Heart failure, or heart failure, is a complex clinical syndrome characterized by impaired heart function that involves cardiac output and, consequently, an inadequate oxygen supply to meet the body's metabolic needs. This chronic disease is growing rapidly with a progressively increasing incidence rate. Considering the size of the problem, the high costs of managing patients with heart failure and the morbidity and mortality rate associated with this chronic disease, there is an increasing need for more efficient and effective management solutions. Outpatient management, integrated with counseling and follow-up nursing interventions, allows for correct management of the chronic patient. This allows for continuous monitoring of his clinical conditions and the progress of the disease, and at the same time an increase in knowledge and self-care skills on the part of those suffering from heart failure. In fact, numerous clinical studies have demonstrated the effectiveness of outpatient management in the follow-up of patients with this pathology. In this regard, this paper describes the design of the heart failure clinic carried out at the Cardiology unit of the Civitanova Marche hospital. The objective of this study is to describe the benefits of managing patients with chronic heart failure through the outpatient clinic, in which the nurse plays an important role through counseling and follow-up activities. An observational study was conducted by analyzing the data obtained from the telephone follow-up carried out by the Civitanova Marche clinic. Structured interviews were carried out consisting of four questionnaires divided into modules: self-assessment, pharmacotherapy, diet and physical activity. For each topic, the nurse assesses the patient's degree of understanding about his or her pathology and the implementation of the recommended behaviors. This analysis was conducted on a sample of 153 people with chronic heart failure taken care of by the Civitanova clinic in the period of time from April 2017 to March 2021. Based on the results of the survey, the patients demonstrate a '' high percentage of positive responses in understanding and practicing correct behavior. In addition, the outpatient follow-up of Civitanova, conducted through scheduled telephone contacts, contributed to a significant reduction in hospitalizations and access to the emergency room of patients with chronic heart failure. This study, albeit carried out on a small sample, has allowed us to demonstrate the benefits of outpatient management, in terms of patient self-management capacity, reduction of hospital admissions and improvement of the quality of life.
Lo scompenso cardiaco, o insufficienza cardiaca, è una sindrome clinica complessa caratterizzata da un’alterata funzionalità del cuore che comporta una portata cardiaca e, conseguentemente, un apporto di ossigeno inadeguati a soddisfare le esigenze metaboliche dell’organismo. Questa patologia cronica è in rapida crescita con un tasso di incidenza che aumenta progressivamente. Considerando le dimensioni del problema, i costi elevati di gestione dei pazienti con scompenso cardiaco ed il tasso di morbilità e mortalità associato a tale malattia cronica, si è avvertita sempre più l’esigenza di soluzioni gestionali più efficienti ed efficaci. La gestione ambulatoriale, integrata con interventi infermieristici di counselling e di follow-up, permette una corretta gestione del paziente cronico. Questo consente un monitoraggio continuo delle sue condizioni cliniche e dell’andamento della patologia, ed allo stesso tempo un aumento della conoscenza e della capacità di auto-cura da parte dei soggetti affetti da insufficienza cardiaca. Infatti, numerosi studi clinici hanno dimostrato l’efficacia della gestione ambulatoriale nel follow-up del paziente con tale patologia. A tal proposito, questo elaborato descrive il progetto dell’ambulatorio dello scompenso cardiaco realizzato presso l’unità operativa di Cardiologia dell’ospedale di Civitanova Marche. L’obiettivo di questo studio è di descrivere i benefici apportati dalla gestione dei soggetti con insufficienza cardiaca cronica attraverso l’ambulatorio, in cui l’infermiere svolge un ruolo rilevante attraverso le attività di counselling e di follow-up. E’ stato condotto uno studio osservazionale analizzando i dati ricavati dal follow-up telefonico effettuato dall’ambulatorio di Civitanova Marche. Sono state eseguite delle interviste strutturate composte da quattro questionari divisi in moduli: autovalutazione, farmacoterapia, dieta e attività fisica. Per ogni argomento, l’infermiere valuta il grado di comprensione del paziente circa la sua patologia e l’attuazione dei comportamenti raccomandati. Questa analisi è stata condotta su un campione di 153 persone con scompenso cardiaco cronico prese in carico dall’ambulatorio di Civitanova nel periodo di tempo compreso da Aprile del 2017 a Marzo del 2021. Sulla base dei risultati dell’indagine condotta, i pazienti dimostrano un’alta percentuale di risposte positive nella comprensione e nella pratica dei comportamenti corretti. Inoltre, il follow-up ambulatoriale di Civitanova, condotto tramite contatti telefonici programmati, ha contribuito a determinare una significativa riduzione dei ricoveri e degli accessi in pronto soccorso dei pazienti con scompenso cardiaco cronico. Questo studio, seppur effettuato su un campione ridotto, ha permesso di dimostrare i benefici apportati dalla gestione ambulatoriale, in termini di capacità di autogestione del paziente, di riduzione degli accessi ospedalieri e di miglioramento della qualità di vita.
La gestione del paziente cronico con scompenso cardiaco: il ruolo dell'infermiere nel follow-up ambulatoriale
CAMPETELLI, GIORGIA
2020/2021
Abstract
Heart failure, or heart failure, is a complex clinical syndrome characterized by impaired heart function that involves cardiac output and, consequently, an inadequate oxygen supply to meet the body's metabolic needs. This chronic disease is growing rapidly with a progressively increasing incidence rate. Considering the size of the problem, the high costs of managing patients with heart failure and the morbidity and mortality rate associated with this chronic disease, there is an increasing need for more efficient and effective management solutions. Outpatient management, integrated with counseling and follow-up nursing interventions, allows for correct management of the chronic patient. This allows for continuous monitoring of his clinical conditions and the progress of the disease, and at the same time an increase in knowledge and self-care skills on the part of those suffering from heart failure. In fact, numerous clinical studies have demonstrated the effectiveness of outpatient management in the follow-up of patients with this pathology. In this regard, this paper describes the design of the heart failure clinic carried out at the Cardiology unit of the Civitanova Marche hospital. The objective of this study is to describe the benefits of managing patients with chronic heart failure through the outpatient clinic, in which the nurse plays an important role through counseling and follow-up activities. An observational study was conducted by analyzing the data obtained from the telephone follow-up carried out by the Civitanova Marche clinic. Structured interviews were carried out consisting of four questionnaires divided into modules: self-assessment, pharmacotherapy, diet and physical activity. For each topic, the nurse assesses the patient's degree of understanding about his or her pathology and the implementation of the recommended behaviors. This analysis was conducted on a sample of 153 people with chronic heart failure taken care of by the Civitanova clinic in the period of time from April 2017 to March 2021. Based on the results of the survey, the patients demonstrate a '' high percentage of positive responses in understanding and practicing correct behavior. In addition, the outpatient follow-up of Civitanova, conducted through scheduled telephone contacts, contributed to a significant reduction in hospitalizations and access to the emergency room of patients with chronic heart failure. This study, albeit carried out on a small sample, has allowed us to demonstrate the benefits of outpatient management, in terms of patient self-management capacity, reduction of hospital admissions and improvement of the quality of life.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/1165