Self-care support for patients with chronic heart failure
Heart failure (HF) is a universally prevalent and money-consuming condition associated with heavy symptom burden and frequent hospital admissions. In Japan, I started to work on my own research interest, being improving care and quality of life of HF patients and their families. I started the first research in translating HF self-care scales developed in European countries (Kato et al, 2008) and in exploring factors associated with poor HF self-care behavior (Kato et al, 2009) as my master’s thesis at the department of Adult Nursing, University of Tokyo. In addition, we developed a HF self-care educational program provided by a multidisciplinary team and tested effects of the program in a randomized pilot study as my PhD dissertation at the department of Adult Nursing, University of Tokyo (Kato et al, 2012; Kato et al 2016). To assess effects of the program, the HF self-care scale as well as a Japanese HF knowledge scale we had developed previously were used (Kato et al, 2008; Kato et al, 2013). Moreover, we have revealed that insufficient self-care is associated with an increased risk of HF hospitalization and mortality in chronic HF patients (Kato et al, 2013).
Self-care support for patients with a left ventricular assist device (LVAD) and their caregivers
During my postdoctoral fellowship at the department of cardiovascular medicine, University of Tokyo Hospital in Japan, I have started a new research for patients after an implantation of LVAD. We showed that QoL of patients were improved after LVAD implantation (Kato et al, 2015), whereas caregiver’s QoL score were significantly impaired compared with the score from normal population (Kato et al, 2018). Additionally, we have conducted systematic review regarding self-care of these LVAD patients (Kato et al, 2014), and identified LVAD self-care behaviors. On the basis of the results, a LVAD self-care behavior scale was developed using a Delphi method including 10 international healthcare professionals. A study for examining the validity and reliability of this scale is now ongoing in the team of Professor Jaarsma and Professor Strömberg.
Telemonitoring for chronic HF patients
Since August 2013, I had worked as a postdoc at Linköping University in the team of Professor Jaarsma and Professor Strömberg. We have performed a questionnaire survey about HF telemonitoring in Japan and Sweden. We found that only a few Japanese hospitals and no Swedish hospitals/clinics have introduced telemonitoring for HF patients, but cardiologist and nurses could see a role for telemonitoring for their HF patients. (Kato et al, 2015).
β-blockers therapy in systolic HF patients
During my postdoc in Japan, we revealed that the composite endpoint rate of HF hospitalization and/or all-cause death was significantly decreased. Recent improvement of clinical outcome among HF with reduced ejection fraction patients may be attributable to the up-titration policy of β-blocker accompanying lowered heart rate. Resting heart rate ≤71 beats/min and β-blocker ≥10 mg/day (i.e., 50% of the target dose for Japanese patients) could be surrogate markers when titrating β-blocker (Kato et al, 2013; Kato et al, 2014).
