Feasibility Study of the Health Empowerment Intervention to Evaluate the Effect on Self-Management, Functional Health, and Well-Being in Older Adults with Heart Failure

abstract: ABSTRACT The population of older adults in the United States is growing disproportionately, with corresponding medical, social and economic implications. The number of Americans 65 years and older constitutes 13.7% of the U.S. population, and is expected to grow to 21% by 2040. As the adults age, they are at risk for developing chronic illness and disability. According to the Centers for Disease Control and Prevention, 5.7 million Americans have heart failure, and almost 80% of these are 65 years and older. The prevalence of heart failure will increase with the increase in aging population, thus increasing the costs associated with heart failure from 34.7 billion dollars in 2010 to 77.7 billion dollars by 2020. Of all cardiovascular hospitalizations, 28.9% are due to heart failure, and almost 60,000 deaths are accounted for heart failure. Marked disparities in heart failure persist within and between population subgroups. Living with heart failure is challenging for older adults, because being a chronic condition, the responsibility of day to day management of heart failure principally rests with patient. Approaches to improve self-management are targeted at adherence, compliance, and physiologic variables, little attention has been paid to personal and social contextual resources of older adults, crucial for decision making, and purposeful participation in goal attainment, representing a critical area for intervention. Several strategies based on empowerment perspective are focused on outcomes; paying less attention to the process. To address these gaps between research and practice, this feasibility study was guided by a tested theory, the Theory of Health Empowerment, to optimize self-management, functional health and well-being in older adults with heart failure. The study sample included older adults with heart failure attending senior centers. Specific aims of this feasibility study were to: (a) examine the feasibility of the Health Empowerment Intervention in older adults with heart failure, (b) evaluate the effect of the health empowerment intervention on self-management, functional health, and well-being among older adults with heart failure. The Health Empowerment Intervention was delivered focusing on strategies to identify and building upon self-capacity, and supportive social network, informed decision making and goal setting, and purposefully participating in the attainment of personal health goals for well-being. Study was feasible and significantly increased personal growth, and purposeful participation in the attainment of personal health goals.Dissertation/ThesisDoctoral Dissertation Nursing and Healthcare Innovation 201

Additional file 4: Table S4. of Transcriptome profiling of Kentucky bluegrass (Poa pratensis L.) accessions in response to salt stress

Prioritized differentially expressed transcripts from shoot tissue, BLASTx-based annotation, GO terms, and average normalized expression values of two Kentucky bluegrass accessions under control and salt treated conditions. (XLSX 90 kb

Additional file 3: Table S3. of Transcriptome profiling of Kentucky bluegrass (Poa pratensis L.) accessions in response to salt stress

Prioritized differentially expressed transcripts from root tissue, BLASTx-based annotation, GO terms, and average normalized expression values of two Kentucky bluegrass accessions under control and salt treated conditions. (XLSX 44 kb