Semester

Summer

Date of Graduation

2011

Document Type

Dissertation

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Susan McCrone.

Abstract

Introduction. The prevalence of heart failure (HF) has continued to increase around the globe in the past 30 years. Despite advanced technology and rigorous management protocols, patients diagnosed with HF continue to suffer heart failure symptoms. These debilitating symptoms frequently lead to anxiety, depression, decreased quality of life, and frequent hospitalizations. The aim of this study was to examine the impact of an outpatient phone intervention on 30-day hospital readmissions, anxiety, depression, and quality of life in heart failure patients.;Methods. This study used a prospective, longitudinal design to evaluate the effectiveness of a phone intervention for patients discharged with a diagnosis of heart failure. All patients were enrolled at the time of hospital discharge to an outpatient phone monitoring intervention. They received weekly phone calls to assess HF symptoms, and medical compliance. The Minnesota Living with Heart Failure Questionnaire (MLHF-Q) and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline and again after the four week intervention. Data was analyzed using a paired t test. Thirty-day heart failure readmission rates were compared to hospital readmission rates for heart failure patients prior to the intervention.;Results. A total of 33 participants were enrolled in the intervention. The sample (N=33) included females (66.7%) who were predominantly white (96.9%) with a mean age of 75.65 +/- 12.36 years. Heart failure type was mainly systolic (51.5%) with 39.3% documented as diastolic heart failure. A total of 31 (94%) individuals completed the four week phone intervention. The baseline mean MLHF-Q score was 49. The post intervention mean MLHF-Q score was 14.65 (95% CI 27.965-40.744, p<0.000). The baseline mean HADS score was 4.26. The post intervention HADS score was 3.00 (95% CI .274-2.242, p=0.014). Preprogram facility readmission rate for the primary diagnosis of heart failure was 22.3%. The admission rate for the intervention group was 12%.;Discussion/Conclusion. The results of this study demonstrate the effectiveness of a nurse-led telephone program on quality of life, anxiety, and 30 day readmissions. Further research is needed to establish the efficacy of a telephone intervention on depression, long-term effectiveness, and to identify the usefulness of this type of program for each heart failure functional class.

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