Autocuidado de pacientes com insuficiência cardíaca nos primeiros três meses após a alta hospitalar
Bibliographic record
Abstract
Introduction.The heart failure (HF) is a syndrome that attacks mainly the elderly people.The actions of self-care are fundamental for these patients, involving pharmacological and non-pharmacological measures.When there is an error in some of these actions, the patients may have a period of decompensation.Aims. 1) To analyse the evolution of self-care actions, during the first outpatient return after hospital discharge and three months after the first contact of patients that had been admitted with decompensated HF; 2) To analyse which variables are associated on the determination of self-care actions, in both moments of evaluation of the study's participants; 3) To characterise and to analyse the patients' evolution according to the presence of symptoms of anxiety and depression, cognitive impairment, sleep quality and social support on the first outpatient return after hospital discharge and on the three months following the first outpatient meeting.Method.Observational, analytical and longitudinal study realized at the cardiology ambulatories of two Ribeirão Preto's public hospitals.The data was collected through consultation of the medical records and through individual interviews with participants on the first outpatient return after hospital discharge (T0) and three months following the first return (T1).The relevant variables were evaluated by Brazilian Portuguese validated versions of the following instruments: Self-Care of Heart Failure Index (SCHFI), Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Medical Outcome Survey-Social Support (MOS-SS) and Pittsburgh Sleep Quality Index (PSQI-BR).The data was analysed by rate comparison tests (paired and non-paired t Student tests) and paired (McNemar) and non-paired (chisquare and Fisher's exact) distribution with a 0,05 significance level.Results.On the evaluation of the self-care evolution, the three subscales (Maintenance, Management and Confidence) present recoveries three months following the first outpatient return (p<0,001).The cognitive impairment, symptoms of anxiety and depression and social support obtained lower rates in T1 when compared to T0, indicating the participant's worsening after the first outpatient return.The sleep quality presented a recovery in T1 (p<0,001).We have not found any statistically significant difference when comparing the SCHFI scores to the explanatory variables.Conclusion.Self-care and sleep quality improve three months following the first outpatient return for HF decompensation.More studies should be realized to verify which are the variables that are associated to self-care recovery after hospital admission.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".