BackgroundDifficulty in adherence to treatment and self-care behaviours is a leading cause of preventable readmission in people with chronic heart failure (CHF). Although there is evidence of benefits of health coaching for the management of this situation, few interventions have been tested in the hospital setting.AimTo evaluate a coaching programme (H-Coaching) designed to develop nursing capacity in health coaching for chronic heart failure inpatients.MethodsA quasi-experimental pre-post study including all nurses in a single centre cardiology ward (N = 19). The intervention consisted of two training packages: (1) five theoretical-practical sessions on health-coaching competencies, emotional intelligence, communication and support of chronic heart failure patients in their illness in the hospital setting; and (2) training sessions seven months after the first training package to reinforce the theoretical and practical knowledge. On four occasions, the Competence Instrument of Health Education for the Nursing professional was used to measure nurses' knowledge, skills and attitudes in health coaching for chronic heart failure patients.ResultsThe difference between the preintervention and postintervention scores were statistically significant for knowledge [mean difference = 1.00 (95% CI -1.45 to -0.51; p = 0.000)], skills in general [mean difference = 0.50 (95% CI -1.41 to -0.21; p = 0.015)] and personal/social skills [mean difference = 1.00 (95% CI -1.10 to -0.01; p = 0.048)]. While attitudinal and affective domains did not differ, there were differences in knowledge and skills.ConclusionThe H-Coaching programme proved to be effective for building nursing capacity in health coaching CHF inpatients. Similar programmes designed to improve knowledge in verbal and nonverbal communication techniques, and skills for coaching interventions adapted to meet the needs of individual patients, should be tested in future interventional experimental studies.Clinical Trial Registration NumberNCT05300880Impact statementTo our knowledge, this is the first nursing training intervention in health coaching for chronic heart failure the inpatient setting. This study has demonstrate improvements in both the knowledge and personal and social skills of cardiology nurses with regard to the development of health coaching in a hospital setting. Given the study design, further research is warranted.Plain Language SummaryMany patients with chronic heart failure have problems in adhering to the treatment and self-care behaviours and this is one of the main causes of preventable readmission. To promote self-care, patients need to be empowered to integrate these habits into their daily lives and we should implement innovative strategies to achieve this. Health coaching is an ideal alternative to this but very few nurses in the hospital cardiology setting are experienced in health coaching. Our study has shown preliminary results demonstrating that a structured theoretical and practical training programme for nurses can improve nurses' knowledge and skills in health coaching for inpatient patients with chronic heart failure. This study provides an opportunity for future research to demonstrate whether nurses with this training have a positive impact on the health outcomes of chronic heart failure patients and, more specifically, on their levels of self-care and empowerment.

Background: Chronic heart failure (CHF) is a syndrome that greatly impacts people's lives. Due to the poor prognosis of CHF, together with the frequent exacerbations of symptoms, death is a topic that is very present in the lives of patients with CHF. Objective: To explore thoughts about death experienced by patients with chronic heart failure in their daily lives. Methods: A hermeneutic phenomenological study was carried out. Conversational interviews were conducted with 20 outpatients with chronic heart failure. Analysis of the responses was based on the method proposed by van Manen. Results: From the analysis, four main themes emerged: (1) Feeling afraid of the possibility of dying; (2) Acceptance of the possibility of death; (3) Desiring death for relief from suffering; and (4) Striving to continue living to enjoy family. Conclusions: This study presents, as a novel finding, that people with CHF experience the possibility of near death on a daily basis. This experience, which they must encounter on their own, makes them afraid. In addition, some of them, in view of the discomfort they are living, wish to die, with some even considering committing suicide. (C) 2021 The Authors. Published by Elsevier Inc.

Currently, the dying process in Spain is moving to the home environment where responsibility for care falls largely on the family, thereby challenging and testing the stability of the family. Previous research has focused on the impact of illness on the primary caregiver; therefore, a knowledge gap exists. This study aimed to understand families' unitary experiences of providing home care to terminally ill family member. Using the "Model of Interpersonal Relationship Between the Nurse and the Person/Family Cared For," narrative research included family and individual interviews with nine families (9 groups/23 individuals). Thematic narrative analysis was used to interpret the interviews. The results highlight the impact of illness on family well-being as a whole. Family members often felt abandoned while caring for an ill family member and wished to be cared for themselves. However, their immediate community and the nurses caring for their ill family member neglected them. A paradigm shift is required by society and in home care at the end of life to better support the family.

Fundamento. Conocer el nivel de empoderamiento de las personas con insuficiencia cardiaca crónica hospitalizadas es crucial para identificar a las personas con un nivel de empoderamiento más bajo y fundamentar el diseño de estrategias efectivas para mejorar su control sobre las decisiones y acciones que afectan a su salud y bienestar. La falta de estudio de este fenómeno en esta población y contexto, sugiere que estos pacientes no están siendo atendidos adecuadamente. Material y métodos. Estudio descriptivo, prospectivo. Se utilizó el Cuestionario de empoderamiento del paciente con enfermedad crónica, traducido y validado al español, que consta de 47 ítems, agrupados en tres dimensiones: Actitud positiva y sentido del control, Toma de decisiones compartida e informada, y Búsqueda de información y compartir entre iguales. Fue distribuido para su cumplimentación en las 24 horas previas al alta hospitalaria. Resultados. Se recogieron 25 cuestionarios (81%). La puntuación global media de empoderamiento fue de 165,92 ± 20,9. La dimensión Actitud positiva y sentido de control fue la peor puntuada, con una media de 3,4 ± 0,5. Se encontró una relación inversa y débil entre el nivel de empoderamiento y la edad (rho¿=¿-0,240; p¿=¿0,000) y una relación débil y positiva con la supervivencia a los 10 años (rho¿=¿0,316; p¿=¿0,01). Conclusión. El nivel de empoderamiento de los pacientes de este estudio fue medio-alto. Las estrategias para abordar la atención de esta población deberían centrarse en trabajar su actitud respecto a la enfermedad y percepción de control de la situación e individualizarse conforme a la edad.

The complicated situation experienced by chronic heart failure (CHF) patients affects their entire well-being but clinical practice continues to fail to adequately respond to their demands. The aim of this study was to understand the meaning of living with CHF from the patient¿s perspective. A hermeneutic phenomenological study was conducted according to Van Manen's phenomenology of practice method. Individual conversational interviews were held with 20 outpatients with CHF. Six main themes emerged from the analysis: (1) Living with CHF involves a profound change in the person; (2) The person living with CHF has to accept their situation; (3) The person with CHF needs to feel that their life is normal and demonstrate it to others; (4) The person with CHF needs to have hope; (5) Having CHF makes the person continuously aware of the possibility of dying; (6) The person with CHF feels that it negatively influences their close environment.

Aim To explore the perception of normality in life experienced by patients with chronic heart failure. Design A hermeneutic phenomenological study was conducted. Methods Individual conversational interviews were held with 20 outpatients with chronic heart failure between March 2014-July 2015. Van Manen's phenomenology of practice method was used for data analysis. Results From the analysis, four main themes emerged: (a) Accepting my new situation; (b) Experiencing satisfaction with life; (c) Continuing with my family, social and work roles; and (d) Hiding my illness from others. Conclusions The present study makes a novel contribution to understanding the importance of the perception of normality in the lives of patients with chronic heart failure. It was found that patients need to incorporate this health experience into their lives and reach a 'new normal', thus achieving well-being. Several factors were identified that can help promote this perception in their lives; therefore, nursing interventions should be designed to help develop scenarios encouraging this normalization process. Impact Although the implications of having a sense of normality or experiencing 'normalization' of the illness process in life have been studied in other chronic patient populations, no studies to date have examined how patients with chronic heart failure experience this phenomenon in their lives. For the first time, the results of this research prove that the perception of normality is a key aspect in the experience of living with chronic heart failure.

Es preciso desarrollar entornos de la práctica que permitan realizar un trabajo de enfermería acorde a sus objetivos y capacitación, y a las necesidades de salud de las personas/familias. Las organizaciones están desarrollando modelos de práctica profesional de enfermería (MPPE), para empoderar a sus enfermeras y mejorar la calidad de sus intervenciones. Se presenta el MPPE de la Clínica Universidad de Navarra. Su estructura y valores están basados en el Modelo de relación interpersonal entre la enfermera y la persona/familia cuidada, obtenido de la investigación. Además, se han identificado y definido las características del entorno de la práctica profesional enfermera. La implicación más importante de su definición y desarrollo tiene que ser la mejora de la práctica de enfermería y de la relación que las enfermeras establecen con la persona/familia. Este hecho está asociado con una satisfacción de las enfermeras y de las personas/familia y de los resultados obtenidos.

Although the concept of Transforming care' is promising for improving health care, there is no consensus in the field as to its definition. The aim of this concept analysis is to develop a deeper understanding of the term Transforming care' within the nursing discipline, in order to facilitate its comprehension, implementation, and evaluation. We performed a comprehensive literature review on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Web of Science, Wiley-Blackwell, ScienceDirect, and SpringerLink and used Walker and Avant's approach to analyse the concept. From the 20 studies selected for this analysis, 3 main attributes of Transforming care' were identified: patient-centredness, evidence-based change, and transformational leadership driven. We suggest an operational definition to facilitate the implementation of the concept in practice. Furthermore, we propose that implementation is guided by the following key ideas: (1) fostering a culture of continuous improvement; (2) encouraging bottom-up initiatives; (3) promoting patient-centred care; and (4) using transformational leadership. Lastly, the evaluation of Transforming care' initiatives should assess care processes and professionals' and patients' outcomes.

The aim of the study was to understand the experience of people living with advanced-stage cancer through literature. The search included The Cochrane Library, PubMed, PsycInfo, CINAHL and Cuiden. Thirteen studies were included. A qualitative meta-synthesis was conducted. One thread emerged from the thematic synthesis: the desire to live as normally as possible, despite being aware of the proximity of death. Three themes also emerged: "a process that is unique" with its four sub-themes; "support network" and "health context," each of them having two sub-themes. This study concludes that living with advanced-stage cancer is a unique and complex process which has both positive and negative aspects. The review provides a comprehensive view of the experience, which considers the importance of the support network and the health context in which the person lives. In this study, "normalcy" is the adjustment to the new reality and living as closely as possible to the way one lived before the disease, while developing a new relationship with being finite and death. A better understanding of the experience of living with advanced-stage cancer will help health professionals to identify the needs of the patients in order to plan individual, high-quality care.

AIMS AND OBJECTIVES: To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions. BACKGROUND: Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life. DESIGN: Qualitative meta-synthesis. METHODS: A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies. RESULTS: Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage. CONCLUSIONS: Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to underst [...]

Introduction. The new university demands require redefining the management model of nursing research in order to consolidate its quality and socio-health impact. Aim. To present the strategies used in the implementation of a management model for the development of nursing research at the University of Navarra (UN). Methodology. The four phases of Marchette (the simulation, the individualistic, the unified and the balanced phases) are the framework to present the management model implemented by the UN to foster research in Nursing. Results. The following strategies are described: organizing conferences and meetings on research; research investment in teacher training; approval of the research areas as organizational structures for the development of nursing knowledge; creation of the Chair Maria Egea for research; implementation of the Research Strategic Plan 2013-2018; approval of the Doctoral Program in Nursing Science. Conclusions. There is a need to adopt and adapt new management structures that encourage disciplinary knowledge, the development of competitive research teams, interdisciplinary research, teamwork, and training of new researchers. Also, these structures must respond to new health and social demands, and promote clinical nursing practice of excellence.