Abstract

LOPEZ, Ervin Ambota; RAYGOZA, Nicolas Padilla  and  CALVO, Neidys Zapata. Chronic heart failure public health problem and health management in general hospital, Nicaragua. Vive Rev. Salud [online]. 2023, vol.6, n.18, pp.880-894.  Epub Sep 25, 2023. ISSN 2664-3243.  https://doi.org/10.33996/revistavive.v6i18.271.

The health care system in Nicaragua is based on the Chronic Non-Communicable Diseases Program, which shows clinical benefit in high-risk individuals, but in the case of patients with severe heart failure (CHF), hospital admissions, hospital readmissions and mortality are not reduced. Objective. To propose a comprehensive care management model for CHF patients in a general hospital in Nicaragua. Materials and methods. This was a prospective observational study, the sample consisted of 289 patients with CHF, selected in a simple randomized probabilistic manner; they agreed to participate with their consent. The management proposal consisted of evaluating during one year demographic and clinical descriptors, quality indicators, primary predictors of quality of life, and educational efficiency. The European Self-Care Scale (ESCS) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) were used for data collection. Results. The total sum of baseline EEAC was 49.1 and control 19.1 points, representing low self-care in patients. The overall sum of the baseline KCCQ was 86.84 and the control 30.84 points, representing statistically significant results, at 5% Wilcoxon test, for all dimensions of the questionnaire associated with quality of life. Conclusions. Health management in patients with CHF, based on integrated care, hospital and primary care, with follow-up through home visits, education-self-care, reduces admissions, readmissions and visits to the emergency department during the first year of diagnosis with outpatient follow-up for comorbidities.

Keywords : Heart Failure; Self Care, Quality of Life; Comorbidity.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )