**Victor Chaban, Ph.D., MS**

**Chapter 1**

**Abstract**

home visiting nursing

**1. Introduction**

A Home-Based Heart Failure

Self-Management and Lives

heart failure and intervention strategies in the home care setting.

*Motohiro Sano and Tomoko Majima*

Nursing Intervention Supporting

In the era of a super-aged society, along with the rapid development of medical techniques to treat cardiovascular disease, there are an increasing number of aged patients with heart failure (HF). To cope with this near pandemic, coordinated-HF management combining hospital-based optimal therapy and home-based care is required. Accordingly, the concept of "living with HF" is advocated and is widely accepted as a key to improve patients' quality of life as well as prognosis. To achieve it, home visiting nursing services are essential. But these services have some difficulties. This chapter shows the importance of promoting self-management for patients with

**Keywords:** heart failure, self-management, re-hospitalization, home-based intervention,

HF is the quintessential cardiovascular syndrome of aging that results from age-related cardiovascular conditions and age-associated changes in cardiovascular structure and function. The prevalence of HF among approximately 1–2% of the adult population in developed countries, rising to ≧10% among those over 70 years of age and the most common reason for hospitalization in older adults. Usually, as studies only include diagnosed HF cases, the true prevalence is likely to be higher [1, 2]. Although some progress has been made in reducing mortality in patients with HF, rates of rehospitalization continue to rise and approach 40–50% within 1 year after discharge [3, 4]. To reduce mortality and rehospitalization rate, it is widely recognized that, in addition to optimizing medical and device therapies for HF, attention should also be given to how HF care is delivered. Several position papers that cover non-pharmacological

management, discharge planning, and standards for delivering HF care.

Appropriate self-management by patients with HF plays an important role in the prevention of HF decompensation and improvement of survival and quality of life (QOL) [5]. A literature review stated that most HF treatment figure on self-management intervention and focus on self-management strategies, such as to become more informed about their illness and be actively engaged in their own care, which

Professor and Chairman, Department of Biomedical Science Education, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

> Professor, Department of Medicine, University of California, Los Angeles, CA, USA
