Chronic Disease Health Promotion And Maintenance For Adults Age 35 65 ✓ Solved

CHRONIC DISEASE HEALTH PROMOTION AND MAINTENANCE FOR ADULTS AGE Chronic Disease Health Promotion and Maintenance for adults age 35–65 Student’s Name Institutional Affiliation Chronic Disease Health Promotion and Maintenance for adults age 35–65 Heart failure is one of such chronic illness that requires collaborative and comprehensive care. Chronic heart failure is defined as a progressive and debilitating disease. The management of a patient with chronic disease from hearth failure demands non-pharmacologic, pharmacologic, and invasive procedures, depending on the context and the necessity of the intervention. Interventions in chronic heart failure intend to promote and restore the quality of life.

Chronic heart failure (CHF) requires evidenced-based management. The evidenced-based intervention has been associated with long-term survival in patients with heart failure, but there are unintended consequences regarding increased longevity (Alpert et al., 2017). The unwanted consequence revolves around the increasing burden of symptoms. It is not only typical symptoms like dyspnea and edema, which patients with HF suffer from, but also other symptoms that include pain, fatigue, gastrointestinal disturbances, and depression, and this symptom when untreated impacts negatively in the quality of life. The HF symptoms account for hospitalizations, emergency departments’ visitation, morbidities, and mortalities.

Chronic heart failure management is approached from two fundamental strategies, i.e., comprehensive symptom assessment and adequate knowledge about the available interventions of mitigating the symptom (Alpert et al., 2017). CHF management is addressed holistically, where it is not only about physical treatment but also must extend to include emotional, social, and spiritual interventions. Healthcare providers should strive to educate patients on symptom recognition and subtle changes. Significant involvement of the patient should be encouraged in symptom recognition, and the patient’s symptom diary can aid the patient track any changes. The older or senior patients with existing comorbidities may express declining cognitive dysfunction, which makes them fail in the interpretation of symptoms; this may require more family involvement that is combined with more clinical engagements to identify nonverbal cues associated with suffering (Alpert et al., 2017).

Various tools are designed for assessment. One example of the assessment tool is the Edmonton Symptom Assessment Scale (ESAS), which is effective and efficient: ESAS is composed of ten-question symptomatic evaluation to assess the level of distress associated with pain, nausea, fatigue, depression, anxiety, sleepiness, dyspnea, appetite, anxiety, and any other symptom on a scale of 1-10. Another example is the measurement of the severity of the disease biomarkers, e.g., B-type natriuretic peptide) and NT-proBNP (N-terminal pro-B-type natriuretic peptide), to establish the diagnosis and prognosis (Yancy et al., 2017) Pain is troublesome in CHF patients. Pain contributes to suffering, and this requires urgent improvement.

Patients with pain show lower medication adherence, worse self-care, and are more likely to get depression and anxiety, leading sleeplessness, anxiety, fear, declined cognitive functioning, hopelessness, suicidal ideation, and more hospitalization (Alpert et al.,2017). Arguably, pain is cardiac, or angina pain is controlled by both pharmacologic and revascularization approaches, but some analgesics are contraindicated in HF patients (Alpert et al., 2017). Furthermore, there are effective adjuvants in the pain control that are non-pharmacologic, and they include acupuncture, physical therapy, music, mindfulness-based stress reduction, and exercise, among others. According to Alpert et al.,(2017), non-steroidal anti-inflammatory drugs are contraindicated in a patient with HF because they increase the risk of fluid retention, gastrointestinal, bleeding, and kidney injury.

Acetaminophen and topical lidocaine preparations are promising in control of neuropathic pain, and opioids medication like Tramadol, oxycodone, hydromorphone, and fentanyl are, have shown satisfactory be safety levels and effectiveness (Alpert et al., 2017). Non-pharmacologic approaches can be implemented based on the severity of the HF, and these measures include fluid restriction, dietary sodium reduction. The common pharmacological interventions involve the use of diuretics, beta-blockers, digoxin, anticoagulants, and vasodilators. Invasive interventions can be done, which include cardiac resynchronization therapy (CRT), use of implantable cardioverter-defibrillators, coronary artery bypass grafting (revascularization procedure), ventricular restoration, valve replacement, and percutaneous coronary intervention, among others.

Dyspnea is breathlessness that causes discomfort in breathing, and this symptom explains many visitations to the emergency departments. Supplemental oxygen can remedy dyspnea but is not more superior to ambient room air at rest, but may prove beneficial during exertion. Breathlessness can resolve if it is treated suitably; non-pharmacological approaches such as oscillating fans and open windows can help address the problem of dyspnea. Depression in CHF patients must be recognized and addressed. It is challenging to diagnose depression, but the heightened suspension of depression can occur when there are worsening symptoms of fatigue, dwindling appetite, and sleep disturbances, among others.

Psychotherapy can be complemented by antidepressants like selective serotonin reuptake inhibitors (SSRIs) (Alpert et al., 2017). Gastrointestinal disturbances like nausea, anorexia, and constipation can be managed to improve the quality of life. Phenothiazines, stool softeners, osmotic laxatives, and Dronabinol, can be used to manage gastrointestinal problems (Alpert et al., 2017). The CHF patients and their families undergo stress and suffering related to disease experience. Palliative care is a potential intervention to address suffering from HF, and improve the quality of life, regardless of the prognosis.

A lot has not been learned on palliative care in the context of CHF patients, but the evidence is quite promising that palliative care through physical, emotional, and advanced care planning interventions may help in addressing unmet palliative care needs (Kavalieratos et al., 2017). Healthcare providers and patients with HF must share responsibility for the development of assessment and reporting tools of symptoms. Findings indicate that patients with severe symptoms are the most unlikely to visit clinics, and this observation may indicate a mismatch between providers and patients in urgent need of care (Alpert et al., 2017). References Alpert, C. M., Smith, M.

A., Hummel, S. L., & Hummel, E. K. (2017). Symptom burden in heart failure: assessment, impact on outcomes, and management. Heart failure reviews , 22 (1), 25-39.

Kavalieratos, D., Gelfman, L. P., Tycon, L. E., Riegel, B., Bekelman, D. B., Ikejiani, D. Z., ... & Arnold, R.

M. (2017). Palliative care in heart failure: rationale, evidence, and future priorities. Journal of the American College of Cardiology , 70 (15), . Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.

E., Colvin, M. M., ... & Hollenberg, S. M. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of the American College of Cardiology , 70 (6), .

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Introduction

Chronic diseases represent a significant burden on health care systems worldwide. Among these, chronic heart failure (CHF) is a particularly debilitating condition. Defined as a progressive disorder in which the heart is unable to pump effectively to meet the body's needs, CHF requires comprehensive care that encompasses medical, psychological, and emotional facets (Alpert et al., 2017). This paper discusses health promotion and maintenance strategies targeting adults aged 35–65 suffering from chronic diseases, with an emphasis on CHF management.

Holistic Management of Chronic Heart Failure

Management of CHF must consider the multifaceted nature of this disease. Comprehensive symptom assessment involves understanding not only the physiological aspects of heart failure but also the psychosocial impact it has on individuals. As noted by Alpert et al. (2017), CHF patients often experience a range of symptoms including dyspnea, edema, fatigue, and depression, all of which can severely compromise their quality of life.
Holistic management approaches have been supported by evidence, showing that integrating physical treatment with emotional, social, and spiritual interventions can result in improved quality of life. Empowering patients through education on symptom recognition and management can be beneficial. It is crucial for patients and healthcare providers to engage collaboratively in the management process (Alpert et al., 2017). For instance, maintaining a symptom diary can help patients identify patterns and changes, facilitating timely medical intervention.

Assessment Tools

Effective management of heart failure begins with accurate assessment which can be accomplished using validated tools. The Edmonton Symptom Assessment Scale (ESAS) is one such tool, designed to gauge symptom distress across various dimensions, including pain and anxiety (Yancy et al., 2017). Biomarkers such as B-type natriuretic peptide (BNP) also play a key role in diagnosing and evaluating the severity of CHF (Yancy et al., 2017).
Moreover, challenges exist in the cognitive and functional assessment of older adults with CHF. Cognitive decline complicates the recognition of symptoms and may necessitate the involvement of family members. Clinical engagement strategies must account for these limitations (Alpert et al., 2017).

Pain Management

Pain is a prevalent issue among CHF patients and can hinder adherence to medication and self-management practices. The relationship between unaddressed pain and comorbid conditions, including depression and anxiety, underscores the need for effective pain management strategies. Research highlights the significance of distinguishing between different types of pain associated with CHF, such as angina and neuropathic pain (Alpert et al., 2017).
Pharmacological interventions involve the careful selection of analgesics, as many common medications may be contraindicated due to their potential to exacerbate CHF symptoms. For instance, while opioids may be effective for pain management in CHF patients, alternatives such as non-pharmacological interventions (acupuncture, mindfulness practices) can also be valuable (Alpert et al., 2017).

Managing Other Symptoms

Dyspnea is another distressing symptom in CHF, often leading to emergency department visits. Strategies for dyspnea management include supplemental oxygen and environmental modifications (such as fans) to improve comfort (Alpert et al., 2017). Addressing depressive symptoms is equally essential, as untreated depression can adversely affect treatment adherence and overall well-being (Alpert et al., 2017). Medical professionals should be trained to recognize signs of depression early on.
Gastrointestinal disturbances—common in heart failure patients—further complicate the clinical picture. Management options include pharmaceuticals like osmotic laxatives for constipation and antiemetics for nausea (Alpert et al., 2017). Continuous evaluation of treatment efficacy is vital to enhance patient outcomes.

The Role of Palliative Care

Palliative care offers a crucial strategy for improving the quality of life in patients with advanced chronic diseases. While more research is needed in this area, evidence increasingly supports palliative care in CHF management, which addresses physical symptoms and emotional needs (Kavalieratos et al., 2017). A focus on advanced care planning is essential to help guide discussions about goals of care and patient preferences.

Collaborative Responsibility

Healthcare providers must assume a shared responsibility with patients for symptom assessment and management. This collaborative dynamic not only empowers patients but also fosters trust and accountability in the healthcare relationship (Alpert et al., 2017). The importance of regular follow-ups cannot be overstated; they foster adherence and allow for timely modifications to treatment strategies.

Conclusion

Chronic diseases such as heart failure require an integrative, multi-dimensional approach to health promotion and maintenance. For adults aged 35–65, addressing not only the physical aspects of CHF but also its psychological, social, and spiritual dimensions is key to enhancing the quality of life. Evidence-based strategies that promote interdisciplinary communication, empower patients, and recognize the unique needs of this demographic can lead to improved health outcomes.

References

1. Alpert, C. M., Smith, M. A., Hummel, S. L., & Hummel, E. K. (2017). Symptom burden in heart failure: assessment, impact on outcomes, and management. Heart Failure Reviews, 22(1), 25-39.
2. Kavalieratos, D., Gelfman, L. P., Tycon, L. E., Riegel, B., Bekelman, D. B., Ikejiani, D. Z., ... & Arnold, R. M. (2017). Palliative care in heart failure: rationale, evidence, and future priorities. Journal of the American College of Cardiology, 70(15).
3. Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Colvin, M. M., ... & Hollenberg, S. M. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. Journal of the American College of Cardiology, 70(6).
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