A. Azzam

A. Nunes

E. Moreira

J. S. Cardoso

São Luís Castro

T. Fidelis

Teresa Limpo

English

Repositório Aberto da Universidade do Porto

Poster Session 3 439was classified based on LVEF into HFpEF (>=50%)& HFrEF (<50%). The precipi-tants were defined as Infections -Diagnosed based on clinical,laboratory and imag-ing findings,felt to be clinically contributing Medication Adherence-assessed usingMorisky 8 Point medication adherence scale, Arrhythmias-documented on ECG &clinically felt to be contributing, predominantly atrial fibrillation Ischemia-based onhistory, clinical and ECG findings with or without cardiac enzyme rise, Medicationchange by other services involved in care of HF patient-defined as a reduction in HFtherapies or use of contraindicated therapies Dietary non-compliance defined asexcess sodium intake, Excess alcohol intake-defined as >1iu/d for women & >2iufor men Others-precipitants not falling in the above categories The identified precip-itants were analysed against variables of interest, using chi squared , independent ttest & fisher exact test , a p value of <0.05 was considered significant.Results Single Precipitant was identified in 43.7 %(n=59), multiple precipitants wereidentified in 29.5%(n=35), no precipitant was identified in 30.4%(n=41). In dHF(n=67) predominant precipitants were LRTI (43%), Arrhythmias(39%), non compliantdiet(34%), Ischemia(21%) ,Excess Alcohol(15%) ,Medication Change(7%),Others (4%) & Low Medication Adherence ( 1%). In eHF(68) predominant precipitants wereLRTI(27%),Non compliant diet (24%),Arrhythmias(22%),Medication change(18%),Low Medication Adherence(15%),Excessive alcohol (15%) Ischemia ( 6%) & others(1%). No statistically significant difference was observed between HFrEF & HFpEF.Conclusion Major observations from this prospective analysis highlight no signif-icant difference between precipitants recorded comparing HFpEF & HFrEF in thetotal population. In eHF these precipitants remain prevalent ,but of note, medicationadjustment & medication adherence remain a significant problem despite empha-sis on self care education in these programs. These findings highlight the needfor improvement in patient education & communication among different servicesinvolved in care of HF patient.P1749Development and validation of a Portuguese questionnaire to evaluateknowledge about heart failureT Fidelis1; A Azzam1; A Nunes1; T Limpo1; E Moreira2; JS Cardoso2; SL Castro11University of Porto, Centre of Psychology at University of Porto, Porto, Portugal;2CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto,PortugalFunding Acknowledgements: “Symbiotic technology for societal efficiencygains: Deus Deus ex Machina” (co-funded by NORTE 2020 and FEDER,NORTE-01-0145-FEDER-00026)Introduction . Heart Failure (HF) has a difficult diagnosis and, once diagnosed,it is essential to give patients critical knowledge to deal with it. The greater theinformation patients have about their illness, the lower the chances of hospitalreadmission. Knowledge of the disease includes the cause, symptoms, probableduration and expected evolution of the clinical condition.Purpose. The present research aimed to adapt the "Knowledge Questionnaire onChronic Heart Failure" developed by De Walt et al. (2004) to the Portuguese context.Method. The Portuguese version was developed across six stages: independenttranslation; discussion to obtain a single version; retroversion; questionnaire eval-uation by cardiologists; first amendment; pilot test; second amendment. The finalversion achieved was then tested across three studies. In Study 1, 57 subjects(of which 37 women), aged between 14 and 66 years (M = 40, SD = 35.3),were randomly divided by two experimental conditions: flyer-questionnaire (FQ) vs.questionnaire-flyer (QF). In the FQ condition, after a presentation of an informativeflyer about on HF, participants were asked to complete the questionnaire indepen-dently. In the QF condition, the reverse procedure was followed (i.e., the question-naire was filled in before the flyer presentation). In Study 2, 21 participants (of which10 women), aged between 20 and 34 years (M = 25.86, SD = 3.59), were asked tofill in the HF questionnaire before and after a 5-min period to read the flyer. Finally, inStudy 3, 169 subjects with HF (of which 47 women), aged between 32 and 87 years(M = 62.57, SD = 10.93), were asked to fill in the questionnaire.Results. In Study 1, FQ participants ( M = 9.31, SD = 1.81) gave more correctresponses than those in the QF condition (M = 5.90, SD = 2.40), t(55) = -5.95, p< .001, d = 1.60. In Study 2, participants gave more correct responses after readingthe flyer (M = 10.38, SD = 1.69) than before reading it (M = 6.48, SD = 2.89), t(30)= -6.77, p < .001, d = 1.64. Finally, Study 3 participants with HF were found to give8.53 correct answers out of 14 (SD = 2.19). Additionally, results showed that womenhad more knowledge than men (M = 9.13, SD = 2.08 vs. M = 8.30, SD = 2.19), t(167)= 2.25, p = .026, d = 0.38, and that greater knowledge was associated with highereducation (r = .34, p < .001) and younger age (r = .17, p = .03).Conclusion. Overall, the present research showed that the Portuguese version of theHF knowledge questionnaire is valid instrument for the assessment of knowledgeabout HF. This seems a useful tool for doctors to assess their patients’ knowledgeof the disease and act accordingly. Patients who have a chronic illness, such as HF,should have an adequate awareness about their condition, as this awareness canmake a make a significant difference in the treatment.P1750Active screening using electronic medical record system for patientrecruitment in case management of heart failure with reduced ejectionfractionCT Chia-Te Liao1; FH Kuo1; MC Lee2; SL Lio3; HY Lai3; EC Chu4; PL Ko3; YS Yen5;ZC Chen1; HS Toh61Chi-Mei Medical Center, Cardiology, Tainan, Taiwan, Province of China; 2Chi-MeiMedical Center, Department of pharmacology , Tainan, Taiwan, Province of China;3Chi-Mei Medical Center, Department of Internal medicine, Tainan, Taiwan,Province of China; 4Chi-Mei Medical Center, Nutritional Service, Tainan, Taiwan,Province of China; 5Chi-Mei Medical Center, Rehabilitation, Tainan, Taiwan,Province of China; 6Chi-Mei Medical Center, Department of intensive care unit,Tainan, Taiwan, Province of ChinaIntroduction Patients with heart failure (HF), especially those with reducedejection fraction (HFrEF) usually have longer hospitalisation days and higherre-hospitalisation rate. Case management and multidisciplinary teamwork havebeen reported to improve these outcomes. However, the recognition of patientswith HF might be missed or delayed during the hospital stay, and these interventionsare traditionally initiated only after the consultation of the cardiologists.Purpose We aimed to assess if the active screening for the HF patients with theelectronic medical record (EMR) system would shorten their hospital days anddecrease re-hospitalisation rate.Methods We constructed and launched a mobile system which can connect tothe EMR since 01 July 2018. The system was designed to actively identify allhospitalised patients with a diagnosis of heart failure (ICD-10: I50) and left ventricularejection fraction (LVEF) ≤ 35% during admission. It notified the HF multidisciplinaryteam automatically, and the team will provide healthcare and the relevant educationto the patients like the way before this system was launched. Regarding theoutcome evaluation, we compared the length of hospitalisation and three-monthsre-hospitalisation rate before and after launching the system.ResultA total of 15 patients were actively identified three months after launching themobile system with the connection of EMR. Their mean age was 59.4 ± 14.9 years,and 80% of them are men. The mean LVEF was 26.6 ± 6.3%. Comparing to the36 patients before using the system, the demographic characteristics are similar,except a lower prevalence of coronary artery disease and hypertension. Regardingthe primary outcome, three-months re-hospitalization rate after launching mobilesystem significantly decreased from 12% to 0% (p = 0.01) and the hospitalisationdays marginally decreased from 10.6 to 7.2 days (p = 0.06).Conclusion The preliminary analysis showed that active screening system throughthe connection of the EMR system might recognise the patients with HErEF earlier.By early recognition, we could initiate interventions promptly and hence, improve theHFrEF outcomes. In the future, longer follow-up and larger cohort studies are neededto confirm the benefits of the active screening and the continuing multidisciplinaryteam care for patients with heart failure.P1751The examination about the clinical feature related to re-admission incongestive heart failure patients introduced our original clinical pathwayH Hiroyuki Wake1; A Iwai1; Y Kuroiwa1; T Kubo1; J Inoue1; N Kajiwara1; K Kimura1;Y Katou2; A Takaishi21Mitoyo General Hospital, rehabilitation , Kanonji, Japan; 2Mitoyo General Hospital,Cardiovascular disease center, Kanonji, JapanBackground: We had introduced original clinical pathway(PATH) in congestive heartfailure(CHF) cases for efficient medical care from August 2015. Introducing PATH, thegreat shortening of hospitalization period was achieved. But we can not still confirmthe reducing effect about re-admission with CHF exacerbation even in the casesintroduced PATH.Purpose: For finding of the clue about suppression of re-admission, we retrospec-tively investigated the clinical feature about the CHF cases who ware introducedPATH and re-admitted with worsening of CHF after discharge.Methods: We enrolled 246 cases(mean age: 80±11 years old, male/female: 139/107cases) , admitted with CHF in our hospital and introduced PATH for the first timebetween August 2015 and November 2017. And we divided them in two groups,Y-group consisted of the 67 cases who ware re-admitted by worsening of CHF within1year after discharge and N-group consisted of 179 cases who ware not re-admittedwithin 1 year. About all cases in both groups we investigated patient characteristics,various clinical data on first admission and clinical course until discharge. And weexamined the difference of each survey item between two groups.Results: In Y-group, the mean age was significantly higher(82±9 vs 79±11 yearsold); p<0.05) and the ratio of cases with admission history by CHF within the past3 years was higher than N-group(43 vs17%; p<0.0001). The ratio of cases whohad the past history of any coronary heart disease as an underlying disease ofCHF was higher in Y-group(40 vs 26%; p<0.05). About cardiac function, the meanvalue of brain natriuretic peptide concentration in blood and the ejection fraction© 2019 The AuthorsEuropean Journal of Heart Failure © 2019 European Society of Cardiology, 21 (Suppl. S1), 5–592

Development and validation of a portuguese questionnaire to evaluate knowledge about heart failure

https://repositorio-aberto.up.pt/bitstream/10216/133610/2/462683.pdf

Development and validation of a portuguese questionnaire to evaluate knowledge about heart failure

Abstract

Similar works

Full text

Available Versions

Repositório Aberto da Universidade do Porto