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Righi GDA, Schuch FB, Tolves T, De Nardi AT, Righi NC, Signori LU, da Silva AMV. Combined aerobic and strength training for fitness outcomes in heart failure: meta-analysis and meta-regression. Disabil Rehabil 2021; 44:4149-4160. [PMID: 33789068 DOI: 10.1080/09638288.2021.1900411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the effects of combined training (CT) versus aerobic training (AT) or versus control on VO2 peak and quadriceps muscle strength in patients with heart failure (HF). MATERIALS AND METHODS Major electronic databases were searched, from inception to November 2020, for randomized clinical trials comparing the effects of CT against AT or control on VO2 peak and/or quadriceps muscle strength in patients with HF. Random effects meta-analyses were conducted, calculating the standardized mean difference (SMD). RESULTS Twenty-eight articles were included. An increase on VO2 peak (SMD = 0.77, 95%CI 0.39-1.14, I2=80.1%) and quadriceps muscle strength (SMD = 0.67, 95%CI 0.18-1.16, I2=0%) was found in CT compared to control. CT increased quadriceps muscle strength, versus AT (SMD = 0.44, 95%CI 0.15-0.74, I2=0%). There were no differences between CT and AT on VO2 peak (SMD=-0.01, 95%CI -0.36 to 0.34, I2=65%). Time of session and training duration moderate the effects of CT over control on VO2 peak. CONCLUSIONS CT promotes increases on quadriceps muscle strength and aerobic capacity over control and provides additional gains on quadriceps muscle strength, having the same effects on VO2 peak compared to AT. A longer time of session is associated with greater benefits to aerobic capacity.Implications for rehabilitationCombining aerobic and strength training increases the functional capacity and quadriceps muscle strength in heart failure patients.Using longer sessions of training has a greater impact on aerobic capacity.
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Affiliation(s)
| | - Felipe Barreto Schuch
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Tainara Tolves
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Luis Ulisses Signori
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.,Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Antônio Marcos Vargas da Silva
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.,Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
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Toukhsati SR, Mathews S, Sheed A, Freijah I, Moncur L, Cropper P, Ha FJ, Hare DL. Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure. Eur J Cardiovasc Nurs 2019; 19:165-171. [DOI: 10.1177/1474515119876784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Low confidence to exercise is a barrier to engaging in exercise in heart failure patients. Participating in low to moderate intensity exercise, such as the six-minute walk test, may increase exercise confidence. Aim: To compare the effects of a six-minute walk test with an educational control condition on exercise confidence in heart failure patients. Methods: This was a prospective, quasi-experimental design whereby consecutive adult patients attending an out-patient heart failure clinic completed the Exercise Confidence Scale prior to and following involvement in the six-minute walk test or an educational control condition. Results: Using a matched pairs, mixed model design ( n=60; 87% male; Mage=58.87±13.16), we identified a significantly greater improvement in Total exercise confidence ( F(1,54)=4.63, p=0.036, partial η2=0.079) and Running confidence ( F(1,57)=4.21, p=0. 045, partial η2=0.069) following the six-minute walk test compared to the educational control condition. These benefits were also observed after adjustment for age, gender, functional class and depression. Conclusion: Heart failure patients who completed a six-minute walk test reported greater improvement in exercise confidence than those who read an educational booklet for 10 min. The findings suggest that the six-minute walk test may be used as a clinical tool to improve exercise confidence. Future research should test these results under randomized conditions and examine whether improvements in exercise confidence translate to greater engagement in exercise behavior.
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Affiliation(s)
- SR Toukhsati
- Psychology, School of Health and Life Sciences, Federation University Australia, Australia
- Department of Cardiology, Austin Health, Australia
| | - S Mathews
- Department of Cardiology, Austin Health, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, Australia
| | - A Sheed
- Department of Cardiology, Austin Health, Australia
| | - I Freijah
- Department of Cardiology, Austin Health, Australia
- Department of Psychiatry, University of Melbourne, Australia
| | - L Moncur
- Department of Cardiology, Austin Health, Australia
| | - P Cropper
- Department of Cardiology, Austin Health, Australia
| | - FJ Ha
- Department of Cardiology, Austin Health, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, Australia
| | - DL Hare
- Psychology, School of Health and Life Sciences, Federation University Australia, Australia
- Department of Cardiology, Austin Health, Australia
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Abidi S, Vallis M, Piccinini-Vallis H, Imran SA, Abidi SSR. Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform. JMIR Med Inform 2018; 6:e25. [PMID: 29669705 PMCID: PMC5932333 DOI: 10.2196/medinform.9629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. OBJECTIVE The aim of this study was to develop and evaluate a computerized decision support platform called "Diabetes Web-Centric Information and Support Environment" (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. METHODS A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners' readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association's (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients' progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient's self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. RESULTS For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool's screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. CONCLUSIONS This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients' feedback is now being used to make necessary modification to DWISE.
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Affiliation(s)
- Samina Abidi
- Medical Informatics Program, Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Michael Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Helena Piccinini-Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Syed Ali Imran
- Division of Endocrinology and Metabolism, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Syed Sibte Raza Abidi
- Knowledge Intensive Computing for Healthcare Enterprises Research Group, Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients. J Cardiovasc Nurs 2018; 31:343-9. [PMID: 25774840 DOI: 10.1097/jcn.0000000000000246] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. OBJECTIVE The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. METHODS For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. RESULTS Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P < .001), heart rate recovery (P = .04), and self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P < .001) and self-efficacy (P < .001) were sustained at 1 month after hospital discharge. CONCLUSION Our inpatient multimedia exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.
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Deka P, Pozehl B, Williams MA, Yates B. Adherence to recommended exercise guidelines in patients with heart failure. Heart Fail Rev 2018; 22:41-53. [PMID: 27671166 DOI: 10.1007/s10741-016-9584-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Exercise training has been shown to be beneficial in patients with heart failure, and its effectiveness is connected to adherence to the exercise program. Nonetheless, adherence to exercise in these patients remains a concern. Heart failure patients can be considered adherent to an exercise program if they meet 80 % of the recommended dose. We summarize exercise recommendations for patients with heart failure, identify exercise prescription methodologies used in studies that have reported exercise adherence, identify strategies and tools used to improve adherence and examine whether these strategies were developed using a theoretical platform with the primary aim to change behavior and improve adherence to exercise. Factors which may also impact adherence such as exercise setting, intensity and length of participation, gender, race, New York Heart Association functional class and heart failure with preserved and reduced ejection fraction were also investigated. Finally, recommendations for future studies for improving adherence to exercise in patients with heart failure are provided.
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Affiliation(s)
- Pallav Deka
- College of Nursing, University of Nebraska Medical Center, Commerce Court 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA.
| | - Bunny Pozehl
- College of Nursing, University of Nebraska Medical Center, Commerce Court 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA
| | - Mark A Williams
- Divison of Cardiology, Creighton University School of Medicine, Omaha, NE, USA
| | - Bernice Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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Picha KJ, Howell DM. A model to increase rehabilitation adherence to home exercise programmes in patients with varying levels of self-efficacy. Musculoskeletal Care 2018; 16:233-237. [PMID: 28401666 DOI: 10.1002/msc.1194] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Patient adherence to rehabilitation programmes is frequently low - particularly adherence to home exercise programmes. Home exercise programmes have been identified as complementary to clinic-based physical therapy in an orthopaedic setting. Barriers to patient adherence have previously been identified within the literature. Low self-efficacy is a barrier to adherence that clinicians have the ability to have an impact on and improve. The theory of self-efficacy is defined as a person's confidence in their ability to perform a task. This theory examines the ability of a person to change through exerting control over inner processes of goal setting, self-monitoring, feedback, problem solving and self-evaluation. If clinicians are able to identify patients with low self-efficacy prior to the prescription of a home exercise programme, adjustments to individualized care can be implemented. Individualized care based on improving self-efficacy for home exercise programmes may improve patient adherence to these programmes. The purpose of this article was to use the theory of self-efficacy to direct clinicians in providing individualized programmes to patients with varying levels of self-efficacy.
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Affiliation(s)
- Kelsey J Picha
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA
| | - Dana M Howell
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, KY, USA
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Ha FJ, Hare DL, Cameron JD, Toukhsati SR. Heart Failure and Exercise: A Narrative Review of the Role of Self-Efficacy. Heart Lung Circ 2017; 27:22-27. [PMID: 28969981 DOI: 10.1016/j.hlc.2017.08.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 05/23/2017] [Accepted: 08/13/2017] [Indexed: 12/21/2022]
Abstract
Chronic heart failure (CHF) is a common, debilitating condition associated with significant health and economic burden. CHF management is multidisciplinary, however, achieving better health relies on a collaborative effort and patient engagement in self-care. Despite the importance of self-care in CHF, many patients have poor adherence to their medical and lifestyle regimens, in particular with regards to engaging in physical exercise. The patient's confidence in their ability, otherwise known as self-efficacy, is an important determinant of CHF health outcomes, most likely due to its effect on the uptake of CHF self-care activities especially exercise initiation and maintenance. Self-efficacy is responsive to experience such as exercise training, however the critical components of exercise interventions to improve self-efficacy have yet to be determined. This narrative review provides an overview of the role of self-efficacy in exercise adherence in CHF.
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Affiliation(s)
- Francis J Ha
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia; Department of Cardiology, Austin Hospital, Melbourne, Vic, Australia.
| | - David L Hare
- Department of Cardiology, Austin Hospital, Melbourne, Vic, Australia; University of Melbourne, Melbourne, Vic, Australia
| | - James D Cameron
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia
| | - Samia R Toukhsati
- Department of Cardiology, Austin Hospital, Melbourne, Vic, Australia; University of Melbourne, Melbourne, Vic, Australia
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Understanding physical activity and exercise behaviors in patients with heart failure. Heart Lung 2015; 44:2-8. [DOI: 10.1016/j.hrtlng.2014.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 11/30/2022]
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The home physical environment and its relationship with physical activity and sedentary behavior: a systematic review. Prev Med 2014; 67:221-37. [PMID: 25084562 DOI: 10.1016/j.ypmed.2014.07.026] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 07/18/2014] [Accepted: 07/20/2014] [Indexed: 11/20/2022]
Abstract
Reviews of neighborhood (macro) environment characteristics such as the presence of sidewalks and esthetics have shown significant correlations with resident physical activity (PA) and sedentary (SD) behavior. Currently, no comprehensive review has appraised and collected available evidence on the home (micro) physical environment. The purpose of this review was to examine how the home physical environment relates to adult and child PA and SD behaviors. Articles were searched during May 2014 using Medline, PsycINFO, PubMed, Scopus, and SPORTDiscus databases which yielded 3265 potential studies. Papers were considered eligible if they investigated the presence of PA (ie. exercise equipment, exergaming devices) or SD (ie. television, videogames) equipment and PA or SD behavior. After, screening and manual cross-referencing, 49 studies (20 experimental and 29 observational designs) were found to meet the eligibility criteria. Interventions that reduced sedentary time by using TV limiting devices were shown to be effective for children but the results were limited for adults. Overall, large exercise equipment (ie. treadmills), and prominent exergaming materials (exergaming bike, dance mats) were found to be more effective than smaller devices. Observational studies revealed that location and quantity of televisions correlated with SD behavior with the latter having a greater effect on girls. This was similarly found for the quantity of PA equipment which also correlated with behavior in females. Given the large market for exercise equipment, videos and exergaming, the limited work performed on its effectiveness in homes is alarming. Future research should focus on developing stronger randomized controlled trials, investigate the location of PA equipment, and examine mediators of the gender discrepancy found in contemporary studies.
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Caldieraro-Bentley AJ, Andrews JO. An integrative review: application of self-efficacy instruments for walking in populations with peripheral arterial disease. JOURNAL OF VASCULAR NURSING 2014; 31:118-30. [PMID: 23953861 DOI: 10.1016/j.jvn.2013.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 01/31/2013] [Accepted: 01/31/2013] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The study objective was to identify which self-efficacy measurement instruments are being used for walking in patients with peripheral arterial disease (PAD), the psychometrics of these instruments, and recommendations for use in research on patients with PAD. BACKGROUND PAD is a common problem for individuals with similar risk factors as cardiovascular disease (CVD). Experts recommend a supervised walking program with incremental increases in speed and distance as an initial treatment for patients with intermittent claudication. Because patients may experience pain while walking, there is a tendency to be nonadherent with exercise therapy, and many limit or avoid walking all together, resulting in a sedentary lifestyle. Self-efficacy plays a role in determining a person's confidence in his or her ability to participate in an exercise program. Data sources for this study were PubMed, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and the Cochrane database. METHODS The integrative review method described by Wittemore and Knafl was used for this review (Wittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs 2005;52:546-53.). Publications were retrieved electronically and reviewed for inclusion on the basis of studies that measured self-efficacy for walking in populations with PAD, peripheral vascular disease, and CVD. The analysis consisted of 9 publications. RESULTS Only 2 studies were specific to the population with PAD. The remaining studies addressed self-efficacy issues in CVD or congestive heart failure. The analysis identified 4 instruments based on Bandura's Social Cognitive Theory that were used to assess self-efficacy: (1) the Self-Efficacy Expectation Scale, (2) the Self-Efficacy for Managing Chronic Disease Scale, (3) the Performance-Based Efficacy Scale, and (4) the Barriers Self-Efficacy Scale. The Self-Efficacy Expectation Scale was most frequently used in these studies. CONCLUSIONS The use of the Self-Efficacy Expectation Scale instruments for walking in patients with PAD is limited because reliability and validity have been demonstrated in an older, mostly white population with CVD and congestive heart failure. Instruments that encompass the key constructs of self-efficacy, including physical, personal, and environmental aspects, would allow full evaluation with identification of potential explanations for success or failure for the chosen outcome. This should be taken into consideration in future studies when using instruments of self-efficacy.
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Allahverdipour H, Asgharijafarabadi M, Heshmati R, Hashemiparast M. Functional status, anxiety, cardiac self-efficacy, and health beliefs of patients with coronary heart disease. Health Promot Perspect 2013; 3:217-29. [PMID: 24688971 DOI: 10.5681/hpp.2013.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 12/19/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Beliefs and emotions could effect on functional status, quality of life, and mortality amongst patients who are suffering coronary heart disease (CHD). Current study examined the role of anxiety: trait/ state, self-efficacy, health beliefs, and functional status among patient with history of CHD. METHOD In this correlational study, 105 hospitalized and outpatients patients suffering CHD in Tehran Heart Center Hospital participated by using convenience sampling method in 2012. Cardiac self-efficacy, Seattle Angina, and research-designed health beliefs questionnaires were used to gather data. RESULTS The functional status in CHD patients showed significant relationships with gender, job, and type of medical insurance of the participants (All ps<0.05). In addition , perceived vulnerability to face again cardiac attack in the future, per-ceived severity of next cardiac attack, anxiety, state anxiety and trait anxiety (All ps<0.05) had significant and negative relationships with functional status. Con-versely, the cardiac self-efficacy had a positive and significant relationship (P<0.001) with functional status. CONCLUSION Psychological factors have important role in functional status and quality of life of patients who suffering CHD. Therefore, it is necessary to emphasize on supportive and complementary programs to promote Cardiac Reha-bilita-tion Programs.
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Affiliation(s)
- Hamid Allahverdipour
- Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, 14711, Iran
| | | | - Rasoul Heshmati
- Department of Health Psychology, Tehran University, Tehran, 84449, Iran
| | - Mina Hashemiparast
- Department of Health Education, Tehran University of Medical Sciences, Tehran, Iran
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Hwang R, Redfern J, Alison J. A narrative review on home-based exercise training for patients with chronic heart failure. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/174328808x309278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Shoemaker MJ, Keenoy B, Smith B, Slotman P. Interventions to improve daily activity in individuals with COPD and CHF: A systematic review. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/wjcd.2013.33044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wu MP, Wu SFV, Wang TC, Kao MJ, Yang WL. Effectiveness of a community-based health promotion program targeting people with hypertension and high cholesterol. Nurs Health Sci 2012; 14:173-81. [DOI: 10.1111/j.1442-2018.2011.00675.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stuifbergen AK, Morris M, Jung JH, Pierini D, Morgan S. Benefits of wellness interventions for persons with chronic and disabling conditions: a review of the evidence. Disabil Health J 2011; 3:133-45. [PMID: 20628583 DOI: 10.1016/j.dhjo.2009.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Persons living with the effects of chronic and disabling conditions are often at increased risk for the development of secondary conditions and disabilities that can lead to further decline in health status, independence, functional status, life satisfaction, and overall quality of life. OBJECTIVE The purpose of this study was to review the evidence for the benefits of wellness/health promotion interventions for persons with chronic and disabling conditions. METHODS The authors conducted a Medline search (1990-2007) using terms related to wellness and health promotion cross-referenced with general terms for chronic and disabling conditions, as well as 15 specific chronic and/or disabling conditions (e.g., multiple sclerosis, spinal cord injury). Selection of studies was limited to those published in English that reported randomized controlled trails or prospective studies that involved adult human subjects with a chronic and/or disabling condition. All selected studies focused on some aspect of a wellness or health promotion intervention and involved a comparison or control group. Of the 5,847 studies initially identified in the search using medical subject heading terms, 190 met the criteria for full review. Data were extracted from these publications and summarized using descriptive statistics. RESULTS Almost all studies (95%) explored the effects of wellness intervention in a sample diagnosed with a single condition (e.g., cancer, stroke, arthritis). Although the mean sample size was 100, the range in sample size varied widely (6-688); 25% of the studies had sample of 30 or fewer. Almost all studies (89.5%) reported positive effects of the wellness intervention, although the delivery and content of interventions as well as the measurement of outcomes, varied greatly. CONCLUSIONS Our findings support an immediate post-intervention positive impact of wellness interventions across persons with a wide variety of chronic and disabling conditions. Future research that clearly specifies primary study outcomes and follows the CONSORT guidelines will strengthen future reviews of the evidence and facilitate application of the evidence of practice.
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Affiliation(s)
- Alexa K Stuifbergen
- The University of Texas at Austin School of Nursing, Center for Health Promotion and Disease Prevention Research in Underserved Populations, 1700 Red River, Austin, Texas 78701, USA.
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Limitations to high intensity exercise prescription in chronic heart failure patients. Eur J Cardiovasc Nurs 2010; 10:167-73. [PMID: 20643582 DOI: 10.1016/j.ejcnurse.2010.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 06/02/2010] [Accepted: 06/03/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Interval training is recommended for chronic heart failure patients (CHF), but specific guidelines on setting appropriate workloads have not been fully established. The aim of this study was to compare a traditional method of interval training prescription with a protocol specifically designed for CHF. METHODS Ten CHF and 7 healthy controls performed 2 maximal incremental cycle tests to determine interval training workload; a standard test (10Wmin(-)(1)) and a steep test (25W.10(-)(s)). Peak work rate and oxygen uptake (VO(2 peak)) were determined. Training workloads were defined as 100% standard test and 50% steep test peak work rate. RESULTS Training workload determined from the standard test was higher than from the steep test in healthy controls (151 ± 17W vs 118 ± 13W; P<0.01), whereas in CHF there was no significant difference between methods (88 ± 10W vs 96 ± 9W; P>0.05). Steep test VO(2peak) reached 91 ± 5% of standard test VO(2 peak) in controls, and 99 ± 4% in CHF, with no significant differences between tests in either group. CONCLUSION Prescribing interval training from a standard test results in higher workloads than from a steep test in healthy individuals, but in CHF both methods prescribe similar workloads. However it should not be assumed that the two tests can be used interchangeably for CHF. This small-sized study raises issues about interval training prescription that may be hypothesis-generating for future larger-scale studies.
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Shin KR, Kang Y, Park HJ, Heitkemper M. Retracted:Effects of Exercise Program on Physical Fitness, Depression, and Self-Efficacy of Low-Income Elderly Women in South Korea. Public Health Nurs 2009; 26:523-31. [DOI: 10.1111/j.1525-1446.2009.00812.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sarkar U, Ali S, Whooley MA. Self-efficacy as a marker of cardiac function and predictor of heart failure hospitalization and mortality in patients with stable coronary heart disease: findings from the Heart and Soul Study. Health Psychol 2009; 28:166-73. [PMID: 19290708 DOI: 10.1037/a0013146] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The authors sought to evaluate the association of self-efficacy with objective measures of cardiac function, subsequent hospitalization for heart failure (HF), and all-cause mortality. DESIGN Observational cohort of ambulatory patients with stable CHD. The authors measured self-efficacy using a published, validated, 5-item summative scale, the Sullivan Self-Efficacy to Maintain Function Scale. The authors also performed a cardiac assessment, including an exercise treadmill test with stress echocardiography. MAIN OUTCOME MEASURES Hospitalizations for HF, as determined by blinded review of medical records, and all-cause mortality, with adjustment for demographics, medical history, medication use, depressive symptoms, and social support. RESULTS Of the 1,024 predominately male, older CHD patients, 1013 (99%) were available for follow-up, 124 (12%) were hospitalized for HF, and 235 (23%) died during 4.3 years of follow-up. Mean cardiac self-efficacy score was 9.7 (SD 4.5, range 0-20), corresponding to responses between "not at all confident" and "somewhat confident" for ability to maintain function. Lower self-efficacy predicted subsequent HF hospitalization (OR per SD decrease = 1.4, p = .0006), and all-cause mortality (OR per SD decrease = 1.4, p < .0001). After adjustment, the association of cardiac self-efficacy with both HF hospitalization and mortality was explained by worse baseline cardiac function. CONCLUSION Among patients with CHD, self-efficacy was a reasonable proxy for predicting HF hospitalizations. The increased risk of HF associated with lower baseline self-efficacy was explained by worse cardiac function. These findings indicate that measuring cardiac self-efficacy provides a rapid and potentially useful assessment of cardiac function among outpatients with CHD.
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Affiliation(s)
- Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, Box 1732, San Francisco, CA 94143-1732, USA.
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Abstract
There are growing numbers of people with heart failure, which is disabling for the individuals and costly for the health services. Heart failure is often associated with anxiety and depression. Nurses can improve patients' well-being by promoting regular exercise and self-care. Palliative care, which includes specialist heart failure services improves end-of-life experiences. This article reports the findings of a literature review derived from a search of 5 electronic databases to identify studies relating to the promotion of quality of life in chronic heart failure.
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Affiliation(s)
- Alison While
- King's College London, Florence Nightingale School of Nursing and Midwifery, London, UK.
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Chien CL, Lee CM, Wu YW, Chen TA, Wu YT. Home-based exercise increases exercise capacity but not quality of life in people with chronic heart failure: a systematic review. ACTA ACUST UNITED AC 2008; 54:87-93. [DOI: 10.1016/s0004-9514(08)70041-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dougherty CM, Johnston SK, Thompson EA. Reliability and validity of the self-efficacy expectations and outcome expectations after implantable cardioverter defibrillator implantation scales. Appl Nurs Res 2007; 20:116-24. [PMID: 17693214 PMCID: PMC2699595 DOI: 10.1016/j.apnr.2007.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to assess the reliability and validity characteristics of two new scales that measure self-efficacy expectations (Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale [SE-ICD]) and outcome expectations (Outcome Expectations After ICD Implantation Scale [OE-ICD]) in survivors (N = 168) of sudden cardiac arrest, all of whom received an ICD. Cronbach's alpha reliability demonstrated good internal consistency (SE-ICD alpha = .93 and OE-ICD alpha = .81). Correlations with other self-efficacy instruments (general self-efficacy and social self-efficacy) were consistently high. The instruments were responsive to change across time with effect sizes of .46 for SE-ICD and .26 for OE-ICD. These reliable, valid, and responsive instruments for measurement of self-efficacy expectations and outcome expectations after an ICD can be used in research and clinical settings.
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Affiliation(s)
- Cynthia M. Dougherty
- Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Box 357266, Room T608D, Seattle, WA 98195, USA, (206) 221-7927 Phone, (206) 543-4771 FAX, Nurse Practitioner, VA Puget Sound Health Care System, Seattle,
| | | | - Elaine Adams Thompson
- Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA,
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Sarkar U, Ali S, Whooley MA. Self-efficacy and health status in patients with coronary heart disease: findings from the heart and soul study. Psychosom Med 2007; 69:306-12. [PMID: 17510290 PMCID: PMC2771191 DOI: 10.1097/psy.0b013e3180514d57] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the relationship between cardiac self-efficacy and health status, including symptom burden, physical limitation, quality of life, and overall health among outpatients with stable coronary heart disease (CHD). We hypothesized that lower self-efficacy would predict worse health status, independent of CHD severity and depression. METHODS We performed a cross-sectional study of 1024 outpatients with CHD, who were recruited between 2000 and 2002 for the Heart and Soul Study. We administered a validated measure of cardiac self-efficacy, assessed cardiac function using exercise treadmill testing with stress echocardiography, and measured depressive symptoms using the Patient Health Questionnaire. Health status outcomes (symptom burden, physical limitation, and quality of life) were assessed using the Seattle Angina Questionnaire, and overall health was measured as fair or poor (versus good, very good, or excellent). RESULTS After adjustment for CHD severity and depressive symptoms, each standard deviation (4.5-point) decrease in self-efficacy score was independently associated with greater symptom burden (adjusted odds ratio (OR) = 2.1, p = .001), greater physical limitation (OR = 1.8, p < .0001), worse quality of life (OR = 1.6, p < .0001), and worse overall health (OR = 1.9, p < .0001). Depressive symptoms and poor treadmill exercise capacity were also associated with poor health status, but left ventricular ejection fraction and ischemia were not. CONCLUSIONS Among patients with CHD, low cardiac self-efficacy is associated with poor health status, independent of CHD severity and depressive symptoms. Further study should examine if self-efficacy constitutes a useful target for cardiovascular disease management interventions.
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Affiliation(s)
- Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA 94143-1211, USA.
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