1
|
Thompson DR, Ski CF. Adopting adaptation in REACH-HF. Eur J Cardiovasc Nurs 2024:zvae076. [PMID: 38813943 DOI: 10.1093/eurjcn/zvae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/31/2024]
Affiliation(s)
- David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| |
Collapse
|
2
|
Wills WB, Athilingam P, Beckie TM. Exercise-based cardiac rehabilitation in women with heart failure: a review of enrollment, adherence, and outcomes. Heart Fail Rev 2023; 28:1251-1266. [PMID: 37059937 DOI: 10.1007/s10741-023-10306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 04/16/2023]
Abstract
Exercise-based cardiac rehabilitation (CR) is an evidence-based recommendation for patients with stable heart failure (HF). Less clear is how effective exercise-based CR is for women with HF. The aim of this review was to synthesize the evidence for the effects of exercise-based CR on mortality, hospitalizations, exercise capacity, and quality of life (QOL) among women with HF. We identified 18 studies comprising 4917 patients, of which 1714 were women. The interventions evaluated consisted of various combinations of supervised in-hospital and out-patient sessions as well as home-based programs that included aerobic (walking, treadmill, bicycle) and resistance training. The interventions ranged from 12 to 54 weeks, with a frequency of 2-7 sessions per week, lasting from 30 to 105 min per session. Because of a paucity of sex-specific analyses of the outcomes, it was not possible to draw conclusions for women. There was limited evidence for mortality benefit for men or women participating in exercise-based CR. There was more substantial evidence for reductions in hospitalizations for the participants. Generally, exercise training improved exercise capacity. The effects of exercise-based CR on QOL were mixed with most studies favoring CR at 3 months but not at 4, 5, and 12 months. Moreover, generally, the physical dimension of QOL but not the mental dimensions improved. Recommendations for future research to reduce the gap in knowledge about the effects of exercise-based CR for women are offered.
Collapse
Affiliation(s)
- Walter B Wills
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd., MDC Box 22, Tampa, FL, 33612, USA
| | - Ponrathi Athilingam
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd., MDC Box 22, Tampa, FL, 33612, USA
| | - Theresa M Beckie
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd., MDC Box 22, Tampa, FL, 33612, USA.
| |
Collapse
|
3
|
Liu S, Xiong XY, Chen H, Liu MD, Wang Y, Yang Y, Zhang MJ, Xiang Q. Transitional Care in Patients with Heart Failure: A Concept Analysis Using Rogers' Evolutionary Approach. Risk Manag Healthc Policy 2023; 16:2063-2076. [PMID: 37822727 PMCID: PMC10563773 DOI: 10.2147/rmhp.s427495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
Objective The purpose of this study was to clarify the concept of transitional care in patients with heart failure. Background Transitional care is increasingly being applied in patients with heart failure, but the concept of transitional care in heart failure patients is not uniform and confused with other definitions, which limits further research and practice on transitional care for these patients. Design Rodgers' evolutionary concept analysis. Methods A comprehensive literature search was conducted using the PUBMED, EMBASE, EBSCO, Chinese Biological Medicine (CBM), CNKI, and WANFANG databases (up to January 26, 2023). We used Rodgers' evolutionary concept analysis method to identify related concepts, attributes, antecedents, and consequences of transitional care in patients with heart failure. Results A total of 33 articles were included. The following attributes belonging to transitional care in patients with heart failure were extracted from the literature: self-care, multidisciplinary collaboration, and information transmission. The antecedents were patients' health status, the health literacy of patients and caregivers, the role functions of the main implementer and social and medical resources. Consequences were separated into two categories: patient-centered health outcomes (all-cause mortality, health-related quality of life, discharge preparedness, self-care behaviors, satisfaction of patients) and healthcare utilization outcomes (hospital readmission, length of hospital stay, emergency department visits). Conclusion This study found that transitional care in heart failure patients is a systemic care process during a vulnerable period that improves patient self-management and coordination between hospital resources and social support systems for continuous management to promote smooth patient transitions between different locations. This concept analysis will inform healthcare providers in designing evidence-based interventions and quality improvement strategies to ensure that transition processes lead to desired outcomes. In addition, this study will also be helpful for developing specific assessment tools to identify patients with HF who need transitional care.
Collapse
Affiliation(s)
- Si Liu
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
- Nursing Department, the Second Affiliated Hospital of Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Xiao-yun Xiong
- Nursing Department, the Second Affiliated Hospital of Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Hua Chen
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Meng-die Liu
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Ying Wang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Ying Yang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Mei-jun Zhang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Qin Xiang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| |
Collapse
|
4
|
Marston C, Morgan DD, Philip J, Agar M. Supporting Carers as Patients Move between Hospital and Home: A Systematic Review of Interventions to Support These Transitions in Care. J Palliat Med 2023; 26:270-298. [PMID: 36251853 DOI: 10.1089/jpm.2022.0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Hospital-to-home transitions become more frequent and complex as people approach end of life. Although carers are critical to enabling these transitions, they report high levels of unmet need. A review of the interventions to assist these care transitions, along with understanding those intervention components and mechanisms that support carers of people with advanced illness, is required to inform an optimal care model for palliative care practice. Aim: To describe the characteristics and reporting quality of intervention studies aimed at improving hospital-to-home transitions for carers of people with advanced illness. Design: This is a systematic review with a narrative synthesis. (international prospective register of systematic reviews [PROSPERO] ID: CRD42020192088). Data Sources: MEDLINE, EMCare, and PsychINFO databases were searched (2000-2021) for prospective studies reporting on interventions that (1) aimed to improve hospital-to-home transitions and (2) targeted carers of people with advanced illness. The Template for Intervention Description and Replication (TIDieR) checklist and constructs of the Care Transition Framework were used to assess the reporting quality of intervention design, delivery, and outcomes. Results: In total, 37 articles were analyzed that included a range of study designs, interventions, and outcomes. Health care utilization (n = 29) and clinical patient-related (n = 21) measures were the most reported outcome. Theoretical discussion was minimal (n = 5) with most studies using efficacy data from past research to justify intervention choice. Conclusion: Carers are critical partners in hospital-to-home transitions at end of life; yet they are largely under-represented in intervention design, delivery, and outcomes. Improving the reporting quality of carer-focused care transition interventions will inform future study design and support translation into practice and policy.
Collapse
Affiliation(s)
- Celia Marston
- Department of Occupational Therapy, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Occupational Therapy, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Occupational Therapy, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Deidre D Morgan
- Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, South Australia, Australia
| | - Jennifer Philip
- Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Palliative Care Service, St. Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Palliative Care Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Meera Agar
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
5
|
R Thompson D, F Ski C, M Clark A, M Dalal H, S Taylor R. Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation? Card Fail Rev 2022; 8:e28. [PMID: 36303590 PMCID: PMC9585646 DOI: 10.15420/cfr.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022] Open
Abstract
Many people with heart failure do not receive cardiac rehabilitation despite a strong evidence base attesting to its effectiveness, and national and international guideline recommendations. A more holistic approach to heart failure rehabilitation is proposed as an alternative to the predominant focus on exercise, emphasising the important role of education and psychosocial support, and acknowledging that this depends on patient need, choice and preference. An individualised, needs-led approach, exploiting the latest digital technologies when appropriate, may help fill existing gaps, improve access, uptake and completion, and ensure optimal health and wellbeing for people with heart failure and their families. Exercise, education, lifestyle change and psychosocial support should, as core elements, unless contraindicated due to medical reasons, be offered routinely to people with heart failure, but tailored to individual circumstances, such as with regard to age and frailty, and possibly for recipients of cardiac implantable electronic devices or left ventricular assist devices.
Collapse
Affiliation(s)
- David R Thompson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Alexander M Clark
- School of Health Disciplines, Athabasca University, Edmonton, Canada
| | - Hasnain M Dalal
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rodney S Taylor
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
6
|
Li Y, Fang J, Li M, Luo B. Effect of nurse-led hospital-to-home transitional care interventions on mortality and psychosocial outcomes in adults with heart failure: a meta-analysis. Eur J Cardiovasc Nurs 2021; 21:307-317. [PMID: 34792110 DOI: 10.1093/eurjcn/zvab105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/08/2021] [Accepted: 10/22/2021] [Indexed: 11/14/2022]
Abstract
AIMS To determine the effectiveness and dose-response of nurse-led hospital-to-home transitional care interventions (TCIs) on patient mortality and psychosocial outcomes of health-related quality of life (HRQoL), self-care behaviours, and emotional well-being in adults hospitalized with heart failure (HF) and to recognize pertinent characteristics that potentially affect the overall effectiveness. METHODS AND RESULTS Relevant studies were identified through electronic database searches, including MEDLINE, Embase, CINAHL, and Cochrane Library from January 2000 until January 2021. Two independent authors performed study selection, data abstraction, and risk-of-bias assessment. When appropriate, we used random-effects meta-analysis to derive pooled effect estimates, investigated dose-response relationships, and ran meta-regressions to locate the source of heterogeneity. A total of 27 studies with 7635 participants were included. Our findings revealed that nurse-led hospital-to-home TCIs reduced the risk of all-cause mortality by 21% [risk ratio = 0.79; 95% confidence interval (CI) 0.68-0.92; P = 0.003] and improved HRQoL (mean difference = -3.29; 95% CI -6.51 to -0.07; P = 0.04) compared to usual care, but non-significant effects were found for emotional well-being. The narrative summary of evidence for self-care behaviours showed positive intervention effects. Meta-regression did not find any covariates that were significantly related to mortality or HRQoL. Dose-response analysis showed that mortality risk was reduced with increased intensity and complexity of the nurse-led TCIs. CONCLUSION Generally, nurse-led hospital-to-home TCIs may play a beneficial role in decreasing mortality, and improving HRQoL and self-care behaviours for adults with HF. Additional studies are warranted to characterize the optimal nurse-led TCIs for HF management.
Collapse
Affiliation(s)
- Yuan Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education/Nursing Department, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu 610041, China.,West China School of Nursing, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu 610041, China
| | - Jinbo Fang
- West China School of Nursing, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu 610041, China
| | - Minlu Li
- West China School of Nursing, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu 610041, China
| | - Biru Luo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education/Nursing Department, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu 610041, China.,West China School of Nursing, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu 610041, China.,Nursing Department, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu 610041, China
| |
Collapse
|
7
|
Thompson DR, Clark AM. Heart failure disease management interventions: time for a reappraisal. Eur J Heart Fail 2020; 22:578-580. [PMID: 32091664 DOI: 10.1002/ejhf.1777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | |
Collapse
|