Interventions in people with cardiovascular disease: Nursing for individualized care
Worldwide, cardiovascular diseases (CDV) constitute the first cause of morbidity and mortality, which generates loss of productive years of life, disability and premature death, in addition to social costs and for health systems derived from their attention. For the proper control of risk factors and ECV management, the person is required to modify their lifestyle, assume healthy habits and adhere to pharmacological treatment. In this context, it is essential not only to achieve the active participation of the patient in the maintenance of their own health, but also that health professionals recognize the individual as an active being, with skills to manage their health, capable of discerning and taking decisions aimed at achieving therapeutic objectives.
Nursing, as a professional discipline focused on the care of people’s health experiences, faces the challenge of adapting to new ways to recognize, interpret and respond to phenomena of interest to discipline by integrating the theory, the practice and research, so that together it contributes to the verification and the generation of knowledge that supports, guides and transforms the practice3. This is how, in recent years, interest in designing, implementing and evaluating intervention strategies that serve as essential components of nursing practice has increased that contribute to improving the health of people in an environment that seeks to achieve therapeutic objectives and health results that are cost-effects at the individual and social level4.
The development of nursing interventions implies a logical, rational and systematic process that includes the integral understanding of the problem (definition, causal or determining factors, severity, manifestations and consequences). The above allows to identify essential, specific elements or active components of the intervention, which are derived from the use of average range theories, specific situation or empirical evidence.
In that context, and according to the characteristics and aspects of the problem that requires change or solution, it is possible people using the same mode of delivery, dose and intensity, regardless of their personal characteristics. However, this type of interventions contrasts with a nursing practice that recognizes the individualization of care and that considers that individuals are exposed to the change in behavior, since they face in their daily lives situations that can lead to improve or affect the given health who are constantly interaction with their surroundings.
However, adapted or personalized interventions constitute an alternative to operationalize patient -centered individualized care, since they respond to the needs, preferences and beliefs of people. These types of interventions are complex since they integrate several components with their respective actions and are focused on addressing different aspects or determinants of the problem; In addition to having a structure in which the elements and procedures guide customization and are previously defined8. Therefore, they have been mainly used to promote healthy behaviors and are supported by different theoretical frameworks, within which cognitive-behaviorals stand out.
For the design of adapted interventions, a sequence of steps must be followed; The first is to identify the characteristic of the individual from which the intervention will be adapted, this arises from understanding the nature of the problem that is susceptible to change, knowing the experience of patients in relation to the current health problem (beliefs , perceived barriers), the profile of the individual (sociodemographic characteristics, psychological qualities), the general state of health or social resources; The second is to evaluate this characteristic, through the use of valid and reliable instruments; The third implies the definition of relevant and specific activities that must coincide with the components, activities and individual characteristic that together will produce the expected outcome. Finally, establishing a decision -making algorithm, which indicates what activities or intervention strategies should be used at a given time.
At present, the role that the patient should have in the management of their health status and the role that nursing professionals should perform to implement strategies that help people with ECV to assume a healthy lifestyle should have, participate participate, participate participate, participate, participate, participate in treatment and maintain self-care and therapeutic adhesion behaviors in order to prevent complications derived from inappropriate control of the disease. These processes are dynamic, complex and multidimensional since they are determined by the interaction of a set of factors, so it is common to observe important differences between individuals. Therefore, adapted interventions constitute a novel strategy that highlights the importance of individualized care and that leads to patient satisfaction, since the health professional is perceived as someone who also cares about the person and not only for the factors of risk and treatment of the disease; They also allow to identify, prioritize and focus on achieving the objectives in collaboration with the patient.
Finally, it is important to highlight that the use of adapted interventions focused on individual needs of patients is an opportunity for nursing in the improvement of knowledge of health phenomena and problems, which will contribute to the identification of the necessary elements to be intervened with the purpose of improving the well -being of the population. Therefore, it is necessary that nursing researchers carry out studies with a good level of evidence that allow evaluating the effectiveness of these interventions, generating new knowledge and producing a professional advance towards excellence.
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