Proceeding Manado Health Polytechnic 1st International Conference.

ISSN : 2599-2031

CORRELATION FACTORS WITH CHF (Congestive Heart Failure)

EVENTS AT CARDIOLOGY WARD
Ns. Verra Karame, S.Kep., M.Kes
Nursing Faculty Of The University of Development of Indonesia, Manado
HP. 081340244332

In general: Heart failure or CHF is a cardiovascular problem that the heart cannot provide
adequate blood flow or pressure to meet the needs of the whole body. This syndrome can occur
due to several abnormalities, including coronary heart disease, hypertension and myocardial
infraction. Several factors trigger this disease are stress, smoking and little physical activity.
Introduction/aim/purpose:The purpose of this study are CHF stress sufferers, CHF patients with
smoking behavior, physical activities of CHF patients, to analyze the correlation between stress
and the incidence of CHF at Cardiology Ward to analyze the correlation between smoking and
CHF incidence at Cardiology Ward, to analyze the correlation between physical activity and CHF
incidence at Cardiology Ward.
Method:The type of research used is quantitative and analytical descriptive. This research was
conducted in August 2017.
Results:The results of this study indicate that there is a correlation between stress and CHF
incidence, there is no correlation between smoking and the incidence of CHF, there is a correlation
between physical activity and the incidence of CHF at Cardiology Ward.
Conclusion:The conclusion of this research is that there is a correlation between stress and CHF
incidence, there is no correlation between smoking and CHF incidence, there is a correlation
between physical activity and CHF incidence at Cardiology Ward.
Keywords: Stress, Smoking Behavior, Physical Activity, CHF Incidence.

INTRODUCTION Sulawesi in 2015 recorded cardiovascular

A. Background Research
Heart failure is a serious public health
problem because of the severity of the
symptom and its prevalence, with nearly 5.3
million people in the United States
experiencing it, especially in people over 65
years old. At the age over 25 years old the
prevalence is 0.89% to 2% and increases to
7.6% to 16.1% due to advancing years
(Makalew, 2014). Data from basic health
research (Riskesdas) in 2007 mentioned that
heart disease was still the main cause (31.9%)
of the deaths of most patients in all hospitals
in Indonesia. Health Service of North
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disease was the highest disease with the
number of cases of 32,000 patients caused by
various factors, including stress, smoking,
diet and minimal physical activity
(Anonymous, 2015).
Research conducted by Majid (2010) in
Dr. Sardjito, stated that patients with chronic
heart failure who were hospitalized in 2007
were as many as 427 people or 18.2% of total
in patients and in 2010 based on medical
records in the Heart Polyclinic Dr. Sardjito,
chronic heart failure was the most common
disease after hypertension. Another study
conducted by Makalew (2014) stated that
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there was a correlation between smoking
behavior and the incidence of heart disease in
Heart Polyclinic, Prof. Dr. Aloei Saboe
Gorontalo.
Factors associated with the incidence of
CHF, among others is stress. Excessive stress
will cause vasoconstriction of blood vessels
that can cause heart problems in pumping
blood throughout the body. Previous research
made by Sudayasa (2014) who examined the
factor’s relation to the incidence of heart
disease at Bahteramas General Hospital,
Southeast Sulawesi Province stated that there
is a relationship of stress with the incidence
of heart disease.
In addition to stress, factor of smoking
behavior can also cause the occurrence of
heart disease. This is also evidenced by
research conducted by Sudayasa (2014)
which states that there is a significant
relationship between smoking behavior and
the incidence of heart disease at Bahteramas
General Hospital Southeast Sulawesi
Province.
Physical activity is also a factor that is
believed also affect the health of a person’s
heart. The more frequent physical activity are
carried out, the better the heart’s health is
maintained (Romantika, 2010). Previous
research conducted at the Muhammadiyah
Babat Hospital of Lamongan Sub-district by
Wibowo and Ponco (2015) stated that there is
a relationship between physical activity and
the incidence of heart failure.
Initial survey was conducted in the F
installation, Cardiology Ward at Prof. Dr. R.
D. Kandou hospital Manado, from October-
December 2016, covering 37 patients. As the
result of interview with 10 patients, 4 of them
admitted that they had hypertension and are
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ISSN : 2599-2031
smokers, other 4 patients said that they
suffered obesity because of bad eating pattern
and lack of physical activities, whereas 2
patients said that they used to unable
handling stress and had hypertension when
they were working. These are among factors
that trigger the CHF.
B. Core Problem
Based on the above background, the
researcher formulates the research problem is
"What factors are related to the incidence of
CHF in Irina F Cardiology Prof Dr R. D
Kandou hospital Manado?"
C. Purposes of Research
1. General Purpose:
To analyze the factors related to the
incidence by CHF in Cardiology Ward,
the F Installation of Prof. Dr. R. D
Kandou hospital Manado.
2. Special Purpose
a. To analyze the relationship between
stress and CHF incident in Cardiology
Ward, the F Installation of Prof. Dr. R.
D Kandou hospital Manado.
b. To analyze smoking relationship with
CHF incident in Cardiology Ward, the
F Installation of Prof. Dr. R. D Kandou
hospital Manado.
c. To analyze the relationship between
physical activity and CHF incident in
Cardiology Ward, the F Installation of
Prof. Dr. R. D Kandou hospital
Manado.
D. Advantage of Research
1. For Educational Institutions
The results of this study can be used as a
reference of concrete learning about the
relationship between obesity and the
incidence of CHF in CardiologyWard, the
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F Installation of Prof. Dr. R. D Kandou Dr. R. D Kandou hospital Manado and

hospital Manado.
2. For Advanced Researchers
This research can be carried out the future,
especially for researchers who will
examine about hypertension.
3. For Research Venue
As input for room in CHF incident in
Cardiology Ward, the F Installation of
Prof. Dr. R. D Kandou hospital Manado in
the framework of decision making in the
prevention of hypertension.
METHOD OF RESEARCH
A. Type of Research
This research type is quantitative by
using descriptive analytical research design
with cross-sectional study. This research is
done and collected only once and
simultaneously (Setiadi, 2013). This study
aims to see the relationship correlation
factors with CHF (Congestive Heart Failure)
Incident at Cardiology Ward, the F
Installation of Prof. Dr. R. D Kandou hospital
Manado.
B. Time and Place of Research
The research was located in CHF in
Cardiology Ward, the F Installation of Prof.
conducted in August 2017.
C. Population and Sample
1. Population
The population of this study was all
CHF patients who did the control during
the last 3 months in the F installation,
Cardiology Ward, Prof Dr R. D Kandou
hospital Manado, as many as 36 people.
2. Sample
The sample is part of the population
number and characteristics possessed by
the population (Sugiono, 2008).
Determination of the number of samples is
done by using the Slovin formula. The
sample used in this study was up to 36
patients in Cardiology Ward, the F
Installation of Prof. Dr. R. D Kandou
hospital Manado, using the purposive
sampling technique.
RESULT AND DISSCUSION
A. Result Of Research
1. Characteristics of Respondents
Distribution of respondents by age can be
seen in the description of the table below.

a. Distribution by Age of Respondents

Age of Respondent Frequency Percent
26-35 years 2 5.4
36-45 years 20 54.1
46-55 years 15 40.5
Total 37 100

Most respondents are from 36-45 years old, as many as 20 people (54,1%).

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b. Distribution by Sex
Sex Frequency Percent
Male 8 21,6
Female 29 78,4
Total 37 100

Most respondents are female, as many as 29 people (78,4%).

c. Distribution by Education Level

Education Frequency Percent
SMA 28 75.7
D3 6 16.2
S1 3 8.1
Total 37 100

Most respondents have high school education, as many as 28 people (75,7%).

d. Distribution by Occupancy
Occupancy Respondent Frequency Percent
Pegawai Swasta 12 32.4
PNS 18 48.6
Wiraswasta 5 13.5
IRT 2 5.4
Total 37 100

Most respondents have high school education as many as 28 people (75,7%).

2. Univariate Analysis
a. Stress Variable.
Stress Frequency Percent
Light Stress 9 24.3
Medium Stress 20 54.1
Heavy Stress 8 21.6
Total 37 100

Most respondents have medium stress, as many as 20 people (54,1%).

b. Smoking Behaviour Variable
Smoking Variable Frequency Percent
Smoking 17 45.9
No Smoking 20 54.1
Total 37 100

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Most respondents are categorized non-smokers, as many as 20 people (54,1%).

c. Physical Activity Variable

Physical Activity Frequency Percent
More 22 59.5
Less 15 40.5
Total 37 100

Most respondents have more physical activities, as many as 22 people (59,5%).

d. CHF Variable
CHF Frequency Percent
CHF Grade I 7 18.9
CHF Grade II 16 43.2
CHF Grade III 11 29.7
CHF Grade IV 3 8.1
Total 37 100

Most respondents have CHF Grade II, as many as 16 people (43,2%).

3. Bivariate Analysis
a. The Correlation Between stress and Level of CHF Disease
CHF Disease
Class I Class II Class III Class IV Tot
(%) n (%) n (%) n (%) n (%) n p
Stress Light 0,0 0 13,5 5 5,4 2 5,4 2 24,3 9 0,031
Medium 8,1 3 18,9 7 24,3 9 2,7 1 54,1 20
Heavy 10,8 4 10,8 4 0,0 0 0,0 0 21,6 8
Total 18,9 7 43,2 16 29,7 11 8,1 13 100 37

b. The Correlation Between Smoking Behaviour and Level of CHF Disease

CHF Disease
Class I Class II Class III Class IV Tot p
(%) n (%) n (%) n (%) n (%) n
Smoking Smoking 5,4 2 24,3 9 13,5 5 2,7 1 45,9 17 0,631
No Smoking 13,5 5 18,9 7 16,2 6 5,4 2 54,1 20
Total 18,9 7 43,2 16 29,7 11 8,1 3 100 37

c. The Correlation Between Physical Activity and Level of CHF Disease

CHF Disease
Class I Class II Class III Class IV Tot
(%) n (%) n (%) n (%) n (%) n p
Physical Activity More 18,9 7 21,6 8 27,0 10 0,0 0 59,5 22 0,023
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Less 8,1 3 21,6
Total 18,9 7 43,2
B. DISCUSSION
1. Description of Stress in CHF
sufferer in Cardiology Ward, the F
Installation of Prof. Dr. R. D.
Kandou hospital Manado.
Stress in patients treated at
Cardiology Ward, in the F Installation
of Prof. Dr. R. D. Kandou hospital
Manado generally has medium stress.
Result of research indicates that about
54,1% of respondents are in medium
stress category. Based on the data of
the research results found, most
respondents experience stress
because they are easily angry about
small / trivial things; respondents tend
to over-react in certain situations;
respondents are difficult to relax
because of busyness; respondents
easily feel annoyed; respondents
spend a lot of energy because of
anxiety and impatience and
irritability.
2. Description of Smoking Behavior
of CHF Sufferers at Cardiology
Ward, in the F Installation of Prof.
Dr. R. D. Kandou hospital Manado.
Based on the results of research
of CHF patients at Cardiology Ward,
in the F Installation of Prof. Dr. R. D.
Kandou hospital Manado, most
respondents experience moderate
stress. This is reflected from the
results obtained among 34
respondents that about 47.1%
respondents experience moderate
stress after the results of assessment
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8 2,7 1 8,1 3 40,5 15
16 29,7 11 8,1 3 100 37
and observation of stress levels using
DASS instruments.
The respondents in this study had
a history of smoking, but most also
included non-smokers. Some patients
who suffer CHF had smoking history
and after suffering CHF they stop the
habit. Smoking habits are stopped
because new patients realize that
smoking is dangerous and at risk of
causing heart disease. The carbon
monoxide (CO) gas produced by
cigarette can reach 3-6%, this gas can
be suctioned by anyone who smokes,
the person closest to the smoker, or
the person who is in one room. A
smoker will only inhale 1/3 of a part,
the middle or mid-stream stream,
while the side-stream will remain
outside. After that the smoker will not
swallow all the smoke but he spits out
again.
3. Description of Physical Activity to
CHF Sufferers at Cardiology Ward
in F Installation of Prof. Dr. R. D.
Kandou hospital Manado.
Based on the results of research
conducted by researchers in the F
Installation, Cardiology Ward of
Prof. Dr. R. D. Kandou hospital,
Manado 37 CHF sufferers were
treated in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado, obtained
the result that most respondents less
physical activity before suffering
CHF. Most of the respondents do not
have physical activity because most
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of them work as civil servants. Most
of the time is spent for working and
most of their works do not require
enormous energy, so this factor is the
cause of cardiovascular disorders and
even CHF disease.
CHF respondents in the F
Installation, Cardiology Ward of
Prof. Dr. R. D. Kandou hospital
Manado generally lacks in this matter
because most of the respondents’
work require them to work in a sitting
position, rarely stand or walk and
rarely lifting heavy loads.
Respondents quickly feel tired after
work and this is what causes
respondents rarely do physical
activity, so there is a problem in the
blood vessels and develop into
cardiovascular disease and CHF.
4. Correlation between Stress and
CHF Disease in Cardiology Ward,
the F Installation of Prof. Dr. R. D.
Kandou hospital Manado.
Results of research conducted on
37 respondents in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado, proved that
as many as 54.1% of respondents are
in the category of moderate stress.
Likewise, the incidence of CHF in
patients treated at the F Installation,
Cardiology Ward, Prof. Dr. R. D.
Kandou hospital Manado, as many as
43.2% of patients were suffering CHF
Class II.
The results of the analysis
between stress and CHF incidence in
this study indicate that there is a stress
relationship with the incidence of
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CHF in patients in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado. This is
evidenced by the value of research
results of 0.031, which is smaller than
the value of α 0.05. This shows that
there is a stress relationship with the
incidence of CHF in the F
Installation, Cardiology Ward of
Prof. Dr. R. D. Kandou hospital
Manado or Ha accepted and Ho
rejected.
Based on the result of cross
tabulation between stress and CHF
incidence on 37 respondents data
obtained from 20 respondents, who
are classified as moderate stress, as
many as 3 respondents had CHF
Class I, 7 respondents had CHF Class
II, 9 respondents experienced CHF
Class III and 1 respondent
experienced CHF Class IV.
4. Relationship between Smoking
and CHF Disease, Cardiology
Ward in the F Installation of Prof.
Dr. R. D. Kandou hospital
Manado.
Results of research conducted on
37 respondents in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado, proved that
as many as 17 respondents (45.9%)
are smokers and 20 respondents
(54.1%) are non-mokers. Likewise,
the incidence of CHF in patients
treated in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado, as many as
43.2% of patients with CHF Class II.
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The results of analysis between
smoking and CHF incidence in this
study showed that there was no
smoking relationship to CHF
incidence in patients in the F
Installation, Cardiology Ward of
Prof. Dr. R. D. Kandou hospital
Manado. This is evidenced by the
acquisition value of research results
of 0.631 greater than the value of α
0.05. This shows that there is no
smoking relationship to CHF
incidence in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado or Ho
accepted and Ha rejected.
In this study, there is no
relationship between smoking and
CHF incidence because most of the
respondents are non-smokers and
most are female. Although smoking
factor theoretically becomes one of
the originators of CHF, but in this
study the results are different.
5. Relationship between Physical
Activity and CHF Disease in
Cardiology Ward in the F
Installation of Prof. Dr. R. D.
Kandou hospital Manado.
Results of research conducted on
37 respondents in the F Installation of
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado, proved that
as many as 17 respondents (45.9%)
are smokers and 20 respondents
(54.1%) are non-smokers. Likewise,
the incidence of CHF in patients
treated in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
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Kandou hospital Manado, as many as
43.2% patients suffer CHF Class II.
The results of analysis between
smoking and CHF incidence in this
study showed that there was no
smoking relationship between CHF
incidence and patients in the F
Installation of Cardiology Ward of
Prof. Dr. R. D. Kandou hospital
Manado. This is evidenced by the
acquisition value of research results
of 0.631 greater than the value of α
0.05. This shows that there is no
smoking relationship to CHF
incidence in the F Installation of
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado or Ho
accepted and Ha rejected.
In this study there is no
relationship between smoking and
CHF incidence, this is because most
of the respondents are non-smokers
and most are female. Although
smoking factor theoretically becomes
one of the originators of CHF, but in
this study the results are different.
Theoretically, smoking factor is
the cause factor of CHF, but in this
study there is no relationship between
smoking and CHF incidence because
based on the data obtained, most of
the respondents are female. In this
study, there were nine women who
had smoking history, whereas others
had no history as smokers except for
male respondents.
CONCLUSIONS
1. Respondents in Cardiology Ward in F
Installation of Prof. Dr. R. D. Kandou
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Manado generally experience moderate
stress.
2. Respondents in the F Installation,
Cardiology Ward of Prof. Dr. R. D.
Kandou hospital Manado are generally
non-smoker.
3. Respondents in F Installation, Cardiology
Anonim. 2013. Dampak stres terhadap
Ward of Prof. Dr. R. D. Kandou hospital
Manado generally have good physical
activities.
4. There is correlation between stress and
CHF Disease in Cardiology Ward of F
Installation of Prof. Dr. R. D. Kandou
hospital Manado.
5. There is correlation between smoking
behavior and CHF Disease in Cardiology
Ward of F Installation of Prof. Dr. R. D.
Kandou hospital Manado.
6. There is correlation between physical
activity and CHF Disease in Cardiology
Ward of the F Installation of Prof. Dr. R.
D. Kandou hospital Manado.
SUGGESTIONS
1. For educational institutions, the results of
this study can be used as reference
materials by educational institutions for
younger students who will carry out future
research, especially on nursing
management.
2. For the venue of research, this research
can be used as input for those in
Cardiology Ward, of the F Installation of
Prof. Dr. R. D. Kandou hospital Manado
in providing excellent service to meet
patients’ satisfaction. This research can
also be used by the nurse in order to
provide health promotion for patients and
family families to control blood pressure,
to do physical activities and so on.
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ISSN : 2599-2031
3. For future researchers, the results of this
study can be used as input to add
knowledge about nursing management.
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