kuo, L., & Chiou, A. (2018). Effects of a
Multidisciplinary Disease Management Programme with or without Exercise Training
for Heart
Failure Patients: Secondary Analysis of a Randomized Controlled Trial.
International Journal of Nursing Studies, 87, 94-102.
doi:10.1016/j.ijnurstu.2018.06.010Lycholip, E., Aamodt, I. T., Lie, I., Simbelyte, T., Puronait, R., Hillege, H., De Vries,
A., … Krai, I. (2018). The Dynamics of Self-Care in the Course of Heart Failure
Management: Data from the TOUCH Study. Patient Preference and Adherence,
12, 1113-1122. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC6027682/
Riegel, B., Moser, D. K., Buck, G. C., Dickson, V. V., Dunbar, S. B., & Lindenfeld, J.
(2017). Self-Care for the Prevention and Management of Cardiovascular Disease
and Stroke. Journal of the American Heart Association, 6(9). Retrieved from
https://www.ahajournals.org/doi/10.1161/JAHA.117.006997
Shao, J. H., Shao, J., & Chen, S. H. (2019). Randomized Control Trial of a Self-
Management Intervention for Heart Failure Older Adults in Northern Taiwan. The Aus
tralian Journal of Nursing, Scholarship & Research, 26(2), 288-294. Retrieved
from https://www.collegianjournal.com/article/S1322-7696(18)30122-7/fulltext
Toukhsati, S. R., Driscoll, A., & Hare, D. L. (2015). Patient Self-Management in
Chronic Heart Failure: Establishing Concordance between Guidelines and Practice.
Cardiac Failure Review, 1(2), 128-131. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490946/
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