The latest research from JHUSON associate professor and cardiovascular nursing expert Cheryl R. Dennison, PhD, RN, ANP, is showcased along with that of other Hopkins cardiovascular researchers in a special Valentine's Day-themed feature package on the Johns Hopkins University website, which includes links to popular songs about the heart.
Dennison notes that knowledge is power for the one in three American adults living with cardiovascular disease--over 5.7 million of them with heart failure.
The challenge, she says, has been in assuring that people with heart and vascular diseases both understand and take the steps necessary to live with these chronic illnesses, including understanding the illness and its symptoms, proper use of medications, and appropriate changes in diet, exercise, and tobacco and alcohol use. Dennison observes, "Because self-care is a real challenge for some people with heart disease, too many wind up back in the emergency room or hospital bed. I wanted to know why and how nurses and other health professionals can help change that for the better."
Her study explores ways in which gaps in heart patient knowledge and self-care ability can be bridged through technology and enhanced health literacy and heart health education. Writing in the Journal of Cardiovascular Nursing [Adequate Health Literacy Is Associated with Higher Heart Failure Knowledge and Self-Care Confidence in Hospitalized Patients, November 2010], Dennison describes the impact of health literacy--the ability to understand and manage knowledge about an illness and its treatment--on self-care competence and confidence among people with heart failure. She found health literacy, as well as understanding of heart failure and self-care confidence, were lowest among people with the greatest need for health knowledge: older adults with heart failure and heart failure patients with lower educational attainment. Her solution? Find ways to better identify, educate and motivate these individuals.
To that end, Dennison has explored the utility of an automated telemanagement system to help congestive heart failure patients living at home collaborate with their clinical team of doctors and nurses to manage treatment and monitor progress. "Technology can't replace nurses and doctors," Dennison notes, "But, thanks to cell phones and hand-helds, this tool can boost both patient self-monitoring and heart health knowledge." [Exploring Feasibility of Home Telemanagement in African Americans with Congestive Heart Failure, Studies in Health Technology and Informatics, October, 2010]. Finally, to help clinicians ensure heart health information is well-received and heeded by patients, Dennison urges doctors and nurses to adopt a specialized approach to promoting behavior change: motivational interviewing, a collaborative, non-confrontational philosophy that encourages patient-directed, individualized positive behavior change. [Motivating our Patients to Adopt and Maintain Healthy Lifestyles, Journal of Cardiovascular Nursing, January-February 2011.]