Symptom Perceptions and Self-care Behaviors in Patients Who Self-manage Heart Failure

Background: Patients with heart failure (HF) are at heightened risk for acute exacerbation requiring hospitalization. Although timely reporting of symptoms can expedite outpatient treatment and avoid the need for hospitalization, few patients recognize and respond to symptoms until acutely ill. Objective: The purpose of this study was to explore patients’ perceptions of symptoms and self-care behaviors for symptom relief, leading up to a HF hospitalization. Methods: To examine prehospitalization symptom scenarios, semistructured interviews were conducted with 60 patients hospitalized for acute decompensated HF. Results: Thirty-seven patients (61.7%) said that they had a sense that “something just wasn’t quite right” before their symptoms began but were unable to specify further. Signs and symptoms most often recognized by the patients were related to dyspnea (85%), fatigue (53.3%), and edema (41.7%). Few patients interpreted their symptoms as being related to worsening HF and most often attributed symptoms to changes in diet (18.3%) and medications (13.3%). Twenty-six patients (43.3%) used self-care strategies to relieve symptoms before hospital admission. More than 40% of the patients had symptoms at least 2 weeks before hospitalization. Conclusions: Despite the wide dissemination of HF evidence-based guidelines, important components of symptom self-management remain suboptimal. Because most of HF self-management occurs in the postdischarge environment, research is needed that identifies how patients interpret symptoms of HF in the specific contexts in which patients self-manage their HF. These findings suggest the need for interventions that will help patients expeditiously recognize, accurately interpret, and use appropriate and safe self-care strategies for symptoms

Aging-in-place: Tips for staying in your home

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Family and Consumer Sciences Extension Agent Receptiveness to Innovative Caregiving Programming

Communities can adapt to residents\u27 needs through innovative citizen-led initiatives. Extension can facilitate these innovation initiatives, but are Extension agents always receptive to such change? We conducted a study to examine the association between organizational change and personal factors and Extension family and consumer sciences agents\u27 innovativeness regarding caregiving programming. Respondents rated their receptiveness to change and answered questions regarding psychosocial health factors. We found that years in current position, leadership self-efficacy, interoffice support, and social support were significant predictors of innovativeness. Results suggest that personal factors rather than organizational change factors may be the more crucial mechanisms for driving agents\u27 innovativeness

Full Circle or Spiralling Out of Control?: State Violence and the Control of Urbanisation in Papua New Guinea

There is an administrative reluctance to recognise the permanency of urban settlement in Papua New Guinea. This reluctance, evident since the 1960s, has been characteristic of both the colonial and post-colonial administrations. Opposition to some facets of urbanisation continues today, despite growing population and land pressures in most rural areas and real problems of landlessness emerging in particular rural areas. Colonial control of urban populations has been replicated in contemporary times, often in more draconian form. Eviction of urban settlers has been tied to issues of crime and urban respectability, and lingering perceptions that Melanesians should be rural residents. The growth of informal settlements and urbanisation are not seen as issues of urban planning, nor is the context of urban migration linked to socioeconomic inequality, hence other forms of urban policy are largely absent. Strengthening alliances between land-owners and the state (especially police and provincial administrations) have thus emphasised intraurban inequality and hampered national development

Family and consumer sciences extension agent receptivenessto innovative caregiving programming

Communities can adapt to residents\u27 needs through innovative citizen-led initiatives. Extension can facilitatethese innovation initiatives, but are Extension agents always receptive to such change? We conducted a study toexamine the association between organizational change and personal factors and Extension family and consumersciences agents\u27 innovativeness regarding caregiving programming. Respondents rated their receptiveness tochange and answered questions regarding psychosocial health factors. We found that years in current position, leadership self-efficacy, interoffice support, and social support were significant predictors of innovativeness. Results suggest that personal factors rather than organizational change factors may be the more crucialmechanisms for driving agents\u27 innovativeness