Are We Missing the Mark? Understanding Health Literacy in A Rural-Border Hospital.

Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population.

Sociodemographic Indicators of Social Position and Self-care Maintenance in Adults with Heart Failure.

Social determinants of health (SDH) are known to influence health. Adequate self-care maintenance improves heart failure (HF) outcomes. However, the relationship between self-care maintenance and SDH remains unclear.

Gender Differences in Hispanic Patients of Mexican Origin Hospitalized with Heart Failure.

Background: More than 3 million women in the United States die of heart failure (HF) annually. Women are significantly underrepresented in studies that inform practice guidelines, especially women hospitalized for HF despite the associated negative outcomes. HF is common in Hispanic people, the largest ethnic minority group in the United States, who are mostly of Mexican origin.

Predictors of Heart Failure Readmission in a High-Risk Primarily Hispanic Population in a Rural Setting.

Background: High risk for readmission in patients with heart failure (HF) is associated with Hispanic ethnicity, multimorbidity, smaller hospitals, and hospitals serving low-socioeconomic or heavily Hispanic regions and those with limited cardiac services. Information for hospitals caring primarily for such high-risk patients is lacking.

Objective: The aim of this study was to identify factors associated with 30-day HF readmission after HF hospitalization in a rural, primarily Hispanic, low-socioeconomic, and underserved region.

Evaluation of the effectiveness of the healthy heart tracker on heart failure self-care.

Objective: We evaluated the effectiveness of a newly designed patient education booklet, the Health Heart Tracker (HHT), in promoting Heart Failure Self-Care (HFSC) behaviors compared to usual patient discharge handouts.

Methods: We conducted a quasi-experimental, comparative two-group study using patients admitted for HF to four intermediate care units. The HHT was instituted on two units; patients on the other units served as control.

Psychometric Testing of the Revised Self-Care of Heart Failure Index.

Background: Self-care is essential in people with chronic heart failure (HF). The process of self-care was refined in the revised situation specific theory of HF self-care, so we updated the instrument measuring self-care to match the updated theory. The aim of this study was to test the psychometric properties of the revised 29-item Self-Care of Heart Failure Index (SCHFI).

Multiple chronic conditions: Implications for cognition - Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP).

Introduction: Several chronic illnesses have demonstrated relationships to cognitive decline in the context of aging. However, researchers have largely ignored the effects of multi-morbidity in the context of Alzheimer's disease and related dementias (ADRD) risk. The purpose of this study is to examine the relationship between multiple chronic conditions (MCC) and cognitive decline.

Predictors of overall perceived health in patients with heart failure.

Background: Overall perceived health (OPH) is a powerful and independent predictor of negative health outcomes and low health-related quality of life. Overall perceived health is conspicuously low in patients with heart failure (HF).

Objective: The purpose of this study was to determine the key predictors of OPH in persons with HF and explore possible mediating relationships.

An update on the self-care of heart failure index.

Background: The Self-care of Heart Failure Index (SCHFI) is a measure of self-care defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiological stability (maintenance) and the response to symptoms when they occur (management). In the 5 years since the SCHFI was published, we have added items, refined the response format of the maintenance scale and the SCHFI scoring procedure, and modified our advice about how to use the scores.

Objective: The objective of this article was to update users on these changes.

Psychometric testing of the Immigrant Barriers to Health Care Scale: Hispanic Version.

Barriers to care contribute to health inequities for immigrant populations. Although inadequate health insurance is a known barrier, other factors impact the issue. Few instruments exist to specifically measure these other barriers.

Symptom clusters of heart failure.

Patients with heart failure (HF) report multiple symptoms. Change in symptoms is an indicator of HF decompensation. Patients have difficulty differentiating HF symptoms from comorbid illness or aging.

Heart failure self-care in developed and developing countries.

Background: Heart failure (HF) self-care is poor in developed countries like the United States, but little is known about self-care in developing countries.

Methods And Results: A total of 2082 adults from 2 developed (United States and Australia) and 2 developing countries (Thailand and Mexico) were studied in a descriptive, comparative study. Self-care was measured using the Self-Care of HF Index, which provided scores on self-care maintenance, management, and confidence.

Effective strategies for implementing a multicenter international clinical trial.

Purpose: International collaboration in research is essential in order to improve worldwide health. The purpose of this paper is to describe strategies used to administer an international multicenter trial to assess the effectiveness of a nursing educational intervention.

Design: The study design was a two-group randomized multicenter international clinical trial conducted to determine whether a brief education and counselling intervention delivered by a nurse could reduce prehospital delay in the event of symptoms suggestive of acute coronary syndrome (ACS) in patients previously diagnosed with cardiovascular disease.

Acute coronary syndrome: what do patients know?

Background: The effectiveness of therapy for an acute coronary syndrome (ACS) is dependent on patients' quick decision to seek treatment. We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease.

Methods: Patients (N = 3522) had a mean age of 67 years, 68% were male, and all had a history of AMI or invasive cardiac procedure for ischemic heart disease.

Ethnic differences in quality of life in persons with heart failure.

Background: Chronic illness burdens some groups more than others. In studies of ethnic/racial groups with chronic illness, some investigators have found differences in health-related quality of life (HRQL), whereas others have not. Few such comparisons have been performed in persons with heart failure.

Programmable infusion pumps in ICUs: an analysis of corresponding adverse drug events.

Background: Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable.

Objectives: To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software ("smart pump") and to suggest potential improvements in smart-pump design.

Design: Using retrospective medical-record review, we examined preventable IV-ADEs in ICUs before and after 2 hospitals replaced conventional pumps with smart pumps.

Costs of intravenous adverse drug events in academic and nonacademic intensive care units.

Background: Adverse drug events (ADEs), particularly those involving intravenous medications (IV-ADEs), are common among intensive care unit (ICU) patients and may increase hospitalization costs. Precise cost estimates have not been reported for academic ICUs, and no studies have included nonacademic ICUs.

Objectives: To estimate increases in costs and length of stay after IV-ADEs at an academic and a nonacademic hospital.

Randomized controlled trial of telephone case management in Hispanics of Mexican origin with heart failure.

Background: Disease management is effective in the general population, but it has not been tested prospectively in a sample of solely Hispanics with heart failure (HF). We tested the effectiveness of telephone case management in decreasing hospitalizations and improving health-related quality of life (HRQL) and depression in Hispanics of Mexican origin with HF.

Methods And Results: Hospitalized Hispanics with chronic HF (n = 134) were enrolled and randomized to intervention (n = 69) or usual care (n = 65).

Negotiating compliance in heart failure: remaining issues and questions.

Living with heart failure (HF) means living with a chronic illness characterized by periods of acute decompensation alternating with periods of relative stability. Improved medical care for patients with cardiovascular diseases, coupled with the aging of the populations in the developed world, has resulted in a steadily increasing prevalence of HF. Rehospitalization rates are high for this patient population.

Predictors of successful heart failure self-care maintenance in the first three months after hospitalization.

Objective: The objective of this study was to replicate a prior study of predictors of self-care in heart failure (HF).

Design: A non-experimental, correlational replication study retested a model of 7 variables: social support, symptom severity, comorbidity, education, age, gender, and income; the last variable, income, was tested in the prior study but was excluded in this study because of missing data. The model was tested at baseline and 3 months after hospitalization.

Psychometric testing of the self-care of heart failure index.

Background: Self-care is believed to improve outcomes in heart failure (HF) patients. However, research testing this assumption is hampered by difficulties in measuring self-care. The purpose of this study was to evaluate the psychometric properties of a revised instrument measuring self-care in persons with HF, the Self-Care of Heart Failure Index (SCHFI).

Is individual peer support a promising intervention for persons with heart failure?

Peer support has been used effectively in a variety of patient populations, but its effectiveness in improving outcomes in persons with chronic heart failure has not been explored. We trained 9 persons with heart failure to mentor other heart failure patients and tested the effectiveness of this approach in a randomized controlled clinical trial. A low proportion (37%) of the eligible population of hospitalized patients agreed to participate.

Changes over 6-months in health-related quality of life in a matched sample of Hispanics and non-Hispanics with heart failure.

Hispanics are a growing ethnic minority in the United States and one at significant risk for heart failure. Health-related quality of life (HRQL) is poor in individuals with heart failure, especially during and immediately following hospitalization. No prior research into the HRQL of Hispanics with heart failure was located.

Gender differences in quality of life are minimal in patients with heart failure.

Background: Prior investigators have suggested that quality of life differs in men and women with heart failure, especially in the physical functioning domain. The purpose of this study was to compare quality of life in men and women with heart failure to determine if differences exist after controlling for functional status, age, and ejection fraction.

Methods: Data from a sample of 640 men and women (50% each) matched on New York Heart Association functional classification and age were used for this secondary analysis.