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Beard D, Cottam C, Painter J. Evaluation of the Perceived Benefits of a Peer Support Group for People with Mental Health Problems. NURSING REPORTS 2024; 14:1661-1675. [PMID: 39051360 PMCID: PMC11270277 DOI: 10.3390/nursrep14030124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
This paper reports on a service evaluation of PeerTalk, a nationwide charity that organises and facilitates peer support groups for individuals with depression. Therefore, the aim was to gather and synthesise benefits perceived by support group attendees. Thematic analysis was undertaken following the collection of data from two group interviews comprising PeerTalk support group attendees. Once those data were analysed, five key themes emerged: (1) talking/listening, (2) socialising, (3) contrast with other services, (4) personal benefits, and (5) structure and accessibility. Two further minor themes were also identified: (6) wider benefits and (7) areas for development that could lead to overall improvements to the service. PeerTalk's support groups provide multiple opportunities for attendees to meet others who have similar experiences within an environment that does not require formal engagement or commitment. Those that attend find benefit from supporting others and socialising within the group. These benefits are complementary to mainstream services that they may concurrently be involved with, rather than replacing or hindering them. Peer support groups can therefore provide a resource for healthcare professionals to which they can direct individuals who may feel benefit from engaging with other individuals with similar experiences. Sheffield Hallam University granted ethics approval for the study (ER:59716880) prior to its commencement (16 February 2024).
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Affiliation(s)
- David Beard
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S10 2BP, UK; (C.C.); (J.P.)
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Koontalay A, Botti M, Hutchinson A. Illness perceptions of people living with chronic heart failure and limited community disease management. J Clin Nurs 2024. [PMID: 38923175 DOI: 10.1111/jocn.17335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 05/14/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
AIM To explore the cognitive representations and emotional responses to living with chronic heart failure of people receiving limited community disease management. BACKGROUND Individuals living with heart failure face self-care and emotional challenges due to the overwhelming nature of adapting to lifestyle changes, particularly in subtropical areas. DESIGN Qualitative descriptive. We applied Leventhal's Common Sense Model of Self-Regulation as the framework for interviews and analyses. METHODS Twenty patients with chronic heart failure were interviewed during a hospital admission for exacerbation of their condition in a tertiary hospital in Thailand. RESULTS Analysis of the components of Leventhal's model of cognitive representations of illness revealed two themes relating to Illness Identity: (1) lack of knowledge of the diagnosis and how to recognise symptoms of the disease, and (2) recognition of symptoms of an exacerbation of CHF was based on past experience rather than education. These resulted in delays responding to cardiac instability and confusion about the intent of treatment. Participants recognised the chronicity of their disease but experienced it as an unrelenting cycle of relative stability and hospitalisations. Perceived Controllability was low. Two themes were: (1) Low perceived trust in the efficacy of medical treatment and lifestyle changes, and (2) Low perceived trust in their ability to comply with recommended lifestyle changes. The Consequences were significant emotional distress and high burden of disease. The two themes of emotional responses were (1) Frustration and hopelessness with the uncertainty and unpredictability of the disease, and (2) Sense of loss of independence, functional capacity and participation in life's activities. CONCLUSION Chronically ill patients need support to understand their illness and make better treatment and lifestyle decisions. Improving patients' self-efficacy to manage treatment and symptom fluctuations has the potential to improve their mental well-being and minimise the impact of their condition on suffering and participation in employment and community. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Leventhal's Common Sense Model of Self-Regulation can be used to examine cognitive and emotional elements of illness perceptions, which link to individuals' ability to make informed decisions about disease management and influence health behaviours. Understanding illness perceptions underpins strategies for enhancing and sustaining self-management behaviours. IMPACT The study findings accentuate the need to establish long-term condition support programs in low-middle income countries where the burden of heart failure is increasing exponentially. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used to explicitly and comprehensively report our qualitative research. PATIENT OR PUBLIC CONTRIBUTION Patients contributed to the conduct of the study by participating in the data collection via face-to-face interviews.
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Affiliation(s)
- Apinya Koontalay
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anastasia Hutchinson
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Center for Quality and Patient Safety Research-Epworth HealthCare Partnership, Deakin University, Geelong, Victoria, Australia
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Hajdarevic S, Norberg A, Lundman B, Hörnsten Å. Becoming whole again-Caring for the self in chronic illness-A narrative review of qualitative empirical studies. J Clin Nurs 2024. [PMID: 38886987 DOI: 10.1111/jocn.17332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/09/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
AIM AND OBJECTIVES To explore how chronic illness transforms the self when living with and managing chronic illness and what this means for their self and identity. We also discuss how people with chronic conditions could be supported by healthcare professionals to manage illness in daily life. BACKGROUND Self-management recommendations from health care are commonly based on a biomedical understanding of the disease. People's experiences of how a condition affects them and adequate support are crucial for their outcomes in daily self-management. DESIGN A narrative review. METHODS A systematic search was undertaken during January 2021 across the databases MEDLINE, CINAHL, PsycINFO, Soc INDEX and Philosopher's Index. A quality appraisal of articles was performed. Our analysis was inspired by qualitative content analysis. The PRISMA Checklist 2020/EQUATOR guidelines was used to report the study. RESULTS Twenty-eight peer-reviewed qualitative empirical articles focusing on self in a variety of chronic illnesses with relevance to nursing published from January 2010 to December 2020 were included. The main theme, Developing from an uncertain existence to meaning and wholeness, was built up by the five themes: Walking on an unstable ground; Being stalemated; Being involved with others for better or worse; Searching for meaning; and lastly, Modifying self and integrating a new way of living. CONCLUSIONS The results illuminate experiences that seldom are prioritized but need to be addressed by health professionals. Such experiences are oriented more towards the existential self rather than medical issues, why it is important to go beyond the medical lens. RELEVANCE TO CLINICAL PRACTICE This is important knowledge for nurses aiming to support people with chronic illnesses. Nurses supporting people in self-management need to be aware that by teaching and encouraging people to revise their daily habits, they also work on the boundaries of their self-concept. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Senada Hajdarevic
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | | | - Berit Lundman
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
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Ahrari S, Karimi Moonaghi H, Mahdizadeh SM, Heidari Bakavoli A. Experiences of what influences physical activity adherence in Iranian patients with heart failure: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:276. [PMID: 37849884 PMCID: PMC10578557 DOI: 10.4103/jehp.jehp_1029_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/06/2022] [Indexed: 10/19/2023]
Abstract
BACKGROUND Heart failure (HF) is becoming one of the important health care problems around the world. Physical activity as the foundation of the cardiac rehabilitation program is poorly adhered by patients with HF. This study aimed to understand the experiences of patients with HF in terms of adherence to physical activity. MATERIALS AND METHODS This study was conducted using conventional qualitative content analysis. Data were collected by semistructured telephone interviews with 25 patients with HF through open-ended questions. Data were collected from patients with HF in Birjand and Mashhad hospitals and heart departments from December 2021 to March 2022. Data were analyzed using Max-QDA10 and data analysis was continuous, comparative, and simultaneous with data collection. RESULTS After data analysis, three main categories were identified: (1) patient-related barriers and facilitators, (2) support system-related barriers and facilitators, and (3) environmental barriers and facilitators. These categories were subdivided into two main themes: (1) threatening disease and (2) challenging disease. CONCLUSION The results showed that beyond patient-related, support system-related, and environmental categories, perceiving the disease as a challenge or a threat is crucial in the activity of patients with HF. Nurses and other health care providers can train problem-solving behaviors to patients with HF to improve their physical and mental well-being. It is suggested that theoretical-behavioral approaches can be used in future clinical trials to improve adherence to physical activity.
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Affiliation(s)
- Shahnaz Ahrari
- School of Nursing and Midwifery, Department of Para Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Karimi Moonaghi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, and Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mousa Mahdizadeh
- Department of Medical-Surgical, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari Bakavoli
- Department of Cardiology, School of Medicine, Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran
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Purcell C, Dibben G, Hilton Boon M, Matthews L, Palmer VJ, Thomson M, Smillie S, Simpson SA, Taylor RS. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2023; 6:CD013820. [PMID: 37378598 PMCID: PMC10305790 DOI: 10.1002/14651858.cd013820.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. OBJECTIVES: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. The comparator was usual care with no element of social support (i.e. secondary prevention alone or with cardiac rehabilitation). SEARCH METHODS: We undertook a systematic search of the following databases on 9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference lists of relevant systematic reviews and included primary studies, and we contacted experts to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of social network or social support interventions for people with heart disease. We included studies regardless of their duration of follow-up, and included those reported as full text, published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS Using Covidence, two review authors independently screened all identified titles. We retrieved full-text study reports and publications marked 'included', and two review authors independently screened these, and conducted data extraction. Two authors independently assessed risk of bias, and assessed the certainty of the evidence using GRADE. Primary outcomes were all-cause mortality, cardiovascular-related mortality, all-cause hospital admission, cardiovascular-related hospital admission, and health-related quality of life (HRQoL) measured at > 12 months follow-up. MAIN RESULTS: We included 54 RCTs (126 publications) reporting data for a total of 11,445 people with heart disease. The median follow-up was seven months and median sample size was 96 participants. Of included study participants, 6414 (56%) were male, and the mean age ranged from 48.6 to 76.3 years. Studies included heart failure (41%), mixed cardiac disease (31%), post-myocardial infarction (13%), post-revascularisation (7%), CHD (7%), and cardiac X syndrome (1%) patients. The median intervention duration was 12 weeks. We identified notable diversity in social network and social support interventions, across what was delivered, how, and by whom. We assessed risk of bias (RoB) in primary outcomes at > 12 months follow-up as either 'low' (2/15 studies), 'some concerns' (11/15), or 'high' (2/15). 'Some concerns' or 'high' RoB resulted from insufficient detail on blinding of outcome assessors, data missingness, and absence of pre-agreed statistical analysis plans. In particular, HRQoL outcomes were at high RoB. Using the GRADE method, we assessed the certainty of evidence as low or very low across outcomes. Social network or social support interventions had no clear effect on all-cause mortality (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.49 to 1.13, I2 = 40%) or cardiovascular-related mortality (RR 0.85, 95% CI 0.66 to 1.10, I2 = 0%) at > 12 months follow-up. The evidence suggests that social network or social support interventions for heart disease may result in little to no difference in all-cause hospital admission (RR 1.03, 95% CI 0.86 to 1.22, I2 = 0%), or cardiovascular-related hospital admission (RR 0.92, 95% CI 0.77 to 1.10, I2 = 16%), with a low level of certainty. The evidence was very uncertain regarding the impact of social network interventions on HRQoL at > 12 months follow-up (SF-36 physical component score: mean difference (MD) 31.53, 95% CI -28.65 to 91.71, I2 = 100%, 2 trials/comparisons, 166 participants; mental component score MD 30.62, 95% CI -33.88 to 95.13, I2 = 100%, 2 trials/comparisons, 166 participants). Regarding secondary outcomes, there may be a decrease in both systolic and diastolic blood pressure with social network or social support interventions. There was no evidence of impact found on psychological well-being, smoking, cholesterol, myocardial infarction, revascularisation, return to work/education, social isolation or connectedness, patient satisfaction, or adverse events. Results of meta-regression did not suggest that the intervention effect was related to risk of bias, intervention type, duration, setting, and delivery mode, population type, study location, participant age, or percentage of male participants. AUTHORS' CONCLUSIONS: We found no strong evidence for the effectiveness of such interventions, although modest effects were identified in relation to blood pressure. While the data presented in this review are indicative of potential for positive effects, the review also highlights the lack of sufficient evidence to conclusively support such interventions for people with heart disease. Further high-quality, well-reported RCTs are required to fully explore the potential of social support interventions in this context. Future reporting of social network and social support interventions for people with heart disease needs to be significantly clearer, and more effectively theorised, in order to ascertain causal pathways and effect on outcomes.
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Affiliation(s)
- Carrie Purcell
- Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, Edinburgh, UK
| | - Grace Dibben
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michele Hilton Boon
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lynsay Matthews
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Victoria J Palmer
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Meigan Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Susie Smillie
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
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Sanders KH, Chousou PA, Carver K, Pugh PJ, Degens H, Azzawi M. Benefits of support groups for patients living with implantable cardioverter defibrillators: a mixed-methods systematic review and meta-analysis. Open Heart 2022; 9:openhrt-2022-002021. [PMID: 36252993 PMCID: PMC9577922 DOI: 10.1136/openhrt-2022-002021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/09/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Patients with implantable cardioverter defibrillators (ICD) experience anxiety, depression and reduced quality of life (QoL). OBJECTIVES This mixed-methods systematic review evaluates whether ICD support groups have a beneficial effect on mental well-being. METHODS Literature searches were carried out in MEDLINE, Embase, CINAHL, PsycINFO and Web of Science. Eligible studies investigated patient-led support groups for ICD patients aged 18 years or older, using any quantitative or qualitative design. The Mixed-Methods Assessment Tool was used to assess quality. Meta-analysis of measures of mental well-being was conducted. Thematic synthesis was used to generate analytic themes from the qualitative data. The data were integrated and presented using the Pillar Integration Process. RESULTS Ten studies were included in this review. All studies bar one were non-randomised or had a qualitative design and patients had self-selected to attend a support group. Five contributed to the quantitative data synthesis and seven to the qualitative synthesis. Meta-analysis of anxiety and QoL measures showed no significant impact of support groups on mental well-being, but qualitative data showed that patients perceived benefit from attendance through sharing experiences and acceptance of life with an ICD. DISCUSSION ICD support group attendance improved the patients' perceived well-being. Attendees value the opportunity to share their experiences which helps to accept their new life with an ICD. Future research could consider outcomes such as patient acceptance and the role of healthcare professionals at support groups.
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Affiliation(s)
- Katie H Sanders
- Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK,Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Panagiota Anna Chousou
- Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Kathryn Carver
- Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Peter J Pugh
- Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, Manchester, UK,Lithuanian Sports University, Kaunas, Lithuania
| | - May Azzawi
- Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
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Alkouri O, Hendriks JM, Magarey J, Schultz T. Identifying Feasible Heart Failure Interventions Suitable for the Jordan Healthcare system: A Delphi Study. Clin Nurs Res 2022; 31:1263-1275. [PMID: 35466727 DOI: 10.1177/10547738221091875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Interventions and strategies should align with the context and capacity of the health system. Identifying the most feasible and appropriate heart failure interventions in Jordan will improve heart failure management and clinical outcomes. Therefore, this study aimed to derive consensus from clinicians (using the Delphi method) regarding the most feasible and appropriate heart failure interventions in Jordan. A two-round Delphi study involving seven clinicians and policy makers were conducted. The Delphi results found consensus for the feasibility of the educational materials, follow up phone call, cardiac rehabilitation, group session, and training courses for staff. The components that were not feasible were: multidisciplinary team, individual session, and telemonitoring devices. The present study demonstrates the importance of utilizing interventions tailored to patients' characteristics and aligned with the capacity of healthcare system.
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Affiliation(s)
| | | | | | - Tim Schultz
- Flinders University, Adelaide, SA, Australia
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Meng X, Wang Y, Tang X, Gu J, Fu Y. Self-management on heart failure: A meta-analysis. Diabetes Metab Syndr 2021; 15:102176. [PMID: 34186372 DOI: 10.1016/j.dsx.2021.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Heart failure (HF) is a severe public health problem all over the World. Self-management is an effective method to progress self-care ability. However, the role of self-management in heart failure has not been thoroughly elucidated. METHODS The research articles related to heart failure were searched by the PubMed, Embase, Cochrane databases, and China National Knowledge Database on articles published through March 2020. The average 95% of confidence intervals (CIs) were used to calculate using random-effects or fixed-effects. Review Manager (version 5.2) was adopted for meta-analysis, sensitivity analysis, and bias analysis. RESULTS Eight (8) eligible studies with 1707 patients with HF were included in this analysis. In the Meta-analysis showed significant differences for Self-management (SM) groups in Dutch Heart Failure Knowledge Scale (DHFK) (MD = 1.36, 95%CI [-0.03, 2.75], P = 0.04; I2 = 83%), in Self-Care of Heart Failure Index (SCHFI) (MD = 5.51, 95%CI [0.62, 10.40], P = 0.03; I2 = 70%), and in Self-Efficacy for Managing Chronic Disease Scale (SEMCDI) (I2 = 47%, Z = 5.43, P of over effect < 0.0001) than control groups. One bias is detected as attrition bias, and another one is reporting bias. Sensitivity analysis satisfied the stability of the results. CONCLUSION Self-management was associated with significant outcomes in patients with HF through knowledge, attitude, and practice (KAP).
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Affiliation(s)
- Xianghong Meng
- Department of Cardiology, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai, 201399, China
| | - Yuping Wang
- Department of Cardiology, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai, 201399, China
| | - Xiaowen Tang
- Department of Cardiology, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai, 201399, China
| | - Jianfang Gu
- Department of Cardiology, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai, 201399, China
| | - Yonghua Fu
- Department of Cardiology, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai, 201399, China.
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Readmitted Patients With Heart Failure Sick, Tired, and Symptomatic: A Qualitative Descriptive Study From a Quaternary Academic Medical Center. J Cardiovasc Nurs 2021; 37:248-256. [PMID: 33591059 DOI: 10.1097/jcn.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Heart failure (HF) readmissions will continue to grow unless we have a better understanding of why patients with HF are readmitted. Our purpose was to gain an understanding, from the patients' perspective, of how patients with HF viewed their discharge instructions and how they felt when they got home and were then readmitted in less than 30 days. METHODS AND RESULTS We used a qualitative descriptive approach using semistructured interviews with 22 patients with HF. Most participants had multimorbidities, were classified as New York Heart Association class III (n = 13) with reduced ejection fraction (n = 20), and were on home inotrope therapy (n = 13). The overarching theme that emerged was that these participants were sick, tired, and symptomatic. Additional categories within this theme highlight discharge instructions as being clear and easily understood; rich descriptions of physical, emotional, and other symptoms leading up to readmission; and reports of daily activities including what "good" and "not good" days looked like. Moreover, when participants experienced an exacerbation of their HF symptoms, they were sick enough to be readmitted to the hospital. CONCLUSION Our findings confirm ongoing challenges with a complex group of sick patients with HF, with the majority on home inotropes with reduced ejection fraction, who developed an unavoidable progression of their illness and subsequent hospital readmission.
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Pendyal A, Rosenthal MS, Spatz ES, Cunningham A, Bliesener D, Keene DE. "When you're homeless, they look down on you": A qualitative, community-based study of homeless individuals with heart failure. Heart Lung 2021; 50:80-85. [PMID: 32792114 PMCID: PMC7738391 DOI: 10.1016/j.hrtlng.2020.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Outpatient heart failure (HF) care involves intensive self-management (SM). Effective HF SM is associated with improved outcomes. Homelessness poses challenges to successful SM. OBJECTIVES To identify the ways in which homelessness may impede successful SM of HF and engagement with the healthcare system. METHODS We conducted open-ended, semi-structured interviews with homeless adults with HF. Data were analyzed by a multidisciplinary team using a grounded theory approach. RESULTS We interviewed 19 participants, 11 (58%) of whom were homeless at the time of interview. Interviews revealed a combination of influences on HF SM. Major themes included instability and lack of routine, tradeoffs between basic necessities and HF SM, and stigmatization by healthcare providers. CONCLUSIONS Anticipatory guidance aimed at the unique challenges faced by homeless individuals with HF may aid successful SM. HF providers should simlpify medication regimes and engage in non-stigmatizing discourse. Larger-scale interventions include the creation of medical respite programs.
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Affiliation(s)
- Akshay Pendyal
- Novant Health Heart and Vascular Institute, Presbyterian Medical Center, 1718 E. 4th Street, Charlotte, NC 28204, USA; National Clinician Scholars Program, Yale School of Medicine, PO Box 208088, New Haven, CT 06520, USA.
| | - Marjorie S Rosenthal
- National Clinician Scholars Program, Yale School of Medicine, PO Box 208088, New Haven, CT 06520, USA; Department of Pediatrics, Yale School of Medicine, PO Box 208064, New Haven, CT 06520-8064, USA
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Yale School of Medicine, 1 Church Street, New Haven, CT 06510, USA; Section of Cardiovascular Medicine, Yale School of Medicine, PO Box 208017, New Haven, CT 06520-8017, USA
| | | | - Dawn Bliesener
- Community partner, Yale School of Medicine, PO Box 208088, New Haven, CT 06520, USA
| | - Danya E Keene
- National Clinician Scholars Program, Yale School of Medicine, PO Box 208088, New Haven, CT 06520, USA; Yale School of Public Health, P.O. Box 208034, New Haven, CT 06520-0834, USA
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Habibovic M, Kraaij C, Pauws S, G. Widdershoven JM. Patient perspective on telehealth during the COVID-19 pandemic at the cardiology outpatient clinic: Data from a qualitative study. HEART AND MIND 2021. [DOI: 10.4103/hm.hm_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Caccamo F, Stefani I, Pinton A, Sava V, Carlon R, Marogna C. The evaluation of anxiety, depression and Type D personality in a sample of cardiac patients. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1835382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- F. Caccamo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - I. Stefani
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - A. Pinton
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - V. Sava
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - R. Carlon
- Rehabilitation Cardiology Unit of the Cittadella Hospital (SS 4 District of ULSS 6 Euganea), Padua, Italy
| | - C. Marogna
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
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Nordgren L, Söderlund A. An evidence-based structured one-year programme to sustain physical activity in patients with heart failure in primary care: A non-randomized longitudinal feasibility study. Nurs Open 2020; 7:1388-1399. [PMID: 32802359 PMCID: PMC7424435 DOI: 10.1002/nop2.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/24/2020] [Accepted: 04/14/2020] [Indexed: 12/01/2022] Open
Abstract
Aim The primary objective of this non-randomized feasibility study was to test a 1-year model programme for sustaining/increasing patients' motivation to perform daily physical activity. Design Non-randomized longitudinal feasibility study with a one-group repeated measures design. Methods The study took place at a primary care centre in mid-Sweden in 2017-2018. The model programme included individual and group-based support, individualized physical activity prescriptions, a wrist-worn activity tracker and an activity diary. The main outcomes were the participants' perceptions of programme feasibility and scores on the Exercise Self-Efficacy Scale. Results Seven patients were recruited. Six patients completed the programme that was perceived to imply learning, motivation and support. Compared with baseline, the median score of the Exercise Self-Efficacy Scale improved 3 months after participants completed the programme.
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Affiliation(s)
- Lena Nordgren
- Centre for Clinical Research SörmlandUppsala UniversityMälarsjukhusetEskilstunaSESweden
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Anne Söderlund
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
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14
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Heisler M, Kullgren J, Richardson C, Stoll S, Alvarado Nieves C, Wiley D, Sedgwick T, Adams A, Hedderson M, Kim E, Rao M, Schmittdiel JA. Study protocol: Using peer support to aid in prevention and treatment in prediabetes (UPSTART). Contemp Clin Trials 2020; 95:106048. [PMID: 32497783 PMCID: PMC8059966 DOI: 10.1016/j.cct.2020.106048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND There is an urgent need to develop and evaluate effective and scalable interventions to prevent or delay the onset of type 2 diabetes mellitus (T2DM). METHODS In this randomized controlled pragmatic trial, 296 adults with prediabetes will be randomized to either a peer support arm or enhanced usual care. Participants in the peer support arm meet face-to-face initially with a trained peer coach who also is a patient at the same health center to receive information on locally available wellness and diabetes prevention programs, discuss behavioral goals related to diabetes prevention, and develop an action plan for the next week to meet their goals. Over six months, peer coaches call their assigned participants weekly to provide support for weekly action steps. In the final 6 months, coaches call participants at least once monthly. Participants in the enhanced usual care arm receive information on local resources and periodic updates on available diabetes prevention programs and resources. Changes in A1c, weight, waist circumference and other patient-centered outcomes and mediators and moderators of intervention effects will be assessed. RESULTS At least 296 participants and approximately 75 peer supporters will be enrolled. DISCUSSION Despite evidence that healthy lifestyle interventions can improve health behaviors and reduce risk for T2DM, engagement in recommended behavior change is low. This is especially true among racial and ethnic minority and low-income adults. Regular outreach and ongoing support from a peer coach may help participants to initiate and sustain healthy behavior changes to reduce their risk of diabetes. TRIAL REGISTRATION The ClinicalTrials.gov registration number is NCT03689530.
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Affiliation(s)
- Michele Heisler
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America; VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America.
| | - Jeffrey Kullgren
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America; VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States of America; University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States of America.
| | - Caroline Richardson
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America.
| | - Shelley Stoll
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States of America.
| | - Cristina Alvarado Nieves
- University of Michigan, Department of Internal Medicine- Metabolism, Endocrinology and Diabetes, United States of America.
| | - Deanne Wiley
- Kaiser Permanente Northern California, United States of America.
| | - Tali Sedgwick
- Kaiser Permanente Northern California Division of Research, United States of America.
| | - Alyce Adams
- Kaiser Permanente Northern California, United States of America.
| | | | - Eileen Kim
- The Permanente Medical Group (Kaiser Permanente, Northern California), United States of America.
| | - Megan Rao
- The Permanente Medical Group (Kaiser Permanente, Northern California), United States of America.
| | - Julie A Schmittdiel
- Kaiser Permanente Northern California Division of Research, United States of America.
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15
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Nordfonn OK, Morken IM, Lunde Husebø AM. A qualitative study of living with the burden from heart failure treatment: Exploring the patient capacity for self-care. Nurs Open 2020; 7:804-813. [PMID: 32257268 PMCID: PMC7113501 DOI: 10.1002/nop2.455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/25/2019] [Accepted: 01/20/2020] [Indexed: 12/20/2022] Open
Abstract
Aim To explore how patients with heart failure perceive their capacity to manage treatment and self-care. Design A qualitative descriptive study. Methods Patients (N = 17) were recruited from a nurse-led heart failure outpatient clinic from May-August 2017. Data were collected through individual semi-structured interviews and analysed using systematic text condensation. Results Three main themes were identified as follows: "Personal characteristics," "Coping strategies" and "Emotional and informative support." The first main theme contained the subthemes "inherent strength" and "maintenance of a positive attitude." The second main theme included the subthemes "selective denial," "ability to adapt by setting new goals" and "careful selection of information." The third main theme contained the subthemes "support from health professionals enhancing patient capacity," "support from next of kin in patients' self-care" and "practical support and hope from peers."
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Affiliation(s)
- Oda Karin Nordfonn
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Health and Caring Sciences Western Norway University of Applied Sciences Stord Norway
| | - Ingvild Margreta Morken
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Cardiology Stavanger University Hospital Stavanger Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Gastroenterological Surgery Stavanger University Hospital Stavanger Norway
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16
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Roy B, Wolf JRLM, Carlson MD, Akkermans R, Bart B, Batalden P, Johnson JK, Wollersheim H, Hesselink G. An international comparison of factors affecting quality of life among patients with congestive heart failure: A cross-sectional study. PLoS One 2020; 15:e0231346. [PMID: 32267902 PMCID: PMC7141662 DOI: 10.1371/journal.pone.0231346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/20/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To explore associations among twenty formal and informal, societal and individual-level factors and quality of life (QOL) among people living with congestive heart failure (CHF) in two settings with different healthcare and social care systems and sociocultural contexts. SETTING AND PARTICIPANTS We recruited 367 adult patients with CHF from a single heart failure clinic within two countries with different national social to healthcare spending ratios: Minneapolis, Minnesota, United States (US), and Nijmegen, Netherlands (NL). DESIGN Cross-sectional survey study. We adapted the Social Quality Model (SQM) to organize twenty diverse factors into four categories: Living Conditions (formal-societal: e.g., housing, education), Social Embeddedness (informal-societal: e.g., social support, trust), Societal Embeddedness (formal-individual: e.g., access to care, legal aid), and Self-Regulation (informal-individual: e.g., physical health, resilience). We developed a survey comprising validated instruments to assess each factor. We administered the survey in-person or by mail between March 2017 and August 2018. OUTCOMES We used Cantril's Self-Anchoring Scale to assess overall QOL. We used backwards stepwise regression to identify factors within each SQM category that were independently associated with QOL among US and NL participants (p<0.05). We then identified factors independently associated with QOL across all categories (p<0.05). RESULTS 367 CHF patients from the US (32%) and NL (68%) participated. Among US participants, financial status, receiving legal aid or housing assistance, and resilience were associated with QOL, and together explained 49% of the variance in QOL; among NL participants, financial status, perceived physical health, independence in activities of daily living, and resilience were associated with QOL, and explained 53% of the variance in QOL. CONCLUSIONS Four formal and informal factors explained approximately half of the variance in QOL among patients with CHF in the US and NL.
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Affiliation(s)
- Brita Roy
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Judith R. L. M. Wolf
- Impuls ‐ Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michelle D. Carlson
- Minneapolis Veterans Administration Health Care System, Minneapolis, MN, United States of America
- University of Minnesota Medical School, Minneapolis, MN, United States of America
| | - Reinier Akkermans
- IQ Health Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bradley Bart
- Minneapolis Veterans Administration Health Care System, Minneapolis, MN, United States of America
- University of Minnesota Medical School, Minneapolis, MN, United States of America
| | - Paul Batalden
- The Dartmouth Institute of Health Policy and Clinical Practice, Geisel Medical School at Dartmouth, Hanover, NH, United States of America
| | - Julie K. Johnson
- Department of Surgery, Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Hub Wollersheim
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gijs Hesselink
- IQ Health Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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17
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Yu DSF, Li PWC, Yue SCS, Wong J, Yan B, Tsang KK, Choi KC. The effects and cost‐effectiveness of an empowerment‐based self‐care programme in patients with chronic heart failure: A study protocol. J Adv Nurs 2019; 75:3740-3748. [DOI: 10.1111/jan.14162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/04/2019] [Accepted: 07/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Doris S. F. Yu
- The Nethersole School of Nursing The Chinese University of Hong Kong Shatin Hong Kong
| | - Polly W. C. Li
- The Nethersole School of Nursing The Chinese University of Hong Kong Shatin Hong Kong
| | - Sunny C. S. Yue
- Department of Medicine and Geriatrics United Christian Hospital Kwun Tong Hong Kong
| | - John Wong
- Division of Cardiology, Department of Medicine and Geriatrics Tseung Kwan O Hospital Tseung Kwan O Hong Kong
| | - Bryan Yan
- Department of Medicine and Therapeutics The Chinese University of Hong Kong Shatin Hong Kong
| | | | - Kai Chow Choi
- The Nethersole School of Nursing The Chinese University of Hong Kong Shatin Hong Kong
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18
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Sakakibara BM, Chakrabarti S, Krahn A, Mackay MH, Sedlak T, Singer J, Whitehurst DG, Lear SA. Delivery of Peer Support Through a Self-Management mHealth Intervention (Healing Circles) in Patients With Cardiovascular Disease: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12322. [PMID: 30635261 PMCID: PMC6330197 DOI: 10.2196/12322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 01/29/2023] Open
Abstract
Background Cardiovascular disease (CVD) is a leading cause of hospitalization and death around the world. The prevalence of CVD is increasing and, therefore, development and investigation of effective programs to help people better self-manage their CVD and prevent secondary complications are needed. Objective In this paper, we report on a protocol to evaluate Healing Circles—an evidence-based and patient-informed peer support mobile health program designed to facilitate self-management and support patients in their recovery from and management of CVD. We hypothesize that individuals with CVD who use Healing Circles will experience greater improvements to their self-management ability than individuals receiving usual care. Methods In this single-blinded (assessor) randomized controlled trial, 250 community-living individuals with CVD will be randomized on a 1:1 basis to either Healing Circles or Usual Care. The primary outcome of self-management will be measured using the Health Education Impact Questionnaire version 3.0. Secondary outcomes include self-efficacy with chronic disease management, health-related quality of life, health resource use and costs, and electronic health literacy. Measurements will be taken at the baseline and every 6 months for 24 months. Results The study started recruitment in September 2017. Individuals are currently being recruited for participation, and existing participants are currently on follow-up. Measurements will be taken every 6 months until the study end, which is anticipated in December 2019. Conclusions Healing Circles is a novel program aimed toward improving self-management through peer support. Given our real-world study design, our findings will be readily translatable into practice. If the results support our hypothesis, it will indicate that Healing Circles is an effective intervention for improving self-management and reducing health care use. Trial Registration ClinicalTrials.gov NCT03159325; https://clinicaltrials.gov/ct2/show/NCT03159325 (Archived by WebCite at http://www.webcitation.org/74DvxVKUd) International Registered Report Identifier (IRRID) DERR1-10.2196/12322
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Affiliation(s)
| | | | - Andrew Krahn
- Division of Cardiology, Providence Health Care, Vancouver, BC, Canada
| | - Martha H Mackay
- Division of Cardiology, Providence Health Care, Vancouver, BC, Canada
| | - Tara Sedlak
- Division of Cardiology, Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Joel Singer
- School of Public and Population Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.,Division of Cardiology, Providence Health Care, Vancouver, BC, Canada
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19
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Sano M, Majima T. Self-management of congestive heart failure among elderly men in Japan. Int J Nurs Pract 2018; 24 Suppl 1:e12653. [PMID: 29667310 DOI: 10.1111/ijn.12653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to explore the process of self-management in elderly male patients with congestive heart failure among those who have had not needed re-hospitalization for more than 2 years. Semi-structured interviews were conducted with 10 male congestive heart failure patients. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the modified grounded theory approach. As a result of the analysis, the core concept identified was a process of living life such that symptoms do not worsen, while balancing good choices and preferences. By trial and error, the men tried to find the limits of physical capacity and dietary choices that would lead to the worsening of symptoms, while also trying to maintain quality of life to the extent possible.
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20
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Graven LJ, Gordon G, Keltner JG, Abbott L, Bahorski J. Efficacy of a social support and problem-solving intervention on heart failure self-care: A pilot study. PATIENT EDUCATION AND COUNSELING 2018; 101:266-275. [PMID: 28951026 DOI: 10.1016/j.pec.2017.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/30/2017] [Accepted: 09/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the preliminary effects of a coping partnership intervention comprised of social support and problem-solving on HF self-care maintenance, management, and confidence. METHODS A 3-group randomized controlled pilot study was conducted. The intervention group received 1 home visit, weekly (month 1), and biweekly (months 2 and 3) telephone calls. The attention group received telephone calls starting at week 2, following a similar pattern. The control group received usual care only. The Self-care of Heart Failure Index, was administered at baseline, 5, 9, and 13 weeks. Linear mixed modeling examined intervention effect on study outcomes. RESULTS A total of 66 participants completed the study. The participants were mean age 61 years; 54.2% male; 56% Non-Caucasian; and 43.9% New York Heart Association HF Class II. Significant treatment-by-time interaction effects were noted for self-care maintenance (F=4.813; p=0.010) and self-care confidence (F=4.469; p=0.014). There was no significant treatment-by-time interaction effect on self-care management. CONCLUSIONS Coping partnership interventions that strengthen support and social problem- solving may improve self-care maintenance and confidence in individuals with HF. PRACTICE IMPLICATIONS Clinicians should consider including these components in HF patient education and clinical follow-up.
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Affiliation(s)
- L J Graven
- Florida State University College of Nursing, 98 Varsity Way, Tallahassee, FL 32306-4310, United States.
| | - G Gordon
- Florida State University College of Nursing, 98 Varsity Way, Tallahassee, FL 32306-4310, United States
| | - J Grant Keltner
- University of Alabama at Birmingham School of Nursing, 1720 2nd Ave. South, Birmingham, AL 35294-1210, United States
| | - L Abbott
- Florida State University College of Nursing, 98 Varsity Way, Tallahassee, FL 32306-4310, United States
| | - J Bahorski
- University of Alabama at Birmingham School of Nursing, 1720 2nd Ave. South, Birmingham, AL 35294-1210, United States
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21
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Arruda CS, Pereira JDMV, Figueiredo LDS, Scofano BDS, Flores PVP, Cavalcanti ACD. Effect of an orientation group for patients with chronic heart failure: randomized controlled trial. Rev Lat Am Enfermagem 2018; 25:e2982. [PMID: 29319747 PMCID: PMC5768213 DOI: 10.1590/1518-8345.2167.2982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 10/26/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the effect of the orientation group on therapeutic adherence and self-care among patients with chronic heart failure. METHOD Randomized controlled trial with 27 patients with chronic heart failure. The intervention group received nursing consultations and participated in group meetings with the multi-professional team. The control group only received nursing consultations in a period of four months. Questionnaires validated for use in Brazil were applied in the beginning and in the end of the study to assess self-care outcomes and adherence to treatment. Categorical variables were expressed through frequency and percentage distributions and the continuous variables through mean and standard deviation. The comparison between the initial and final scores of the intervention and control groups was done through the Student's t-test. RESULTS The mean adherence in the intervention group was 13.9 ± 3.6 before the study and 4.8 ± 2.3 after the study. In the control group it was 14.2 ± 3.4 before the study and 14.7 ± 3.5 after the study. The self-care confidence score was lower after the intervention (p=0.01). CONCLUSION The orientation group does not improve adherence to treatment and self-care management and maintenance and it may reduce confidence in self-care. Registry REBEC RBR-7r9f2m.
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Affiliation(s)
- Cristina Silva Arruda
- MSc, RN, Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, RJ, Brazil
| | - Juliana de Melo Vellozo Pereira
- Doctoral student, Universidade Federal Fluminense, Niterói, RJ, Brazil. RN, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lyvia da Silva Figueiredo
- Doctoral student, Universidade Federal Fluminense, Niterói, RJ, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Paula Vanessa Peclat Flores
- Doctoral student, Universidade Federal Fluminense, Niterói, RJ, Brazil. Assistant Professor, Universidade Federal Fluminense, Niterói, RJ, Brazil
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22
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Cohen LB, Parent M, Taveira TH, Dev S, Wu WC. A Description of Patient and Provider Experience and Clinical Outcomes After Heart Failure Shared Medical Appointment. J Patient Exp 2017; 4:169-176. [PMID: 29276763 PMCID: PMC5734515 DOI: 10.1177/2374373517714452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Shared medical appointments (SMAs) are clinical visits in which several patients meet with 1 or more providers at the same time. Objective: To describe the outcomes of an interdisciplinary SMA for veterans recently discharged for heart failure (HF). Methods: A retrospective chart review for patients’ readmission rates, survival, medication adherence, and medication-related problems. For qualitative outcomes, we performed semistructured interviews on 12 patients who had undergone HF SMAs and their respective caregivers focusing on care satisfaction, HF knowledge, disease self-care, medication reconciliation, and peer support. Results: The cohort comprised 70 patients—49% had left ventricular function <40% and 50% were prescribed >10 medications. Medication-related problems occurred in 60% of patients. Interviews revealed overall satisfaction with HF-SMA, but patients felt overwhelmed with HF instructions, perceived lack of peer support and self-efficacy, and feelings of hopelessness related to HF. Conclusion: Shared medical appointments are well-perceived. Medication problems and need for medication management are prevalent along with patient’s lack of self-efficacy in HF care. Multiple HF-SMA visits may be needed to reinforce concepts, reduce confusion, and garner peer support.
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Affiliation(s)
- Lisa B Cohen
- Department of Veterans Affairs, Providence VA Medical Center, Providence, RI, USA.,Department of Pharmacy Practice, University of Rhode Island, Kingston, RI, USA
| | - Melanie Parent
- Department of Veterans Affairs, Providence VA Medical Center, Providence, RI, USA
| | - Tracey H Taveira
- Department of Veterans Affairs, Providence VA Medical Center, Providence, RI, USA.,Department of Pharmacy Practice, University of Rhode Island, Kingston, RI, USA.,Department of Medicine, Alpert Medical School, Brown University, Providence, RI, USA
| | - Sandesh Dev
- Phoenix VA Healthcare System, Phoenix, AZ, USA
| | - Wen-Chih Wu
- Department of Veterans Affairs, Providence VA Medical Center, Providence, RI, USA.,Department of Medicine, Alpert Medical School, Brown University, Providence, RI, USA
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23
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Danet A, Rodríguez MÁP, Peña FG, Doblas ML, Martín NL, Cerdà JCM. Chronicity and use of health services: peer education of the School of Patients. Rev Esc Enferm USP 2017; 51:e03280. [PMID: 29267742 DOI: 10.1590/s1980-220x2017004203280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 08/17/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the impact of the training strategy of the Escuela de Pacientes (School of Patients) on the use of health services among people with chronic diseases. METHOD Quantitative design study of pretest and posttest evaluation with a population of 3,350 chronic patients of the Escuela de Pacientes (Andalusia, 2013-2015). A questionnaire adapted from the Stanford University was used. It measured the self-perceived health, number of health visits, and level of trust and communication with health personnel. A descriptive and bivariate study, a correlation study and a pretest/posttest net gain analysis were performed. RESULTS Participation of 964 patients (28.8% of the population), of which 18.8% were men, mean age 56 years. Training increased trust in Primary Care (PC) and Hospital Care (HC) professionals (0.44 and 0.65 points), medical visits decreased by 25%, and hospital admissions fell by 51% with statistically significant differences by sex and disease. The correlation index between trust in professionals and use of health services was -0.215. CONCLUSION The training strategy had a positive impact on the use of health services and trust in health professionals, and were identified areas of improvement from which recommendations are established.
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Affiliation(s)
- Alina Danet
- Ciber Epidemiología y Salud Pública, Madrid, España.,Escuela Andaluza de Salud Pública, Granada, España.,Instituto de Investigación Biosanitaria de Granada, España
| | - María Ángeles Prieto Rodríguez
- Ciber Epidemiología y Salud Pública, Madrid, España.,Escuela Andaluza de Salud Pública, Granada, España.,Instituto de Investigación Biosanitaria de Granada, España
| | | | - Manuela López Doblas
- Escuela Andaluza de Salud Pública, Granada, España.,Instituto de Investigación Biosanitaria de Granada, España
| | - Nuria Luque Martín
- Escuela Andaluza de Salud Pública, Granada, España.,Instituto de Investigación Biosanitaria de Granada, España
| | - Joan Carles March Cerdà
- Ciber Epidemiología y Salud Pública, Madrid, España.,Escuela Andaluza de Salud Pública, Granada, España.,Instituto de Investigación Biosanitaria de Granada, España
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Borregaard B, Ludvigsen MS. Exchanging narratives-A qualitative study of peer support among surgical lung cancer patients. J Clin Nurs 2017; 27:328-336. [PMID: 28557003 DOI: 10.1111/jocn.13903] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVE The aim of this study was to examine how hospitalised, surgical lung cancer patients experience talking to a former patient, and how the former patient experiences the role as supportive. BACKGROUND During hospitalisation, patients often create a community in which they can engage with fellow patients. The exchange of experiences with others in a similar situation might increase opportunities for support and complement nursing care, but there is a need for more evidence and understanding on the topic. DESIGN The methodological framework is based on the French philosopher Paul Ricoeur's text interpretation theory. Qualitative interviews were conducted with nine patients, including a peer informant, using a narrative structure. The analysis was conducted on three levels: (i) naïve reading, (ii) structural analysis and (iii) critical interpretation . RESULTS Four themes were developed from the analysis of the interviews: Exchanging emotional thoughts is easier with a peer; Talking to a peer reduces loneliness; Being ambiguous about a relationship with fellow patients; and Being the main person in the conversation with a peer. Sharing stories about having similar symptoms and undergoing similar journeys predominated, and the key feature of the contact between patients was the commonality of their stories. CRITICAL INTERPRETATION AND CONCLUSION Telling one's story to a former patient, and thereby creating a joint, common story, is the essence of this study. The support received in this process can be empowering because knowledge of the illness experience is shared and increased. This can help create new coping strategies. The contact with a former patient offered a way to confirm one's thoughts and to find a way out of the illness perspective, by seeing how the former patient had recovered. RELEVANCE TO CLINICAL PRACTICE The nursing field faces challenges in the relational aspect of caring because of ever greater efficient and shortened hospital stays; therefore, the peer support concept is becoming increasingly relevant. Patient peers offer each other their own perspectives, and it is important to raise awareness of the value of this and incorporate it into patient stays in hospital.
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Affiliation(s)
- Britt Borregaard
- Department of Cardiothoracic- and Vascular Surgery, Odense University Hospital, Odense C, Denmark.,University of Southern Denmark, Odense C, Denmark
| | - Mette Spliid Ludvigsen
- Clinical Research Unit, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Noguchi-Watanabe M, Yamamoto-Mitani N, Arimoto A, Murashima S. Relationship between patient group participation and self-care agency among patients with a history of cardiac surgery: A cross-sectional study. Heart Lung 2017; 46:280-286. [PMID: 28506495 DOI: 10.1016/j.hrtlng.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 04/01/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known regarding the influence of participation in patient groups on self-care in patients with a cardiac surgery history. OBJECTIVES To investigate the relationship between patient group participation and self-care among patients with a cardiac surgery history. METHODS Participants were 956 patients with cardiac surgery history from a patient group. Information on self-care agency, patient group participation, and health status was collected through a self-administered questionnaire. RESULTS There were 566 valid responses. Participants were mostly male (76.4%), and the mean age was 70.6 years. A high social support level from a patient group was associated with each subscale of the self-care agency as follows: self-care operations (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.12), adjusting one's condition (OR 1.04, 95% CI 1.01-1.07), and attention to self-care (OR 1.05, 95% CI 1.02-1.07). CONCLUSIONS Patient group participation may promote self-care performance in patients with a cardiac surgery history.
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Affiliation(s)
- Maiko Noguchi-Watanabe
- Department of Gerontological Home Care and Long-term Care Nursing, School of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, School of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Azusa Arimoto
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Sachiyo Murashima
- Oita University of Nursing and Health Sciences, 2944-9 Megusuno, Oita, 870-1201, Japan
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Sakakibara BM, Ross E, Arthur G, Brown-Ganzert L, Petrin S, Sedlak T, Lear SA. Using Mobile-Health to Connect Women with Cardiovascular Disease and Improve Self-Management. Telemed J E Health 2017; 23:233-239. [DOI: 10.1089/tmj.2016.0133] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Brodie M. Sakakibara
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, British Columbia, Canada
- Healthy Heart Program, St. Paul's Hospital, Providence Health Care, British Columbia, Canada
| | - Emily Ross
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
- Healthy Heart Program, St. Paul's Hospital, Providence Health Care, British Columbia, Canada
| | - Gavin Arthur
- Heart and Stroke Foundation of Canada, Toronto, Canada
| | | | - Samantha Petrin
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
- Healthy Heart Program, St. Paul's Hospital, Providence Health Care, British Columbia, Canada
| | - Tara Sedlak
- Vancouver Coastal Health Authority, British Columbia, Canada
| | - Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
- Healthy Heart Program, St. Paul's Hospital, Providence Health Care, British Columbia, Canada
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Hutting N, Detaille SI, Heerkens YF, Engels JA, Staal JB, Nijhuis-van der Sanden MWG. Experiences of Participants in a Self-Management Program for Employees with Complaints of the Arm, Neck or Shoulder (CANS): A Mixed Methods Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:35-48. [PMID: 26875155 PMCID: PMC5306216 DOI: 10.1007/s10926-016-9630-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose To investigate the experiences of participants of a self-management program for employees with complaints of the arm, neck or shoulder (CANS). The program consisted of six group sessions combined with an eHealth module. Methods Semi-structured interviews with the first 31 consecutive participants of the intervention group participating in a randomized controlled trial. Participants were interviewed after their last group session. Semi-structured interviews were guided by an interview guide and audio-recorded. Data were analyzed using thematic analysis and the emerging themes were discussed. All participants in the intervention group were asked about their experiences with a questionnaire at three (n = 58) and 12-months (n = 53) follow-up. Results Most participants appreciated the diversity of the program and benefited from the interaction with their peers. The eHealth module, although not used by everyone, was generally experienced as positive, especially the section with the physical exercises. Participants obtained more insight into their complaints and increased awareness, which contributed to the acceptance of and coping with the complaints. There was also criticism about the content of the program and the lack of a follow-up session. Results of the questionnaires showed that participants had a high level of satisfaction. Conclusions In general, the intervention fitted the needs of employees with CANS. Participants obtained more knowledge and insight into their complaints, as well as increased awareness; all this contributed to a behavioral change and improved coping. Many participants made changes at work and during their leisure time, whereas some felt that continuing their 'changed' behavior would be a challenge.
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Affiliation(s)
- Nathan Hutting
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Sarah I Detaille
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
- HAN Seneca, Expertise Centre for Sports, Work and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - Josephine A Engels
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - J Bart Staal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Group Musculoskeletal Rehabilitation, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
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28
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Sinclair JMA, E. Chambers S, C. Manson C. Internet Support for Dealing with Problematic Alcohol Use: A Survey of the Soberistas Online Community. Alcohol Alcohol 2017; 52:220-226. [PMID: 28182197 PMCID: PMC5859982 DOI: 10.1093/alcalc/agw078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/26/2016] [Accepted: 10/04/2016] [Indexed: 12/02/2022] Open
Abstract
Aims Advances in technology have led to an increased range of possibilities for forms of mutual aid in addictions, and patient empowerment in the management of long-term conditions. However, the effective processes involved may be different online than for those that meet in person. Soberistas is a ‘social network site for people who are trying to resolve their problematic drinking patterns’. We aim to describe the population, component parts and processes that define this online community, and consider potential mechanisms of action for future research. Methods Cross-sectional online survey through an advert embedded within the Soberistas website. Participants were asked questions about themselves, their alcohol use and use of the website. Results Four hundred and thirty-eight people completed the survey, primarily women, 50% of whom lived with their children. Over 60% described having problematic alcohol use for over 10 years and 46.5% had not tried any form of previous support. Participants accessed the site at different stages of change; over half still drinking alcohol, cutting down or recently stopped. Over 18% reported abstinence of over 1 year. Anonymity, the ability to be honest, being a source of trusted information, and ongoing support were all cited as reasons for continued membership. Conclusion Soberistas offers a form of mutual aid primarily for women who have often not engaged with other treatment or support. This preliminary study suggests that the online, flexible, platform affords members an accessible and anonymous community to address their difficulties and encourages a positive ‘alcohol free’ identity. Short Summary Soberistas is ‘an online community of people who are trying to resolve their problematic drinking patterns’. Preliminary data suggest that it offers a flexible platform for mutual aid primarily for women who have often not engaged with other treatment or support, by encouraging a positive ‘alcohol free’ identity.
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Affiliation(s)
- Julia M. A. Sinclair
- Faculty of Medicine, University of Southampton, Southampton SO14 3DT, UK
- Corresponding author: Department of Psychiatry, University of Southampton, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton SO14 3DT, UK. Tel.:+44 2380 718 520; Fax:+44 2380 718 532; E-mail:
| | - Sophia E. Chambers
- Faculty of Medicine, University of Southampton, Southampton SO14 3DT, UK
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Graven LJ, Martorella G, Gordon G, Grant Keltner JS, Higgins MK. Predictors of depression in outpatients with heart failure: An observational study. Int J Nurs Stud 2017; 69:57-65. [PMID: 28182959 DOI: 10.1016/j.ijnurstu.2017.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/02/2016] [Accepted: 01/30/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depression is a common comorbidity of heart failure. Little is known about the influence of heart failure symptomatology and coping resources, such as social support and social problem-solving, on depression. OBJECTIVE To examine whether individual and clinical characteristics, heart failure symptomatology, and the subcomponents of social support and social problem-solving increase the likelihood of depression in outpatients with heart failure. METHODS A secondary data analysis of a cross sectional study with 201 outpatients with heart failure was conducted. The following self-report questionnaires were used to collect data: the Heart Failure Symptom Survey, the Interpersonal Support Evaluation List-12, the Graven and Grant Social Network Survey, the Social Problem-Solving Inventory Revised-Short, and the Center for Epidemiological Studies - Depression scale. Descriptive statistics examined patient characteristics. Logistic regression explored predictors of depression from among individual and clinical characteristics, heart failure symptomatology, and subcomponents of social support (i.e., belonging, tangible, and appraisal support) and social problem-solving (i.e., positive and negative problem orientation; rational, impulsiveness/carelessness, and avoidance problem-solving styles). RESULTS The sample was primarily Caucasian (86.1%) male (62.6%) with an average age of 72.57 years. Individuals who were unmarried, experienced a higher symptom burden, and those who perceived less belonging support were more likely to be depressed. The subcomponents of social problem-solving did not influence depression. CONCLUSIONS Belonging support was the most beneficial type of social support related to depression. Components of social problem-solving were not related to depression. Assessment of marital status, heart failure symptomatology, and perceived belonging support is needed to identify potential stressors and available social support in order to promote psychological adaptation.
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Affiliation(s)
| | | | - Glenna Gordon
- Florida State University College of Nursing, United States
| | | | - Melinda K Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, United States
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Azad N, Lemay G, Li J, Benzaquen M, Khoury L. Perspectives from Geriatric In-patients with Heart Failure, and their Caregivers, on Gaps in Care Quality. Can Geriatr J 2016; 19:195-201. [PMID: 28050224 PMCID: PMC5178862 DOI: 10.5770/cgj.19.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Evidence indicates that care experiences for complex HF patients could be improved by simple organizational and process changes, rather than complex clinical mechanisms. This survey identifies care gaps and recommends simple changes. Methods The study utilized both quantitative and qualitative methods at The Ottawa Hospital, Geriatric Medical Unit (GMU) during a three-month period. Results Nineteen patients (average age 85, 12 female) surveyed. Twelve participants lived alone. Fourteen lived in own home. Four patients had formal home-care services. Fifteen relied on family. Gaps were identified in in-patient practice, discharge plan, and discharge summary implementation feedback. Only five participants had seen a cardiologist or a specialist. Half of the patients did not know if they were on a special Heart-Failure (HF) diet. Participants did not recall receiving information on life expectancy but were comfortable discussing EoL care and dying. HF-specific management recommendations were mentioned in only 37% of discharge summaries to primary care providers (PCPs). Conclusion The results provide the starting point for a quality assurance and process re-engineering program in GMU. Organization change is needed to develop and integrate a cardiogeriatric clinical framework to allow the cardiologist, geriatrician, and PCP to actively work as a team with the patient/caregiver to develop the optimal care plan pre- and post-discharge.
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Affiliation(s)
- Nahid Azad
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Division of Geriatrics, The Ottawa Hospital, Ottawa, ON, Canada
| | - G Lemay
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - J Li
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - M Benzaquen
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - L Khoury
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Rong X, Peng Y, Yu HP, Li D. Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure. J Clin Nurs 2016; 26:717-726. [PMID: 27532343 DOI: 10.1111/jocn.13515] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Xiaoshan Rong
- Nursing Department; Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Shanghai China
| | - Youqing Peng
- Department of Nursing; Shanghai East Hospital; Tongji University School of Medicine; Shanghai China
| | - Hai-Ping Yu
- Nursing Department; Shanghai East Hospital; Tongji University School of Medicine; Shanghai China
| | - Dan Li
- Nursing Department; Shanghai East Hospital; Tongji University School of Medicine; Shanghai China
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Inflammatory Bowel Disease (IBD) Connect: A Novel Volunteer Program for Hospitalized Patients with IBD and Their Families. Inflamm Bowel Dis 2016; 22:2748-2753. [PMID: 27755272 DOI: 10.1097/mib.0000000000000952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patients with inflammatory Bowel Disease (IBD) often require hospitalization and this experience is stressful. Health care providers frequently do not have adequate time to address the emotional impact of the hospitalization on the patient and family. Nonmedical support for inpatients was identified as an unmet need by a Crohn's disease patient's family. This led to the development of a volunteer peer specialist network, IBD Connect, where peer volunteers visit hospitalized patients with IBD to offer emotional support and educational materials. We aimed to determine the feasibility of incorporating IBD Connect into an inpatient IBD service, evaluate the impact of IBD Connect on patients' willingness to share their disease experience with family and friends, and improve stress. Since the inception of IBD Connect in 2012, peer volunteers have made 1469 total visits to 677 unique inpatients. Patient satisfaction of IBD Connect has been favorable with a significant decrease in stress related to the hospitalization. Similarly, there was significant increase in patients sharing their IBD diagnosis and experience with family and friends. Patients and their families are willing to share important information and ask questions to volunteers that may not have been discussed with their health care providers. In an era of patient-reported outcomes and patient-centered care, peer volunteers are an important component of chronic disease management and should be incorporated into IBD inpatient health care teams.
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Abstract
PURPOSE OF REVIEW To evaluate recent literature on psychological interventions in cardiovascular disease. RECENT FINDINGS Mindfulness-based stress reduction did not reduce blood pressure, and a self-management programme in heart failure patients (HART), showed no improvement in health-related quality of life. Web-based decision aids are as effective as individually tailored counseling at reducing cardiovascular risk. Among health attack survivors, the ProActive Heart study involving telephone delivered counseling reduced anxiety whereas integrated motivational interviewing cognitive behavioral therapy (Beating Heart Problems) reduced depression and anger with no physiological or behavioral benefits. SUMMARY Psychological conditions increase cardiovascular risk as well as complicate cardiovascular disease. Psychological interventions are, however, far less studied compared with pharmacological and device therapies for cardiovascular disease. Interventions can either be delivered in isolation or in combination with other interventions including education, exercise, and medications, whereas outcomes measured could include psychometrics, behavior, risk scores, cardiovascular endpoints, and mortality. Due to the large variety of possible interventions and outcomes, published studies have reported mixed results and it remains unclear which modes of delivery and which types of intervention are most appropriate.
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