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Showing 3 results for Heart Failure
Development & psychometric properties of the social dignity questionnaire in heart failure patients
Hossein Bagheri, Faride Yaghmaei, Tahere Ashktorab, Farid Zayeri,
Volume 6, Issue 6 (2-2014)
Abstract
Heart failure not only affacts the patients but also their families and social networks. This study was conducted to evaluate the development & psychometric properties of the Social Dignity Questionnaire (SDQ) in heart failure patients. This study is an exploratory research of questionnaire design type. Twenty two patients with class II to IV heart failure (New York Heart Association Functional Classification) were chosen through purposive sampling from selected hospitals of Tehran, and semi-structured interviews were conducted with them. Qualitative content analysis was performed to analyze the interviews. The primary items were developed based on the findings obtained from the interviews, literature and designed questionnaires about social dignity. Content validity and construct validity were determined in 130 patients with heart failure. The data were analyzed using SPSS version 19. Through face validity and content validity analysis, 16 out of 101 primary items were removed. As a result of exploratory factor analysis, 2 items with factor loading less than 0.5 were deleted, and 6 were removed due to inclusion in other factors. The following five factors were extracted: family communication and support, social communication and support, health care communication and support, burden to others (physical, emotional and social), and burden to others (economic). Reliability of the Social Dignity Questionnaire (SDQ) was calculated to be 0.97 by using Cronbach’s alpha coefficient, and 0.99 by using split-half method.Considering the acceptable validity and reliability of the questionnaire in the present study, its application can be useful in planning support for patients and improving their treatment and care. The questionnaire may also be helpful in conducting further research related to dignity in different patients
Development and psychometric properties of Inherent Dignity Questionnaire in heart failure patients
Hossein Bagheri, Faride Yaghmaei, Tahere Ashktorab, Farid Zayeri,
Volume 6, Issue 6 (2-2014)
Abstract
Respect for the inherent dignity of human beings means respecting their basic rights in different environments, and this has an important role in studies and discussions about health care. This study was conducted on the development and psychometric properties of the Inherent Dignity Questionnaire (IDQ) in heart failure patients. The present study is a methodological research for designing a questionnaire. First, 22 patients with class II to IV heart failure were chosen by purposive sampling from patients of Hazrate Rasoule Akram, Imam Hossein and Shariati hospitals of Tehran, and semi-structured interviews were conducted on ethical issues until data saturation was achieved. A qualitative content analysis was carried out to analyze the interviews. Then, based on the findings obtained from the interviews, literature, and the designed questionnaires about inherent dignity, 39 items associated with inherent dignity in heart failure patients were developed. The face validity of the questionnaire was determined. To measure the content validity of the questionnaire, opinions of 12 experts were used considering Content Validity Index (CVI), Content Validity Ratio (CVR) and Lawshe table. To assess construct validity of the IDQ, exploratory factor analysis and to determine the reliability of the questionnaire, internal consistency with Chronbach’s alpha coefficient and split-half method were used on 130 patients with heart failure. The data were analyzed using SPSS version 19.Through face validity and content validity analysis, 4 out of the 39 primary items were removed, leaving 35 items. Through exploratory factor analysis, 11 items with factor loading less than 0.5 were removed and the IDQ was created with 24 items and three factors (9 items on the first factor, 8 items on the second factor and 7 items on third factor). These factors were: "inherent dignity in family", "inherent dignity in the community" and "inherent dignity in health care environments". Reliability of the Social Dignity Questionnaire (SDQ) was calculated to be 0.94 by using Cronbach's alpha coefficient, and 0.96 by using split-half method.Results of this study showed that the IDQ is adequately valid and reliable. Therefore, using this questionnaire can be beneficial to planning support for patients and improving their treatment and care and doing further research related to dignity in different patients.
Exploring Advance Directives and End-of-Life Preferences in Heart Failure Patients: A Systematic Review and Meta-Analysis
Aydin Feyzi, Amirali Soheili, Samira Chaibakhsh, Fidan Shabani, Shiva Khaleghparast,
Volume 17, Issue 0 (12-2024)
Abstract
Advance directives (ADs) are legal instruments that enable individuals to express their healthcare preferences in anticipation of a future loss of decision-making capacity. These directives are particularly important in the context of chronic conditions such as heart failure (HF), a disease marked by progressive functional decline and unpredictable medical crises. ADs help safeguard patient autonomy by ensuring that care aligns with personal values and preferences, especially at the end of life. This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines to examine the preferences of patients with heart failure regarding life-sustaining treatments and end-of-life decision-making. A comprehensive literature search was performed across PubMed, Scopus, and Web of Science databases, covering publications up to March 2024. Search terms included "advance directive," "advance care planning," "heart failure," and "end-of-life decision-making." Studies were included if they were original, peer-reviewed, full-text articles focusing on HF patients aged 18 and older. Non-peer-reviewed works and inaccessible full texts were excluded. A total of 25 eligible studies were identified and appraised using the NIH quality assessment tool. Extracted data included demographic characteristics, preferences for treatment, surrogate decision-making, and educational interventions. Findings from the reviewed literature reveal consistently low levels of awareness and completion of ADs among HF patients. Completion rates varied significantly across studies, reflecting potential cultural and systemic influences. Preferences for surrogate decision-makers overwhelmingly favored family members over healthcare professionals. A notable finding from Jawahri et al. (2016) indicated that patients who received video-based education were significantly less inclined to choose cardiopulmonary resuscitation (CPR) or mechanical ventilation compared to those receiving only verbal information. Additional qualitative insights, such as those from Formiga et al. (2004), showed that patients prioritized maintaining dignity, independence, and meaningful relationships over merely extending life. These patterns highlight the necessity of aligning care with patients’ broader goals and values. Across the 25 studies included, a total of 4,091 heart failure patients were analyzed, with a mean age of 68.22 years. Meta-analytic findings demonstrated diverse preferences regarding life-sustaining interventions: approximately 53.73% of patients favored such treatments, while 45.37% declined CPR. These statistics underscore a substantial variability in end-of-life preferences, further reinforcing the need for individualized care planning. In conclusion, patients with heart failure display heterogeneous preferences concerning end-of-life care, shaped by cultural context, personal values, and the type of information provided. Despite the established importance of ADs, significant deficits in awareness, understanding, and documentation persist. These findings point to a critical need for tailored educational interventions, improved provider-patient communication, and culturally sensitive approaches to advance care planning. Future research should focus on designing and integrating standardized AD facilitation tools into routine clinical practice to support truly patient-centered care.

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