LOOKING AT LONG-TERM CONDITIONS
Coronary heart disease: self-care, communication and quality of life Aysha Mendes discusses coronary heart disease, the UK’s biggest killer, and describes the range of roles that nurses play in prevention, treatment and support
What is CHD? CHD occurs when fatty material gradually builds up within the coronary arteries, causing them to become narrower, interrupting or blocking the blood supply to the heart (BHF, 2014; NHS Choices, 2014a). The most common symptoms of CHD are angina, heart attacks and heart failure (NHS Choices, 2014a), all of which are significant problems in the UK, both in relation to and separate from CHD (Department of Health (DH), 2013). However, individual patients’ experiences of CHD are unique and they may have different symptoms or may not experience any symptoms at all prior to being diagnosed (NHS Choices, 2014a).
Current national status Much work has gone into addressing the high number of deaths caused by CHD in the UK and, as a result, successes have been noted. In England, for example, there was a 43% decrease in CHD mortality rates between 2004 and 2011, and there have also been decreases in smoking and increases in physical activity (DH, 2013).The National Service Framework for Coronary Heart Disease (DH, 2000) and Smoking Kills (DH, 1998), among other guidelines and the work of charities, can surely be credited for part of these gains. However, the ageing population, current levels of obesity, and the fact that physical activity and fruit and vegetable intake in the UK are still well below the levels recommended by the World Health Organization and below the levels in other European countries demonstrates the distance we have yet to travel—particularly as these factors could lead to the loss of any gains that have been made (DH, 2013).
Aysha Mendes
Freelance journalist specialising in health, psychology and nursing Email: [email protected]
42
Prevention and treatment Diet, exercise, smoking and blood pressure are lifestyle factors that can lead to the development of many long-term conditions, particularly cardiovascular diseases (DH, 2013) and can often be interrelated. For example, high levels of salt are linked with high blood pressure and can lead to CHD (or stroke) (National Institute for Health and Care Excellence (NICE), 2010), and salt intake in England is above recommended levels (DH, 2013). Lifestyle changes and rehabilitation are therefore an essential aspect of the prevention and management of CHD. Supporting patients to make such changes, combined with the appropriate medical treatment and, in some cases, surgery, is the best way to effectively manage symptoms, prevent further complications and improve the heart’s function so that patients can live well with their condition (NHS Choices, 2014b).
Increasing quality of life One of the most essential and sometimes overlooked aspects of a nurse’s role with CHD involves helping to increase the quality of life of patients living with this condition. Any LTC diagnosis has an impact on a patient’s emotional and psychological health and quality of life, and CHD is no exception. Patients require support with everything from effective selfcare and the practicalities of applying for financial support or returning to work after a heart attack, for example, to the changes in their personal, sexual and professional relationships that can result from living with CHD (NHS Choices, 2014c). Although the importance of treatment, information and rehabilitation cannot be underestimated, the resources of time, reassurance, clear explanation and compassionate care can go a long way to increasing a patient’s confidence to continue living well in their day-to-day lives with CHD. BJCN British Heart Foundation (2012) Coronary Heart Disease Statistics. A Compendium of Health Statistics. BHF, London British Heart Foundation (2014) Coronary heart disease. http://tinyurl.com/ prbsx65 (accessed 16 December 2014) Department of Health (1998) Smoking Kills: A White Paper on Tobacco. DH, London. http://tinyurl.com/ps8azuf (accessed 17 December 2014) Department of Health (2000) National Service Framework for Coronary Heart Disease. DH, London. http://tinyurl.com/ojxd626 (accessed 17 December 2014) Department of Health (2013) Cardiovascular Disease Outcomes Strategy. Improving Outcomes for People with or at Risk of Cardiovascular Disease. DH, London National Institute for Health and Care Excellence (2014) Prevention of cardiovascular disease. http://tinyurl.com/mhnjecf (accessed 16 December 2014) NHS Choices (2014a) Coronary heart disease. http://tinyurl.com/yhfdpu8 (accessed 16 December 2014) NHS Choices (2014b) Coronary heart disease: treatment. http://tinyurl. com/82aknrx (accessed 16 December 2014) NHS Choices (2014c) Coronary heart disease: Recovery. http://tinyurl.com/ jwk3p5u (accessed 16 December 2014)
© 2015 MA Healthcare Ltd
C
oronary heart disease (CHD) is not only the leading cause of death in the UK, but also throughout the world (NHS Choices, 2014a). CHD, also referred to as ischaemic heart disease, kills 73 000 people in the UK every year, and 2.3 million people are living with this long-term condition (LTC) (NHS Choices, 2014a), compromising their quality of life.Additionally, CHD costs the UK economy more than £6.7 billion a year (British Heart Foundation (BHF), 2012). However, community nurses play an essential role in the prevention and treatment of this disease, and can also have a drastic impact on the day-to-day experiences of people with CHD.
British Journal of Community Nursing January 2015 Vol 20, No 1
h Journal of Community Nursing. Downloaded from magonlinelibrary.com by 147.188.128.074 on September 1, 2015. For personal use only. No other uses without permission. . All rights res
Coronary heart disease: self-care, communication and quality of life Aysha Mendes discusses coronary heart disease, the UK’s biggest killer, and describes the range of roles that nurses play in prevention, treatment and support
What is CHD? CHD occurs when fatty material gradually builds up within the coronary arteries, causing them to become narrower, interrupting or blocking the blood supply to the heart (BHF, 2014; NHS Choices, 2014a). The most common symptoms of CHD are angina, heart attacks and heart failure (NHS Choices, 2014a), all of which are significant problems in the UK, both in relation to and separate from CHD (Department of Health (DH), 2013). However, individual patients’ experiences of CHD are unique and they may have different symptoms or may not experience any symptoms at all prior to being diagnosed (NHS Choices, 2014a).
Current national status Much work has gone into addressing the high number of deaths caused by CHD in the UK and, as a result, successes have been noted. In England, for example, there was a 43% decrease in CHD mortality rates between 2004 and 2011, and there have also been decreases in smoking and increases in physical activity (DH, 2013).The National Service Framework for Coronary Heart Disease (DH, 2000) and Smoking Kills (DH, 1998), among other guidelines and the work of charities, can surely be credited for part of these gains. However, the ageing population, current levels of obesity, and the fact that physical activity and fruit and vegetable intake in the UK are still well below the levels recommended by the World Health Organization and below the levels in other European countries demonstrates the distance we have yet to travel—particularly as these factors could lead to the loss of any gains that have been made (DH, 2013).
Aysha Mendes
Freelance journalist specialising in health, psychology and nursing Email: [email protected]
42
Prevention and treatment Diet, exercise, smoking and blood pressure are lifestyle factors that can lead to the development of many long-term conditions, particularly cardiovascular diseases (DH, 2013) and can often be interrelated. For example, high levels of salt are linked with high blood pressure and can lead to CHD (or stroke) (National Institute for Health and Care Excellence (NICE), 2010), and salt intake in England is above recommended levels (DH, 2013). Lifestyle changes and rehabilitation are therefore an essential aspect of the prevention and management of CHD. Supporting patients to make such changes, combined with the appropriate medical treatment and, in some cases, surgery, is the best way to effectively manage symptoms, prevent further complications and improve the heart’s function so that patients can live well with their condition (NHS Choices, 2014b).
Increasing quality of life One of the most essential and sometimes overlooked aspects of a nurse’s role with CHD involves helping to increase the quality of life of patients living with this condition. Any LTC diagnosis has an impact on a patient’s emotional and psychological health and quality of life, and CHD is no exception. Patients require support with everything from effective selfcare and the practicalities of applying for financial support or returning to work after a heart attack, for example, to the changes in their personal, sexual and professional relationships that can result from living with CHD (NHS Choices, 2014c). Although the importance of treatment, information and rehabilitation cannot be underestimated, the resources of time, reassurance, clear explanation and compassionate care can go a long way to increasing a patient’s confidence to continue living well in their day-to-day lives with CHD. BJCN British Heart Foundation (2012) Coronary Heart Disease Statistics. A Compendium of Health Statistics. BHF, London British Heart Foundation (2014) Coronary heart disease. http://tinyurl.com/ prbsx65 (accessed 16 December 2014) Department of Health (1998) Smoking Kills: A White Paper on Tobacco. DH, London. http://tinyurl.com/ps8azuf (accessed 17 December 2014) Department of Health (2000) National Service Framework for Coronary Heart Disease. DH, London. http://tinyurl.com/ojxd626 (accessed 17 December 2014) Department of Health (2013) Cardiovascular Disease Outcomes Strategy. Improving Outcomes for People with or at Risk of Cardiovascular Disease. DH, London National Institute for Health and Care Excellence (2014) Prevention of cardiovascular disease. http://tinyurl.com/mhnjecf (accessed 16 December 2014) NHS Choices (2014a) Coronary heart disease. http://tinyurl.com/yhfdpu8 (accessed 16 December 2014) NHS Choices (2014b) Coronary heart disease: treatment. http://tinyurl. com/82aknrx (accessed 16 December 2014) NHS Choices (2014c) Coronary heart disease: Recovery. http://tinyurl.com/ jwk3p5u (accessed 16 December 2014)
© 2015 MA Healthcare Ltd
C
oronary heart disease (CHD) is not only the leading cause of death in the UK, but also throughout the world (NHS Choices, 2014a). CHD, also referred to as ischaemic heart disease, kills 73 000 people in the UK every year, and 2.3 million people are living with this long-term condition (LTC) (NHS Choices, 2014a), compromising their quality of life.Additionally, CHD costs the UK economy more than £6.7 billion a year (British Heart Foundation (BHF), 2012). However, community nurses play an essential role in the prevention and treatment of this disease, and can also have a drastic impact on the day-to-day experiences of people with CHD.
British Journal of Community Nursing January 2015 Vol 20, No 1
h Journal of Community Nursing. Downloaded from magonlinelibrary.com by 147.188.128.074 on September 1, 2015. For personal use only. No other uses without permission. . All rights res
