Congestive Heart Failure (CHF) is one of the common health challenges in aging persons. The health condition is one of the major causes of deaths and health complications for individuals that above sixty five years. Congestive Heart Failure is not only a major cause of health complication and death in aging individuals but also contribute high number of re-admission among aging person.
Moreover, treating Congestive Heart Failure cost a fortune and is a major challenge to families with a CHF patient. Considering its significance to the health of aging persons, Health care provision for aging persons should therefore consider CHF management.
Because of increased cases of CHF and its health and cost implications, various recent research studies have focused towards coming up with better CHF management (Whalley, et a., 2002; Ross, J., et al., 2010; Goldberg, et al., 2005; Colonna, et al., 2003).
Congestive Heart Failure as an area of research is not fully exhausted despite of many research studies dedicated to it. This paper will discuss the process involved in coming up with a topic for research study, resources for information, search strategy and summary, and evaluation of sources.
The major challenge in management of Congestive Heart Failure is frequent re-admission of CHF patients. Considering health risk and treatment cost implication, re-admission of CHF patients have high implication to the patients, their families and health care providers. The cause of frequent re-admission of CHF patients have been a subject to many researchers.
Among the frequently proposed causes of re-admission, include narrow understanding of the health condition among patients and poor adherence to treatment and diet.
Other proposed causes of re-admission include poor management of other health conditions such as respiratory infection and hypertension. In addition, poor discharge and planning and poor follow up of patients are cited as possible factors that contribute to increased CHF re-admission cases (Reis, et al., 1997; Jaarsma, et al., 1998).
Most of literature addressing hospitalization of CHF patients agree that much can be done reduce re-admission cares and improve quality of life of CHF (Kornowski, Zeeli, Averbuch, et al. 1995; Smith, Fabbri, Pai, et al.,1997; Rich, Beckham, Wittenberg, et al., 1995). This study will revisit re-admission of CHF patients in relation to medication compliance, diet modification and community health programs.
The study will also explore the role of case management in mitigating re-admission. In order to address the problem, the study will seek to provide answers to the question: What are the reasons why Congestive Heart Failure cases have high number of admissions?
Congestive heart failure refers to a health condition where the heart is unable pump enough blood to other body parts especially critical body organs. CHF is a major health issue in United States as well as other parts of the world. The health conditions incapacitate patients and can lead to death (Schocken, Arrieta, Leaverton & Ross, 1992).
In United States, about three million people suffer from congestive heart failure. As the number of elderly people increase, without better management programs CHF a major health challenge in the future. Currently, treating congestive heart failure cost as much as ten thousand US dollars.
The cost is definitely very expensive to majority of people and a heavy burden to health care providers and health insurance companies. Apart from the high cost of treating congestive heart failure, the health condition has low mortality at an average of about five years.
Congestive heart failure is a major health challenge and cause of hospitalization for individuals above sixty five years. Symptoms to congestive heart failure include progressive shortness of breath for long, fluid retention in the body, weight gained within three days, loss of appetite, and swollen feet, legs and ankle before admission.
The health condition is correlated to other health issues such as diabetes (Nichols, et al., 2004; Dokainish, et al., 2004). For instance, diabetes patients are almost twice as vulnerable to CHF compared to other individuals.
A search strategy is required for a successful research study. Important to a search strategy is keywords. Key words refer to words or phrase that, when used, can help a researcher to identify the appropriate sources and information for a research study. Key word ought to capture the topic under study and direct a researcher towards most appropriate literature. There could be many sources related to a research study.
As a good researcher, one has to sort out the many sources to come up with the most relevant and appropriate sources. The key words that were used for the study were related to congestive heart failure and re-admission. Below is a list of the key words that were used to search for appropriate sources for the study.
Shortness of Breath
Congestive heart failure
Types of heart diseases
Cardiac Risk Factors
Among the search terms “Congestive heart failure” was found to be the most resourceful. Searches using the keyword provided important results related to research problem.
Resources of a research study have high contribution to quality of a study. A good resource should provide wide range of information on a research topic. In addition to wide range of information, a research resource should be reliable. For the study, two primary resources were identifies:
In order refine results from searches using keywords, modification of search terms was necessary. Modification of search terms helped in identifying specific information and sources to the research problem. Boolean operations were very helpful in modifying the search terms.
The search started by tying the word heart failure, and all the topics related to Congested Heart Failure came out. By putting the word CHF + the word specifically needed such as medication, diet, signs and symptoms, the search brought in specific articles necessary for the study. Below is modification of search terms that were most resourceful
Heart failure OR congestive heart failure
Congestive heart failure AND re-admission
Heart failure+ causes and symptoms
Congestive heart failure AND edema
Congestive heart failure AND diabetes
Congestive heart failure AND mortality
Congestive heart failure+ medication compliance
Congestive heart failure AND diet modification
The most useful word in the search made is Congestive heart failure. A very broad topic to search but with the help of the Boolean sign it narrows down to specific search.
Nichols, G., Gullion, C., Koro, C., Ephross, S. & Brown, J. (2004). The Incidence of Congestive Heart Failure in Type 2 Diabetes. Diabetes Care 27(8)
Reis, S., Holubkov, R. Edmundowicz, D., McNamara, D., Zell, K., Detre, K. & Feldman A. (1997). Treatment of patients admitted to the hospital with congestive heart failure: specialty-related disparities in practice patterns and outcomes. J Am Coll Cardiol 30(3), 733-738
Schocken, D., Arrieta, M., Leaverton, P. & Ross, E. (1992). Prevalence and mortality rate of congestive heart failure in the United States. J Am Coll Cardiol 20, 301-306
Jaarsma, T., Halfens, R., Huijer, H., Dracup, K., Gorgels, T., Van Ree, J. & Stappers, J. (1998). Effect of education and support on self-care and resource utilization in patients with heart failure. European Heart Journal 20(9), 673-682
Dokainish, H., Zoghbi, W., Lakkis, N., Ambriz, E., Rajnikant, P., Quinones, M. & Nagueh, S. (2004). Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure. Journal of the American College of Cardiology 45(8), 1223-1226
Whalley, G., Doughty, R., Gamble, G., Wright, S., Walsh, H., Muncaster, S. & Sharpe, N. (2002). Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure. Journal of the American College of Cardiology 39(11), 1787-1795
Ross, J., et al. (2010).Recent National Trends in Readmission Rates after Heart Failure Hospitalization. Circulation 122, 1645-51
Goldberg, R., Farmer, C., Spencer, F., Pezzella, S. & Meyer, T. (2005). Use of nonpharmacologic treatment approached in patients with heart failure. International Journal of Cardiology 110(3), 348-353
Colonna, P., Sorino, M., Agostino, C., Bovenzi, F., De Luca, L. Arrigo, F. & de Luca, I. (2003). Nonpharmacologic care of heart failure: counseling, dietary restriction, rehabilitation, treatment of sleep apnea, and ultrafiltration. American Journal of Cardiology 91(9), 41-50
Kornowski R, Zeeli D, Averbuch M, et al. (1995). Intensive home-care surveillance prevents hospitalization and improves morbidity rates among elderly patients with severe congestive heart failure. American Heart Journal 129, 162–6.
Smith L., Fabbri S. Pai R., et al. (1997). Symptomatic improvement and reduced hospitalization for patients attending a cardiomyopathy clinic. Clin Cardiol 20, 949–54
Rich M, Beckham V, Wittenberg C, et al. (1995). A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med 333, 1190–5
CARS Evaluation table
SourceCredibility AccuracyReasonability Support
Nichols, G., et al. (2004). The Incidence of Congestive Heart Failure in Type 2 Diabetes. Diabetes Care 27(8)The article has high credibility. The authors are scholars at University of Pittsburgh. The article is peer reviewed.Methodology used for the study seems to be reliable. The authors reviews and cite other reliable sources and provide comprehensive information. In addition, the article is relatively recent.No bias was observed in the article. The authors were objective in their study and did not side with any side.The authors provide complete list references that they used for the study. Appropriate in-text citations were provided
Schocken, D., Arrieta, M., Leaverton, P. & Ross, E. (1992). Prevalence and mortality rate of congestive heart failure in the United States. J Am Coll Cardiol 20, 301-306Article has high credibility. The article is peer reviewed and authors are scholars in the field of medicineThe article is relatively old and some of information presented could not accurate.No bias was observed in the article. The authors demonstrated objectiveness and professionalism in conducting the study.Adequate support is observed in the article. The article cites and is cited in other journal articles
Nichols, G., Gullion, C., Koro, C., Ephross, S. & Brown, J. (2004). The Incidence of Congestive Heart Failure in Type 2 Diabetes. Diabetes Care 27(8)All the authors are PHD holders and scholars in the fields of diabetes and cardiovascular health. The article is peer reviewed and therefore credibleThe study is recent and therefore information in the article is likely to be accurate. Sufficient sample size reliable research methods were used for the studyThe authors assume a balanced approach to the study. No explicit bias was observed in the article.Supportive article are cited in the article. In addition to providing reliable reference list, the authors provide contact details through which they can be contacted.
Jaarsma, T., et al. (1998). Effect of education and support on self-care and resource utilization in patients with heart failure. European Heart Journal 20(9), 673-682European Heart Journal is a reputable journal that published credible articles. In addition, the authors are seasoned researchers in the area nor cardiac healthThe article is relatively recent and uses and appropriate research methodology. However, the sample size used for the study was small to generalize the outcome.The authors were fair in the study and were not biased.The authors give credit to other authors whom they cite their articles
Dokainish, H., et al. (2004). Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure. Journal of the American College of Cardiology 45(8), 12223-1226The article is highly credible. Journal of the American college of Cardiology is reliable and the authors are credibleAccuracy of information in the article appears to be high. The article is recent and therefore information in the article is current.There is high reasonability for the article. The authors addressed the subject under study objectively without apparent bias.The article meets the criteria for support. The authors provided comprehensive background information and cite credible sources in their article
Whalley, G., et al. (2002). Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure. Journal of the American College of Cardiology 39(11), 1787-1795The article meets credibility criteria. The authors are scholars in field of cardiac health and the journal in which the article is published is reliable.The authors provide comprehensive information in the article. In addition, the article is relative recent.The article is reasonable. Comprehensive information is provided and fair method of study is appliedSufficient support is provided for the study and the study is consistent with other recent studies
Ross, J., et al. (2010).Recent National Trends in Readmission Rates after Heart Failure Hospitalization. Circulation 122, 1645-51Authors are PHD holders in the field of Cardiac health and therefore their study can be credibleThe study was conducted for a period of six years. The outcome of the study seem to accurateNo bias was observed in the articleCredible sources are cited in the article.
Goldberg, R., Farmer, C., Spencer, F., Pezzella, S. & Meyer, T. (2005). Use of nonpharmacologic treatment approached in patients with heart failure. International Journal of Cardiology 110(3), 348-353International Journal of Cardiology is a reputed journal and therefore the article appears to be credible.The article is recent and consistent with worldview and other related research studyThe authors provide comprehensive information.Credible reference list is provided