Self-care Resources and Activity as Predictors of Quality of Life in Persons After Myocardial Infarction

The Effect of Self-Care Program Based on Modeling and Role Modeling Theory on Body Image Nurturance in Patients With Colorectal Cancer: A Randomized Clinical Trial

One of the most critical disorders among patients with colorectal cancer is a change in their body image. This study aimed to examine the effect of a self-care program based on the modeling and role-modeling theory on nurturing body image of patients with colorectal cancer. In 2018, a 2-group randomized clinical trial was conducted in Mashhad, Iran. According to the modeling and role-modeling theory, 27 patients allocated in the experimental group received five 30- to 45-minute sessions at the hospital and 4 sessions of phone counseling within 2 weeks. Twenty-seven patients randomly allocated in the control group received the routine care. Data were collected by demographic and body image scales 3 times with the patients. The mean age of the patients in experimental and control groups was not significantly different (P = .46). The mean scores of the body image at the admission time were 26.8 ± 2.6 in the experimental and 27.9 ± 3.1 in control groups (P = .12). However, the mean scores of body image of the experimental group were 24.3 ± 4.6 at the discharge time and 28.1 ± 2.1 during the follow-up phase. In the control group, the body image scores were 21.0 ± 5.6 at discharge time and 22.9 ± 6.1 during the follow-up phase. Repeated-measures analysis of variance revealed significant differences between the 2 groups (P ≤ .001). Application of the self-care program based on the modeling and role-modeling theory can play a critical role in nurturing the body image of patients with colorectal cancer.

Assessment of functional performance in Chagas heart disease by Human Activity Profile questionnaire

PURPOSE

To verify the association between Human Activity Profile and functional capacity, functional class and systolic function of the patients with Chagas heart disease (CHD).

METHODS

Sixty-two patients with CHD were evaluated by echocardiography, maximal exercise testing and Human Activity Profile questionnaire. The sample was stratified, according to the values of peak oxygen uptake (low or normal), functional class (symptomatic or asymptomatic), and left ventricular ejection fraction (preserved or systolic dysfunction). Linear regression and two-group comparisons analyses were used. Receiver-operating characteristic analysis was used to determine different cutoff values of the Human Activity Profile for low peak oxygen uptake prediction.

RESULTS

Peak oxygen uptake was an independent predictor of Human Activity Profile (R²-adjusted = 0.27). Patients with low peak oxygen uptake had lower scores in Human Activity Profile [difference of 6.9 (95%CI 2.5-11.4)] than those with normal peak oxygen uptake. Symptomatic patients also showed lower scores when compared to the asymptomatic [difference of 6.2 (95%CI 1.7-10.8)]. There was no difference between left ventricular ejection fraction classes. The Human Activity Profile score of 76.5 was the optimal cut point value in predicting low peak oxygen uptake (sensitivity = 66.0% and specificity = 71.8%).

CONCLUSION

The Human Activity Profile questionnaire is associated with functional capacity of patients with CHD and is able to identify individuals with low peak oxygen uptake.Implications for rehabilitationFunctional impairment is one of the most common clinical findings in all stages and is an important predictor of poor prognosis of the Chagas heart disease;A patient-derived measure of functional capacity is potentially useful in the setting of the Chagas heart disease;The Human Activity Profile questionnaire is effective in the identification of patients with Chagas heart disease with functional impairment and may be a valid method for functional evaluation.

Correlates of health-related quality of life in patients with myocardial infarction: A literature review

BACKGROUND

By the increasing emphasis on health-related quality of life (HRQoL) in patients with myocardial infarction (MI), it is necessary to explore factors that affect HRQoL in this population.

OBJECTIVES

This study aimed to identify correlates of HRQoL in patients with MI.

DESIGN

A literature review of the factors that affect HRQoL in patients with MI (1995-2016).

DATA SOURCES

Three main databases-CINAHL, MEDLINE and PsychINFO-were searched to retrieve relevant peer-reviewed articles published in English.

REVIEW METHODS

In consultation with a medical librarian, we identified relevant MeSH terms and used them for searching the literature: health-related quality of life/quality of life/HRQoL/QoL, myocardial infarction/heart attack/MI and predict*/factor. Data elements were extracted and narratively described variables synthesised into four categories.

RESULTS

A total of 48 studies met the inclusion criteria and were included in the review. Correlates of HRQoL in patients with MI were identified in the following categories: demographic, behavioural, disease-related, and psychosocial factors. Specific correlates included age and gender-identity for demographic factors; physical activity and smoking for behavioural factors; severity of MI, symptoms, and comorbidities for disease-related factors; anxiety and depression for psychosocial factors.

CONCLUSIONS

Identifying correlates of HRQoL can help identify patients who are at risk for poor HRQoL in the recovery or rehabilitation stage of post-MI. Future intervention should focus on adjustable correlates such as behavioural and psychosocial factors to promote HRQoL among patients after experiencing MI.

Validity and Reliability of a Scale for Rating Self-care in Persons with Heart Failure

Objetivo: determinar la validez y confiabilidad, en el contexto colombiano, de la Escala de valoración de comportamientos de autocuidadoen personas con falla cardiaca (FC) diseñada por Nancy Artinian. Método: estudio de validación de la escala Revised HeartFailure Self Care Behavior. Se realizó validación cultural (n = 13 enfermeros expertos en cuidado cardiovascular y 12 pacientes con FC),validación factorial y análisis de la confiabilidad (n = 206 pacientes con FC). Resultados: la validación cultural de la escala fue adecuada. La validación factorial mostró que la versión en español tenía cuatro dominios (solicitud de ayuda, adaptación a vivir con la enfermedad,adherencia al tratamiento farmacológico y adherencia al tratamiento no farmacológico) que explicaron el 34,2% de la varianza del constructolatente en la escala. Se eliminaron siete ítems por explicar menos del 0,2% de la varianza, quedando la escala final reducida a 21ítems. El coeficiente de confiabilidad alfa de Cronbach para la escala total fue aceptable (0,75). Conclusión: la nueva versión de la escalatiene adecuadas propiedades psicométricas en términos de confiabilidad y validez, lo que permitirá su utilización por enfermeros en ladetección de cambios de comportamientos de autocuidado clínicamente importantes en los pacientes con FC.

A critical review of appropriate conceptual models for use by coronary care nurses

BACKGROUND

There is little evidence of the extent of conceptual model use within cardiovascular nursing. Concern exists within nursing that nursing theory and conceptual model use within practice is less than optimal. It is further suggested that there is little evidence of nursing theory occupying its true position as the central tenet of nursing practice and cardiovascular nurses have been challenged to reconsider this aspect of practice.

AIM

The aim of this review is to explore the effectiveness of conceptual models used within cardiovascular nursing to further explore their potential benefit.

METHODS

Using key terms, a search was conducted using electronic databases CINAHL and PUBMED; yielding seven papers that fulfilled selection criteria.

FINDINGS

Few papers related to research studies in the area. However, of those identified significant examination and testing of concepts emerged within the studies. Rather than merely using concepts as an organizing framework or a component of the study, theories alluded to were scrutinized and consistently applied. Although studies identified mostly referred to specific testing and examination of aspects of conceptual models, the notion of self-care and support for clients emerges as a strong theme within the review. The relationship between nurse and client seemed to be pivotal in any noted improvements.

CONCLUSIONS

The findings have limited application to practice. In the absence of large-scale longitudinal studies, only selected aspects of conceptual models or theory were scrutinized. Further research is required in this area to identify conceptual models of nursing that are most appropriate for cardiovascular nursing care.

A systematic review of the Human Activity Profile

OBJECTIVE

To review the measurement properties (reliability, validity, responsiveness) of the Human Activity Profile (HAP), a self-report measure of energy expenditure or physical fitness.

DATA SOURCES

MEDLINE, CINAHL and EMBASE were searched up to September 2005 and the reference lists of included studies were checked for additional relevant studies.

REVIEW METHOD

Studies were included that reported Human Activity Profile scores, test-retest reliability, correlations with other measures, or responsiveness (sensitivity to change). Of 83 potentially relevant articles, 39 articles were included plus the test manual. Two independent reviewers extracted data from the included studies.

RESULTS

The Human Activity Profile has been used to evaluate physical activity in a wide variety of clinical populations and in healthy individuals. The change in score required to be 90% confident that change is beyond measurement error was estimated to be 7.8 for the Maximum Activity Score and 6.8 for the Adjusted Activity Score. The construct validity of the Human Activity Profile was supported by a large number of studies, although evidence for criterion validity was limited to four studies. No studies have investigated a priori the responsiveness or minimum clinically important difference of the Human Activity Profile.

CONCLUSION

The Human Activity Profile appears to be a useful indicator of physical activity levels in people with chronic pain, arthritis, renal failure, various neurological and cardiorespiratory conditions, as well as in healthy older people.

A critical analysis of the potential contribution of Orem's (2001) self-care deficit nursing theory to contemporary coronary care nursing practice

BACKGROUND

Over the last three decades, nurse theorists have strongly advocated the use of conceptual models of nursing to guide nursing practice. Within coronary care units, conceptual model-based care has had inconsistent application and is currently challenged by contemporary approaches such as pathways of care.

AIMS

This paper aims to critically analyze the use of Orem's self-care deficit nursing theory as a modus operandi to effectively meet the needs of hospitalized patients in coronary care.

RESULTS

Although complex both in the language and construction, the self-care model , provides a comprehensive and holistic approach to the care of people in coronary care.

CONCLUSIONS

This paper highlights the potential contribution the application of the self-care deficit nursing theory to the coronary care setting from a philosophical and practical perspective. Orem's conceptual model of nursing and current practice in coronary care units share certain similarities that render a useful model for use in practice. However, while it is recommended for consideration for use in both practice and educational settings, further empirical work is required in the area, together with realistic and practical application of the theory to practice in a way that embraces contemporary notions.

Conceptual models used by nurses working in coronary care units--a discussion paper

In the UK, Europe and the USA conceptual models of nursing are features of many undergraduate nursing curricula [Alligood MR. The nature of knowledge needed for nursing practice. In Alligood MR, Marriner-Tomey A, editors. Nursing theory utilisation and application. London: Mosby, 2002, Tierney AJ. Nursing models extant or extinct? J Adv Nurs 1998;8(1):77-85] and commonly used in practice. However, UK nurses in practice continue to be dissatisfied with conceptual model use [Griffiths P. An investigation into the description of patients' problems by nurses using two different needs-based nursing models. J Adv Nurs 1998;28(5):969-977, Mason C. Guide to practice or 'load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland. J Adv Nurs 1999;29(2):380-387, Murphy K, Cooney A, Casey D, Connor M, O'Connor J., Dineen B. The Roper, Logan and Tierney Model: perceptions and operationalization of the model in psychiatric nursing within one health board in Ireland. J Adv Nurs 2000;31(6):1333-1341]. An association with increased paperwork and documentation together with a belief that these abstract concepts do not quite fit with the practice setting has resulted in a generalised apathy towards their use in some areas [Timmins F. Critical care nursing in the 21st Century. Intensive Crit Care Nurs 2002;18:118-127]. In an era of concerns about both cost and quality, together with an increased impetus towards multi-professional working patterns and role expansion, alternative models of care, such as critical pathways and care pathways are gaining increased favour in the clinical setting [Johnson S, editor. Pathways of care. Oxford; Blackwell Science 1997]. The aim of this paper is to consider whether or not the traditional conceptual models of nursing are apt for today's practicing coronary care nurse. Specific questions to be addressed are: what is the research evidence that informs conceptual model use in coronary care and what are the conceptual models that commonly inform contemporary practice in coronary care nursing? Suggested ways forward for conceptual model use within nursing are also proposed.