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Hong C, Yan Q, Qi H, Zhang Y, Yu L, Dong L, Wang J. Acceptability, Preferred Medium, and Components of Nurse-Led Cardiac Telerehabilitation: A Cross-Sectional Study. Clin Nurs Res 2024; 33:146-156. [PMID: 38291821 DOI: 10.1177/10547738241228634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t-test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program.
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Affiliation(s)
- Chaochao Hong
- School of Nursing, Nanchang University, Jiangxi Province, China
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Qiong Yan
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Hongmei Qi
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Yaoyao Zhang
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Ling Yu
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Lijie Dong
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Jing Wang
- Department of Cardiology, First Affiliated Hospital of Nanchang University, Jiangxi Province, China
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Svavarsdóttir MH, Halapi E, Ketilsdóttir A, Ólafsdóttir IV, Ingadottir B. Changes in disease-related knowledge and educational needs of patients with coronary heart disease over a six-month period between hospital discharge and follow-up. PATIENT EDUCATION AND COUNSELING 2023; 117:107972. [PMID: 37703621 DOI: 10.1016/j.pec.2023.107972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To describe changes in the disease-related knowledge and educational needs of individuals with coronary heart disease (CHD). METHODS Patients hospitalized for CHD answered questionnaires about disease-related knowledge (Coronary Artery Disease Education Questionnaire-short version (CADE-Q-SV), score 0-20), educational needs (investigator-designed questions), health literacy (Short version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16)), self-care (Self-Care of Coronary Heart Disease Inventory version (SC-CHDI)), and physical activity (Leisure-time Physical Activity Questionnaire) at discharge (T1) and six months later (T2). RESULTS Participants' (N = 308; mean [M] age=65.5 years [SD=8.7]; 81.5% male) knowledge scores increased from M= 13.8 (SD=3.2) to M= 14.8 (SD=2.8) (p < 0.001). At T1, educational level, age, health literacy, smoking, and self-care maintenance explained 14.5% of knowledge variability. At T2, these variables plus lack of awareness of CHD diagnosis explained 20.3% of the variability. Substantial educational needs were reported at both time points, although 89% received predischarge education. CONCLUSION The patients' educational needs were unfulfilled despite an increase in disease-related knowledge over time. Improved evidence-based patient education and follow-ups that address diagnosis, treatment, and self-care are needed. PRACTICE IMPLICATIONS Healthcare professionals can improve care of patients with CHD by providing focused patient education, prioritizing "need-to-know" topics and considering patients' health literacy.
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Affiliation(s)
| | - Eva Halapi
- University of Akureyri, Faculty of Nursing, Nordurslod 2, 600 Akureyri, Iceland
| | - Auður Ketilsdóttir
- Landspitali University Hospital, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Faculty of Nursing and Midwifery, Eiríksgata 34, 101 Reykjavik, Iceland
| | | | - Brynja Ingadottir
- Landspitali University Hospital, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Faculty of Nursing and Midwifery, Eiríksgata 34, 101 Reykjavik, Iceland
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Jeong S, Kim H, Kim WS, Chang WK, Cha S, Choi E, Kim C, Grace SL, Baek S. Translation, Cultural Adaptation, and Validation of a Korean Version of the Information Needs in Cardiac Rehabilitation Scale. Ann Rehabil Med 2023; 47:403-425. [PMID: 37907232 PMCID: PMC10620489 DOI: 10.5535/arm.23042] [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: 04/05/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE : To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. METHODS : The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach's alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. RESULTS : Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants' sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach's alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). CONCLUSION : The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.
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Affiliation(s)
- Seungsu Jeong
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Heeju Kim
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eunjeong Choi
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Chul Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sherry L. Grace
- Faculty of Health, York University, Toronto, Canada
- KITE Research Institute–Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Canada
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
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Barry-Hickey D, Aultman C, Danischewsky G, Occhipinti C, Ghisi GLDM. Information needs of women with breast cancer participating in cardiovascular rehabilitation: A mixed-methods study. PATIENT EDUCATION AND COUNSELING 2023; 113:107761. [PMID: 37099840 DOI: 10.1016/j.pec.2023.107761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine the information needs of women with a history of breast cancer attending a cardiovascular rehabilitation (CR) program. METHODS A mixed-methods approach was used, including a cross-sectional online survey using an adapted version of the Toronto Information Needs Questionnaire Breast Cancer (TINQ-BC) and 7 virtual focus group sessions (n = 20). RESULTS Overall, 50 responses were received. The TINQ-BC mean was 4.2 ± 0.5/5, with 34/42 items scoring higher than 4 (very important). The highest information needs were related to knowing if cancer is in their bodies or has come back, ways to prevent treatment side effects, and how the illness may affect their future. Participants identified their preferences for education delivery as discussion with peers/healthcare providers and lectures. The focus groups revealed six overarching themes: need for peer support, to make connections, and build relationships; comfort with and utility of technology; desire to learn about specific educational topics; preferences for education sessions; value of education; and value of exercise. CONCLUSIONS These findings provided insight into the information needs of women with a history of breast cancer who participate in CR. PRACTICAL IMPLICATION The care of these patients should be personalized based on these needs to support their adherence to the program.
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Affiliation(s)
- Danielle Barry-Hickey
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Gerilyn Danischewsky
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Christine Occhipinti
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
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Vanzella LM, Pakosh M, Oh P, Ghisi G. Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:3398-3409. [PMID: 36167758 DOI: 10.1016/j.pec.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations. METHODS Five databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively. RESULTS Of 35,698 initial records, 19 studies were included, most in observational design and classified as "fair" quality. Underserved populations - women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status - presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals' needs were assessed and reported. CONCLUSION Underserved populations with CVD have unique information needs and preferences that should be address during their care. PRACTICAL IMPLICATION Information from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.
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Affiliation(s)
| | - Maureen Pakosh
- Library & Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Paul Oh
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
| | - Glm Ghisi
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada.
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Walquist MJ, Svendsen K, Garcia BH, Bergmo TS, Eggen AE, Halvorsen KH, Småbrekke L, Ringberg U, Lehnbom EC, Waaseth M. Self-reported medication information needs among medication users in a general population aged 40 years and above - the Tromsø study. BMC Public Health 2022; 22:2182. [PMID: 36434564 PMCID: PMC9700964 DOI: 10.1186/s12889-022-14573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To determine the prevalence and associated factors of self-reported medication information needs among medication users in a general population aged 40 years and above - The Tromsø Study. METHODS Cross-sectional study of medication users (n = 10,231) among participants in the Tromsø Study, a descriptive analysis of questionnaire data and multivariable logistic regression (n = 9,194). RESULTS Sixteen percent of medication users expressed a need for more information about own medications. Overall, medication users agreed to a higher degree to have received information from the GP compared to the pharmacy. Concerned medication users and those disagreeing to have received information about side effects had the highest odds for needing more information (OR 5.07, 95% CI 4.43-5.81) and (OR 2.21, 95% CI 1.83-2.68), respectively. Medication users who used heart medications (e.g., nitroglycerin, antiarrhythmics, anticoagulants) (OR 1.71, 95% CI 1.46-2.01), medication for hypothyroidism (OR 1.36, 95% CI 1.13-1.64) or had moderately health anxiety had expressed need for medication information. Whereas medication users with lower education, those that never used internet to search for health advice, and medication users who disagreed to have received information about reason-for-use were associated with lower odds (OR 0.75, 95% CI 0.62-0.91), (OR 0.85, 95% CI 0.74-0.98) and (OR 0.68, 95% CI 0.53-0.88), respectively. CONCLUSION This study demonstrated that there is need for more information about own medications in a general population aged 40 years and above and shed light on several characteristics of medication users with expressed information need which is important when tailoring the right information to the right person.
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Affiliation(s)
- Mari J. Walquist
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.10919.300000000122595234Norwegian College of Fishery Science, The Faculty of biosciences, fisheries and economics, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristian Svendsen
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Beate H. Garcia
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trine S. Bergmo
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
| | - Anne Elise Eggen
- grid.10919.300000000122595234Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kjell H. Halvorsen
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Småbrekke
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Unni Ringberg
- grid.10919.300000000122595234Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin C. Lehnbom
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit Waaseth
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Shah ZA, Jamal QM, Ullah N, Ahmad T, Ahmed M. Effectiveness of Cardiac Rehabilitation in Myocardial Infarction Patients After Percutaneous Coronary Intervention. Cureus 2022; 14:e26684. [PMID: 35949754 PMCID: PMC9358053 DOI: 10.7759/cureus.26684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 11/05/2022] Open
Abstract
Background Post myocardial infarction rehabilitation can have a positive impact on overall patient health. Therefore, the present study investigated the role of cardiac rehabilitation in reducing the frequency of arrhythmias, recurrent angina, readmission, and mortality in patients who underwent percutaneous coronary intervention. Methodology A prospective observational study was conducted at the Cardiology Department, Khyber Teaching Hospital, Pakistan, between 1st March 2021 and 30th May 2021. All patients who were discharged after being diagnosed with acute myocardial infarction were included in the study. Patients who were not able to give consent, had physical fragility, mental impairment, or those who have critical illness were excluded from the study. 40 patients underwent cardiac rehabilitation while the other 40 acted as controls. The cardiac rehabilitation group patients were asked to engage in 15-30 minutes of activity daily and keep a record of all their activities. Death, recurrence, rhythm abnormalities, rehospitalizations, and BMI (body mass index) were all documented on a predesigned proforma and compared between intervention and control. A three-month-long follow-up plan was established. Results A total of 80 patients were enrolled in the study. Post-infarction angina (p = 0.0012) was significantly higher in patients who did not receive cardiac rehabilitation (CR). The incidence of arrhythmias was significantly higher in the control group as compared to the rehab group (p=0.002). Moreover, the mean left ventricular ejection fraction (LVEF) was also significantly higher in patients who underwent CR as compared to the control group (44.76 ± 13.8 vs. 42.9 ± 13.5, p = 0.01). There was no significant difference between the post-intervention BMI in the rehab group. Conclusion In conclusion, the present study findings revealed that mild to moderate cardiac rehabilitation (CR) was related to the less frequent occurrence of post-infarction angina and arrhythmias. Moreover, we found that patients who received CR experienced a significant improvement in left ventricular ejection fraction (LVEF) as compared to the control group. However, further large-scale studies from multiple centers are warranted.
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Ghisi GL, Santos RZ, Korbes AS, Souza CAD, Karsten M, Oh P, Benetti M. Percepções dos Participantes de Reabilitação Cardíaca sobre seus Comportamentos em Saúde e Necessidades de Informação durante a Pandemia COVID-19 no Brasil. Arq Bras Cardiol 2022; 118:949-960. [PMID: 35384967 PMCID: PMC9368887 DOI: 10.36660/abc.20210447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/28/2021] [Indexed: 11/18/2022] Open
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Paalimäki-Paakki K, Virtanen M, Henner A, Nieminen MT, Kääriäinen M. Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review. J Med Internet Res 2022; 24:e30077. [PMID: 34989681 PMCID: PMC8778552 DOI: 10.2196/30077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background Patients who are chronically ill need novel patient counseling methods to support their self-care at different stages of the disease. At present, knowledge of how effective digital counseling is at managing patients’ anxiety, depression, and adherence to treatment seems to be fragmented, and the development of digital counseling will require a more comprehensive view of this subset of interventions. Objective This study aims to identify and synthesize the best available evidence on the effectiveness of digital counseling environments at improving anxiety, depression, and adherence to treatment among patients who are chronically ill. Methods Systematic searches of the EBSCO (CINAHL), PubMed, Scopus, and Web of Science databases were conducted in May 2019 and complemented in October 2020. The review considered studies that included adult patients aged ≥18 years with chronic diseases; interventions evaluating digital (mobile, web-based, and ubiquitous) counseling interventions; and anxiety, depression, and adherence to treatment, including clinical indicators related to adherence to treatment, as outcomes. Methodological quality was assessed using the standardized Joanna Briggs Institute critical appraisal tool for randomized controlled trials or quasi-experimental studies. As a meta-analysis could not be conducted because of considerable heterogeneity in the reported outcomes, narrative synthesis was used to synthesize the results. Results Of the 2056 records screened, 20 (0.97%) randomized controlled trials, 4 (0.19%) pilot randomized controlled trials, and 2 (0.09%) quasi-experimental studies were included. Among the 26 included studies, 10 (38%) digital, web-based interventions yielded significantly positive effects on anxiety, depression, adherence to treatment, and the clinical indicators related to adherence to treatment, and another 18 (69%) studies reported positive, albeit statistically nonsignificant, changes among patients who were chronically ill. The results indicate that an effective digital counseling environment comprises high-quality educational materials that are enriched with multimedia elements and activities that engage the participant in self-care. Because of the methodological heterogeneity of the included studies, it is impossible to determine which type of digital intervention is the most effective for managing anxiety, depression, and adherence to treatment. Conclusions This study provides compelling evidence that digital, web-based counseling environments for patients who are chronically ill are more effective than, or at least comparable to, standard counseling methods; this suggests that digital environments could complement standard counseling.
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Affiliation(s)
- Karoliina Paalimäki-Paakki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Mari Virtanen
- School of Rehabilitation and Examination, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Anja Henner
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Miika T Nieminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
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Keessen P, van Duijvenbode IC, Latour CH, Kraaijenhagen RA, Janssen VR, Jørstad HT, Scholte Op Reimer WJ, Visser B. Design of a remote coaching program to bridge the gap from hospital discharge to cardiac rehabilitation: an intervention mapping study. (Preprint). JMIR Cardio 2021; 6:e34974. [PMID: 35612879 PMCID: PMC9178457 DOI: 10.2196/34974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paul Keessen
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ingrid Cd van Duijvenbode
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Corine Hm Latour
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | - Veronica R Janssen
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Harald T Jørstad
- Department of Cardiology, Heart Center, Amsterdam University Medical Center, Amsterdam, Netherlands
| | | | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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Ghisi GLDM, Seixas MB, Pereira DS, Cisneros LL, Ezequiel DGA, Aultman C, Sandison N, Oh P, da Silva LP. Patient education program for Brazilians living with diabetes and prediabetes: findings from a development study. BMC Public Health 2021; 21:1236. [PMID: 34174860 PMCID: PMC8236150 DOI: 10.1186/s12889-021-11300-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background Globally, the incidence of diabetes is increasing and strategies to reach a comprehensive approach of care are needed, including education in self-management. This is particularly true in low and middle-income countries where the number of people living with diabetes is higher than in the high-income ones. This article describes the development of a structured patient education program for Brazilians living with diabetes or prediabetes. Methods These steps were undertaken: 1) a 4-phase needs assessment (literature search of local diabetes guidelines, environmental scan, evaluation of information needs of patients identified by diabetes experts, and patient focus groups); and, 2) the translation and cultural adaptation of the patient guide (preparation, translation, back-translation, back-translation review, harmonization, and proofreading). Results Four of the seven guidelines identified include educational aspects of diabetes management. No structured education program was reported from the environmental scan. Regarding the information needs, 15 diabetes experts identified their patients’ needs, who referred that they have high information needs for topics related to their health condition. Finally, results from six patient focus groups were clustered into six themes (self-management, physical activity, eating habits, diabetes medication, psychosocial being, and sleep), all embedded into the new education program. Constructive theory, adult learning principles, and the Health Action Process Approach model were used in program development and will be used in delivery. The developed program consists of 18 educational sessions strategically mapped and sequenced to support the program learning outcomes and a patient guide with 17 chapters organized into five sections, matched with weekly lectures. Conclusions This program is a sequential and theoretical strategic intervention that can reach programs in Brazil to support diabetes and prediabetes patient education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11300-y.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Mariana Balbi Seixas
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, MG, 36038-330, Brazil
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | - Ligia Loiola Cisneros
- Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | | | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Nicole Sandison
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Lilian Pinto da Silva
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, MG, 36038-330, Brazil.
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Nascimento IDO, Assis MG, Ghisi GLDM, Britto RR. A qualitative study of patient's perceptions of two cardiac rehabilitation models. Braz J Phys Ther 2021; 25:552-562. [PMID: 33722508 DOI: 10.1016/j.bjpt.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/22/2021] [Accepted: 02/24/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Understanding patients' perceptions about rehabilitation can guide healthcare administrators on modifications of program elements, which can ultimately improve cardiac rehabilitation (CR) use, adherence of heart-health behaviors, and improvements in clinical outcomes. OBJECTIVE To examine the perception of patients about their participation in CR. METHODS Qualitative study using semi-structured interviews, performed in a public CR center in Brazil. Twenty-eight patients were interviewed 2-years following participation in two CR models: exercise-based and comprehensive CR. RESULTS Themes identified included: knowledge acquisition, improvement in functionality, and psychosocial well-being. It appeared that the perceived benefits of CR participation were overall positive and similar between the two models; however, those in the comprehensive CR identified additional subthemes: self-care need and knowledge transfer. CONCLUSIONS This study suggested that patients from two different CR models perceived in the long term that the CR participation positively impacted their disease-related knowledge, promoted functional gains, and improved psychosocial well-being. Structured educational interventions seemed to be associated with improved participants' perception about CR, which could contribute to long-term maintenance of heart-health behavior and better outcomes.
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Affiliation(s)
- Isabella de Oliveira Nascimento
- Post-Graduate Program Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), 63. Condomínio Pasárgada, CEP: 34.009-568. Nova Lima, Belo Horizonte, MG, Brazil
| | - Marcella Guimarães Assis
- Post-Graduate Program Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), 63. Condomínio Pasárgada, CEP: 34.009-568. Nova Lima, Belo Horizonte, MG, Brazil
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Raquel Rodrigues Britto
- Post-Graduate Program Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), 63. Condomínio Pasárgada, CEP: 34.009-568. Nova Lima, Belo Horizonte, MG, Brazil.
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Ghisi GLDM, Alavinia M, Aultman C, Rouleau F, Ross MK, Dufour-Doiron M, Belliveau SL, Brideau JR, Oh P. Predictors of Exercise Maintenance 6 Months After Comprehensive Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2021; 41:100-108. [PMID: 33186197 DOI: 10.1097/hcr.0000000000000552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The objectives of this study were (1) to assess the effects of a comprehensive education intervention on maintenance of knowledge, exercise behavior, heart-healthy food intake, self-efficacy, and health literacy 6 mo after comprehensive cardiac rehabilitation (CR), and (2) to identify predictors of exercise maintenance 6 mo after comprehensive CR. METHODS A prospective longitudinal study was conducted to test the effects of a structured educational curriculum in three CR programs in Canada. Participants completed surveys pre-, post-CR and 6 mo post-discharge to assess knowledge, heart-healthy food intake, self-efficacy, and health literacy. Exercise behavior was measured by number of steps/d using a pedometer. RESULTS One hundred twenty participants completed the final survey. Increases in disease-related knowledge and self-efficacy, as well as behavior changes (increases in exercise and heart-healthy food intake), were achieved in comprehensive CR and sustained 6 mo post-program. Exercise maintenance was predicted by changes in heart-healthy food intake, self-efficacy, health literacy, and exercise-related knowledge. CONCLUSIONS In this three-site study focusing on patient education for CR patients in Canada, the benefits of an education intervention in maintaining knowledge, exercise, healthy food intake, and self-efficacy were supported.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (Drs Ghisi, Alavinia, and Oh and Ms Aultman); Programme PREV Prévention Secondaire et Réadaptation Cardiovasculaire, Lévis, Canada (Ms Rouleau and Dr Ross); Réseau de santé Vitalité Health Network, Programme Cœur en santé/Cardiac Wellness Program, Moncton, Canada (Mss Dufour-Doiron and Belliveau and Dr Brideau)
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Halldorsdottir H, Thoroddsen A, Ingadottir B. Impact of technology-based patient education on modifiable cardiovascular risk factors of people with coronary heart disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:2018-2028. [PMID: 32595027 DOI: 10.1016/j.pec.2020.05.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/19/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To collect evidence on what types of technology and content are most effective in helping people with coronary heart disease (CHD) to change their modifiable cardiovascular risk factors. METHODS A literature search was performed to find relevant studies published between 1 January 2008 and 31 December 2018 in PubMed, CINAHL, PROQUEST and Scopus databases. Selected outcomes were risk factors (exercise, diet, blood pressure, blood sugar, cholesterol, body mass index, tobacco use). The quality of the studies was evaluated according to Joanna Briggs Institute Reviewers Manual Checklists for risk for bias, TIDieR for quality of interventions, and PRISMA statement for presenting results. RESULTS Eighteen quantitative (17 RCT´s and one quasi-experimental) studies were included. Patient education delivered through telephone, text messaging, webpages, and smartphone applications resulted in significant changes in some risk factors of people with CHD. Sufficient descriptions of the content and intervention methods were lacking. CONCLUSION Patient education delivered with technology can help people with CHD to modify their risk factors. There is a need for better descriptions of the content and delivery of educational interventions in studies. PRACTICE IMPLICATIONS Patient education needs to be delivered with technological solutions that best support the multidimensional needs of CHD patients.
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Affiliation(s)
- Hulda Halldorsdottir
- Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
| | - Asta Thoroddsen
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Brynja Ingadottir
- Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Marofi Z, Bandari R, Heravi-Karimooi M, Rejeh N, Montazeri A. Cultural adoption, and validation of the Persian version of the coronary artery disease education questionnaire (CADE-Q): a second-order confirmatory factor analysis. BMC Cardiovasc Disord 2020; 20:345. [PMID: 32703152 PMCID: PMC7379361 DOI: 10.1186/s12872-020-01628-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 07/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Evaluating knowledge in patients with coronary artery disease requires a specific measure. The aim of the present study was to translate and evaluate the CADE-Q in patients with coronary artery disease in Iran. METHODS Forward-backward procedure was applied to translate the questionnaire from English into Persian. Then a cross-sectional study was conducted to evaluate psychometric properties of the questionnaire. A sample of patients with coronary artery disease attending to cardiac departments of teaching hospitals affiliated to medical universities in Tehran, Iran completed the 19-item CADE-Q from April to December 2017. Structural validity of CADE-Q was assessed using both exploratory and confirmatory factor analyses. Reliability was examined using Cronbach's alpha coefficient. Stability was evaluated by estimation intraclass correlation coefficient. RESULTS In all 500 patients participated in the study. The mean age of patients was 53.63. (SD = 14.36) years, and 57% were male. The results obtained from the exploratory factor analysis showed a four factor solution (lifestyle habits and exercise, risk factors, diagnosis and treatment, signals & symptoms and medicine) that jointly explained 48.9% of the total variance observed. However, the second-order confirmatory factor analysis supported the three-factor solution while convergent and divergent validity were not confirmed. Finally, the Cronbach's alpha coefficient of 0.84 ranging from 0.50 to 0.82 was obtained for the scale and its subscales. In addition, the ICC value of 0.88 showed satisfactory stability for the questionnaire. CONCLUSION The Coronary Artery Disease Education Questionnaire was found to be a multidimensional instrument. The results confirmed the factor structure of the questionnaire with a second-order analysis. Since the convergent and divergent validity of the scale were not confirmed, further assessment is essential to establish fitness of the questionnaire in Iran.
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Affiliation(s)
- Zahra Marofi
- Faculty of Nursing & Midwifery, Shahed University, Tehran, Iran
| | - Razieh Bandari
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Majideh Heravi-Karimooi
- Elderly Care Research Center, Faculty of Nursing & Midwifery, Shahed University, Tehran, Iran.
| | - Nahid Rejeh
- Elderly Care Research Center, Faculty of Nursing & Midwifery, Shahed University, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
- Faculty of Humanity Sciences, University of Science & Culture, ACECR, Tehran, Iran.
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Abstract
PURPOSE Cardiac rehabilitation (CR) is effective at reducing further cardiac events. However, dropout rates are high, and maintenance of behavioral change post-CR is challenging. Health literacy (HL) may influence self-management of cardiac risk, yet few studies have explored this association. This study aimed to describe HL among CR attendees; first to describe the HL profiles of people commencing CR and second to examine HL changes between program entry and completion. METHODS CR attendees in Melbourne, Australia, completed the Health Literacy Questionnaire (HLQ) at program admission and completion. The HLQ measures HL across 9 scales. Cluster analysis grouped participants according to their HL profile. Effect sizes were used to determine changes in HLQ scores. Post-program interviews explored the role of HL in participant recovery. RESULTS Participants completed baseline (n = 60) and post-program (n = 38) data collection. Mean age was 60.3 ± 11.7 yr, and 38.3% had myocardial infarction and/or percutaneous coronary intervention. Approximately 18% of participants did not complete the program. Five HL clusters were revealed. The clusters most likely to drop out were confident users of the health system. The cluster least likely to drop out reported lower confidence in their ability to find health information and navigate services. Information-seeking ability improved over time, but no other HL improvements were seen. CONCLUSION There is a wide range of HL profiles in people attending CR. Findings suggest that CR programs should consider a variety of approaches to meet the diverse HL requirements of attendees.
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Cappelletti ER, Greco A, Maloberti A, Giannattasio C, Steca P, D'Addario M. What hypertensive patients want to know [and from whom] about their disease: a two-year longitudinal study. BMC Public Health 2020; 20:308. [PMID: 32164658 PMCID: PMC7068893 DOI: 10.1186/s12889-020-8421-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/27/2020] [Indexed: 01/03/2023] Open
Abstract
Background This study explored both the evolution of the information needs and the perceived relevance of different health information sources in patients with essential hypertension. It also investigated the relationships between information needs and the perceived relevance of information sources with socio-demographic and clinical variables. Methods Two hundred and two patients with essential arterial hypertension were enrolled in the study and evaluated at baseline and during three follow-ups at 6, 12 and 24 months after baseline. Patients had a mean age of 54.3 years [range 21–78; SD = 10.4], and 43% were women. Repeated measures ANOVA, Bonferroni post hoc tests, and Cochran’s Q Test were performed to test differences in variables of interest over time. Results It was observed a significant reduction in all the domains of information needs related to disease management except for pharmacological treatment and risks and complications. At baseline, patients reported receiving health information primarily from specialists, general practitioners, relatives, and television, but the use of these sources decreased over time, even if the decrease was significant only for relatives. Multiple patterns of relationships were found between information needs and the perceived relevance of sources of information and socio-demographics and clinical variables, both at baseline and over time. Conclusions The findings showed a general decrease in both the desire for information and the perceived relevance of different information sources. Hypertensive patients appeared to show little interest in health communication topics as their disease progressed. Understanding patients’ information needs and the perceived relevance of different information sources is the first step in implementing tailored communication strategies that can promote patients’ self-management skills and optimal clinical outcomes.
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Affiliation(s)
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Alessandro Maloberti
- Cardiology 4, "A. De Gasperis" Department, ASST GOM Niguarda Ca' Granda Hospital, Milan, Italy.,School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Cristina Giannattasio
- Cardiology 4, "A. De Gasperis" Department, ASST GOM Niguarda Ca' Granda Hospital, Milan, Italy.,School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
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Mares MA, McNally S, Fernandez RS. Effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery: a systematic review. ACTA ACUST UNITED AC 2019; 16:2304-2329. [PMID: 30204710 DOI: 10.11124/jbisrir-2017-003565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW OBJECTIVE The objective of this review was to investigate the effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery on patients' health-related quality of life and hospital readmission. INTRODUCTION Coronary heart disease is a major cause of death and disability worldwide, putting a great strain on healthcare resources. For the past two decades, population-wide primary prevention and individual healthcare approaches have resulted in a dramatic decline in overall cardiac mortality. Over the intervening years, surgical techniques in cardiology have also improved substantially. As a result, long-term outcomes in patients treated with coronary artery bypass graft surgery have established the treatment's effectiveness and survival benefit. Furthermore, participating in cardiac rehabilitation following coronary artery bypass graft surgery has also demonstrated a significant decrease in all-cause cardiac mortality in these patients. INCLUSION CRITERIA This review included studies with participants aged 18 years and over, post coronary artery bypass graft surgery that evaluated nurse-led cardiac rehabilitation (CR) programs compared with usual care or other forms of CR. The outcomes of interest were the health-related quality of life and hospital readmissions following coronary artery bypass graft surgery and measured using validated scales. Randomized controlled trials reported in English between 2000 to June 2017 were considered for inclusion. METHODS The search strategy aimed to find both published and unpublished studies using a three-step search strategy. An initial search of MEDLINE, CINAHL and Scopus was undertaken, followed by a search for unpublished studies including Dissertation Abstracts International, ProQuest Dissertations and Theses, Google Scholar, MedNar and ClinicalTrials.gov. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal tools from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Quantitative data was extracted from papers included in the review using the standardized data extraction tool from JBI-SUMARI. No meta-analysis was undertaken due to heterogeneity of the outcome measures. All results were subject to double data entry. Effect sizes expressed as risk ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were calculated for analysis. RESULTS Three trials involving 329 patients were included in the final review. The trials that investigated the effect of home based cardiac rehabilitation programs compared to usual care at six weeks, three months and six months follow-up demonstrated no statistically significant difference in health-related quality of life at any of the follow-up periods. However, one study demonstrated significantly higher scores related to health-related quality of life among those who received nurse-led home based cardiac rehabilitation (154.93 ± 4.6) compared to those who received usual care (134.20 ± 8.2) at two months follow-up. No trials were identified that compared the effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery on readmissions to hospital. CONCLUSION There is not enough evidence to support or discourage nurse-led cardiac rehabilitation programs on health-related quality of life in patients following coronary artery bypass graft surgery. However, the sparse data available suggests improvements in health-related quality of life at two months follow-up among those who received a nurse-led program. Further large-scale multicenter trials with standardized methodology are needed to determine the effect of nurse-led cardiac rehabilitation programs on health-related quality of life and rates of readmission to hospital following coronary artery bypass graft surgery.
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Affiliation(s)
- Maria A Mares
- School of Nursing and Midwifery, Western Sydney University, Parramatta, Australia.,Centre for Applied Nursing Research, Liverpool, Australia.,The New South Wales Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Stephen McNally
- School of Nursing and Midwifery, Western Sydney University, Parramatta, Australia.,The New South Wales Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Ritin S Fernandez
- School of Nursing, University of Wollongong, Wollongong, Australia.,Centre for Research in Nursing and Health, St George Hospital, Kogarah, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence
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Ghisi GLDM, Chaves GSS, Loures JB, Bonfim GM, Britto R. Validation of the Brazilian-Portuguese Version of a Short Questionnaire to Assess Knowledge in Cardiovascular Disease Patients (CADE-Q SV). Arq Bras Cardiol 2018; 111:841-849. [PMID: 30281691 PMCID: PMC6263460 DOI: 10.5935/abc.20180169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/27/2018] [Indexed: 11/20/2022] Open
Abstract
Background Patient education is an essential part of cardiovascular patients' care
targeting self-management behavior to reduce risk factors and subsequent
events. Herein, a short and reliable tool to assess patients' knowledge in
Brazil is warranted. Objectives To translate, culturally-adapt and psychometrically validate the Portuguese
version of the Coronary Artery Disease Education Questionnaire Short Version
(CADE-Q SV). Methods The Portuguese CADE-Q SV - translated and culturally-adapted - was reviewed
by five bilingual experts in cardiovascular disease. This version was then
pre-tested in 21 patients, and clarity of items was checked using a
Likert-type scale ranging from 1 = not clear to 10 = very clear. It was then
psychometrically tested in 200 cardiovascular patients (41%women; mean age =
58.4 ± 11.6 years old). The internal consistency was assessed using
Kuder-Richardson-20 (KR-20) and Cronbach's alpha, test-retest reliability
through intraclass correlation coefficient (ICC), factor structure using
confirmatory factor analysis, and construct validity regarding educational
level, family income, and time of diagnosis. Results All questions were considered clear by patients (clarity range:7.8-9.6).
KR-20 was 0.70. All ICC values were > 0.70. Factor analysis revealed 6
factors, all internally consistent. Construct validity was supported by
significant differences in total scores by educational level and family
income (p < 0.001). The overall mean was 13.08 ± 2.61. The area
with the highest knowledge was risk factors and the lowest was psychosocial
risk. Conclusions The Portuguese CADE-SV was demonstrated to have good validity and
reliability. This tool can be applicable in clinical and research settings,
assessing cardiovascular patients' knowledge as part of an education
programming.
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Affiliation(s)
| | | | | | | | - Raquel Britto
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brazil
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Validation of a Spanish Version of the Information Needs in Cardiac Rehabilitation Scale to Assess Information Needs and Preferences in Cardiac Rehabilitation. J Cardiovasc Nurs 2018; 33:E29-E34. [DOI: 10.1097/jcn.0000000000000505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chen Z, Geng J, Wang M, Hu L, de Melo Ghisi GL, Yu H. The Chinese version of the Coronary Artery Disease Education Questionnaire-II (CADEQ-II): translation and validation. Patient Prefer Adherence 2018; 12:1587-1596. [PMID: 30214161 PMCID: PMC6118335 DOI: 10.2147/ppa.s176639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES It is necessary to assess disease-related knowledge in patients with coronary artery disease (CAD) for tailored patient education; however there is a lack of a well-validated measurement in China. The objective of this study was to translate and validate a Chinese version of the Coronary Artery Disease Education Questionnaire-II (CADEQ-II). METHODS The Chinese version of CADEQ-II was translated and culturally adapted. Then, it was tested for psychometric properties through a convenient sampling. Content validity was examined based on a panel of five experts. The item difficulty index and item discrimination index were calculated to assess the item difficulty and item discrimination. Internal consistency reliability was measured with the Cronbach's alpha coefficient. Criterion-related validity was established through comparing scores in patients with different education levels. Construct validity was assessed through confirmatory factor analysis (CFA). RESULTS The Chinese version of the CADEQ-II was finalized after deleting three items and modifying two items from the original version. Three hundred and sixteen participants completed the whole questionnaire. Content validity index of the whole questionnaire was 0.87. The Cronbach's alpha coefficient of the overall questionnaire was 0.907. The significant difference of the knowledge scores among patients with different education levels supported criterion-related validity. CFA confirmed the proposed four-factorial structure of the questionnaire. CONCLUSION The Chinese version of CADEQ-II had an acceptable reliability and validity among Chinese patients with CAD. It could be used to develop individualized health education for Chinese patients with CAD. Also, it could serve as a suitable outcome measurement to evaluate the effectiveness of education interventions related to CAD.
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Affiliation(s)
- Zi Chen
- School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China,
| | - Jing Geng
- Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Mian Wang
- Infrastructure Management Department, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Liu Hu
- Department of Nursing, Wuhan Asian Heart Hospital, Wuhan, Hubei, 430022, China
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute (TRI), University Health Network (UHN), University of Toronto, Toronto, ON, Canada
| | - Huidan Yu
- School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China,
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Fradgley EA, Paul CL, Bryant J, Zucca A, Oldmeadow C. System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020179. [PMID: 29360743 PMCID: PMC5858254 DOI: 10.3390/ijerph15020179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/16/2017] [Accepted: 01/17/2018] [Indexed: 11/16/2022]
Abstract
Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting 23 patient-centred improvement initiatives. Using univariate tests and multivariable logistic regressions, this multi-site study also identifies initiatives differentially selected by outpatients according to clinical and demographic characteristics. A total of 475 outpatients participated (49% response). Commonly selected initiatives included: reducing wait-times (22.3%); convenient appointment scheduling (16.0%); and receiving up-to-date treatment information (16.0%). Within univariate tests, preferences for information and service accessibility initiatives were not significantly associated with specific subgroups. However, seven initiatives were preferred according to age, gender, diagnosis status, and chronic disease type within multivariate models. For example, neurology outpatients were more likely to select assistance to manage psychological symptoms when compared to oncology outpatients (OR: 2.89). Study findings suggest that system-wide programs to enhance information provision are strategic approaches to improve experiences across patient characteristics. Furthermore, a few initiatives can be targeted to specific groups and emphasized the importance of detailed scoping analyses and tailored implementation plans when designing patient-centred quality improvement programs.
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Affiliation(s)
- Elizabeth A Fradgley
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Christine L Paul
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
- Health Behaviour Research Group, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Alison Zucca
- Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
- Health Behaviour Research Group, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Australia.
- School of Mathematical and Physical Sciences, Faculty of Science and Information Technology, University of Newcastle, Callaghan, NSW 2308, Australia.
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Zhou Y, Li J, Du S, Du X, Fu C, Cao C, Wang Y. Cardiac rehabilitation knowledge in patients with coronary heart disease in Baoding city of China: A cross-sectional study. Int J Nurs Sci 2017; 4:24-28. [PMID: 31406713 PMCID: PMC6626076 DOI: 10.1016/j.ijnss.2016.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/30/2016] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The purpose of this study is to assess the awareness on cardiac rehabilitation (CR) in patients with coronary heart disease (CHD). METHODS Inpatients diagnosed with coronary heart disease were recruited from 3 hospitals in this study. The study employed a cardiac structured questionnaire to assess respondents' level of awareness, and bivariate to analyze the sociodemographic factors that influence the awareness on CR. RESULTS Of all 500 participants, 66.40% were male and the mean age was 62.51 ± 9.96 years. The mean score of knowledge was 44.00 ± 17.00 (score range: 0-93), and the mean level of awareness was 47.31% (awareness range: 0-100%). The highest mean level of awareness was in the reexamination subscale (98%) and the lower were in the basic information about CR program, SP optimized medication and heart rate subscale. Bivariate analysis showed that higher age was associated with less knowledge. Patients with higher education level and better income status had better knowledge. And patients who lived in rural and had no jobs had less knowledge. CONCLUSIONS This study showed low levels of awareness on CR program in CHD patients in Baoding. Therefore, the need for health education is indicated in this study to improve the awareness on CR among CHD patients.
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Affiliation(s)
| | | | | | | | | | | | - Yan Wang
- School of Nursing, Hebei University, Hebei, China
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Greco A, Cappelletti ER, Monzani D, Pancani L, D'Addario M, Magrin ME, Miglioretti M, Sarini M, Scrignaro M, Vecchio L, Fattirolli F, Steca P. A longitudinal study on the information needs and preferences of patients after an acute coronary syndrome. BMC FAMILY PRACTICE 2016; 17:136. [PMID: 27646507 PMCID: PMC5028970 DOI: 10.1186/s12875-016-0534-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 09/14/2016] [Indexed: 01/30/2023]
Abstract
Background Research has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome. Methods Two hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35–75; SD = 7.98). Patients’ needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran’s Q Test were performed to test differences in variables of interest over time. Results Results showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time. Conclusion The present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients’ information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0534-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea Greco
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Erika Rosa Cappelletti
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.
| | - Dario Monzani
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Maria Elena Magrin
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Massimo Miglioretti
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Marcello Sarini
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Marta Scrignaro
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Luca Vecchio
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
| | - Francesco Fattirolli
- Department of Medical and Surgical Critical Care, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero, Universitaria Careggi, Florence, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
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Vieira AM, Costa IZ, Oh P, Lima de Melo Ghisi G. Questionnaires Designed to Assess Knowledge of Heart Failure Patients. J Cardiovasc Nurs 2016. [DOI: 10.1097/jcn.0000000000000281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Knowledge and exercise behavior maintenance in cardiac rehabilitation patients receiving educational interventions. Heart Lung 2015; 44:474-80. [PMID: 26459971 DOI: 10.1016/j.hrtlng.2015.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/11/2015] [Accepted: 09/14/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To test whether a theoretically-based education curriculum results in more sustained knowledge, higher scores on Health Action Process Approach (HAPA) constructs, and greater exercise behavior 6 months post-cardiac rehabilitation (CR) when compared to traditional CR education. BACKGROUND Patient education is a core component of CR. No research has examined whether this education results in sustained improvements post-program. METHODS In this quasi-experimental study, participants exposed to the traditional vs HAPA-based education completed surveys pre, post-CR, and 6 months post-discharge assessing knowledge, HAPA constructs, and exercise. RESULTS Ninety-three participants completed the final survey. Knowledge increases post-CR were sustained 6 months post-program, with no differences by curriculum. Many improvements in HAPA constructs observed post-CR were sustained, except for some decay in self-efficacy. Minutes of exercise per week were significantly greater in participants exposed to the HAPA-based curriculum 6 months post-program. CONCLUSIONS HAPA-based education in CR has sustained effects on exercise.
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Ghisi GLDM, Britto R, Motamedi N, Grace SL. Disease-related knowledge in cardiac rehabilitation enrollees: correlates and changes. PATIENT EDUCATION AND COUNSELING 2015; 98:533-539. [PMID: 25577470 DOI: 10.1016/j.pec.2014.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 11/16/2014] [Accepted: 12/21/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To describe (1) patients' disease-related knowledge at cardiac rehabilitation (CR) entry; (2) correlates of this knowledge; (3) whether CR completion is related to knowledge; and (4) behavioral correlates of knowledge. METHODS For this prospective, observational study, a convenience sample of new CR patients was approached at 3 programs to complete a survey. It consisted of sociodemographic items, heart-health behavior surveys, and the CADE-Q. Patients were provided a similar survey 6 months later. RESULTS 214 patients completed the CADE-Q at both points, with scores demonstrating "acceptable" to "good" knowledge. Higher knowledge at CR entry was significantly associated with greater education, being married, greater English-language proficiency, and history of percutaneous coronary intervention (p≤0.05). The 118 (55.1%) patients that completed CR demonstrated significantly higher knowledge than non-enrollees at post-test (p≤0.05). There was a significant positive association between knowledge and physical activity (p≤0.01) and nutrition (p≤0.05) at post-test, but no association with smoking or medication adherence. CONCLUSIONS CR adherence ensures patients sustain knowledge needed to optimize their disease management, and perhaps ultimately their health outcomes. PRACTICE IMPLICATIONS CR completion should be promoted so patients remain educated about their disease management, and the health behaviors observed will be practiced in a greater proportion of patients.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiac Rehabilitation and Prevention Program, University Health Network, Toronto, Canada; Exercise Sciences Department, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada.
| | - Raquel Britto
- Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, Brazil; School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Nickan Motamedi
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Sherry L Grace
- Cardiac Rehabilitation and Prevention Program, University Health Network, Toronto, Canada; School of Kinesiology and Health Science, York University, Toronto, Canada
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Ghisi GLDM, Grace SL, Thomas S, Evans MF, Oh P. Development and psychometric validation of the second version of the Coronary Artery Disease Education Questionnaire (CADE-Q II). PATIENT EDUCATION AND COUNSELING 2015; 98:378-383. [PMID: 25481574 DOI: 10.1016/j.pec.2014.11.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 11/10/2014] [Accepted: 11/17/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To develop and psychometrically-validate a revised version of the Coronary Artery Disease Education Questionnaire (CADE-Q)--a tool to assess patients' knowledge about CAD in cardiac rehabilitation (CR). METHODS After a needs assessment, a literature review and focus group with CR experts, the revised questionnaire was developed. It underwent pilot-testing in 30 patients, which lead to further refinement. The questionnaire was then psychometrically-tested in 307 CR patients. Internal consistency was assessed using Cronbach's alpha, the dimensional structure through exploratory factor analysis, and criterion validity with regard to educational level. RESULTS Cronbach's alpha was 0.91. Criterion validity was supported by significant differences in mean scores by educational level (p<0.001). Factor analysis revealed four factors, which were internally-consistent (0.65-0.77), and well-defined by items. The mean total score was 64.2±18.1/93. Patients with a history of heart failure, cardiomyopathy and percutaneous coronary intervention (p<0.05) had significantly higher knowledge scores compared with patients without such a history. Knowledge about exercise and their medical condition was significantly higher than risk factors, nutrition and psychosocial risk. CONCLUSIONS The CADE-QII has good reliability and validity. PRACTICAL IMPLICATIONS This tool may be useful to assess CR participants' knowledge gaps, and to evaluate the efficacy of educational delivery in CR.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Exercise Sciences Department, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada; Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
| | - Sherry L Grace
- Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Scott Thomas
- Exercise Sciences Department, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | | | - Paul Oh
- Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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