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P: 555.123.4568 F: 555.123.4567 123 West Main Street, New York, NY 10001 www.rightcare.com |

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Presentación del tema: "P: 555.123.4568 F: 555.123.4567 123 West Main Street, New York, NY 10001 www.rightcare.com |"— Transcripción de la presentación:

1 P: F: West Main Street, New York, NY |

2 P: F: West Main Street, New York, NY |CONTENT 1. Problem description 2. Problem statement 3. Justification 4. Objetives 5. Methodology 6. Results 7. Conclusions and recommendations

3 P: F: West Main Street, New York, NY | PROBLEM STATEMENT Millions of people are affected in Europe and United States. Cause of death in these countries and some Latin American countries. RODRÍGUEZ, Leonor. Et. Al. Capítulo 24, Cuidado al paciente con Falla Cardíaca, Enfermería Cardiovascular, Editorial Distribuna, Comité Editorial, Capítulo de Enfermería, Sociedad Colombiana de Cardiología, Bogotá, Colombia, Pg ISBN: Consultado: Marzo 20 de Rate of 9.3 x 100,000 habitants. In Colombia… Ministry of Social Protection, causes 6% of hospitalizations in adults, 7% of emergency department visits.

4 P: F: West Main Street, New York, NY | SELF-CARE Patients have between low and intermediate self-care. The dont carry out all actions and indications given by health professionals. RIEGEL, Barbara. Et. al. A motivational Counseling approach to improving Heart Failure Self-Care, Journal of Cardiovascular Nursing, Vol. 21, No. 3, pg. 232 – 241, 2007, Estados Unidos. Consultado: Octubre 10 de PARADIS, Veronique. Et. al. The Efficacy of a Motivational Nursing Intervention Based on the stages of change on Self-Care in Heart Failure patients, Journal of Cardiovascular Nursing, Vol. 25, No. 2, pg. 130 – 141, Estados Unidos, Consultado: Octubre 29 de Daily practices and decisions on them, made by a person, family or group to take care of their own health. TOBON, Ofelia. El auto cuidado una habilidad para vivir. Departamento de enfermería. Universidad del Caldas. Disponible en línea: Consultado: 28 Octubre 2011.

5 P: F: West Main Street, New York, NY | PROBLEM DESCRIPTION SELF-CARE The professional nurse should encourage the patient to make changes and adjustments in his lifestyle, for better control of the disease. Motivation: the probability that a person begins and continue adhering to a determined strategy and therefore to the treatment. PORTILLO, Mónica. Intervención terapéutica desde la entrevista motivacional. La entrevista motivacional en las mujeres consumidoras de cannabis. III jornadas nacionales de patología dual y género. Clínica-UCA Hospital Universitario de la Ribera, Madrid, España, Diciembre Disponible en línea: Consultada: 23 mayo autocuidado medio, es decir, que no lleva a cabo todas las indicaciones y acciones dadas por el profesional de salud., RIEGEL, Barbara. Et. al. A motivational Counseling approach to improving Heart Failure Self-Care, Journal of Cardiovascular Nursing, Vol. 21, No. 3, pg. 232 – 241, 2007, Estados Unidos. Consultado: Octubre 10 de 2011.

6 P: F: West Main Street, New York, NY | (…) A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence FLÓREZ-ALARCÓN, Luis. Et Al. Entrevista motivacional como herramienta para el fomento de cambios en el estilo de vida de personas con enfermedad crónicas no trasmisibles. Avances en psicología latinoamericana. Julio-Diciembre. Volumen 25. Universidad del Rosario. Bogotá, Colombia Referencia a Casals. MILLER, William. ROLLNICK, Stephen. ¿Qué es la entrevista motivacional?. En: Revista de toxicomanías, Reino Unido, no. 6. Disponible en línea: 1.pdf. Consultado el 18 de Octubre de MOTIVATIONAL INTERVIEWING 1. Create patient motivation for changing 2. Strengthen the compromise for change

7 P: F: West Main Street, New York, NY | PROBLEM STATEMENT ¿What is the effectiveness of Motivational Interviewing as nursing intervention to promote self-care in patients with Heart Failure at a fourth level institution in Bogotá between January and May of 2012?

8 P: F: West Main Street, New York, NY |JUSTIFICATION Patient Empowerment, decision making and generation of new changes. Decrease hospitalizations rate and/or complications. Professional nurse New intervention: MI Improve quality of nursing care. Fourth level institution - Added – Value (plus) - Future

9 P: F: West Main Street, New York, NY |OBJECTIVES Determine whether motivational interviewing, as a nursing intervention, is effective to promote self-care in patients with heart failure at a fourth level institution in Bogota between January and May of General

10 P: F: West Main Street, New York, NY |OBJECTIVES Determine socio-demographic characteristics of the patients with HF in a fourth level institution during the period between January to May of Determine seeking help to respond rising or exacerbation of symptoms of HF before and after implementation of MI, at a fourth level institution during the period between January to May of Specific

11 P: F: West Main Street, New York, NY |OBJECTIVES Determine adaptation activities and behavior to limitations imposed by the disease before and after implementation of MI, in patients with HF at a fourth level institution during the period between January to May of Determine compliance to treatment regimen before and after implementation of MI in patients with HF at a fourth level institution between the period between January to May of Specifics Compare levels of self-care before and after implementation of MI in patients with HF at a fourth level institution during the period between January to May of 2012.

12 P: F: West Main Street, New York, NY |METHODOLOGY Design Quasi-experimental with a unique group. Independent variable: Motivational Interviewing Dependent variable: Self-care Population For this study population corresponded to 48 hospitalized patients at a fourth level institution in Bogota with HF diagnosis during the period between February and March of Sample size Statistical power 80% and risk of error 0.05 = 25 patients 4 process not culminated = 21 patients Sampling Probabilistic simple random sampling.

13 P: F: West Main Street, New York, NY | INCLUSION CRITERIA Men and woman with HF diagnosis functional class I, II and III hospitalized in a fourth level institution in Bogota. People capable of understanding, adequate mindset and alphabetized. People residing in Bogotá and had telephone service. Men and woman with HF diagnosis functional class IV, or whom can not achieve their self-care. People incapable to respond and participate in the study. EXCLUSION CRITERIA

14 P: F: West Main Street, New York, NY | Nohelia Hewitt Dean School of Psychology Victoria V. Dickson, PhD, CRNP Brookdale Leadership in Aging Fellow New York University

15 P: F: West Main Street, New York, NY |PROCEDURE 11 M.I. 22

16 P: F: West Main Street, New York, NY | INSTRUMENT European Heart Failure Self-Care Behavior Scale (EHFScBS) 6 item: therapeutic regimen compliance 4 item: seeking help to respond rising or exacerbation of symptoms 2 item: adaptation activities and behavior to limitations imposed by the disease Validated in 442 patients Cronbach Alpha of 0,81. GONZALEZ, Beatriz. Et Al. Aplicación de la escala europea de autocuidado en insuficiencia cardíaca (EHFScBS) en una unidad de insuficiencia cardíaca en España. Revista Española de Cardiología Vol. 59, N° 2. Pags: YU, Doris; et. Al. Psychometric properties of the Chinese version of the European Heart Failure Self-care Behaviour Scale, International Jpurnal of Nursing, Studies 48, Disponible en línea: Consultado: Octubre 7 de Pg

17 P: F: West Main Street, New York, NY |

18 P: F: West Main Street, New York, NY |RESULTS Figure 1. Socio-demographic characteristics of patients with Heart Failure featured by age Fuente: Test de información de características sociodemográficas en pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Figure 2. Socio-demographic characteristics of patients with Heart Failure featured by gender.

19 P: F: West Main Street, New York, NY |RESULTS Fuente: Test de información de características sociodemográficas en pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Figure 4. Socio-demographic characteristics of patients with Heart Failure featured by socioeconomic stratum Figure 3. Socio-demographic characteristics of patients with Heart Failure featured by marital status

20 P: F: West Main Street, New York, NY |RESULTS Fuente: Test de información de características sociodemográficas en pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Figure 5. Socio-demographic characteristics of patients with Heart Failure featured by support network Figure 6. Socio-demographic characteristics of patients with Heart Failure featured by level of education

21 P: F: West Main Street, New York, NY |RESULTS Fuente: Test de información de características sociodemográficas en pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Figure 7. Socio-demographic characteristics of patients with Heart Failure featured by education received prior to the intervention

22 P: F: West Main Street, New York, NY |RESULTS Table 1. Therapeutic regimen compliance results in patients with Heart Failure Fuente: Resultados Escala Europea de Autocuidado aplicada a pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Always Sometimes Every once in a while Rarely Never Always Sometimes Every once in a while Rarely Never

23 P: F: West Main Street, New York, NY |RESULTS Table 2. Ability to adjust to sickness in patients with HF. Fuente: Resultados Escala Europea de Autocuidado aplicada a pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Always Sometimes Every once in a while Rarely Never Always Sometimes Every once in a while Rarely Never

24 P: F: West Main Street, New York, NY |RESULTS Table 3. Seeking help to respond rising or exacerbation of symptoms in patients with HF Fuente: Resultados Escala Europea de Autocuidado aplicada a pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Always Sometimes Every once in a while Rarely Never Always Sometimes Every once in a while Rarely Never

25 P: F: West Main Street, New York, NY | INFERENCIAL RESULTS Fuente: Resultados Escala Europea de Autocuidado aplicada a pacientes con insuficiencia cardíaca en una institución de cuarto nivel en Bogotá, Table 5. Compared self-care levels results before and after implementation of Motivational Interviewing

26 P: F: West Main Street, New York, NY | Stating that < 0.05 is possible to reject the null hypothesis and conclude that Motivational Interviewing as a nursing intervention to promote self-care in patients with Heart Failure in a fourth level hospital, in Bogotá, is effective. The support network was considered as a protective factor when promoting self-care in patients with Heart Failure, as well as the family support to help strengthen practices.

27 P: F: West Main Street, New York, NY | Professional nurses can use MI to promote self-care in patients with this disease, because, while intrinsic motivation occurs, the person is able to generate changes in behaviors unfavorable for his/her health. Further research on MI implementation in a longer time tracking to assess the effectiveness on the intervention over time.

28 P: F: West Main Street, New York, NY |


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