© 2003 European Society of Cardiology
Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards
a Center for Health Services and Nursing Research Catholic University of Leuven, Kapucijnenvoer 35/4, B-3000 Leuven, Belgium
b Institute of Nursing Science University of Basel, Bernoullistrasse 28, CH-4056 Basel, Switzerland
c Department of Cardiology University Hospitals of Leuven, Herestraat 49, B-3000 Leuven, Belgium
d Department of Geriatrics University Hospitals of Leuven, Herestraat 49, B-3000 Leuven, Belgium
* Corresponding author. Tel.: +32-16-344251; fax: +32-16-344240 E-mail address: johan.vanhaecke{at}uz.kuleuven.ac.be
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Abstract |
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Background: Heart failure represents a growing epidemic, primarily in the elderly. Development and implementation of management programs designed for use in daily clinical practice remains a major challenge.
Aims: This study aimed at profiling a hospitalized heart failure population in view of medical, behavioral, educational, psychosocial and health resources utilization parameters stratified by admission to cardiology and geriatric wards.
Methods and results: Using a descriptive comparative design, 109 European heart failure patients admitted to cardiology (42%) and geriatric wards (58%) were included. Significant differences (all P<0.0001) were identified between the two groups. Patients admitted to cardiology had a mean age of 68.5, 33% were women, and the mean ejection fraction was 38%. Patients admitted to geriatrics had a mean age of 85, 68% were women, and the mean ejection fraction was 56%. Sixty-six percent were admitted for cardiac reasons. Medical, educational, behavioral, psychosocial and health resources utilization data were retrieved from medical files as well as by patient and family interviews. Results showed significant differences between groups. Patients admitted to geriatric wards received significantly less ACE inhibition and β-blockers. Moreover, these patients were significantly less knowledgeable, showed poorer self-management, poorer hearing, more cognitive impairment, a higher degree of depressive symptomatology, more problems with ADL and IADL, and used significantly more home health care services compared to patients admitted to cardiology wards.
Conclusion: The characteristics of the heart failure population at large are quite different from those of populations included in large-scale therapeutic trials. Findings from this study provide options for tailored management strategies for both profiled subgroups.
Key Words: Heart failure • Elderly • Compliance • Patient education • Psychosocial
Received December 17, 2001; Revised October 1, 2002; Accepted December 12, 2002
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