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

Details

• Personal Author:
  Dickson VV ; Riegel B ; Tkacs N ; Dickson VV ; Riegel B ; Tkacs N
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Behavior Cardiovascular Diseases Cardiovascular System Education Men Mental Health Nervous System Occupational Health Respiratory System Respiratory Tract Diseases Safety Women

  More +
• Keywords:
  Attitude Cardiac-function Cardiopulmonary-function Cardiopulmonary-system Cardiopulmonary-system-disorders Cardiovascular-disease Cardiovascular-function Cardiovascular-system Cardiovascular-system-disease Cardiovascular-system-disorders Diseases Heart Humans Neurological-reactions Neurological-system Psychological-effects Psychological-reactions Psychology

  More +
• ISSN:
  0002-8703
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  424-431
• Volume:
  154
• Issue:
  3
• NIOSHTIC Number:
  nn:20044951
• Citation:
  Am Heart J 2007 Sep; 154(3):424-431
• Contact Point Address:
  Victoria V. Dickson, PhD, MSN, CRNP, School of Nursing, 420 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104-6096
• Email:
  vdickson@nursing.upenn.edu
• Federal Fiscal Year:
  2007
• Performing Organization:
  University of Pennsylvania
• Peer Reviewed:
  True
• Start Date:
  20020701
• Source Full Name:
  American Heart Journal
• End Date:
  20120630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2c4c2fa011e95aaad1b555695b9d5716ab0fd9c42f0fb15adc04249513f66239911e112d4dbb37f29c93207354655415ad9dc5e9932e6d8bfcf99dd599b0edd9
• Download URL:
  https://stacks.cdc.gov/view/cdc/200531/cdc_200531_DS1.pdf
• File Type:
  [PDF - 241.46 KB ]