Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Cognitive influences on self-care decision making in persons with heart failure.

Authors
Dickson-VV; Tkacs-N; Riegel-B
Source
Am Heart J 2007 Sep; 154(3):424-431
NIOSHTIC No.
20044951
Abstract
Background: Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. Conclusions: There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.
Keywords
Humans; Men; Women; Heart; Cardiac-function; Cardiopulmonary-function; Cardiopulmonary-system; Cardiopulmonary-system-disorders; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Education; Behavior; Attitude; Diseases; Psychology; Psychological-reactions; Psychological-effects; Neurological-system; Neurological-reactions
Contact
Victoria V. Dickson, PhD, MSN, CRNP, School of Nursing, 420 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104-6096
CODEN
AHJOA2
Publication Date
20070901
Document Type
Journal Article
Email Address
vdickson@nursing.upenn.edu
Funding Type
Grant
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T01-OH-008417
Issue of Publication
3
ISSN
0002-8703
Source Name
American Heart Journal
State
PA
Performing Organization
University of Pennsylvania
TOP