NR 716 Week 4 Translation Science and Synthesis

NR 716 Week 4 Translation Science and Synthesis

Student Name

Chamberlain University

NR-716: Analytic Methods

Prof. Name

Date

Evidence Synthesis: Heart Failure

Heart failure (HF) is a chronic and progressive disorder characterized by the heart’s reduced ability to pump sufficient blood to meet the body’s metabolic demands. This impaired cardiac output leads to significant challenges in long-term disease management (Piña et al., 2021; Centers for Disease Control and Prevention [CDC], 2019). Congestive heart failure (CHF), a common form of HF, is strongly associated with modifiable lifestyle factors such as smoking, high sodium and cholesterol intake, excessive alcohol consumption, and physical inactivity (CDC, 2023; Ding et al., 2020; Mohammadi et al., 2021; Pereira Sousa et al., 2021). Furthermore, comorbidities including hypertension, diabetes, obesity, and coronary artery disease substantially increase the risk of developing HF (CDC, 2023).

Preventive measures are crucial for reducing both morbidity and mortality. Early detection of cardiovascular complications enables prompt intervention and treatment (World Health Organization [WHO], 2021). Additionally, strong social and clinical support systems are essential for lowering psychological stress, improving treatment adherence, and enhancing quality of life (Singh et al., 2021). This evidence synthesis examines HF outcomes at national and state levels, reviews both research and non-research evidence, and highlights the importance of multimedia education, teach-back techniques, and reflective learning in alleviating anxiety, decreasing hospital readmissions, and improving patient self-management.

Analysis

CHF is a major global contributor to morbidity and mortality. Effective management depends on patients’ ability to recognize symptoms, adhere to medication regimens, make lifestyle changes such as diet modification and physical activity, and engage in daily self-monitoring practices like weight checks (Mohammadi et al., 2021; Ding et al., 2020). Although cardiac function continues, insufficient blood flow limits oxygen delivery to vital organs, which can lead to frequent hospitalizations if self-care practices are inadequate.

Patient education is central to HF management as it empowers patients to manage their condition effectively and reduces hospital readmissions (Pereira Sousa et al., 2021). Epidemiological data indicate that approximately 6.7 million U.S. adults aged 20 and above are living with HF, a number projected to rise to 8.5 million by 2030 (CDC, 2023). Globally, the annual incidence ranges from 1–9 per 1,000 individuals, with higher prevalence among those older than 55 years (Groenewegen et al., 2020).

Racial and Geographic Disparities

What are the disparities in heart failure outcomes among different populations?

Disparities in HF-related mortality reveal significant inequities in cardiovascular health across racial and geographic groups. In 2020, African Americans experienced the highest HF mortality rate at 675.4 per 100,000, compared to 154.8 per 100,000 among Hispanics (CDC, 2020). National data further indicated that African Americans had nearly twice the mortality rate of Hispanic individuals (Mujib et al., 2011). Geographically, southeastern states such as Alabama and Mississippi exhibited the greatest burden of HF-related deaths (CDC, 2020).

Economic Burden

How does heart failure affect healthcare costs?

Heart failure places a heavy financial burden on both patients and healthcare systems. The average annual healthcare expenditure per HF patient in the United States is approximately $30,000 (Heidenreich et al., 2022). These expenses are compounded by frequent hospital readmissions. Long-term cost reduction requires sustainable approaches such as continuous patient education, consistent follow-up, and coordinated care models to mitigate both clinical and financial challenges.

Evidence Synthesis

A review of three randomized controlled trials (RCTs) identified common challenges in HF care, such as poor self-management and limited provider support. However, interventions including telemonitoring, patient-centered education, symptom recognition training, and teach-back techniques demonstrated substantial benefits (Ding et al., 2020; Mohammadi et al., 2021; Pereira Sousa et al., 2021). Reflective learning methods were particularly effective in improving disease understanding, enhancing adherence to treatment, and reducing readmission rates.

Comparative Summary of the Three Studies

Study	Design	Key Intervention	Follow-Up Period	Key Findings
Mohammadi et al. (2021)	RCT	Multimedia education + teach-back	8 weeks	Improved quality of life, reduced cardiac anxiety, and decreased hospital readmissions
Pereira Sousa et al. (2021)	RCT	Symptom recognition + self-care training	10 weeks	Enhanced patient adherence and self-care awareness
Ding et al. (2020)	RCT	Telemonitoring + comprehensive care program	12 weeks	Increased compliance rates and fewer hospitalizations

Collectively, the studies demonstrate consistent evidence supporting technology-enhanced education, continuous provider involvement, and reflective learning as effective strategies for improving HF outcomes.

Practice Question

In patients aged 18–60 with heart failure (P), how does multimedia education with teach-back and reflective learning (I), compared to multimedia education only (C), reduce patient anxiety, hospital readmission, and improve quality of life (O) within 8–10 weeks (T)?

Evidence indicates that structured education programs, especially when combined with follow-up support, significantly reduce hospital readmissions (Rahmani et al., 2020). Integrating teach-back with reflective learning ensures comprehensive understanding of clinical instructions, thereby improving self-management skills and enhancing overall well-being.

Translation Science Theory

What theory guides the translation of evidence into practice?

The Knowledge-to-Action (KTA) Framework offers a structured model for translating evidence into clinical practice (Lee & Ho, 2019). It emphasizes the continuous process of knowledge creation, adaptation, and implementation to bridge the gap between research and practice.

Components of KTA Application in Heart Failure Care

KTA Component	Description
Knowledge Creation	Identifying gaps in HF care, particularly deficiencies in patient education.
Adaptation	Integrating multimedia tools and reflective learning into patient discharge plans.
Barrier Assessment	Addressing challenges such as low health literacy, socioeconomic factors, and limited support systems.
Implementation	Providing structured education through teach-back and follow-up interventions.
Monitoring and Sustainability	Tracking outcomes such as readmission rates, adherence patterns, and patient-reported quality of life.

Effective HF management requires collaboration among nurses, physicians, dieticians, case managers, and patients. Such interprofessional teamwork promotes patient-centered care and supports sustainability in long-term management (Quanbeck, 2019; Ten Ham-Baloyi, 2022).

Conclusion

Heart failure remains one of the most prevalent and costly chronic conditions worldwide. Poor outcomes are frequently linked to patients’ limited understanding of the disease and inadequate self-care capacity. Evidence strongly supports that incorporating multimedia education, teach-back, and reflective learning significantly enhances patient comprehension, reduces anxiety, and lowers readmission rates. Sustainable implementation of these educational strategies, guided by the KTA framework, is vital for improving patient outcomes and promoting health equity in HF care.

References

Centers for Disease Control and Prevention. (2019). Hospitalization for congestive heart failure, United States. https://www.cdc.gov/nchs/products/databriefs/db108.htm

Centers for Disease Control and Prevention. (2020). Interactive atlas of heart disease and stroke. https://nccd.cdc.gov/DHDSPAtlas/reports.aspx

Centers for Disease Control and Prevention. (2022). Public health action plan to prevent heart disease and stroke. https://www.cdc.gov/dhdsp/action_plan/pdfs/action_plan_full.pdf

Centers for Disease Control and Prevention. (2023). Facts of heart failure in the United States. https://www.cdc.gov/heartdisease/heart_failure.htm

Ding, H., Jayasena, R., Chen, S., Maiorana, A., Dowling, A., Layland, J., Good, N., Karunanithi, M., & Edwards, I. (2020). The effects of telemonitoring on patient compliance with self-management recommendations and outcomes of the innovative telemonitoring enhanced care program for chronic heart failure: Randomized controlled trial. Journal of Medical Internet Research, 22(7), e17559. https://doi.org/10.2196/17559

Groenewegen, A., Rutten, F., Mosterd, A., & Hoes, A. (2020). Epidemiology of heart failure. European Journal of Heart Failure, 22(8), 1342–1356. https://doi.org/10.1002/ejhf.1858

Heidenreich, P. A., Fonarow, G. C., Opsha, Y., Sandhu, A. T., Sweitzer, N. K., Warraich, H. J., & HFSA Scientific Statement Committee Members. (2022). Economic issues in heart failure in the United States. Journal of Cardiac Failure, 28(3), 453–466. https://doi.org/10.1016/j.cardfail.2021.12.017

Lee, C., & Ho, K. (2019). Knowledge to action framework for home health monitoring. Healthcare Management Forum, 32(4), 183–187. https://doi.org/10.1177/0840470419855364

Mohammadi, F., Jahromi, M. S., & Bijani, M. (2021). Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: A randomized clinical trial. BMC Cardiovascular Disorders, 21(1), 535. https://doi.org/10.1186/s12872-021-02357-z

Mujib, M., Zhang, Y., Feller, M. A., & Ahmed, A. (2011). Evidence of a “heart failure belt” in the southeastern United States. The American Journal of Cardiology, 107(6), 935–937. https://doi.org/10.1016/j.amjcard.2010.11.012

Pereira Sousa, J., Neves, H., & Pais-Vieira, M. (2021). Does symptom recognition improve self-care in patients with heart failure? A pilot study randomized controlled trial. Nursing Reports, 11(2), 418–429. https://doi.org/10.3390/nursrep11020040

Piña, I. L., Allen, L. A., & Desai, N. R. (2021). Managing the economic challenges in the treatment of heart failure. BMC Cardiovascular Disorders, 21(1), 612. https://doi.org/10.1186/s12872-021-02408-5

Quanbeck, A. (2019). Using stakeholder values to promote the implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR mHealth and uHealth, 7(6), e13301. https://doi.org/10.2196/13301

Rahmani, A., Vahedian-Azimi, A., Sirati-Nir, M., Norouzadeh, R., Rozdar, H., & Sahebkar, A. (2020). The effect of the teach-back method on knowledge, performance, readmission, and quality of life in heart failure patients. Cardiology Research and Practice, 2020, 8897881. https://doi.org/10.1155/2020/8897881

Singh, R., Javed, Z., Yahya, T., Valero-Elizondo, J., Acquah, I., Hyder, A. A., Maqsood, M. H., Amin, Z., Al-Kindi, S., Cainzos-Achirica, M., & Nasir, K. (2021). Community and social context: An important social determinant of cardiovascular disease. Methodist DeBakey Cardiovascular Journal, 17(4), 15–27. https://doi.org/10.14797/mdcvj.846

Ten Ham-Baloyi, W. (2022). Assisting nurses with evidence-based practice: A case for the Knowledge-to-Action framework. Health SA Gesondheid, 27, 2118. https://doi.org/10.4102/hsag.v27i0.2118

Torres, C. P., Mendes, F. J., & Barbieri-Figueiredo, M. (2023). Use of “The Knowledge-to-Action Framework” for the implementation of evidence-based nursing in child and family care: Study protocol. PLOS ONE, 18(3), e0283656. https://doi.org/10.1371/journal.pone.0283656

NR 716 Week 4 Translation Science and Synthesis

World Health Organization. (2021). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Bashi, N., Karunanithi, M., Fatehi, F., Ding, H., & Walters, D. (2020). Remote monitoring of patients with heart failure: An overview of systematic reviews. Journal of Medical Internet Research, 22(1), e20017. https://doi.org/10.2196/20017

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., Falk, V., González-Juanatey, J. R., Harjola, V. P., Jankowska, E. A., Jessup, M., Linde, C., Nihoyannopoulos, P., Parissis, J. T., Pieske, B., Riley, J. P., Rosano, G. M., Ruilope, L. M., Ruschitzka, F., … Van der Meer, P. (2021). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 42(36), 3599–3726. https://doi.org/10.1093/eurheartj/ehab368

Ziaeian, B., & Fonarow, G. C. (2020). Epidemiology and aetiology of heart failure. Nature Reviews Cardiology, 17(6), 368–382. https://doi.org/10.1038/s41569-019-0290-3

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