• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.247-256
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• 2016

Purpose: This study aimed to examine the relationships between the N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels with the sociodemographic and clinical factors, self-care behaviors, and the physical symptom experiences in patients with heart failure. Methods: This cross-sectional study utilized a convenience sample of adult outpatients and inpatients who attended a cardiology department in a tertiary hospital in Seoul, Korea. The data from 154 patients with heart failure were collected using a questionnaire, and their clinical data were extracted from their electronic medical records. Results: Compared with the patients with high NT-proBNP levels, those with low NT-proBNP levels had significantly lower physical symptom experiences scores. Patients with low- and mid-NT-proBNP levels were more likely to be employed compared with those with high NT-proBNP levels. Patients with low NT-proBNP levels had higher left ventricular ejection fractions, and were less likely to have arrhythmias and comorbidities. Conclusion: The results from this study showed that patients with more severe heart failure had higher physical symptom experiences scores; hence, individualizing treatment approaches based on heart failure severity is necessary.

• Perspectives in Nursing Science
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• v.9 no.1
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• pp.45-50
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• 2012

Purpose: Despite poor cognitive function in heart failure (HF), few studies have examined cognition and its probable implication in self-care among Korean HF patients. The purposes of this study were (1) to describe cognition in the domains of global, memory, and executive functions, (2) to explore the relationship between cognition and self-care, and (3) to determine the amount of dietary sodium intake among Korean HF patients. Methods: A pilot study was conducted: 7 HF patients (3 men, mean age 68 years) completed face-to-face interviews for neuropsychological tests of cognition and self-care including dietary sodium intake. Results: More than half of the patients had impaired global cognition, memory, or executive function; patients with more severe HF were at higher risk of poor cognitive function. Korean HF patients exhibited poor self-care, with a high dietary sodium intake (5.6 g/day), approximately twice more than the suggested guideline of 2~3 g/day for patients with stable HF. Conclusion: Cognitive dysfunction and inadequate self-care with noncompliance with dietary sodium restriction were evident in Korean HF patients. More studies are warranted that examine the prevalence of cognitive impairment and areas of deficit using neuropsychological tests in a larger sample and that examine how cognition affects self-care and compliance in salt-intake.

• Journal of Home Health Care Nursing
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• v.15 no.2
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• pp.82-90
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• 2008

Recent shortening of hospitalization has partly led to the transition of health care services from hospitals to communities in cardiovascular (CVD) care. Home healthcare nursing is an alternative modality of care for chronically ill CVD patients. Cardiac rehabilitation (CR) has been redefined as a "secondary prevention center", consisting of: patient assessment; nutritional counseling; blood pressure and diabetes management; tobacco cessation; psychosocial management; and physical activity counseling. Improvement in health-related quality of life (HRQOL) is a major goal of the CR that integrates physical, psychological and social dimensions of care. The review of evidence on effects of CR on HRQOL may allow home healthcare nurses to provide better comprehensive care for CVD patients. There is evidence on beneficial effects of CR on HRQOL in patients with myocardial infarction (MI) as well as patients with chronic heart failure. Specifically, home-based CR, which is more cost-effective than hospital-based CR, has been reported to produce comparable improvements in HRQOL with hospital-based CR in MI patients. In conclusion, a newly-designed, home-based CR may be required to be applied to Korean home healthcare nursing system for improving HRQOL.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.455-458
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• 2015

Excessive dynamic airway collapse (EDAC) is a disease entity of excessive reduction of the central airway diameter during exhalation, without cartilage collapse. An 80-year-old female presented with generalized edema and dyspnea at our hospital. The patient was in a state of acute decompensated heart failure due to pneumonia with respiratory failure. We accordingly managed the patient with renal replacement therapy, mechanical ventilation and antibiotics. Bronchoscopy confirmed the diagnosis of EDAC. We scheduled extubation after the improvement of pneumonia and heart condition. However, extubation failure occurred due to hypercapnic respiratory failure with poor expectoration. Her EDAC was improved in response to high flow nasal oxygen therapy (HFNOT). Subsequently, the patient was stabilized and transferred to the general ward. HFNOT, which generates physiologic positive end expiratory pressure (PEEP) effects, could be an alternative and effective management of EDAC. Further research and clinical trials are needed to demonstrate the therapeutic effect of HFNOT on EDAC.

• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.846-856
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• 2015

Purpose: The focus of this study was on symptom management to predict quality of life among individuals with heart failure. The theoretical model was constructed based on situation-specific theory of heart failure self-care and literature review. Methods: For participants, 241 outpatients at a university hospital were invited to the study from May 19 to July 30, 2014. Data were collected with structured questionnaires and analyzed using SPSSWIN and AMOS 20.0. Results: The goodness of fit index for the hypothetical model was .93, incremental fit index, .90, and comparative fit index, .90. As the outcomes satisfied the recommended level, the hypothetical model appeared to fit the data. Seven of the eight hypotheses selected for the hypothetical model were statistically significant. The predictors of symptom management, symptom management confidence and social support together explained 32% of the variance in quality of life. The 28% of variance in symptom management was explained by symptom recognition, heart failure knowledge and symptom management confidence. The 4% of variance in symptom management confidence was explained by social support. Conclusion: The hypothetical model of this study was confirmed to be adequate in explaining and predicting quality of life among patients with heart failure through symptom management. Effective strategies to improve quality of life among patients with heart failure should focus on symptom management. Symptom management can be enhanced by providing educational programs, encouraging social support and confidence, consequently improving quality of life among this population.

• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.22-36
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• 2019

Purpose: Even though advanced heart failure (HF) severely affects the patient's health-related quality of life (HRQoL), there is little information regarding this issue. This review is aimed to describe the relevant clinical characteristics of patient with advanced HF and identify factors influencing HRQoL in these patients. Methods: Empirical articles were searched from electronic databases issued from January 2000 to June 2018 with using the key terms 'heart failure' and 'quality of life'. There were a total of 22 articles that met the inclusion criteria and were analyzed for this study. Results: First, nine studies among 22 studies clearly stated that their participants were samples of patients with advanced HF. Most reviewed studies showed the New York Heart Association (NYHA) class as the criteria for identifying advanced HF. Second, the level of HRQoL varied depending on the measurement tools utilized by the researchers. Third, the NYHA class, gender, and symptoms were mainly associated with HRQoL in patients with advanced HF. Also, nurse- or physician-led intervention, exercise, spiritual-focused intervention, and palliative care improved the HRQoL of the patients with advanced HF. Conclusion: This study found that the clear application of criteria for advanced HF and the development of advanced HF-specific HRQoL measurement was needed. Prospective studies should be considered for identifying differences in the levels and factors influencing HRQoL in patients with early stage or advanced HF to design patient-centered care.

• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.94-108
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• 2019

Purpose : Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF. Method: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018. Results: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis. Conclusion: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.315-318
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• 2024

The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.

• Korean Journal of Adult Nursing
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• v.17 no.1
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• pp.56-67
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• 2005

Purpose: The main purpose of this study was to examine the effectiveness of a standardized telephone monitoring intervention in addressing the symptom experience and improving self-management ability in patients with heart failure. Methods: A non-equivalent control group pre-post test design was used. There were 17 patients in the experimental group, and 16 in the control group. According to the protocol, patients in the experimental group received 15 to 30 minute-telephone monitoring four times, once a week for 4 weeks. Data were analyzed by ${\chi}^2$-test, Mann-Whitney U test. Results: 1) The experimental group showed a significant increase in compliance with self-management compared to the control group. 2) There was a significant decrease in degree for 3 symptoms(DOE, PND, & continuing fatigue) in the experimental group, after telephone monitoring. However, the experimental group did not show significant decrease in the degree of the total symptom experiences. Conclusions: The results of this study provide evidence that standardized telephone monitoring is effective in relieving symptom experience and improving self-management in patients with heart failure over the course of telephone monitoring.

• Journal of Chest Surgery
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• v.33 no.5
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• pp.385-390
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• 2000

Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.