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Ingram MCE, Nagalla M, Shan Y, Nasca BJ, Thomas AC, Reddy S, Bilimoria KY, Stey A. Sex-Based Disparities in Timeliness of Trauma Care and Discharge Disposition. JAMA Surg 2022; 157:609-616. [PMID: 35583876 PMCID: PMC9118066 DOI: 10.1001/jamasurg.2022.1550] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 02/25/2022] [Indexed: 11/14/2022]
Abstract
Importance Differences in time to diagnostic and therapeutic measures can contribute to disparities in outcomes. However, whether there is an association of timeliness by sex for trauma patients is unknown. Objective To investigate whether sex-based differences in time to definitive interventions exist for trauma patients in the US and whether these differences are associated with outcomes. Design, Setting, and Participants This was a retrospective cohort study conducted from July 2020 to July 2021, using the 2013 to 2016 Trauma Quality Improvement Program (TQIP) databases from level I to III trauma centers in the US. Patients 18 years or older with an Injury Severity Score (ISS) greater than 15 and who carried diagnoses of traumatic brain injury, intra-abdominal injury, pelvic fracture, femur fracture, and spinal injury as a result of their trauma were included in the study. Data were analyzed from July 2020 to July 2021. Main Outcomes and Measures Primary outcomes assessed timeliness to interventions, using Wilcoxon signed rank and χ2 tests. Secondary outcomes included location of discharge after injury, using propensity score-matched generalized estimating equations modeling. Results Of the 28 332 patients included, 20 002 (70.6%) were male patients (mean [SD] age, 43.3 [18.2] years) and 8330 (29.4%) were female patients (mean [SD] age, 48.5 [21.1] years), with significantly different distributions of ISS scores (ISS score 16-24: male patient, 10 622 [53.1%]; female patient, 4684 [56.2%]; ISS score 41-74: male patient, 2052 [10.3%]; female patient, 852 [10.2%]). Male patients more frequently had abdominal (4257 [21.3%] vs 1268 [15.2%]) and spinal cord (3989 [20.0%] vs 1274 [15.3%]) injuries, whereas female patients experienced greater proportions of femur (3670 [44.0%] vs 8422 [42.1%]) and pelvic (3970 [47.6%] vs 6963 [34.8%]) fractures. Female patients experienced significantly longer emergency department length of stay (median [IQR], 184 [92-314] minutes vs 172 [86-289] minutes; P < .001), longer time in pretriage (median [IQR], 52 [36-80] minutes vs 49 [34-77] minutes; P < .001), and increased likelihood of discharge to nursing or long-term care facilities instead of home after matching by age, ISS, mechanism, and injury type (male patient:female patient, odds ratio, 0.72; 95% CI, 0.67-0.78). Conclusions and Relevance Results of this cohort study suggest that female trauma patients experienced slightly longer delays in trauma care and had a higher likelihood of discharge to long-term care facilities than their male counterparts.
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Affiliation(s)
- Martha-Conley E. Ingram
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Monica Nagalla
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ying Shan
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian J. Nasca
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Arielle C. Thomas
- Committee on Trauma, American College of Surgeons, Chicago, Illinois
| | - Susheel Reddy
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Karl Y. Bilimoria
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anne Stey
- Surgical Outcomes Quality Improvement Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Soofi MA, Jafery Z, AlSamadi F. Impact of a Social Support Program Supervised by a Multidisciplinary Team on Psychosocial Distress and Knowledge About Heart Failure Among Heart Failure Patients. J Saudi Heart Assoc 2020; 32:456-463. [PMID: 33299791 PMCID: PMC7721446 DOI: 10.37616/2212-5043.1046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 11/20/2022] Open
Abstract
Background Heart failure drains significant financial resources with morbidity and mortality higher than cancer. Social support is defined as the care provided by the family members, friends and health care workers to the patients. Absence of social support and poor perceived social support will create stress, anxiety, depression and anger which further deteriorate the underlying disease and worsen quality of life. Discussion in group creates better understanding of the disease which helps the patients improving their skills in managing their condition. Objective To evaluate the impact of multidisciplinary team supervised social support program on components of psychosocial distress and knowledge about heart failure among heart failure patients. Methods Adult patients with heart failure attending King Fahad Medical City as inpatient or outpatient were enrolled in this prospective cohort study. Patients were given questionnaire to assess their perception of social support they have at their disposal, quality of life, knowledge regarding heart failure and self-care behavior. They then had interactive education in groups supervised by multidisciplinary team members about the pathogenesis of their disease with management strategies, dietary restriction, importance of exercise and healthy life style pattern. Patients shared their experiences in the group and had opportunity to learn from each other. Patients were assessed regarding their perceived social support, quality of life, knowledge regarding heart failure and self-care behavior immediately after the session and at 1 month interval. Results There were total 500 patients participated in the study. Among the study participants 62% were male and majority was living with the family. Components of psychosocial distress were present in up to 40% of study participants and only 36% considered knowledgeable regarding heart failure. After the interactive social support group meeting components of psychosocial distress were significantly reduced with significant improvement in knowledge about heart failure. At 1 month follow up participants reported persistent improvement in quality of life, improvement in self-care behavior, perceived social support and wanted to continue in social group program. Conclusion Social support program supervised by multidisciplinary team providing education and social support improved knowledge, self-care behavior, perceived social support and quality of life among heart failure patients.
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Affiliation(s)
| | - Zainab Jafery
- Adult Cardiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Faisal AlSamadi
- Adult Cardiology, King Fahad Medical City, Riyadh, Saudi Arabia
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Correa-Rodríguez M, Abu Ejheisheh M, Suleiman-Martos N, Membrive-Jiménez MJ, Velando-Soriano A, Schmidt-RioValle J, Gómez-Urquiza JL. Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E909. [PMID: 32225052 PMCID: PMC7230184 DOI: 10.3390/jcm9040909] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023] Open
Abstract
Coronary artery bypass graft surgery (CABG) might adversely affect the health status of the patients, producing cognitive deterioration, with depression being the most common symptom. The aim of this study is to analyse the prevalence of depression in patients before and after coronary artery bypass surgery. A systematic review and meta-analysis was carried out, involving a study of the past 10 years of the following databases: CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The total sample comprised n = 16,501 patients. The total number of items was n = 65, with n = 29 included in the meta-analysis. Based on the different measurement tools used, the prevalence of depression pre-CABG ranges from 19-37%, and post-CABG from 15-33%. There is a considerable presence of depression in this type of patient, but this varies according to the measurement tool used and the quality of the study. Systematically detecting depression prior to cardiac surgery could identify patients at potential risk.
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Affiliation(s)
- María Correa-Rodríguez
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria, IBS, 18012 Granada, Spain
| | - Moath Abu Ejheisheh
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Campus Universitario de Ceuta, C/Cortadura del Valle s/n, 51001 Ceuta, Spain
| | | | - Almudena Velando-Soriano
- University Hospital Virgen de las Nieves. Andalusian Health Service. Av. de las Fuerzas Armadas 2, 18014 Granada, Spain
| | | | - José Luis Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain
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Social Relationship Factors, Preoperative Depression, and Hospital Length of Stay in Surgical Patients. Int J Behav Med 2019; 25:658-668. [PMID: 30105602 DOI: 10.1007/s12529-018-9738-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE The interrelated associations of social relationship factors, depression, and outcomes of surgical patients are yet unexplored. The purpose of this study was to investigate whether depression mediates effects of general social support, loneliness, and living alone on hospital length of stay (LOS) of 2487 patients from diverse surgical fields. METHOD Social relationship factors and depression were assessed prior to surgery. The PROCESS macro for SPSS was used to conduct three simple mediation models that tested the indirect effects of social relationship factors on LOS mediated through depression. The models were adjusted for age, gender, preoperative physical health, surgical field, severity of medical comorbidity, and extent of surgical procedure. RESULTS Social support and loneliness had significant indirect effects on LOS that were statistically mediated by preoperative depression. Lower social support and the feeling of loneliness were considerably related to higher depression which predicted longer LOS. While social support and loneliness had no direct effects on LOS, there was a small significant direct association of living alone with shorter LOS. CONCLUSION Data suggest that social support and loneliness are indirectly related with surgical outcomes by an association with depression which in turn is related to worse outcomes. TRIAL REGISTRATION NCT01357694.
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5
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Development and Psychometric Properties of the Family Support Questionnaire for Adherence to Low Fat Diet in Patients with Cardiovascular Disease. HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.68261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Langabeer JR, Henry TD, Fowler R, Champagne-Langabeer T, Kim J, Jacobs AK. Sex-Based Differences in Discharge Disposition and Outcomes for ST-Segment Elevation Myocardial Infarction Patients Within a Regional Network. J Womens Health (Larchmt) 2018; 27:1001-1006. [PMID: 29319393 DOI: 10.1089/jwh.2017.6553] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND It is known that women with ST-segment elevation myocardial infarction (STEMI) have higher mortality in comparison to men. While the reasons for this sex-based difference are not completely understood, biologic differences and disparities in care have been implicated. Whether these differences persist within an urban, regional STEMI system of care with defined protocols is unclear. Our objective was to explore sex-related effects in outcomes in a large regional system of care. MATERIALS AND METHODS Data were drawn from a regional subset of the National Cardiovascular Data Registry for 33 hospitals in and around Dallas County, Texas from 2010 to 2015. We explored adjusted differences between women and men for discharge disposition, door to balloon (D2B), total ischemic time (TIS), length of stay, and in-hospital mortality rates. RESULTS Multivariate regressions to control for confounding factors, including age, D2B, and TIS, were significantly prolonged in women compared to men (D2B 58 vs. 54 minutes; TIS 206 vs. 178 minutes; both p < 0.001). Length of stay was 0.45 median days longer. Women were also much less likely to survive at discharge than men [odds ratio (OR): 0.63; 95% confidence interval (CI): 0.52-0.76]. Most notably, they were much less likely to be discharged to home than men (88% vs. 92%, p < 0.001). CONCLUSIONS In this study, we found that sex-based disparities persist for both cardiovascular outcomes and discharge disposition, even in a modern regionalized system of care.
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Affiliation(s)
- James R Langabeer
- 1 School of Biomedical Informatics, University of Texas Health Science Center , Houston, Texas
| | | | - Raymond Fowler
- 3 Department of Emergency Medicine, University of Texas Southwestern Medical Center , Dallas, Texas
| | | | - Junghyun Kim
- 1 School of Biomedical Informatics, University of Texas Health Science Center , Houston, Texas
| | - Alice K Jacobs
- 4 Department of Cardiology, Boston Medical Center, Boston University School of Medicine , Boston, Massachusetts
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Stoicea N, You T, Eiterman A, Hartwell C, Davila V, Marjoribanks S, Florescu C, Bergese SD, Rogers B. Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients. Front Cardiovasc Med 2017; 4:70. [PMID: 29230400 PMCID: PMC5712014 DOI: 10.3389/fcvm.2017.00070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 10/25/2017] [Indexed: 12/20/2022] Open
Abstract
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.
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Affiliation(s)
- Nicoleta Stoicea
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Tian You
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Andrew Eiterman
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Clifton Hartwell
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Victor Davila
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Stephen Marjoribanks
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | | | - Sergio Daniel Bergese
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.,Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Barbara Rogers
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Masoumi M, Shahhosseini Z. Self-care challenges in adolescents: a comprehensive literature review. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2016-0152/ijamh-2016-0152.xml. [PMID: 28599383 DOI: 10.1515/ijamh-2016-0152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 02/21/2017] [Indexed: 11/15/2022]
Abstract
Background Adolescence is the period of accepting self-care responsibility. Many severe diseases that cause early mortality are rooted in adolescence. Hence, adolescence is the definitive time for preventive interventions such as self-care behaviors. In addition to the benefits of self-care behaviors, evidence shows that adolescents face barriers in performing self-care behaviors. Objective The aim of the current study to review the self-care challenges for adolescents. Methods Databases such as Google Scholar, ScienceDirect, PubMed, Web of Science, Scientific Information Database and Scopus were searched to extract papers published from 1994 to 2016 based on the inclusion criterion. The inclusion criterion was English language papers from famous authors on self-care behaviors in adolescents. Results The results of the current study showed that adolescents face cultural (two subcategories, beliefs and convictions, knowledge), socio-economic (five subcategories, family, healthcare providers, peers, social support, economic status) and personal (three subcategories, mental health, gender, ethnicity) challenges. Conclusions Self-care behaviors in adolescents are influenced by biological, psychological, economic and social factors. As this is a multifactorial process, people who deal with adolescents should have enough knowledge regarding adolescent health status and also learn how to perceive the role of culture in self-care behaviors of the adolescents.
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Affiliation(s)
- Maryam Masoumi
- Research Student Committee, Mazandaran University of Medical Science, Nasibeh Nursing and Midwifery Faculty,Sari, Iran
| | - Zohreh Shahhosseini
- Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery Faculty,Mazandaran University of Medical Sciences, Sari, Iran
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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9
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van der Meij E, Bouwsma EVA, van den Heuvel B, Bonjer HJ, Anema JR, Huirne JAF. Using e-health in perioperative care: a survey study investigating shortcomings in current perioperative care and possible future solutions. BMC Surg 2017; 17:61. [PMID: 28535763 PMCID: PMC5442686 DOI: 10.1186/s12893-017-0254-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background An e-health care program has previously shown to have a positive effect on return to work, quality of life and pain in patients who underwent gynaecological surgery. Plausibly, providing the care program to a population undergoing other types of surgery will be beneficial as well. The objectives of this study are to evaluate patients’ opinions, needs and preferences regarding the information and guidance supplied to patients during the perioperative period, to investigate whether e-health may be of assistance and to explore if gender specific needs exist. Methods A questionnaire was sent to all patients between 18 and 75 years (n = 362), who underwent various forms of abdominal surgery between August 2013 to September 2014 in a university hospital in the Netherlands. The questionnaire contained questions about the current situation in perioperative care and questions about patients’ preferences in an e-health care program. Gender differences were evaluated. Results Two hundred seven participants (57.2%) completed the survey. The majority of the participants were relatively satisfied with the perioperative care they received (68.6%). Most reported shortcomings in perioperative care concerning the supply of information regarding the resumption of activities and guidance during the recovery course. An e-health care program was expected to be of added value in perioperative care by 78% of the participants; a website was reported as most useful. In particular practical functions on a website focusing on the preparation to surgery and monitoring after surgery were appraised to be highly valuable. Overall, women had slightly more needs for extra information and support during the perioperative course than men. Conclusions In abdominal surgery, there is a need for an e-health care program, which should focus mainly on the supply of information about the resumption of activities as well as guidance in the postoperative course.
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Affiliation(s)
- Eva van der Meij
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Esther V A Bouwsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - H Jaap Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Judith A F Huirne
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
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Khaledi GH, Mostafavi F, Eslami AA, Rooh Afza H, Mostafavi F, Akbar H. Evaluation of the Effect of Perceived Social Support on Promoting Self-Care Behaviors of Heart Failure Patients Referred to The Cardiovascular Research Center of Isfahan. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e22525. [PMID: 26328063 PMCID: PMC4552959 DOI: 10.5812/ircmj.22525v2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/12/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022]
Abstract
Background: Self-care is one of the most important aspects of treatment in patients with heart failure and ranks among the most important coping strategies against the events and stresses of life. Perceived social support plays an important role in performing self-care behaviors in these patients. Objectives: This study was conducted to evaluate the effect of perceived social support on promoting self-care behaviors among heart failure patients. Patients and Methods: This educational intervention with a randomized control group was performed on 64 heart failure patients referred to The Cardiovascular Research Center of Isfahan. The study population was divided randomly into two groups of intervention and control. The indicators of self-care behavior and perceived social support (before, immediately after, and 2 months after the intervention) were completed by the two groups. The intervention group received educational interventions in 120-minute sessions once a week for 4 weeks. SPSS software (version 20) was used for data analysis in addition to methods of descriptive and inferential statistics. Results: Based on the obtained results, educational intervention was effective in the improvement of perceived social support among our heart failure patients. The results also showed that an increase in perceived social support significantly promoted self-care behaviors in the case group after the intervention compared with the control group (P < 0.001). Conclusions: Perceived social support played an important role in improving the performance of self-care behaviors in our heart failure patients. Given the strengths of the present study, these findings can be considered in future research in this domain.
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Affiliation(s)
- Gholam Hassan Khaledi
- Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Ahmad Ali Eslami
- Cardiovascular Research Center of Isfahan, Isfahan University of Medical Sciences, Isfahan, IR Iran
- Corresponding Author: Ahmad Ali Eslami, Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran, E-mail:
| | - Hamidreza Rooh Afza
- Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Hassanzadeh Akbar
- Department of Statistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran
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Taghadosi M, Memarian R, Ahmadi F. The experiences of "difficult life" in heart valve replaced patients. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e19147. [PMID: 25389487 PMCID: PMC4222013 DOI: 10.5812/ircmj.19147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/30/2014] [Accepted: 07/26/2014] [Indexed: 11/19/2022]
Abstract
Background: Several reports, however, not comprehensive, have been presented about the experiences of patients with replaced heart-valve. Objectives: This study explores the experiences of the patients with heart valve replacement. Patients and Methods: A qualitative research with a content analysis approach was carried out on the patients with cardiac valve replacement during the year 2012 and 2013. A purposeful sampling using a semi-structured interview and open-ended questions (with the main question of "What problems did you have after the valve replacement?" followed by the exploratory questions) were performed until the data saturation. All interviews were recorded, then transcribed and typed. The data analysis was done according to Grancheim and Lundmen content analysis using the MAXQDA software. Results: Of 22 interviews taken from 13 participants, 430 codes were taken. Out of them, after deleting the similar items, 162 initial, 18 subcategory, and 5 subsidiary themes (problematic exposure with valve replacement, continuity of some difficulties, aggravation of life problems, insufficient support, and following a perceived care) were extracted. Based on the abstract and deep perception of the categories, the main theme of "difficult life" was explored. Conclusions: Aggravation and the continuity of some physical problems, and insufficient support after the valve replacement make the life difficult for the patients. Identification of these problems is necessary for planning and improvement of the patients' care, life quality, and survival through consultations, rehabilitation and education.
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Affiliation(s)
- Mohsen Taghadosi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Robabeh Memarian
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
- Corresponding Author: Robabeh Memarian, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-9133634439, E-mail: .
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
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Rude J, Azimova K, Dominguez C, Sarosiek J, Edlavitch S, Mukherjee D. Depression as a Predictor of Length of Stay in Patients Admitted to the Cardiovascular Intensive Care Unit at a University Medical Center. Angiology 2013; 65:580-4. [DOI: 10.1177/0003319713496868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression is a predictor of length of stay (LOS) and adverse outcomes in patients with cardiac disease. Our objective was to assess the impact of depression on LOS in a Hispanic population admitted to a cardiovascular intensive care unit (CVICU). This was a prospective study of 151 consecutive patients admitted to the CVICU. Patients were administered the Center for Epidemiologic Studies Depression (CES-D) scale survey within 24 hours of admission. Patients were followed until discharge to determine LOS and adverse outcomes. Depression was more prevalent in Hispanic patients than in nonHispanic patients based on the CES-D scores (41% vs 14%). Using multivariate analysis, the presence of depression was a significant predictor of increased LOS ( P = .001). Depression has a significant impact on LOS in a Hispanic population. Appropriate treatment of depression may decrease LOS and has the potential to be cost effective in the current health care environment.
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Affiliation(s)
| | | | | | | | - Stanley Edlavitch
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
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13
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Abstract
LEARNING OBJECTIVES After participating in this educational activity, the reader should be better able to measure the risk of depression before and after coronary artery bypass graft (CABG) surgery; examine the course of depression after CABG; and apply the results of the study to the treatment of patients. OBJECTIVE Depression is highly comorbid with coronary artery disease. Clinicians face the question of whether patients' depressive symptoms will improve after coronary artery bypass graft surgery (CABG). The objective of this meta-analysis is to determine the course of depressive symptoms after CABG. METHODS EMBASE, PubMed, and PsycINFO were searched for studies assessing depression before and after CABG. Meta-analyses were performed for depression at early (1-2 weeks), recovery (>2 weeks to 2 months), mid (>2 months to 6 months), and late (>6 months) postoperative time points. Heterogeneity and publication bias were analyzed. RESULTS Thirty-nine studies were included in the meta-analysis. Twelve reported dichotomous outcomes; 18 reported continuous outcomes; and 9 reported both. Risk of depression was increased early (relative risk [RR] = 1.27; 95% confidence interval [CI], 1.01-1.61). There was a significantly decreased risk of depression at recovery (RR = 0.78; 95% CI, 0.67-0.90), mid (RR = 0.64; 95% CI, 0.58-0.70), and late (RR = 0.68; 95% CI, 0.58-0.79) time points without heterogeneity. All studies reporting continuous depression scales had significant heterogeneity. CONCLUSIONS The risk of depression decreased post-CABG when depression was measured dichotomously. While depression improves overall and remits for some patients after CABG, the majority of patients will not experience remission of depression. Preoperative and postoperative depression monitoring is important.
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Brown SB, Colantonio A, Kim H. Gender Differences in Discharge Destination Among Older Adults Following Traumatic Brain Injury. Health Care Women Int 2012; 33:896-904. [DOI: 10.1080/07399332.2012.673654] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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15
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Lapum J, Church K, Yau T, David AM, Ruttonsha P. Arts-informed research dissemination: Patients' perioperative experiences of open-heart surgery. Heart Lung 2012; 41:e4-14. [DOI: 10.1016/j.hrtlng.2012.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 04/17/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
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16
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Davis MC, El-Sayed AM, Ziewacz JE, Jayachandran P, Geisert WC, Zamora-Berridi GJ, Sullivan SE. Sex Disparities in Postoperative Outcomes After Neurosurgical Intervention. Neurosurgery 2012; 70:959-64; discussion 964. [DOI: 10.1227/neu.0b013e31823e9706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Sveinsdóttir H, Ingadóttir B. Predictors of psychological distress in patients at home following cardiac surgery: an explorative panel study. Eur J Cardiovasc Nurs 2011; 11:339-48. [DOI: 10.1016/j.ejcnurse.2011.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Herdís Sveinsdóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
| | - Brynja Ingadóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
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Zimmerman L, Barnason S, Hertzog M, Young L, Nieveen J, Schulz P, Tu C. Gender differences in recovery outcomes after an early recovery symptom management intervention. Heart Lung 2011; 40:429-39. [PMID: 21501872 DOI: 10.1016/j.hrtlng.2010.07.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 07/15/2010] [Accepted: 07/23/2010] [Indexed: 01/29/2023]
Abstract
BACKGROUND Despite known gender differences in recovery, few studies have examined symptom management (SM) interventions or responses by gender after coronary artery bypass surgery (CABS). OBJECTIVE The purpose of this subanalysis was to describe and evaluate differences in response by gender to an SM intervention on the presence and burden of symptoms, physical activity, and physical functioning in elderly CABS patients during the early discharge period (3 and 6 weeks after CABS, and 3 and 6 months after CABS). METHODS The parent study whose data were analyzed to examine gender differences involved a two-group, randomized clinical trial design. The 6-week early recovery SM telehealth intervention was delivered by the Health Buddy. Measures included the Cardiac Symptom Survey, a Modified 7-Day Activity Interview, an RT3 accelerometer, an Activity Diary, and the Medical Outcomes Study Short Form 36. This study was not powered for a gender × group analysis, and we used descriptive statistics, χ(2) tests, t tests, and analysis of variance for statistical analyses. RESULTS Subjects (n = 232) included 192 men and 40 women, with a mean age of 71.2 SD, 7 years. The intervention group consisted of 86 men and 23 women, and the usual care (UC) group consisted of 106 men and 17 women. Data trends suggest that the SM intervention exerted greater impact on women than on men for symptoms such as fatigue, depression, sleep problems, and pain. Again, men exhibited higher levels of physical activity than did women. However, women in the SM group generally had higher scores than did women in the UC group. CONCLUSION Although the parent study found no effect of an early recovery SM intervention, this exploratory secondary analysis indicated that women in the intervention group demonstrated more improvement in measures of physical activity than did those in the UC group. Further study, using a larger sample, is necessary to test these preliminary results.
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Affiliation(s)
- Lani Zimmerman
- College of Nursing, University of Nebraska Medical Center, Lincoln, Nebraska 68588-0220, USA.
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Kendel F, Dunkel A, Müller-Tasch T, Steinberg K, Lehmkuhl E, Hetzer R, Regitz-Zagrosek V. Gender differences in health-related quality of life after coronary bypass surgery: results from a 1-year follow-up in propensity-matched men and women. Psychosom Med 2011; 73:280-5. [PMID: 21364199 DOI: 10.1097/psy.0b013e3182114d35] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine whether the predictive value of gender for health-related quality of life (HRQoL) is independent of clinical health status and depression. Women undergoing coronary bypass surgery generally report a poorer HRQoL than men. METHODS A total of 990 (20% women) patients completed study questionnaires 1 day before coronary bypass surgery and 1 year after surgery. Physical aspects of HRQoL were assessed with the Short Form 36 Health Survey. Depression was measured with the self-reported Patient Health Questionnaire. Propensity score matching was applied to match men and women with respect to 65 clinical variables. Of 198 women, 157 (79.3%) could be matched to a partner, resulting in an excellent balance of clinical variables between the matched groups. RESULTS At baseline, propensity-matched men and women differed in physical functioning (p < .001) and role functioning (p = .007), but not in bodily pain and general health perception. In both men and women, HRQoL outcomes improved over 1 year. Preoperative depression predicted worse physical HRQoL in all outcomes, except general health perception 1 year after surgery. After adjusting for depression, gender lost its predictive power with respect to physical functioning. However, compared with women, men still reported a better role functioning. CONCLUSION Our data suggest that gender is a marker for role functioning, independent of the clinical health status and depression. Rehabilitation measures designed for the specific needs of women might help to improve their HRQoL.
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Affiliation(s)
- Friederike Kendel
- Institut für Medizinische Psychologie, Charité Centrum 1 für Human- und Gesundheitswissenschaften, Charité-Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany.
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20
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Davoodi S, Sheikhvatan M, Karimi A, Hossein Ahmadi S, Sheikhfathollahi M. Determinants of social activity and work status after coronary bypass surgery. Asian Cardiovasc Thorac Ann 2010; 18:551-556. [PMID: 21149404 DOI: 10.1177/0218492310386630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Despite the occurrence of adverse events after coronary artery bypass, the degree of social integration can be increased following this operation. This study addresses the predictive power of risk factors as well as clinical status in determining long-term social functioning and rate of return to work following isolated bypass surgery. A prospective cohort study was conducted in 178 patients who underwent isolated bypass surgery between 2004 and 2007. Information on work status and social relationships was obtained 1-2 days before surgery and during a mean follow-up of 29.4 ± 1.1 months. The proportion of patients who engaged in social activities at 2, 3, and 4 years of follow-up was 0.3, 0.6, and just over 0.8, respectively, and the proportion who had returned to work at these time points was 0.2, 0.45, and 0.63, respectively. Social activity after surgery was less in patients with left ventricular dysfunction, cerebrovascular disease, and higher New York Heart Association functional class. The rate of return to work was lower for men and for patients with left ventricular dysfunction, diabetes, cerebrovascular disease, and those who were hospitalized for more than 14 days.
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Affiliation(s)
- Saeed Davoodi
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Iran.
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21
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Koivula M, Halme N, Astedt-Kurki P. Predictors of depressive symptoms among coronary heart disease patients: A cross-sectional study nine years after coronary artery bypass grafting. Heart Lung 2010; 39:421-31. [PMID: 20561857 DOI: 10.1016/j.hrtlng.2009.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 10/09/2009] [Accepted: 10/21/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study sought to identify the incidence of depression and its associations with demographic, lifestyle, perceived health, symptoms, treatment, and social support variables in patients 9 years after a coronary artery bypass graft. METHODS The questionnaire was mailed to 152 surviving patients who had undergone a coronary artery bypass graft 9 years earlier, and who had been respondents in an earlier study. Depressive symptoms were measured using the Zung Self-Rating Depression Scale, and social support was measured using Social Support from the Network Scale. Descriptive statistics and the linear regression method were used for analysis. RESULTS Depressive symptoms were reported by one fourth of the patients. The predictors for depressive symptoms included gender, perceived health, cardiac ischemic symptoms at rest, and emotional social support, which explained 24% of the variance. Controlling for gender revealed that the predictors for women and men were different. CONCLUSIONS Depression is more difficult to predict in men than in women.
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Affiliation(s)
- Meeri Koivula
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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