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Cardiac rehabilitation in the acute care setting: Integrative review. Aust Crit Care 2016; 30:99-106. [PMID: 27614674 DOI: 10.1016/j.aucc.2016.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 04/30/2016] [Accepted: 07/07/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Phase one cardiac rehabilitation (CR) is an essential component of care for patients with coronary heart disease. With optimal program delivery, health outcomes can be improved. OBJECTIVES To conduct an integrative review that explores Phase one CR for patients hospitalised with coronary heart disease. DESIGN Integrative literature review (2003-2014) Data sources: The literature search included Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Experta Medica Database (EMBASE), Psycinfo, Clinical Practice Guidelines Portal, Cochrane Library, Clinical Evidence (BMJ) and Google Scholar. REVIEW METHODS The Joanna Briggs Institute critical appraisal tools relevant to study methodology were utilised. Studies included for review were peer reviewed, published in English. Studies included Phase one CR intervention/s or the provision of education to patients diagnosed with coronary heart disease in the acute care setting prior to hospital discharge. RESULTS In the past decade cardiac researchers have predominantly focused on patients and health professionals perceptions, CR interventions, and patient education. Factors that impede delivery of Phase one CR, such as time, workload etc. were also reported. CONCLUSIONS The implementation of Phase one CR delivery requires optimisation to enable patients with coronary heart disease to achieve positive health outcomes post hospitalisation. Future interventions should address the factors that impede delivery of Phase one CR.
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Gender and Age Differences Associated With Prehospital Delay in Chinese Patients Presenting With ST-Elevation Myocardial Infarction. J Cardiovasc Nurs 2014; 31:142-50. [PMID: 25419938 DOI: 10.1097/jcn.0000000000000219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES A limited number of studies have examined the interaction between gender and age with regard to extent of prehospital delay. Our aim was to examine gender and age differences associated with prehospital delay in Chinese patients presenting with ST-elevation myocardial infarction (STEMI). METHODS A total of consecutive 1429 records from patients presenting with STEMI were analyzed between June 1, 2009, and June 1, 2010. We compared hospital care data by gender and age for inpatients with acute STEMI presenting within 24 hours of symptom onset. RESULTS The overall median duration of prehospital delay was 150 minutes (mean, 266 minutes). For patients 54 years or younger, 55 to 64 years old, and 75 years or older, women were more likely to experience longer delays compared with men (P < .05) even after controlling for medical history and risk factors. For male patients, compared with groups 54 years or younger, with the exception of men 55 to 64 years old, older male patients were more likely to have greater delays (P < .05) even after controlling for medical history and risk factors. However, after controlling for other variables, these gender and age differences in prehospital delay were no longer statistically significant. Among patients 65 to 74 years old, there were no gender differences in prehospital delay. Among female patients, there were no age differences in prehospital delay. CONCLUSIONS Male elderly patients (aged ≥65 years) and women (aged ≤64 and ≥75 years) with STEMI were more likely to delay seeking timely medical care. These gender and age differences were explained by different education, stable income, medical insurance, typical chest pain, and cognition toward heart diseases.
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Abstract
OBJECTIVE Investigate workers' knowledge and beliefs about cardiometabolic risk. METHODS A survey on the risks of diabetes, cardiovascular disease, and chronic kidney disease was disseminated among Dutch construction workers and employees from the general working population. RESULTS We had 482 respondents (26.8%) among construction workers and 738 respondents (65.1%) among the general working population. Employees showed reasonable basic knowledge, especially about cardiovascular disease risk factors and risk reduction. Nevertheless, they also had knowledge gaps (eg, specific dietary intake) and showed misconceptions of what elevated risk entails. Employees having lower education, being male, and having lower health literacy demonstrated less adequate knowledge and beliefs. CONCLUSION To improve the potential effect of health risk assessments in the occupational setting, physicians should explain what it means to be at elevated cardiometabolic risk and target their messages to employee subgroups.
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Lefler LL, McSweeney JC, Garner KK. "Missing pieces": exploring cardiac risk perceptions in older women. Res Gerontol Nurs 2013; 6:107-15. [PMID: 23293985 DOI: 10.3928/19404921-20121217-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 06/27/2012] [Indexed: 07/13/2024]
Abstract
Approximately 95% of older women have factors that put them at risk for developing cardiovascular disease, but research indicates many do not perceive themselves to be at risk. We examined older women's perceived risk for coronary heart disease (CHD) and the factors influencing their perceptions. We conducted a descriptive, qualitative study using in-depth, individual interviews and quantitative measures to assess perceived risk and risk factors. Twenty-four older African American and Caucasian women had a mean 4.46 cardiac risk factors but perceived their own CHD risk as unrealistically low at 1.95 cm (SD = 1.57, on 0-to-8 cm visual analogue scale). Narrative data clustered in themes that represented a lack of fact-based information and multiple misconceptions about CHD and prevention. Major improvements in CHD health are only achievable if risk factors are prevented. This research suggests older women have substantial needs for consistent CHD information and prevention guidance.
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Affiliation(s)
- Leanne L Lefler
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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Bergman HE, Reeve BB, Moser RP, Scholl S, Klein WMP. Development of a Comprehensive Heart Disease Knowledge Questionnaire. AMERICAN JOURNAL OF HEALTH EDUCATION 2013; 42:74-87. [PMID: 21720571 DOI: 10.1080/19325037.2011.10599175] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND: Heart disease is the number one killer of both men and women in the United States, yet a comprehensive and evidence-based heart disease knowledge assessment is currently not available. PURPOSE: This paper describes the 2 phase development of a novel heart disease knowledge questionnaire. METHODS: After review and critique of the existing literature, a questionnaire addressing 5 central domains of heart disease knowledge was constructed. In Phase I, 606 undergraduates completed a 82-item questionnaire. In Phase II, 248 undergraduates completed a revised 74-item questionnaire. In both phases, item clarity and difficulty were evaluated, along with the overall factor structure of the scale. RESULTS: Exploratory and confirmatory factor analyses were used to reduce the scale to 30 items with fit statistics, CFI = .82, TLI = .88, and RMSEA = .03. Scores were correlated moderately positively with an existing scale and weakly positively with a measure of health literacy, thereby establishing both convergent and divergent validity. DISCUSSION: The finalized 30-item questionnaire is a concise, yet discriminating instrument that reliably measures participants' heart disease knowledge levels. TRANSLATION TO HEALTH EDUCATION PRACTICE: Health professionals can use this scale to assess their patients' heart disease knowledge so that they can create a tailored program to help their patients reduce their heart disease risk.
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Affiliation(s)
- Hannah E Bergman
- Division of Cancer Control and Population Sciences, National Cancer Institute
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Poomsrikaew O, Ryan CJ, Zerwic JJ. Knowledge of heart attack symptoms and risk factors among native Thais: A street-intercept survey method. Int J Nurs Pract 2010; 16:492-8. [DOI: 10.1111/j.1440-172x.2010.01874.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Galdeano LE, Rossi LA, Spadoti Dantas RA. Deficient Knowledge Nursing Diagnosis: Identifying the Learning Needs of Patients With Cardiac Disease. ACTA ACUST UNITED AC 2010; 21:100-7. [DOI: 10.1111/j.1744-618x.2010.01155.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tracy SM. Piloting tailored teaching on nonpharmacologic enhancements for postoperative pain management in older adults. Pain Manag Nurs 2009; 11:148-58. [PMID: 20728064 DOI: 10.1016/j.pmn.2009.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 06/05/2009] [Accepted: 06/08/2009] [Indexed: 11/19/2022]
Abstract
Despite many advances in the pharmacologic treatment of pain, the issue of unresolved postoperative pain continues to plague patients and health care professionals. Little seems to be known about the reasons why nonpharmacologic methods are not more widely used, particularly as they are commonly low in cost, easy to use, and largely free of adverse side effects. A central question has to do with what patients are taught about nonpharmacologic methods and how a novel mode of teaching can be embedded in practice. A seven-step pre-posttest teaching intervention pilot study was deployed with older joint replacement patients within the context of a translational research model. Results of the teaching pilot showed significant post-teaching changes in subjects' knowledge and attitudes about nonpharmacologic methods for pain management, high satisfaction with the nonpharmacologic methods they chose, and incrementally greater use of the nonpharmacologic methods over the course of the hospital stay. A randomized controlled trial of the study is now in the early planning stages in an effort to obtain generalizable results that will help solidify evidence of the impact of music, imagery, and slow-stroke massage on pain management and confirm the value of patient teaching as an important means of offering patients more options for managing their own pain.
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MESH Headings
- Aged
- Aged, 80 and over
- Attitude to Health
- Diffusion of Innovation
- Evidence-Based Nursing
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Imagery, Psychotherapy/education
- Imagery, Psychotherapy/methods
- Male
- Massage/education
- Massage/methods
- Massage/nursing
- Massage/psychology
- Middle Aged
- Models, Educational
- Models, Nursing
- Music Therapy/education
- Music Therapy/methods
- Needs Assessment
- New England
- Nursing Assessment
- Nursing Evaluation Research
- Pain, Postoperative/prevention & control
- Pain, Postoperative/psychology
- Patient Care Planning/organization & administration
- Patient Education as Topic/methods
- Pilot Projects
- Postoperative Care/methods
- Postoperative Care/nursing
- Postoperative Care/psychology
- Self Care
- Teaching/methods
- Translational Research, Biomedical
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Kayaniyil S, Ardern CI, Winstanley J, Parsons C, Brister S, Oh P, Stewart DE, Grace SL. Degree and correlates of cardiac knowledge and awareness among cardiac inpatients. PATIENT EDUCATION AND COUNSELING 2009; 75:99-107. [PMID: 18952393 PMCID: PMC2935489 DOI: 10.1016/j.pec.2008.09.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 08/20/2008] [Accepted: 09/07/2008] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To investigate the degree of CHD awareness as well as symptom, risk factor, and treatment knowledge in a broad sample of cardiac inpatients, and to examine its sociodemographic, clinical and psychosocial correlates. METHODS 1308 CHD inpatients (351 [27.0%] female), recruited from 11 acute care sites in Ontario, participated in this cross-sectional study. Participants were provided with a survey which included a knowledge questionnaire among other measures, and clinical data were extracted from medical charts. RESULTS 855 (68.8%) respondents cited heart disease as the leading cause of death in men, versus only 458 (37.0%) in women. Participants with less than high school education (p<.001), an annual family income less than $50,000CAD (p=.022), low functional capacity (p=.042), who were currently smoking (p=.022), who had no family history of heart disease (p<.001), and who had a perception of low personal control (p=.033) had significantly lower CHD knowledge. CONCLUSIONS Awareness of CHD is not optimal, especially among women, South Asians, and those of low socioeconomic status. CHD patients have a moderate level of disease knowledge overall, but greater education is needed. PRACTICE IMPLICATIONS Tailored educational approaches may be necessary for those of low socioeconomic status, particularly with regard to the nature of CHD, tests and treatments.
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Fernandez RS, Salamonson Y, Griffiths R, Juergens C, Davidson P. Awareness of risk factors for coronary heart disease following interventional cardiology procedures: a key concern for nursing practice. Int J Nurs Pract 2009; 14:435-42. [PMID: 19126071 DOI: 10.1111/j.1440-172x.2008.00717.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiovascular risk factor modification to prevent progression of coronary heart disease is important for patients following percutaneous coronary intervention. The aims of this study were to assess patient's awareness of modifiable cardiac risk factors and examine if patients with modifiable risk factors were more likely to identify these risk as amenable to change. Awareness of risk factors was measured using the Indiana Cardiac Rehabilitation Knowledge Questionnaire in a cohort of prospective, consecutive participants post percutaneous coronary intervention. Completed questionnaires were received from 75% of the participants. The majority were able to identify high cholesterol (87%), smoking (83%) and hypertension (82%) as modifiable risk factors. Less than half (46%) of the respondents identified diabetes as a modifiable risk factor. Only a third of participants recognized all six modifiable risk factors. A large proportion of patients who were smokers, or who had high cholesterol or hypertension, identified these as risk factors. A third of people with documented diabetes did not recognize this condition as a risk factor for heart disease. The findings have important implications for nursing practice in terms of directing educational efforts for the modification of risk factors for coronary heart disease.
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Affiliation(s)
- Ritin S Fernandez
- South Western Sydney Centre for Applied Nursing Research, University of Western Sydney, New South Wales, Australia.
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Jensen LA, Moser DK. Gender Differences in Knowledge, Attitudes, and Beliefs About Heart Disease. Nurs Clin North Am 2008; 43:77-104; vi-vii. [DOI: 10.1016/j.cnur.2007.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Barnason S, Zimmerman L, Nieveen J, Schulz P, Hertzog M, Miller C, Rasmussen D. Usefulness of RISKO Heart Hazard Appraisal to Quantify CAD risk factor burden on the preoperative functioning of coronary artery bypass graft surgery patients. ACTA ACUST UNITED AC 2007; 22:81-7. [PMID: 17541317 DOI: 10.1111/j.0889-7204.2007.05814.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The preoperative status of coronary artery bypass graft (CABG) surgical patients is often evaluated as a means to assess operative risk for mortality and morbidity and to inform how preoperative status influences or predicts outcomes following CABG surgery. The purpose of this study was to examine the influence of coronary artery disease (CAD) risk factor burden on CABG patients' preoperative functioning (functional status and functional capacity). A convenience sample of 152 subjects, 65 years and older, who had been consecutively enrolled in a larger randomized clinical trial, was evaluated. The RISKO Heart Hazard Appraisal was used to quantify CAD risk factor burden of the subjects. There were significant differences by CAD risk factor burden group, with subjects in the highest CAD risk factor burden group having poorer general health functioning (F2,147=3.45; P<.05) and functional capacity (F2,147=5.43; P<.01). These findings elucidate the potential usefulness of evaluating CABG patients' preoperative CAD risk factor burden status.
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Affiliation(s)
- Susan Barnason
- University of Nebraska Medical Center, College of Nursing--Lincoln Division, Lincoln, NE 68588, USA.
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Redfern J, Ellis ER, Briffa T, Freedman SB. High risk-factor level and low risk-factor knowledge in patients not accessing cardiac rehabilitation after acute coronary syndrome. Med J Aust 2007; 186:21-5. [PMID: 17229029 DOI: 10.5694/j.1326-5377.2007.tb00783.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Accepted: 09/04/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To document the risk-factor profile and risk-factor knowledge of patients with an acute coronary syndrome (ACS) not attending standard cardiac rehabilitation. DESIGN AND SETTING Cross-sectional comparison in a tertiary hospital. PARTICIPANTS Patients admitted to hospital with an ACS, residing within 20 km of the hospital, and without severe comorbidity who did not access cardiac rehabilitation (NCR) were compared with a group about to commence standard cardiac rehabilitation (SCR). MAIN OUTCOME MEASURES Risk-factor profile, knowledge of risk factors via face-to-face assessment, quality of life. RESULTS Of the 446 patients eligible for cardiac rehabilitation, 208 attended for assessment (NCR: n = 144; SCR: n = 64). The NCR group had higher mean (+/- SEM) low-density lipoprotein (LDL) cholesterol levels (2.6 +/- 0.1 v 2.3 +/- 0.1; P = 0.02), and were more likely than the SCR group to have a total cholesterol level of > 4.0 mmol/L (78% v 53%; P < 0.001) and an LDL cholesterol level > 2.5 mmol/L (47% v 25%; P = 0.01). They were more likely than the SCR group to be physically inactive (77% v 22%; P < 0.001); obese (46% v 33%; P = 0.04); depressed (21% v 5%; P < 0.001); or current smokers (21% v 1%; P < 0.001). Compared with the SCR group, the NCR group also had higher risk scores (LIPID risk score) (4.5 v 2.1; P < 0.001); lower quality of life (Medical Outcome Short Form [SF-36] Health Survey); and significantly poorer knowledge of risk factors. Among patients with at least two modifiable cardiac risk factors, the NCR group were less likely than the SCR group to be able to state at least one risk factor (24% v 38%; P < 0.001). CONCLUSIONS Patients not participating in cardiac rehabilitation after an ACS have more adverse risk profiles and poorer knowledge of risk factors compared with those about to commence cardiac rehabilitation. Alternate models for secondary prevention are required to improve health outcomes in patients not attending cardiac rehabilitation.
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Liew H, Taylor DM, Tjipto A, Bailey M. Investigation of the variables that impact upon the knowledge of cardiac risk factors. Emerg Med Australas 2006; 18:252-8. [PMID: 16712535 DOI: 10.1111/j.1742-6723.2006.00848.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Awareness of cardiac disease risk factors is required before they can be modified. The present study aimed to investigate risk factor knowledge and the variables that impact upon this knowledge. METHODS We undertook an analytical, cross-sectional survey of 226 patients attending an ED. Patients were asked to recall as many cardiac risk factors as possible and to rate the risk of nine given risk factors. Data relating to sources of risk factor information were collected. Uni- and multivariate (multiple linear regression) analyses determined variables that impacted upon the risk factor knowledge score. RESULTS Mean patient age was 60.2 +/- 15 years, 55.3% (95% confidence interval 48.6-61.9) were male and 19.9% (95% confidence interval 15.0-25.8) had known cardiac disease. The mean risk factor knowledge score of 2.5 +/- 1.5 out of a possible 12 (median 3) was indicative of poor knowledge. Smoking, poor diet and stress/worry/tension were the most common factors reported. Variables impacting significantly on the knowledge score were English as a first language (P < 0.001), age (negative correlation, P < 0.001) and the receipt of information relating to cardiac health (P < 0.001). The patients' general practitioner and the media were the most important sources of information. CONCLUSIONS Patients' knowledge of cardiac risk factors is generally poor and education strategies are indicated. At the individual level, the general practitioner is likely to remain as an important influence on knowledge. However, complementary media education programs are indicated at the community level. Patient subgroups at 'high risk' through poor knowledge should be specifically targeted.
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Affiliation(s)
- Hui Liew
- Emergency Department, Royal Melbourne Hospital, Victoria, Australia
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Tracy S, Dufault M, Kogut S, Martin V, Rossi S, Willey-Temkin C. Translating best practices in nondrug postoperative pain management. Nurs Res 2006; 55:S57-67. [PMID: 16601636 DOI: 10.1097/00006199-200603001-00010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The research-to-practice gap is at the heart of the problem in the underuse of nondrug complementary methods to manage postoperative pain. PURPOSE To show how the six steps of the Collaborative Research Utilization (CRU) model can be used to translate research into practice, using an example of nondrug pain management protocols. METHODS The CRU model was used to translate empirically tested nondrug interventions for surgical pain management enhancement into cost-effective, easy-to-use, best-practice nursing interventions, using tailored patient teaching. RESULTS The preliminary findings of the substudy in the context of the CRU model are reported. DISCUSSION The CRU model was successful in changing patients' knowledge, attitudes, and use of nondrug interventions for pain management. Further research is needed in heterogeneous populations. Organization receptivity to research and a well-integrated computerized documentation system for cueing clinicians' pain management practices are key for effectiveness of change.
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11. PATIENT EDUCATION. JOURNAL OF INFUSION NURSING 2006. [DOI: 10.1097/00129804-200601001-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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