Journal of Cardiac Failure
Volume 12, Issue 2 , Pages 149.e1-149.e11, March 2006

Nonpharmacologic Care by Heart Failure Experts

  • Barbara Riegel, DNSc, RN, CS, FAAN

      Affiliations

    • From the School of Nursing, Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania
    • Corresponding Author InformationReprint requests: Dr. Barbara Riegel, School of Nursing, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA 19104-6096.
    • ,
  • Debra K. Moser, DNSc, RN, FAAN

      Affiliations

    • College of Nursing, University of Kentucky, Lexington, Kentucky
    • ,
  • Mary Powell, DNSc, RN, CS

      Affiliations

    • Center for Health Outcomes Research and Policy, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
    • ,
  • Thomas S. Rector, PharmD, PhD

      Affiliations

    • Center for Chronic Disease Outcomes Research, Minneapolis Veterans Administration Medical Center, Minneapolis, Minneapolis
    • ,
  • Edward P. Havranek, MD

      Affiliations

    • Denver Health Medical Center, University of Colorado, Denver, Colorado

Received 31 May 2005; received in revised form 4 October 2005; accepted 20 October 2005.

Philadelphia, Pennsylvania; Lexington, Kentucky; Minneapolis, Minnesota; Denver, Colorado

Abstract 

Background

Nonpharmacologic clinical management practices have not been studied widely in heart failure (HF). The purpose of this survey was to describe the practices of self-identified experts in HF to identify: topics with uniformity of practice (≥75% agreement) and topics with variability in practice (no uniformity and 2 or more choices endorsed by ≥10% of respondents).

Methods and Results

An online survey of members of the Heart Failure Society of America (HFSA) actively engaged in clinical practice was conducted in Fall 2004. A total of 347 of the 1420 HFSA members in clinical practice (24.4%) responded to the survey. Of these, 321 completed the survey and 290 (90.3%) identified themselves as experts in HF. Areas in which there appears to be variability in practice include advising patients about: (1) sodium-restricted diet; (2) alcohol; (3) sexual activity; (4) increased swelling or weight gain, including use of a flexible diuretic regimen; and (5) palliative care. Providers vary in their treatment of risk factors and comorbid illnesses, the attention given to subtle losses of weight over time, beliefs about treatment adherence and ways to improve it, and opinions about the most important areas for patient education, and beliefs about health literacy.

Conclusion

Research on which to base advice for HF patients is greatly needed.

Key Words: Clinical practice, low health literacy, palliative care, self-care

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 The opinions expressed in this article do not necessarily represent the opinion of the Heart Failure Society of America (HFSA). The authors gratefully acknowledge the willingness of the HFSA to distribute this survey to members, the survey content reviews provided by the HFSA Nursing Committee, and the support of the HFSA Care Standards Committee.

PII: S1071-9164(05)01327-8

doi:10.1016/j.cardfail.2005.10.004

Journal of Cardiac Failure
Volume 12, Issue 2 , Pages 149.e1-149.e11, March 2006

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