CHAPTER- 3

Aims and objectives:

Aim: A descriptive study to assess the level of distress and self esteem in
patients with heart failure.

Objectives:
• To assess the level of distress in patients with heart failure.
• To assess the level of self esteem in patients with heart failure.

Research Design:

A descriptive Study will be done to assess the level of distress and self esteem
in patients with heart failure.

Setting:

This research will be conducted in Cardiology general ward C302 of Ranipet

campus, CMC, vellore.

Population:

All the inpatients with heart failure in cardiology general ward (C302) Ranipet
campus, CMC vellore.

Sample:
All the patients who are diagnosed with heart failure and are currently under
treatment from Ranipet campus CMC, Vellore as in-patient will be included in
the study.

Inclusion Criteria:
  patients who are diagnosed to have a heart failure.
 patients who have ejection fractions from 20-40%  and <20%
 patients who belong to NYHA classification I, II, III, IV.
 patients who can understand and speak tamil, English, Hindi

Exclusion criteria:
 Patients with other cardiac diseases such as HI, valvular disorders.
 Patients who are terminally ill.
 Patients who are unconscious.
 Patients who are not willing to participate in the study.
 Patients who are less than 18 years of age.

Sample Size:
A Total of 30 participants.
Subjects will be chosen using the convenient sampling method.
Data collection Instrument

Demographic variables:

Sex | Gender
Male
Female

Age in years
20- 40 years
41-60 years
61-75 years
>75 years

Marital status:
Married
Single
widow
Separated
Education:
Illiterate
High school
Undergraduate
Post graduate

Monthly Income
<5000
5001 - 8000
>8000

CLINICAL VARIABLES:

Duration of Problem
3 months - 1 year
1 year - 3 year
more than 3 yeary

Associated problem
DH-Diabetic Hellitus
HTN - Hyper tension
COPD | Asthma
IHD - Ischemic Heart Disease.
Both DM and HTN
Others

NYHA Classification
I
II
III
IV

Habits
Smoking
Alcohol
Both smoking and alcohol
Tobacco Chewing

EJECTION Fraction
<20%
20-40%
>40%

Body Mass Index [kg/m³]

underweight <18.5
Normal weight 18.5-24.9
Over weight 25-29.9
Obese Class I 30-34.9
Obese class II 35-39.9
Obese class III

Drugs:

Diuretics
Digoxin
Ace Inhibitors
B blockers
Anti platelet
Anti coagulant

SECTION B

Data collection instruments

Data will be collected using the two scales of Rosen berg's self-esteem scale
used to measure the level of self-esteem of heart failure patients and the Kessler
psychological distress scale (k10) used to measure the distress level of the heart
failure Patients.

Scoring and Interpretation

Rosenberg Scale
Scoring
Items 2,5,6,8,9 are reversely scored Given Strongly Disagree - 1 point Disagree
2 point Agree - 3 point Strongly agree - 4 point.
Interpretation:
Sum of all the scores will be calculated and the higher the scores the higher is
the Self esteem lever of the patient.
Scores [10-25]  has Extremely low self esteem levels
Scores [26-29] have a medium self esteem level.
Scores [30-40] have high self esteem levels.

Kessler Psychological Distress Scale:

Scoring
All of the time - score 5
most of the time - score 4
Some times - score 3
very few times - score 2
None of the time - score 1

Interpretation:
20-24 - mild psychological distress.
25-29 - moderate psychological distress.
>30 - severe psychological distress.

Data Analysis:

The demographic variables, clinical variables and the level of distress and level
of self esteem were analysed by using the descriptive Statistics the findings are
presented under different sections.

Section A
Describe the demographic and clinical variables of the participants.

Section B
Describe the participants responses to the Rosenberg's self-esteem scale and the
Kessler's distress scale.

Data Collection Schedule:

24/7/23 - Monday - Research proposal

25/7/23 - Tuesday - Pilot study.

26/7/ 23 Wednesday - Pilot study & Data analysis

27/7/23 - Thursday - Data Collection

28/7/23 - Friday - Data collection.

29/7/23 - Saturday - Data collection.

30/7/23 -  Sunday

31/7l23 - monday - Data collection

1/7/23- Tuesday - Data collection.

2/7/23 - Wednesday - Data analysis

3/7/23 - Thursday - Presentation

Pilot Study:

Pilot Study will be done to assess the feasibility of the study protocol.

Ethical Considerations:

Oral consent will be obtained from the participants. The study will be
performed under the guidance of research experts.