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Introduction
Heart Failure (HF) is becoming one of the leading causes of deaths in the United States today. According to American Heart Association (2012), prevalence of some of the cardiovascular diseases has reduced significantly over the years, but cases of heart failure are still on the rise. Medical practitioners are concerned that, although some measures have been put in place, HF is still claiming many lives in this country. Kokkinos (2010) observes that treatment of heart failure is very expensive, not only to the patients, but also the government through the department of health. It is, therefore, a worrying trend that some patients are forced to get readmissions because of failure to observe relevant procedures that would help them maintain a healthy heart. Medical experts have tried to develop programs that can be used by HF patients attending cardiac rehabs to help them remain healthy. Some of these programs have been useful in helping cardiac patients avoid causes of readmissions. In this research, the focus will be to determine the effectiveness of exercise as an intervention plan for heart failure patients attending cardiac rehab.
Evaluation of the Effectiveness of the Intervention Plan
It is necessary to reduce or eliminate cases where HF patients are readmitted to the hospital. This can only happen if relevant authorities develop effective programs. This will not only help in the reduction of the cost of treatment, but also help them get back to leading healthy lives. According to this plan, the focus is on intervention other than on managing the disease. HF patients should be able to maintain a healthy lifestyle that will ensure that their condition is not worsened. According to Kokkinos (2010), exercise is one of the best health promotion-prevention plans that can help in help in maintaining a healthy heart. Exercise helps in maintaining an active flow of blood within the body. It helps in burning calories and also strengthens body muscles. The heart muscles will be strengthened during such exercises because they are forced to pump blood at a high rate. According to Eckel (2010), physical exercise is an essential tool that can be used by HF patients to improve their condition. It is worrying that this cheap procedure is ignored by most Americans, even those in the rehabilitation centers. This may be associated with lack of knowledge in a section of the public, but the truth is that most Americans are aware of the importance of physical exercise in improving their cardiac health. When using this plan, a number of factors have been proposed that should be considered in order to avoid subjecting patients to inappropriate programs.
It is important to evaluate the effectiveness of the proposed physical exercise intervention plan to determine its appropriateness in helping HF patients avoid readmissions into hospital. According to Labarthe (2011), an effective intervention plan must achieve the set objectives. The research also emphasizes on the fact that the claims must be in line with the set standards, focused on improving healthcare of the study group. For instance, the aim of the rehabs is to reduce or eliminate incidences where HF patients are readmitted to the hospitals. This means that they should ensure that the lifestyle of the patients is sensitive of issues that affect their heart either positively or negatively. They should avoid negating issues, and embrace those that help in improving their heart conditions. For the physical exercise intervention plan to be considered effective, it must elevate the conditions of HF patients, help them assume a normal life, and reduce any possibility of readmissions. In order to evaluate the effectiveness of this program, it would be necessary to analyze short-term, intermediate and long-term outcomes of this program. The effect of physical exercise is always analyzed from three perspectives. The first aspect analyzes the effects of exercise on bones, muscles, and joints. The second aspects analyze the effect of exercise on the respiratory system. The third aspect focuses on the effect of exercise on the cardiovascular system. This research will be restricted to the effect of physical exercise on the cardiovascular system.
Short-Term Outcomes
According to Kokkinos (2010), short-term outcomes of a physical exercise can be analyzed after 3-7 days of active training. Although some studies may extend it to two or three weeks of active training, the first seven days are always enough to determine the real impact on the cardiovascular system. According to the study by Boren, Wakefield, Gunlock and Wakefield (2009), some of the short-term outcomes of physical exercise include an increase in heart rate and higher volume of blood being circulated in the body. Pulsometers will be use to measure heart rate. Physical exercise increases the need for oxygen in the body. This means that the heart will be forced to pump more blood and at higher speeds. When the cardiac muscles are forced to be active, the heartbeats will become strong. Within this short period, there will be a diversion of blood from the digestive systems and other systems to the muscles. The blood temperatures will rise, especially during the time of exercise. The muscles around the heart will start strengthening due to increased levels of activities. All these short-term outcomes have the effect of reducing the possibility of occurrence of heart failure. Therefore, this plan will help elevate the condition of the patients.
Intermediate Outcomes
According to Moran, Burson and Conrad (2014), the intermediate outcomes of physical training can be analyzes after two to four weeks. This scholar says that the intermediate effects of training will be experienced when the body starts getting used to regular training. One of the outcomes will be an increase in the size of heart muscles because of the constant stretching. According to Eckel (2010), the number of blood capillaries will increase at this stage because the body will try to adjust to the increased need of oxygen in various organs. Weak and smaller muscles have been associated with increased risk of heart failure. Given the fact that the intermediate outcome of physical exercise will be an increase in the size of the heart muscles, it means that the possibility of these muscles to collapse will be reduced considerably. This will consequently, lower the possibility of such a patient being readmitted for heart failure. The increased blood capillaries will also help in increasing the rate of blood absorption. ECG tele-monitoring will be useful in measuring some of the impacts of training on heart muscles. This also helps in minimizing cases of heart failure.
Long-Term Outcomes
Long-term effect, according to Kokkinos (2010), can be analyzed after three months of active exercise. Some may consider six to twelve months as the appropriate time to determine the long-term effects of physical exercise based on ones age, gender, and the rate at which he or she engages in the physical activities. Increased strength and size of the cardiac muscles is one of the most important long-term outcomes of physical exercise. It results into high cardiac output (Eckel, 2010). This means that the amount of blood that is pumped by the heart in a minute will increase. The resting rate of the heart will also reduce, and this reduces chances of occurrence of a heart failure (Labarthe, 2011). The rate of blood circulation in the body will increase, and as Kokkinos (2010) notes, there will be plenty of supply of oxygen in the body because of the increased number of red blood cells. The rate of depression will also be reduced considerably. All these factors play a major role in reducing a possible reoccurrence of heart failure among patients who are in the rehabs. However, this can only be achieved when the participants embraces physical exercise as a tool that can help improve their health. The long-term outcomes of a physical exercise were measured both physiologically and psychologically. The hospital anxiety and depression scale (HADS) helped in determining the reduction in the patients anxiety and rates of depression (Artinian, Magnan, Sloan & Lange, 2002). Some physiological outcomes were measured using tools like pedometers were used to determine the walking capabilities of the patients after the rehabilitation centers. This would be used to compare the conditions of the patient before and after rehab.
Tools Used to Collect Data
According to Chin and Lee (2008), data can only be considered accurate if the tools used in their collection are reliable and valid. In this research, data was collected by directly monitoring the short-term, intermediate, and long-term effects of exercise. An interview was also conducted on the participants so that they could give their own version of the changes they had experienced from exercise. Physical changes such as heart rate and strength of the heartbeat were measured using pulsometres. This is a reliable tool that gives true value of strength and speed of heart rate. Pedometers and accelerometers are also reliable when it comes to measuring the intensity of physical activity (Labarthe, 2011). The Revised Heart Failure Self-Care Behavior Scale questionnaire, International Physical Activity Questionnaire (IPAQ), and Patient Satisfaction Questionnaire were also administered to the participants to enable them share their views about outcomes of exercise on their health (Labarthe, 2011). Atlanta Heart Failure Knowledge Test V2 questionnaire (AHFKT-V2) was used to determine the possibility of occurrence of heart failure among the participating patients. The validity of the tools mentioned above has been proven scientifically, making them reliable enough to be used in this research.
Conclusion
Physical exercise is one of the most effective ways of combating cardiovascular diseases. Heart failure patients who are in rehabilitation centers are highly encouraged to engage in physical exercise in order to improve blood flow in the body, the strength of the heart muscles, the rate of heartbeats and supply of oxygen in the body. In this study, the tools used confirmed that in this intervention plan is used efficiently, HF patients can avoid readmission cases. They can lead healthy lifestyles if they maintain physical exercise.
References
American Heart Association. (2012). Heart Disease and Stroke Statistics2012 Update. Dallas: American Heart Association
Artinian, N., Magnan, M., Sloan, M., & Lange, M. (2002). Self-care behaviors among patients with heart failure. Heart and Lung, 31(3), 161-172. Web.
Boren, S., Wakefield, B., Gunlock, T., & Wakefield, D. (2009). Heart failure self-management education: a systematic review of the evidence. International Journal of Evidence-Based Healthcare, 7 (3), 159-168. Web.
Chin, R., & Lee, B. (2008). Principles and practice of clinical trial medicine. New York: Elsevier.
Eckel, R. H. (2010). Metabolic risk for cardiovascular disease. Dallas: American Heart Association.
Kokkinos, P. (2010). Physical activity and cardiovascular disease prevention. Sudbury: Jones and Bartlett.
Labarthe, D. (2011). Epidemiology and prevention of cardiovascular diseases: A global challenge. Sudbury: Jones and Bartlett Publishers.
Moran, K., Burson, R., & Conrad, D. (2014). The doctor of nursing practice scholarly project. Burlington: Jones and Bartlett.
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