Satisfaction With Treatment and Prevalence of Discomfort After External Electrical Cardioversion

Virtual reality-based preprocedural education increases preparedness and satisfaction of patients about the catheter ablation of atrial fibrillation

BACKGROUND

A recent study suggested to develop and implement more interacted material for preprocedural education to decrease patients' anxiety about the atrial fibrillation (AF) ablation. This study compared the effectiveness of using either newly developed virtual reality (VR) materials (VR group) or paper-based materials (paper group) on giving AF preprocedural education.

METHODS

This study consequentially enrolled 33 AF patients preparing for ablation from November 2019 to October 2020. After enrollment, patients were randomized as either paper (n = 22) or VR (n = 11) groups.

RESULTS

In comparison with the baseline stage, at the posteducation stage, the degree of improvement in patients' self-assessed self-efficacy on AF ablation knowledge was higher among VR group patients than those in the paper group. At the posteducation stage, the patients' satisfaction to preprocedural education and used materials were higher among the VR group than that among the paper group. In addition to meet their needs and give accurate medical information, VR group patients reported that VR materials increased the effectiveness of education, increased their preparedness for AF catheter ablation, achieved paperless purposes, and willing to recommend VR materials to others. Operators subjectively reported that the periprocedure cooperation was increased both among paper and VR group patients after preprocedural education for the details of procedure. Better preparedness of VR group patients was supported by less periprocedure pain, anxiety, and impatience than those among paper group patients.

CONCLUSION

Interactive VR-based materials are superior to the paper-based materials to provide patients immerse and imagine the journey and detail knowledge of AF catheter ablation before the procedure and better prepared patients for the procedure.

Peri-operative care in adults with congenital heart disease: room for improvement in after care

BACKGROUND

Patient satisfaction with care has received little attention within the field of congenital heart disease. Our objective was to examine patient satisfaction with the care received when undergoing open-heart surgery in order to identify the best and worst aspects of peri-operative care. Moreover, we examined whether having contact with a specialised nurse in addition to usual care is associated with higher patient satisfaction levels.

METHODS

Patient satisfaction was measured by the Satisfaction with Hospital Care Questionnaire, evaluating nine aspects of care by answering individual items and giving overall grades. A top 10 of the best and worst items was selected. Linear regression analyses were used to examine the relationship between having contact with a specialised nurse and patient satisfaction (9 grades), independent of patient characteristics--sex, age, educational level, and health status.

RESULTS

Data were available for 75 patients. Grades ranged from 6.74 for "discharge and after care" to 8.18 for "medical care". In all, 21% of patients were dissatisfied with the clarity of the information about lifestyle adjustments given by the surgeon. However, patients who had contact with a specialised nurse were more satisfied with the provided information (B-coefficient is 0.497, p-value is 0.038), independent of patient characteristics.

CONCLUSIONS

Patients were satisfied with the received care, although there is room for improvement, especially in discharge and after care and the clarity of the information provided by the surgeon. This gap in care can be compensated for by specialised nurses, as patients who were counselled by a specialised nurse were more satisfied with the provided information.

Atrial fibrillation among older adults: pathophysiology, symptoms, and treatment

Atrial fibrillation is the most common arrhythmia among older adults. Valvular heart disease, dilated cardiomyopathy, aortic stenosis, hypertension, coronary artery disease, pericarditis, thyrotoxicosis, pulmonary disease, cardiac surgery, alcohol excess, and alcohol withdrawal are associated with atrial fibrillation. Nurses caring for older adults need to understand the condition's pathophysiology, signs and symptoms, diagnostic data and treatment protocols, and adherence issues to prevent the formation of emboli in chronic atrial fibrillation and to understand treatment of this common arrhythmia. This article presents an individual example of an elderly man exhibiting a new onset of atrial fibrillation and the interventions required to manage the associated complications. Atrial fibrillation places patients at risk for stroke from a thromboembolism; thus, pharmacological and nonpharmocological care strategies for managing patients with atrial fibrillation are discussed.

Supraventricular Dysrhythmias

Cardiovascular nursing practice includes accountability for the clinical and organizational processes to ensure positive outcomes for patients having cardiac dysrhythmias. For patients with supraventricular dysrhythmias, nurses have studied patient outcomes related to mortality, morbidity, quality of life, psychological and physical functioning, and symptoms. Nurses have also explored these same outcomes associated with the management of supraventricular dysrhythmias. In addition, nurses have contributed to understanding organizational outcomes such as healthcare utilization and costs associated with these patients. For patients with atrial fibrillation after cardiac surgery, nurses have studied patient and organizational outcomes related to mortality, morbidity, symptoms, psychological and physical functioning, and economic outcomes. This research has included numerous interdisciplinary studies, and most of it has been descriptive or observational in design. Areas for future nursing outcomes research, including more interventional studies, are discussed.

Incidencia de las alteraciones cutáneas secundarias a la cardioversión eléctrica externa

External electrical cardioversion is a technique basically used as treatment of choice in supraventricular arrhythmias, atrial fibrillation standing out for its frequency. This procedure consists in the application of one or several synchronized electrical discharges through the patient's chest to revert cardiac rhythm to sinus rhythm. One of the complications is generally the appearance of the skin alterations, pain or intense local heat. The objectives of this study were to describe the skin lesions that appeared after an external electrical cardioversion procedure and to evaluate the information received by the patients on discharge. A descriptive study was conducted, using a sample of 68 patients who underwent cardioversion between January 1 and December 30 1, 2004. Mean age was 62.71 years, of which 76.5% were males diagnosed of atrial fibrillation in 82.4% of the cases. Erythema appeared in more than 80% of the cases, with the mean duration of 4.76 days. A total of 13.2% developed second-degree burn. Although 92.5% considered written information on the care after the procedure necessary, less than 11% had received it. It is concluded that the prevalence of the skin alterations after cardioversion is elevated, one of the causal factors being lack of information. There is a significant deficiency of knowledge on skin care after the procedure.