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Jul 20th, 2010

Updated Best Practice Recommended Assessment Questions and Observations

Assess Current Practices:

1. What do you typically eat in a day?
2. What types of food do you eat?
3. What times of the day do you usually eat?
4. How many meals do you eat out or order take-out food?
5. Do you use pre-packaged foods?
6. Have you changed anything in your diet since you found out you have heart failure?
7. Are there foods you don’t eat for religious or cultural beliefs?
8. Do you fast for any reason?

Assessing Physical Status:

1. Have you experienced a change in symptoms over the last two weeks?
2. Have you noticed a change in your weight or an increase in swelling over the last two weeks?
3. Do you weigh yourself daily before breakfast with no clothes on?
4. Do you keep a log of your daily weights to share with your healthcare provider?
5. Do you avoid certain foods because it is hard to chew, swallow, or painful to eat, or leads to nausea, constipation, bloating, gas, vomiting etc.?
6. When was the last time you went to the dentist?
7. Are you satisfied with your weight?
8. Have you gained or lost weight in the past year?
9. How much have you gained or lost?
10. Were you trying to gain or lose weight?
11. Do you have difficulty reading package directions?

Assessing Resources, Risk, and Readiness:

1. Who does the shopping and the cooking?
2. Where do you shop?
3. Have you ever not purchased foods due to costs?
4. What have you changed in your diet since you found out you have heart failure?
5. On a scale of 1-10* how important do you think it is for you to make changes in your current diet to help your heart?
6. On a scale of 1-10* how confident are you about making the changes to improve your heart?
7. Do you want to change your diet? What would you change?
8. Do you ever forget to eat a meal?
9. Do you ever not feel like eating at meal time?


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The development of the hypertension and chronic stable angina project was made possible by a grant from the New York State Attorney General on behalf of the Attorneys General of all 50 states, DC and Puerto Rico from litigation settlement funds to benefit the healthcare needs of consumers with high blood pressure and angina. Original funding for the site was provided in part by US Congress and CDC. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.