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Self-Care Monitoring of Heart Failure Symptoms and Lung Impedance at Home Following Hospital Discharge: Longitudinal Study
Oslo Univ Hosp, Norway; Univ Oslo, Norway.
Vilnius Univ, Lithuania.
Vilnius Univ, Lithuania.
Oslo Univ Hosp, Norway.
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2020 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 22, no 1, article id e15445Article in journal (Refereed) Published
Abstract [en]

Background: Self-care is key to the daily management of chronic heart failure (HF). After discharge from hospital, patients may struggle to recognize and respond to worsening HF symptoms. Failure to monitor and respond to HF symptoms may lead to unnecessary hospitalizations. Objective: This study aimed to (1) determine the feasibility of lung impedance measurements and a symptom diary to monitor HF symptoms daily at home for 30 days following hospital discharge and (2) determine daily changes in HF symptoms of pulmonary edema, lung impedance measurements, and if self-care behavior improves over time when patients use these self-care monitoring tools. Methods: This study used a prospective longitudinal design including patients from cardiology wards in 2 university hospitals-one in Norway and one in Lithuania. Data on HF symptoms and pulmonary edema were collected from 10 participants (mean age 64.5 years; 90% (9/10) male) with severe HF (New York Heart Association classes III and IV) who were discharged home after being hospitalized for an HF condition. HF symptoms were self-reported using the Memorial Symptom Assessment Scale for Heart Failure. Pulmonary edema was measured by participants using a noninvasive lung impedance monitor, the Cardio Set Edema Guard Monitor. Informal caregivers aided the participants with the noninvasive measurements. Results: The prevalence and burden of shortness of breath varied from participants experiencing them daily to never, whereas lung impedance measurements varied for individual participants and the group participants, as a whole. Self-care behavior score improved significantly (P=.007) from a median of 56 (IQR range 22-75) at discharge to a median of 81 (IQR range 72-98) 30 days later. Conclusions: Noninvasive measurement of lung impedance daily and the use of a symptom diary were feasible at home for 30 days in HF patients. Self-care behavior significantly improved after 30 days of using a symptom diary and measuring lung impedance at home. Further research is needed to determine if daily self-care monitoring of HF signs and symptoms, combined with daily lung impedance measurements, may reduce hospital readmissions.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC , 2020. Vol. 22, no 1, article id e15445
Keywords [en]
heart failure; telemedicine; lung impedance; diary; self-care; prospective study
National Category
Other Medical Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:liu:diva-163222DOI: 10.2196/15445ISI: 000506042900001PubMedID: 31909717OAI: oai:DiVA.org:liu-163222DiVA, id: diva2:1390993
Note

Funding Agencies|Nordic funding organization, NordForsk; Nordic Programme on Health and Welfare [76015]

Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-02-26

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Jaarsma, TinyStrömberg, Anna
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDivision of Nursing ScienceDepartment of Cardiology in Linköping
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