1203NRS Assessment 2: Annotated Bibliography on Heart Failure

This annotated bibliography addresses the management of heart failure, focusing on a case study of a 75-year-old patient named Charles. The paper analyzes three research articles related to heart failure, including studies on family caregiver involvement, multidisciplinary disease management, and telephone-based self-management programs. The author provides annotations summarizing each article's methodology, findings, and conclusions, and then justifies the selection of these articles based on their relevance to the case study and clinical practice. The discussion highlights the importance of family support, MDM, and self-management skills in improving patient outcomes and reducing hospital readmissions. Finally, the paper offers clinical practice recommendations, advocating for family education, telephone-based self-management programs, and personalized MDM to enhance the quality of life for heart failure patients like Charles. This research underscores the need for a holistic approach to heart failure management, integrating both medical interventions and psychosocial support.

Running head: ANNOTATED BIBLIOGRAPHY
Annotated Bibliography
Name of the Student
Name of the University
Author Note

1ANNOTATED BIBLIOGRAPHY
Deek, H., Chang, S., Newton, P. J., Noureddine, S., Inglis, S. C., Arab, G. A., . . .
Davidson, P. M. (2017). An evaluation of involving family caregivers in the self-care of heart
failure patients on hospital readmission: Randomised controlled trial (the FAMILY study).
International Journal of Nursing Studies, 75, 101-111. doi:10.1016/j.ijnurstu.2017.07.015
In this literature, the authors described about the connection between involvement of
family care givers and self-care of the patients with heart failure. They also mentioned how
the involvement of the family caregivers can affect the risk of readmission to the hospital.
The study carried out in three medical centres in Lebanon for 13 months. The participants
who involved in this study were selected on the basis of several criteria which include age
(more than 18), diagnosed with confirmed heart failure, not living alone or in a nursing home,
not having any planned cardiac surgery and the patients should not be at a stage where he/she
has limited life expectancy. These patients were then distributed in the intervention group and
their family caregivers received specific information on self-care management through
educational sessions along with other resources. After statistical analysis the authors
concluded that education of self-care management among families can reduce the risk of
readmission to the hospital.
The study was designed as multi-site block randomized control trial with blinded
outcome evaluation and it was the first randomized controlled trial focusing on involvement
of family caregivers in heart failure patients. However, the two groups involved in the study
was not equally distributes and it has its effect on data collection which can restrict the
efficiency of block randomization in this study.
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

2ANNOTATED BIBLIOGRAPHY
failure patients: Secondary analysis of a randomized controlled trial. International Journal of
Nursing Studies, 87, 94-102. doi:10.1016/j.ijnurstu.2018.06.010
In this study, the authors describes how exercise and non-exercise based
multidisciplinary disease management can affect the heart failure related treatment. It was a
secondary analysis of a randomized control. The study collected and analysed information
from 212 patients who were hospitalized due to heart failure in Taiwan. The participants were
divided in three groups based on their preferences on exercise training (one control group).
The multidisciplinary disease management includes regular assessments, personalized
education session, optimization of medication as per the condition of the patient, pre
scheduled clinic visits and regular physical exercise in home. The participants who have
contradictions toward physical training was excluded from the physical training program. The
authors concluded that, both groups are observed for better disease outcome. However, they
also recommend outpatient based exercise training for the patients who involved physical
exercise at home.
The study was well constructed and it also primarily indicates that patients who did
not want to involve in physical exercise can produce better outcomes by multidisciplinary
disease management. However, the authors describes that the study was performed in a small
population who can walk for 6 minutes and the study does not indicate any result regarding
the patients who did not have the ability to walk for 6 minutes.
Moon, M. K., Yim, J., & Jeon, M. Y. (2018). The effect of a telephone-based self-
management program led by nurses on self-care behaviour, biological index for cardiac
function, and depression in ambulatory heart failure patients. Asian Nursing Research, 12(4),
251-257. doi:10.1016/j.anr.2018.10.001

3ANNOTATED BIBLIOGRAPHY
This study aimed to find out the involvement of telephone-based self-management
support in self-management of heart failure patients. The authors designed the study as a
quasi-experiment in non-equivalent control group. 36 patients diagnosed with heart failure
participated in this study and they were distributed in two groups (experiment group and
control group). The experimental group was treated with telephone based self-management
support. The self-management support was measured by self-care behaviour, brain natriuretic
peptide level, left ventricular ejection fraction values and depression level. Statistical
analysis of the information reported that the telephone based self-management program can
produce better treatment outcomes.
This study concluded a significant aspect of self-management support. However, the
authors mentioned the experiment was conducted in very small population. Apart from that,
the study did not mention about its implementation in situations where telephone
communication is limited.
Discussion
Patients who are diagnosed with heart failure requires extra effort to promote self-care
in patient. Adequate self-care can help to reduce readmission in hospital and it also reduces
the symptoms related to heart failure (Sedlar et al., 2017). Several studies reported the
involvement of family in promoting self-care of the patient (Harkness, Spaling, Currie,
Strachan & Clark, 2015). Adequate family functioning can lead to reduction of risk in heart
failure patients (Grey, Schulman-Green, Knafl & Reynolds, 2015). As the family members
are mostly connected with the patient, poor family characteristics can increase the
complication in the patient. There are several factors related to family characteristics which
can play important role in improving the self-care of the patient (Harkness, Spaling, Currie,
Strachan & Clark, 2015). For example, patients with heart failure often face social isolation

4ANNOTATED BIBLIOGRAPHY
which is connected with the mortality and morbidity (Cafiero, 2018). Different studies
reported the fact that patients who are detached from their families are mostly suffered from
depression which lead to poor quality of life (Celano, Villegas, Albanese, Gaggin, &
Huffman, 2018). Apart from that, medication adherence and self-care behaviour of a heart
failure patient is also depended upon the family members who lived with the patient (Brown
et al., 2016). The family helps the patient by providing emotional support which can further
help in reduction of depression (Srisuk, Cameron, Ski & Thompson, 2016). Proper
communication with the patient helps the family to develop an understanding on the patient’s
perspective which helps the family to plan the support accordingly (Deek et al., 2017).
Hence, it is understood, that family play a significant role in treatment of a heart failure
patient. Deek et al. (2017), describes about the efficiency of family involvement in better
outcome of the patient. In case of Charles, it can be a significant factor which can enhance his
self-management skill.
Heart failure is a result of different cardiovascular disease (Mozaffarian et al., 2016).
In case of Charles, he had difficulty in normal breathing. Due to insufficiency in oxygen
supply, dysfunction in cardiovascular system occurs (Mozaffarian et al., 2016). As a result,
the patient failed to perform general physical exercise and involvement in physical exercise
can lead to fatigue which induces emotional stress (Mozaffarian et al., 2016).
Implementation of guideline medications such as cardiac resynchronization therapy helps to
provide proper treatment to the patients with heart failure which in turn reduces the mortality
rate due to heart failure (Liu, Wang, Tung, Kuo & Chiou 2018). On the other hand,
rehospitalisation is a major problem related to the heart failure patients. Application of
multidisciplinary disease management programme (MDM) helps to reduce the
rehospitalisation of the heart failure patients (Liu, Wang, Tung, Kuo & Chiou 2018).
However, overweight patients with heart failure mostly face challenge in participating in

5ANNOTATED BIBLIOGRAPHY
physical exercise. Charles is a 75 year old overweight patient, and he may face the challenge
to participate in physical exercise. Liu, Wang, Tung, Kuo and Chiou (2018), reported that
patients who are not comfortable in physical exercise can also be treated with MDM and it
can reduce the chances of rehospitalisation. Therefore, application of non-exercise based
MDM can help Charles to improve his medical condition.
According to European Society of Cardiology and American Heart Association, self-
care behaviour and self-management skills involves in supporting pharmacotherapy which
leads to improvement of the heart failure related complications (Moon, Yim, & Jeon, 2018).
However, health sectors are mostly focused on the pharmacotherapy. As a result, heat failure
patients may face different challenges after discharge from the hospital due to lack of
information towards the health condition (Moon, Yim, & Jeon, 2018). Different studies
reported that rehospitalisation can be reduced if the self-care behaviour and self-
managements skills are applied adequately (Buck et al., 2015). Telephone self-management
support is a nursing approach which helps the outpatients by supporting them with self-
management skills (Hanlon et al., 2017). Hence, patients with heart failure can get benefitted
from this by receiving adequate information. Several studies supported the fact that telephone
based self-management support can help the patients to avoid anxiety, depression and help
them to maintain quality of life after discharge. Moon, Yim, and Jeon (2018) reported that the
mentioned intervention can help the patient in improving cardiac functional index. In case of
Charles, telephone self-management can be beneficial as it can promote self-care behaviours
in outpatients. Hence, telephone self-management support can help him to have an
understanding on his situation which in turn help him to maintain his self-care behaviour.

6ANNOTATED BIBLIOGRAPHY
Clinical Practice Recommendation
According to the different research related to health failure patient management, it is
understood that patients face difficulties in their daily lives after discharge (Moon, Yim, &
Jeon, 2018). These difficulties mostly occurred due to lack of information regarding the
health condition. As a result, readmission in the hospital occurs. There are different factors
which are not clearly associated with the clinical practice but can improve the patient’s
quality of life. Patients who have diagnosed with heart failure requires additional support
from their family and health professionals to avoid rehospitalisation (Hasanpour-Dehkordi,,
Khaledi-Far, A, Khaledi, B, & Salehi-Tali, 2016). Therefore family educational sessions
along with telephone self-management program need to be the additional part of the
traditional clinical practice (Jonkman et al., 2016). Apart from that, application personalised
MDM can also influence in reducing the rehospitalisation cases (Liu, Wang, Tung, Kuo &
Chiou 2018). However, most of the study was carried out with small populations. Therefore,
the efficiency of the mentioned interventions in a huge population is still is a matter of doubt.
Adequate research is required before implementing these in traditional clinical practice.

7ANNOTATED BIBLIOGRAPHY
Reference
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adherence: truth and consequences. The American journal of the medical sciences,
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Buck, H. G., Harkness, K., Wion, R., Carroll, S. L., Cosman, T., Kaasalainen, S., ... &
Strachan, P. H. (2015). Caregivers’ contributions to heart failure self-care: a
systematic review. European Journal of Cardiovascular Nursing, 14(1), 79-89.
https://doi.org/10.1177/1474515113518434
Cafiero, M. E. (2018). Social Isolation and Emotional Loneliness in Older Adults With
Congestive Heart Failure. Retrieved from:
https://sigma.nursingrepository.org/handle/10755/623788. Retrived on:August 5,
2019
Celano, C. M., Villegas, A. C., Albanese, A. M., Gaggin, H. K., & Huffman, J. C. (2018).
Depression and Anxiety in Heart Failure: A Review. Harvard review of psychiatry,
26(4), 175-184. 10.1097/HRP.0000000000000162
Deek, H., Chang, S., Newton, P. J., Noureddine, S., Inglis, S. C., Arab, G. A., . . . Davidson,
P. M. (2017). An evaluation of involving family caregivers in the self-care of heart
failure patients on hospital readmission: Randomised controlled trial (the FAMILY
study). International Journal of Nursing Studies, 75, 101-111.
doi:10.1016/j.ijnurstu.2017.07.015
Grey, M., Schulman-Green, D., Knafl, K., & Reynolds, N. R. (2015). A revised self-and
family management framework. Nursing outlook, 63(2), 162-170.

8ANNOTATED BIBLIOGRAPHY
Hanlon, P., Daines, L., Campbell, C., McKinstry, B., Weller, D., & Pinnock, H. (2017).
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Harkness, K., Spaling, M. A., Currie, K., Strachan, P. H., & Clark, A. M. (2015). A
systematic review of patient heart failure self-care strategies. Journal of
Cardiovascular Nursing, 30(2), 121-135. doi: 10.1097/JCN.0000000000000118
Hasanpour-Dehkordi, A., Khaledi-Far, A., Khaledi-Far, B., & Salehi-Tali, S. (2016). The
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Kempen, G. I. (2016). What are effective program characteristics of self-management
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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.2018.06.010
Moon, M. K., Yim, J., & Jeon, M. Y. (2018). The effect of a telephone-based self-
management program led by nurses on self-care behaviour, biological index for

9ANNOTATED BIBLIOGRAPHY
cardiac function, and depression in ambulatory heart failure patients. Asian Nursing
Research, 12(4), 251-257. doi:10.1016/j.anr.2018.10.001
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., ... &
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