Nurse evaluation of patients in a new multidisciplinary Heart Failure Unit in Spain

To know how compliant patients are, how much they know about their disease and treatment, and how their level of self-care is.

We performed a short nurse questionnaire during the first visit to a new Heart Failure Unit.

Three hundred and twenty-four patients have been evaluated, with a mean age of 65.4 years. Ninety-eight patients (30%) knew and understood the performance of the heart and 85 (29%) understood the disease. Two-hundred and nineteen (67%) knew more than three signs of worsening symptoms. One-hundred and five (32%) knew all the names of the medication they were taking and 74 (23%) knew the action of these medications. Two-hundred and ninety-four (91%) said they were taking all the medication prescribed and 229 (71%) carried on always their written prescription. Sixty-two percent of patients controlled weight only at the medical visit and only 14% controlled weight more than once a week. Fifty-nine (18%) controlled blood pressure more than once a week, while 45% controlled it only at the medical visit. Only 33% of patients were said always to follow sodium restricted diet. The great majority (93%) never smoked and only very rarely took alcohol (83%). While only 18 (6%) performed some kind of physical exercise, the majority (83%) did walking and daily living activities. The 85% of patients with ischemic heart disease knew how to use sublingual nitro-glycerine. When subgroups were analysed, we found significant differences by age, gender and previous specialist management. Younger patients, men and patients referred from the Cardiology outpatient clinic showed a higher level of knowledge and understanding of several aspects of disease and treatment, and performed more physical activities, compared to older patients, women and patients referred from other departments. On the contrary, older patients showed better adherence with sodium restriction, and, as women, better smoking and drinking habits.

There is a lot of work to do in nurse-guided education of patients with heart failure, although treatment compliance, use of nitro-glycerine and abstinence of smoking and alcohol intake seem to be quite assumed by the majority of our patients. Significant differences in knowledge and behaviour were evident between younger and older patients, between men and women, and relating to previous specialist management. In spite of that, we found no differences in treatment compliance.