Advanced Care Management in Patients With Advanced Heart Failure

Study Overview
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Brief Summary
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The purpose of this study is to explore the trajectory of advanced management care in patients with heart failure over a period of 9 months, then comparing the medical treatment accepted by patients after 2 years later and compliance with the preferences of patients and their families.

Detailed Description
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this study is to observe the trajectory of the advanced care management on patients with advanced heart failure and follow the difference between the actual medical treatment accepted by patients on 2years later and the preference of the patient and their families. the advance care management in this study is mean the patients who know about the preference of medical treatment, communication, and prognosis of illness. we also measure the sense of coherence, self-efficacy and their quality of life to compare their relationship of the advanced care management.

Official Title
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Advanced Care Management in Patients With Advanced Heart Failure

Conditions
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Advanced Heart Failure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed with AHA stage D, or NYHA class function 4, or LVEF<=30%. has one or more than one symptoms such as dyspnea, lower legs edema, weakness. ever admission to the hospital (include emergency room or the general room) Exclusion Criteria: with other end-stage diseases such cancer, dementia, COPD, ESRD...etc. had other physical, cognitive, or psychological condition which may influence their answer.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patient with advanced heart failure<br>we included the patients with advanced heart failure who had the poor cardiac function(LVEF<=30%) and was admitted to the general ward or emergency room within one year. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| advanced care management | we use a modified questionnaire assessment the medical needs and preference on terminal patients and their families (Tang, et al., 2004) by literature review and named The prognosis and message status on patients with advanced Heart failure. the questionnaire include 3 parts: medical preference in their advanced status, communication between physician and patients and physician and their families ( the definition of families in this study is the major medical decision for the patients), and the knowledge of disease prognosis. The questionnaire include 17 items with continue and category variables. Before study we use expert validity from 5 experts who works in group at least 10 years. Each items is scored on a five-point Likert scale range from 0(not at all) to 4 (very appropriate to this study). The overall score was calculated as the average of all items and finally we got 3.67-points. | 3 months for each interval and 4 times on each patient (total 9 months on this study) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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advanced care management, advanced heart failure