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Javadzade H, Vahedparast H, Khodaminasab A, Tahmasebi R, Reisi M, Kiani J. The effect of web-based education on self-care behaviors in cardiovascular patients: application of the pender's health promotion model. Arch Public Health 2024; 82:64. [PMID: 38725040 PMCID: PMC11080192 DOI: 10.1186/s13690-024-01299-0] [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: 10/06/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Coronary artery disease is the most common cardiovascular disease, the mortality rate of which is increasing significantly. The most important way to prevent a second attack in patients undergoing angioplasty is self-care, which can be influenced by several factors such as the patient's beliefs. Thus, the present study aimed to determine the effect of a web-based intervention based on the Pender's health promotion model in patients with cardiovascular disease. METHODS The present clinical trial study was conducted with 99 patients undergoing angioplasty treatment referring to Bushehr Heart Specialist Center. Random sampling was done and the participants were divided into two groups (50 subjects in intervention group and 49 subjects in control group). The data collection tool was a three-part questionnaire (including demographic information, a researcher-made questionnaire based on the health promotion model constructs, and self-care behaviors), which was completed in three stages (before, two weeks, and three months after the intervention). In addition to routine hospital services, the intervention group received multimedia training based on the constructs of the Pender's health promotion model from the website. The control group received usual hospital services. Data were analyzed with chi-square, independent T-test and repeated measure ANOVA using SPSS-22 software. RESULTS The results showed that 2 weeks and 3 months after the intervention, the mean scores of perceived benefits, perceived self-efficacy and perceived social support had a significant increase in the intervention group compared to the control group, but the mean score of perceived barriers had a significant decrease in the intervention group (p < 0.001). Regarding self-care behaviors, after the intervention, the mean scores of self-care behaviors, physical activity, healthy diet, medication adherence and stress management had a significant increase in the intervention group compared to the control group (p < 0.001), but no significant was observed between the two groups in terms of changes in the non-smoking (p = 0.38). CONCLUSION The results of the study showed that the web-based educational intervention based on the health promotion model is useful in improving the self-care behaviors of cardiac patients undergoing angioplasty. Nursing education and care have a great role in improving the self-care behaviors of cardiovascular patients. TRIAL REGISTRATION Registration number: IRCT2017080635429N2. Registration date: 09/03/2017 ( https://en.irct.ir/trial/26775 ).
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Affiliation(s)
- Homamodin Javadzade
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hakime Vahedparast
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Azime Khodaminasab
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Rahim Tahmasebi
- Department of Epidemiology & Biostatistics, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mahnoush Reisi
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Jamile Kiani
- Clinical Research Development Center, Shohadaye-Khalije-Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
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ANDO T, WATANABE T, MATSUO S, SAMEJIMA T, YAMAGISHI J, BITO T, NARUSE G, YOSHIDA A, MINATOGUCHI S, AKIYAMA H, NISHIGAKI K, MINATOGUCHI S, OKURA H. The Feasibility of a Newly Developed Local Network System for Cardiac Rehabilitation (the CR-GNet) in Disease Management and Physical Fitness after Acute Coronary Syndrome. Phys Ther Res 2022; 25:18-25. [DOI: 10.1298/ptr.e10155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Takahiro ANDO
- Department of Rehabilitation, Gifu University Hospital
| | - Takatomo WATANABE
- Division of Clinical Laboratory and Department of Cardiology, Gifu University Hospital
| | - Saori MATSUO
- Department of Rehabilitation, Gifu University Hospital
| | | | | | - Takanobu BITO
- Department of Rehabilitation, Gifu University Hospital
| | - Genki NARUSE
- Department of Cardiology, Gifu University Graduate School of Medicine
| | - Akihiro YOSHIDA
- Department of Cardiology, Gifu University Graduate School of Medicine
| | | | - Haruhiko AKIYAMA
- Department of Orthopedics, Gifu University Graduate School of Medicine
| | | | | | - Hiroyuki OKURA
- Division of Clinical Laboratory and Department of Cardiology, Gifu University Hospital
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Jiang W, Feng M, Gao C, Li J, Gao R, Wang W. Effect of a nurse-led individualized self-management program for Chinese patients with acute myocardial infarction undergoing percutaneous coronary intervention. Eur J Cardiovasc Nurs 2019; 19:320-329. [PMID: 31702385 DOI: 10.1177/1474515119889197] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The study of the development and evaluation of self-management intervention among patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is lacking, especially in China. AIM To examine the effects of a nurse-led individualized self-management program (NISMP) on health behaviors, control of cardiac risk factors, and health-related quality of life (HRQoL) among patients with AMI undergoing PCI. METHODS The quasi-experimental design included a convenience sample of 112 participants recruited from a tertiary hospital in China. The participants were assigned to the control group (n = 56) or the intervention group (n = 56). The intervention group underwent the NISMP, which includes six group-based education sessions, a face-to-face individual consultation, and 12-month telephone follow-ups. Data were collected at baseline and at the end of the 12-month program using the Health Promotion Lifestyle Profile, the Risk Factors Assessment Form, and the Short Form 36-item Health Survey. RESULTS The baseline sociodemographic and clinical characteristics of the two groups were comparable (p > 0.05). After the 12-month intervention, the health behaviors and HRQoL of the participants in the intervention group had significantly improved (p < 0.05 for both) compared to those of the control group. Compared to the control group, the participants in the intervention group also reported significantly better control of cardiac risk factors including smoking (χ2 = 4.709, p = 0.030), low-density lipoprotein (χ2 = 4.160, p = 0.041), body mass index (χ2 = 3.886, p = 0.049) and exercise (χ2 = 10.096, p = 0.001). CONCLUSION The NISMP demonstrated positive effects on health behaviors, control of cardiac risk factors, and HRQoL among Chinese patients with AMI undergoing PCI.
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Affiliation(s)
- Wenhui Jiang
- Xi'an Jiaotong University Health Science Center, China
| | - Mei Feng
- Xi'an Jiaotong University Health Science Center, China.,West China Hospital, Sichuan University, China
| | - Chunyan Gao
- Cardiology Department, First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Juanli Li
- Cardiology Department, First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Rui Gao
- Xi'an Jiaotong University Health Science Center, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Chiang CY, Choi KC, Ho KM, Yu SF. Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review. Int J Nurs Stud 2018; 84:28-39. [PMID: 29730084 DOI: 10.1016/j.ijnurstu.2018.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. OBJECTIVES This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. DESIGN A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. DATA SOURCES Twenty-three English and seven Chinese electronic databases were searched to identify the trials. REVIEW METHODS The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. RESULTS 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of SF-36. Furthermore, from single-study results, the intervention was favorable in improving the patients' weight management and alcohol consumption. However, it did not show significant effects on improving the patient's dietary habits, certain cardiac physiological parameters, mortality and self-efficacy. Currently, no addition long-term benefit of the intervention on secondary cardiac prevention was identified. CONCLUSION This review has systematically analyzed the effects of nurse-led patient-centered care on patients' behavioral risks, cardiac physiological parameters, mortality, health-related quality of life and self-efficacy. Given limited quantity of existing evidence regarding certain outcomes and long-term follow-up period; cross-trial heterogeneity of the interventions, measurement methods and statistical results; high or unclear risk of bias in some quality dimensions, the effectiveness of the intervention on secondary cardiac prevention remains inconclusive and subject to additional trials and evidences.
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Affiliation(s)
- Chung-Yan Chiang
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Kai-Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ka-Ming Ho
- Division of Nursing and Health Studies, The Open University of Hong Kong, Homantin, Hong Kong, China
| | - Sau-Fung Yu
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Mohd Azahar NMZ, Krishnapillai ADS, Zaini NH, Yusoff K. Risk perception of cardiovascular diseases among individuals with hypertension in rural Malaysia. HEART ASIA 2017; 9:e010864. [PMID: 29467830 DOI: 10.1136/heartasia-2016-010864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 06/03/2017] [Accepted: 07/09/2017] [Indexed: 11/03/2022]
Abstract
Objective Despite various efforts, hypertension remains poorly controlled, thus allowing cardiovascular disease (CVD) to impact the health burden worldwide. Patients' perception of risk may contribute to this scenario. The present study aims to assess the level of risk perception among individuals with hypertension in rural Malaysia. Methods This is a community-based study conducted among adults between 2010 and 2011 among a rural population in Raub, Pahang, Malaysia. Blood pressure was measured after 5 min of rest. Measurement was done twice and the average was recorded. Cardiovascular risk perception score (CvRPS) was derived using the Modified Risk and Health Behavior Questionnaire. Higher CvRPS indicates the respondent perceives a poorer prognostic outlook. Results A total of 383 respondents who have hypertension participated in this study. The mean age of respondents was 62±10.6 years; men 63.1±9.6 years, women 61.2±11.1 years (p>0.05). Among hypertensives, those who were not on medication had significantly lower CvRPS compared with those who were on medications (115.9±22.1vs 120.9±23.5, p=0.036); those who were not aware of their hypertensive status had significantly lower CvRPS compared with respondents who were aware about their hypertension (116.7±22.5vs 121.7±21.3, p=0.029) and those with uncontrolled hypertension had significantly lower CvRPS compared with those whose blood pressure was controlled (118.2±22.2vs 128.8±25.8, p=0.009). Conclusions Our study shows that respondents who were not on medications, unaware of their hypertension status and those who had uncontrolled hypertension tended to underestimate (lower CvRPS) their risk for CVD. Improving their CvPRS through a concerted health education may lead to better therapeutic behaviour and outcomes.
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Affiliation(s)
- Nazar Mohd Zabadi Mohd Azahar
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA Pulau Pinang, Bertam Campus
| | | | - Noor Hanita Zaini
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khalid Yusoff
- UCSI University, Kuala Lumpur, Malaysia.,Department of Cardiology, Faculty of Medicine, Universiti Teknologi MARA, Kuala Lumpur, Malaysia
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Bhagwat MM, Woods JA, Dronavalli M, Hamilton SJ, Thompson SC. Evidence-based interventions in primary care following acute coronary syndrome in Australia and New Zealand: a systematic scoping review. BMC Cardiovasc Disord 2016; 16:214. [PMID: 27829379 PMCID: PMC5103388 DOI: 10.1186/s12872-016-0388-y] [Citation(s) in RCA: 8] [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: 01/31/2016] [Accepted: 10/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery disease has a significant disease burden, but there are many known barriers to management of acute coronary syndrome (ACS). General practitioners (GPs) bear considerable responsibility for post-discharge management of ACS in Australia and New Zealand (NZ), but knowledge about the extent and efficacy of such management is limited. This systematic review summarises published evidence from Australia and New Zealand regarding management in primary care after discharge following ACS. METHODS A search of PubMed, Scopus, CINAHL-Plus and PSYCINFO databases in August 2015 was supplemented by citation screening and hand-searching. Literature was selected based on specified criteria, and assessed for quality using the Mixed Methods Appraisal Tool (MMAT). Extracted data was related to evidence-based interventions specified by published guidelines. RESULTS The search yielded 19 publications, most of which reported on quantitative and observational studies from Australia. The majority of studies scored at least 75 % on the MMAT. Diverse aspects of management by GPs are presented according to categories of evidence-based guidelines. Data suggests that GPs are more likely to prescribe ACS medications than to assist in lifestyle or psychological management. GP referral to cardiac rehabilitation varied, and one study showed an improvement in the number of ACS patients with documented ACS management plans. Few studies described successful interventions to improve GP management, though some quality improvement efforts through education and integration of care with hospitals were beneficial. Limited data was published about interventions effective in rural, minority, and Indigenous populations. CONCLUSIONS Research reflects room for improvement in GP post-discharge ACS management, but little is known about effective methods for improvement. Additional research, both observational and interventional, would assist GPs in improving the quality of post-discharge ACS care.
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Affiliation(s)
- Manavi M. Bhagwat
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
- Georgetown University, Washington, DC USA
| | - John A. Woods
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Mithilesh Dronavalli
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Sandra J. Hamilton
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
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Dronavalli M, Bhagwat MM, Hamilton S, Gilles M, Garton-Smith J, Thompson SC. Findings from a clinical audit in regional general practice of management of patients following acute coronary syndrome. Aust J Prim Health 2016; 23:170-177. [PMID: 27647550 DOI: 10.1071/py15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 08/29/2016] [Indexed: 11/23/2022]
Abstract
Patients with acute coronary syndrome (ACS) require ongoing treatment and support from their primary care provider to modify cardiovascular risk factors (including diet, exercise and mood), to receive evidence-based pharmacotherapies and be properly monitored and to ensure their take-up and completion of cardiac rehabilitation (CR). This study assesses adherence to National Heart Foundation guidelines for ACS in primary care in a regional centre in Western Australia. Patients discharged from hospital after a coronary event (unstable angina or myocardial infarction) or a coronary procedure (stent or coronary artery bypass graft) were identified through general practice electronic medical records. Patient data was extracted using a data form based on National Heart Foundation guidelines. Summary statistics were calculated and reported. Our study included 22 GPs and 44 patients in a regional centre. In total, 90% (n=39) of discharge summaries recorded medications. Assessment of pharmacological management showed that 53% (n=23) of patients received four or more classes of pharmacotherapy and that GPs often augmented medication beyond that prescribed at discharge. Of 15 smokers, 13 (87%) had advice to quit documented. Minimal advice for other risk-factor modification was documented in care plans. Patients with type 2 diabetes (n=20) were 70% more likely to receive allied health referral (P=0.02) and 60% more likely to receive advice regarding diet and exercise (P=0.007). However, overall, only 30% (n=13) of those eligible were referred to a dietician, and only 25% were referred to CR (n=10) with six completing CR. Although most GPs did not use standardised tools for mood assessment, 18 (41%) patients were diagnosed as depressed, of which 88% (n=16) were started on antidepressants and 28% (n=6) were referred to a psychologist. Although pharmacotherapy, mood management and smoking cessation management generally followed recommended guidelines, risk factor management relating to diet and exercise by GPs require improvement. Detailed care plans and referral to CR and allied health staff for patient support is recommended.
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Affiliation(s)
- Mithilesh Dronavalli
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia
| | - Manavi M Bhagwat
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia
| | - Sandy Hamilton
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia
| | - Marisa Gilles
- Research School of Public Health, Australian National University, Building 62, Mills Road, Acton, ACT 2601, Australia
| | - Jacquie Garton-Smith
- Cardiovascular Health Network, Department of Health WA, 189 Royal Street, East Perth, WA 6004, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia
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Mosleh SM, Eshah NF, Almalik MMA. Perceived learning needs according to patients who have undergone major coronary interventions and their nurses. J Clin Nurs 2016; 26:418-426. [DOI: 10.1111/jocn.13417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Sultan M Mosleh
- Department of Adult Nursing; Faculty of Nursing; Mutah University; Karak Jordan
| | | | - Mona MA Almalik
- Department of Maternal and Child Health Nursing; Faculty of Nursing; Mutah University; Karak Jordan
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Is Knowledge Level of Coronary Heart Disease and Risk Factors Among Post-Percutaneous Coronary Intervention Patients Adequate? J Cardiovasc Nurs 2015; 31:E1-9. [PMID: 26422635 DOI: 10.1097/jcn.0000000000000291] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is now commonly used in the treatment of coronary heart disease. However, shorter hospital stays after intervention may affect patients' knowledge and subsequent required lifestyle changes. OBJECTIVE The aim of this study is to investigate participants' risk factor profile, knowledge of coronary heart disease, and the influence of demographic and risk factors on this knowledge. METHODS This prospective, cross-sectional 1-site study recruited both elective and emergency PCI patients postdischarge. The questionnaire collected data on demographics, risk factor profile, and coronary heart disease knowledge as measured on the Bergman Heart Disease Knowledge Questionnaire. Bivariate and multivariate analyses were used to analyze the influence of 11 risk and sociodemographic factors on knowledge. RESULTS The response rate was 67% (n = 84). The sample was mostly male and aged 65.79 ± 9.9 years, and 59% had an elective PCI. Risk factor burden was high; 2 or more risk factors were seen in 66% of participants. Mean knowledge score overall was 51%, with the highest score achieved in the risk factor domain (61%). Lowest scores were in the medical and symptoms domains (both 46%). Neither the bivariate nor the multivariate analyses were significant. A large proportion of patients believed that coronary heart disease was no longer a concern for them after PCI. CONCLUSIONS As expected, the risk factor profile of post-PCI patients was high. However, their knowledge levels and awareness were unrelated to risk factor profile and poor in comparison with studies in other cardiac patients. This, in addition to the short stay in hospital and the low attendance of this cohort at cardiac rehabilitation, identifies this group of patients as a priority for further targeted education. Innovations are needed to increase knowledge and begin behavioral change predischarge after PCI. This should include target and goal setting for lifestyle change to avail of this critical education opportunity.
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Intensive nursing care by an electronic followup system to promote secondary prevention after percutaneous coronary intervention: a randomized trial. J Cardiopulm Rehabil Prev 2015; 34:396-405. [PMID: 24667664 DOI: 10.1097/hcr.0000000000000056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To investigate the effectiveness of an intensive nursing care electronic followup system for cardiovascular risk management after percutaneous coronary intervention (PCI). METHODS In total, 840 subjects who underwent PCI in a single hospital in Beijing between January 2010 and January 2012 were enrolled. All subjects were randomized into the control and intensive nursing care groups (n = 420 each group). Both groups received standard secondary prevention according to guidelines. The control group received regular followup while the intensive nursing care group was closely monitored and followed by specific nursing staff with the electronic followup system. RESULTS In total, 807 subjects were followed up for 1 year. Compared with subjects in the control group, those in the intensive group had decreased levels of total cholesterol (3.99 ± 1.08 vs 3.76 ± 0.98; P < .05), systolic blood pressure (142.41 ± 11.53 vs 135.71 ± 14.57 mm Hg; P < .05), low-density lipoprotein cholesterol (LDL-C) (2.72 ± 1.01 vs 2.42 ± 0.81; P < .05), and body mass index (25.13 ± 5.12 vs 24.23 ± 6.22; P < .05); a higher percentage with target LDL-C < 2.6 mmol/L (66.99% vs 47.88%; P < .05); increased use of medication including aspirin (96.51% vs 99.26%; P < .05), clopidogrel (87.53% vs 98.77%; P < .05), statins (52.62% vs 93.10%; P < .05), β-blockers (48.63% vs 61.33%; P < .05), and angiotensin-converting enzyme inhibitors (32.92% vs 61.82%; P < .05); and better dietary control and physical exercise (55.66% vs 26.18%, P < .05; 62.56% vs 38.65%, P < .05). CONCLUSIONS Intensive nursing care by the electronic followup system may lead to an improvement in quality of secondary prevention after PCI, including risk factor control, the use of medication, and self-management abilities.
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Liu J, Zhu ZY, Gao CY, Wang XP, Zhang Y, Jin WD, Qi DT, Li MW. Long-term effect of persistent smoking on the prognosis of Chinese male patients after percutaneous coronary intervention with drug-eluting stent implantation. J Cardiol 2013; 62:283-8. [DOI: 10.1016/j.jjcc.2013.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 04/08/2013] [Accepted: 05/02/2013] [Indexed: 01/19/2023]
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Hoogwegt MT, Versteeg H, Hansen TB, Thygesen LC, Pedersen SS, Zwisler AD. Exercise Mediates the Association Between Positive Affect and 5-Year Mortality in Patients With Ischemic Heart Disease. Circ Cardiovasc Qual Outcomes 2013; 6:559-66. [DOI: 10.1161/circoutcomes.113.000158] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Positive affect has been associated with better prognosis in patients with ischemic heart disease, but the underlying mechanisms remain unclear. We examined whether positive affect predicted time to first cardiac-related hospitalization and all-cause mortality, and whether exercise mediated this relationship in patients with established ischemic heart disease.
Methods and Results—
The sample comprised 607 patients with ischemic heart disease from Holbæk Hospital, Denmark. In 2005, patients completed the Global Mood Scale (GMS) to assess positive affect and a purpose-designed question on exercise. Data on mortality and hospitalization were collected from Danish national registers for the period 2006–2010. Adjusted Cox and logistic regression were used to analyze the mediation model. Because no significant association between positive affect and cardiac-related hospitalization was found, we constructed no mediation model for hospitalization. Importantly, patients with high positive affect had a significantly reduced risk of all-cause mortality (hazard ratio, 0.58; 95% confidence interval, 0.37–0.92; unadjusted analysis) and were more likely to exercise (odds ratio, 1.99; 95% confidence interval, 1.44–2.76; unadjusted analysis; odds ratio, 1.48; 95% confidence interval, 1.03–2.13; adjusted analysis). When controlling for positive affect and other relevant variables, patients engaged in exercise were less likely to die during follow-up (hazard ratio, 0.50; 95% confidence interval, 0.31–0.80;
P
=0.004). Importantly, exercise acted as a mediator in the relationship between positive affect and mortality.
Conclusions—
Patients with higher levels of positive affect were more likely to exercise and had a lower risk of dying during 5-year follow-up, with exercise mediating the relationship between positive affect and mortality. Interventions aimed at increasing both positive affect and exercise may have better results with respect to patients’ prognosis and psychological well-being than interventions focusing on 1 of these factors alone.
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Affiliation(s)
- Madelein T. Hoogwegt
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
| | - Henneke Versteeg
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
| | - Tina B. Hansen
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
| | - Lau C. Thygesen
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
| | - Susanne S. Pedersen
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
| | - Ann-Dorthe Zwisler
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands (M.T.H., H.V., S.S.P.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (T.B.H., L.C.T., A.-D.Z.); Department of Cardiology, Roskilde Hospital, Roskilde, Denmark (T.B.H.); Department of Cardiology, Holbæk Hospital, Holbæk, Denmark (A.-D.Z.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, The Netherlands (S.S.P.)
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Phillips JL, Rolley JX, Davidson PM. Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies. Nurs Res Pract 2012; 2012:279431. [PMID: 22852076 PMCID: PMC3407641 DOI: 10.1155/2012/279431] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 04/10/2012] [Indexed: 11/18/2022] Open
Abstract
Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
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Affiliation(s)
- Jane L. Phillips
- School of Nursing, The University of Notre Dame Australia, The Cunningham Centre for Palliative Care, St Vincent's & Mater Health Sydney, 170 Darlinghurst Road, Sydney, NSW 2010, Australia
| | - John X. Rolley
- Cardiac Investigation Unit, St Vincent's Hospital, P.O. Box 2900, Fitzroy, VIC 3065, Australia
| | - Patricia M. Davidson
- Cardiovascular Nursing Research, St Vincent's Hospital and Centre for Cardiovascular and Chronic Care, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Broadway, NSW 2007, Australia
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Peterson JC, Charlson ME, Hoffman Z, Wells MT, Wong SC, Hollenberg JP, Jobe JB, Boschert KA, Isen AM, Allegrante JP. A randomized controlled trial of positive-affect induction to promote physical activity after percutaneous coronary intervention. ARCHIVES OF INTERNAL MEDICINE 2012; 172:329-36. [PMID: 22269589 PMCID: PMC3717982 DOI: 10.1001/archinternmed.2011.1311] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Within 1 year after percutaneous coronary intervention, more than 20% of patients experience new adverse events. Physical activity confers a 25% reduction in mortality; however, physical activity is widely underused. Thus, there is a need for more powerful behavioral interventions to promote physical activity. Our objective was to motivate patients to achieve an increase in expenditure of 336 kcal/wk or more at 12 months as assessed by the Paffenbarger Physical Activity and Exercise Index. METHODS Two hundred forty-two patients were recruited immediately after percutaneous coronary intervention between October 2004 and October 2006. Patients were randomized to 1 of 2 groups. The patient education (PE) control group (n = 118) (1) received an educational workbook, (2) received a pedometer, and (3) set a behavioral contract for a physical activity goal. The positive-affect/self-affirmation (PA) intervention group (n = 124) received the 3 PE control components plus (1) a PA workbook chapter, (2) bimonthly induction of PA by telephone, and (3) small mailed gifts. All patients were contacted with standardized bimonthly telephone follow-up for 12 months. RESULTS Attrition was 4.5%, and 2.1% of patients died. Significantly more patients in the PA intervention group increased expenditure by 336 kcal/wk or more at 12 months, our main outcome, compared with the PE control group (54.9% vs 37.4%, P = .007). The PA intervention patients were 1.7 times more likely to reach the goal of a 336-kcal/wk or more increase by 12 months, controlling for demographic and psychosocial measures. In multivariate analysis, the PA intervention patients had nearly double the improvement in kilocalories per week at 12 months compared with the PE control patients (602 vs 328, P = .03). CONCLUSION Patients who receive PA intervention after percutaneous coronary intervention are able to achieve a sustained and clinically significant increase in physical activity by 12 months. Trial Registration clinicaltrials.gov Identifier: NCT00248846.
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Affiliation(s)
- Janey C Peterson
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA.
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Rolley J, Smith J, DiGiacomo M, Salamonson Y, Davidson P. The caregiving role following percutaneous coronary intervention. J Clin Nurs 2011; 20:227-35. [PMID: 20550622 DOI: 10.1111/j.1365-2702.2009.03104.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study is to describe the experience of caregivers of individuals who have had a percutaneous coronary intervention (PCI). BACKGROUND Decreased lengths of hospital stay and an increased emphasis on chronic disease self-management increase the importance of carers in assisting in recovery and lifestyle modification. DESIGN Cross-sectional dual-moderated focus group design. METHOD Three focus groups using a dual facilitation approach were held in the cardiac rehabilitation setting of a tertiary referral hospital in metropolitan Sydney. All sessions were audio recorded, transcribed and thematically analysed. RESULTS Four themes emerged from the data: (1) a gendered approach to health, illness and caring; (2) shock, disbelief and the process of adjustment following PCI; (3) challenges and changes of the carer-patient relationship and (4) the needs of the carer for support and information. Issues emerging from this study parallel other findings describing the experience, yet provide new insights into the issues surrounding PCI. CONCLUSION These findings highlight the need for including carers in care planning and decision-making and providing them with support and resources. RELEVANCE TO CLINICAL PRACTICE Emphasises the importance of preparing carers of the likely experience following a PCI. Demonstrates the degree to which vigilance, deferment of carer-health needs and role conflict impact on the carer's personal relationship. Demonstrates the need for formal support interventions for carers of patients who have had PCI.
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Affiliation(s)
- John Rolley
- Centre for Cardiovascular and Chronic Care, School of Nursing and Midwifery, Faculty of Health Science, Curtin University of Technology, Chippendale, NSW, Australia.
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Lifestyle and physiological risk factor profiles six weeks after an acute cardiac event: are patients achieving recommended targets for secondary prevention? Heart Lung Circ 2011; 20:446-51. [PMID: 21440501 DOI: 10.1016/j.hlc.2011.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 02/08/2011] [Accepted: 02/09/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who have had a cardiac event are at increased risk of a subsequent event and death and are, therefore, the priority for preventive cardiology in Australia and elsewhere. Guidelines for physiological and lifestyle risk factors have been developed to encourage risk reduction as a means of secondary prevention. The aim of the present study was to investigate achievement of recommended risk factor targets in a sample of Australian cardiac patients. METHOD A consecutive sample of 275 patients admitted to one of two Melbourne hospitals after acute myocardial infarction (AMI; 32%) or for coronary artery bypass graft surgery (CABGS; 40%) or percutaneous coronary intervention (PCI; 28%) participated in risk factor screening approximately five weeks after hospital discharge. The 2007 National Heart Foundation (NHF) of Australia 'Guidelines for Reducing Risk in Heart Disease' (1) and the 2001 NHF and Cardiac Society of Australia and New Zealand lipid management guidelines (2) were used to define risk factor targets. Target achievement was compared for AMI, CABGS and PCI patients. RESULTS Patients ranged in age from 32 to 75 years (mean=59.0; SD=9.1). Most (86%) were male. Almost three quarters of the patients were above recommended targets for waist girth (70%) and almost half were above targets for blood pressure (48%) and below target for high density lipoprotein cholesterol (47%). Around a quarter were over target for total cholesterol (27%) and under target for physical activity (27%). Most patients met the NHF guidelines of non-smoking (95%) and restricted alcohol consumption (88%). For several risk factors, PCI patients were at greater risk of not achieving recommended targets than either CABGS or AMI patients. CONCLUSIONS Six weeks after an acute cardiac event, substantial proportions of Australian patients do not achieve recommended targets for waist girth, blood pressure, total cholesterol, physical activity, and HDL cholesterol. PCI patients are particularly at risk. Considerable potential remains for improving risk factor management in CHD patients, highlighting the important role of general practitioners, outpatient cardiac rehabilitation and other secondary prevention strategies.
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Davidson PM, Salamonson Y, Rolley J, Everett B, Fernandez R, Andrew S, Newton PJ, Frost S, Denniss R. Perception of cardiovascular risk following a percutaneous coronary intervention: a cross sectional study. Int J Nurs Stud 2011; 48:973-8. [PMID: 21367417 DOI: 10.1016/j.ijnurstu.2011.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/06/2010] [Accepted: 01/22/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND An individual's perception of the risk of, and their susceptibility to, future cardiovascular events is crucial in engaging in effective secondary prevention. AIM To investigate the perception of a cardiovascular event by examining the level of agreement between individuals with CHD views of their actual and perceived risk. METHODS This study examined the individual's perception of the risk of a subsequent cardiac event among 220 patients hospitalised for a percutaneous coronary intervention (PCI) at a metropolitan, tertiary referral hospital in Sydney, Australia. Baseline clinical and demographic characteristics were collected, and actual risk (Personal Risk Score) calculated based on the presence or absence of nine cardiovascular risk factors: diabetes, hypertension, high cholesterol, cigarette smoking, previous history of CHD, family history of CHD, depression, overweight or obesity, and physical inactivity. Perception of risk was determined using an investigator-developed 4-item, 11-point Likert scale instrument (Perceived Heart Risk Questionnaire--PHRQ) which measured two dimensions of health threat: perceived seriousness, and perceived susceptibility. The correlation between the Personal Risk Score and the PHRQ was assessed using the Pearson product-moment correlation coefficient. RESULTS The calculated mean Personal Risk Score was 4.63±1.71 and the PHRQ was 25.5±7.04. The correlation between the Personal Risk Score (actual risk) and the PHRQ (perceived risk) was r=0.26 (p<0.01). CONCLUSIONS The weak relationship between actual and perceived risk is of concern, particularly in a population at higher risk for future cardiovascular events. Implementing strategies to personalise risk should be explored to improve the accuracy of risk perception, and facilitate tailoring of behaviour change strategies.
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Affiliation(s)
- Patricia M Davidson
- Centre for Cardiovascular & Chronic Care, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, St Vincent's Hospital, Australia.
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Fernandez RS, Davidson P, Griffiths R, Juergens C, Salamonson Y. Development of a health-related lifestyle self-management intervention for patients with coronary heart disease. Heart Lung 2009; 38:491-8. [PMID: 19944873 DOI: 10.1016/j.hrtlng.2009.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 01/14/2009] [Accepted: 01/28/2009] [Indexed: 11/24/2022]
Abstract
Risk-factor modification after an acute coronary event is imperative, and intervention strategies are continuously being developed to assist patients with behavioral change and, consequently, decreasing the risk of further coronary episodes. This article describes the development of the health-related lifestyle self-management (HeLM) intervention, which is a brief structured intervention embedded within the transtheoretical model of behavioral change. The HeLM intervention was developed by undertaking three discrete yet interrelated studies and consisted of the following components: goal-setting, the HeLM booklet, feedback regarding personal risk, team-building and communication with the patient's family physician, three supportive telephone calls, trained interviewers, a refrigerator magnet, and a health diary for self-monitoring. The HeLM intervention has been successfully implemented in 50 patients with acute coronary syndrome after discharge from hospital and has been demonstrated to be feasible and practical and could easily be delivered by health care professionals.
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Rolley JX, Davidson PM, Salamonson Y, Fernandez R, Dennison CR. Review of nursing care for patients undergoing percutaneous coronary intervention: a patient journey approach. J Clin Nurs 2009; 18:2394-405. [PMID: 19538559 DOI: 10.1111/j.1365-2702.2008.02768.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the existing literature to inform nursing management of people undergoing percutaneous coronary intervention. BACKGROUND. Percutaneous coronary intervention is an increasingly important revascularisation strategy in coronary heart disease management and can be an emergent, planned or rescue procedure. Nurses play a critical role in delivering care in both the independent and collaborative contexts of percutaneous coronary intervention management. DESIGN Systematic review. METHOD The method of an integrative literature review, using the conceptual framework of the patient journey, was used to describe existing evidence and to determine important areas for future research. The electronic data bases CINAHL, Medline, Cochrane and the Joanna Briggs data bases were searched using terms including: (angioplasty, transulminal, percutaneous coronary), nursing care, postprocedure complications (haemorrhage, ecchymosis, haematoma), rehabilitation, emergency medical services (transportation of patients, triage). RESULTS Despite the frequency of the procedure, there are limited data to inform nursing care for people undergoing percutaneous coronary intervention. Currently, there are no widely accessible nursing practice guidelines focusing on the nursing management in percutaneous coronary intervention. Findings of the review were summarised under the headings: Symptom recognition; Treatment decision; Peri-percutaneous coronary intervention care, describing the acute management and Postpercutaneous coronary intervention management identifying the discharge planning and secondary prevention phase. CONCLUSIONS Cardiovascular nurses need to engage in developing evidence to support guideline development. Developing consensus on nurse sensitive patient outcome indicators may enable benchmarking strategies and inform clinical trial design. RELEVANCE TO CLINICAL PRACTICE To improve the care given to individuals undergoing percutaneous coronary intervention, it is important to base practice on high-level evidence. Where this is lacking, clinicians need to arrive at a consensus as to appropriate standards of practice while also engaging in developing evidence. This must be considered, however, from the central perspective of the patient and their family.
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Affiliation(s)
- John X Rolley
- School of Nursing & Midwifery, College of Health Science, Curtin University of Technology, Level 7, 39 Regent Street, Chippendale, Sydney, NSW, Australia.
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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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A pilot randomised controlled trial comparing a health-related lifestyle self-management intervention with standard cardiac rehabilitation following an acute cardiac event: Implications for a larger clinical trial. Aust Crit Care 2009; 22:17-27. [DOI: 10.1016/j.aucc.2008.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Revised: 09/25/2008] [Accepted: 10/14/2008] [Indexed: 11/22/2022] Open
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Son YJ. [The development and effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention]. ACTA ACUST UNITED AC 2008; 38:217-28. [PMID: 18458518 DOI: 10.4040/jkan.2008.38.2.217] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. METHODS Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care. RESULTS The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences. CONCLUSION These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.
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Affiliation(s)
- Youn-Jung Son
- Department of Nursing, Soonchunhyang University, Cheonan, Korea.
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Cardiac Rehabilitation Coordinators' Perceptions of Patient-Related Barriers to Implementing Cardiac Evidence-Based Guidelines. J Cardiovasc Nurs 2008; 23:449-57. [DOI: 10.1097/01.jcn.0000317450.64778.a0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Fernandez RS, Salamonson Y, Griffiths R, Juergens C, Davidson P. Sociodemographic predictors and reasons for participation in an outpatient cardiac rehabilitation programme following percutaneous coronary intervention. Int J Nurs Pract 2008; 14:237-42. [DOI: 10.1111/j.1440-172x.2008.00685.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Validation of the revised cardiac rehabilitation preference form in patients with post-percutaneous coronary intervention. J Cardiopulm Rehabil Prev 2008; 27:390-4. [PMID: 18197074 DOI: 10.1097/01.hcr.0000300267.92516.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Challenges in achieving optimal participation rates in cardiac rehabilitation (CR) are well described and include factors pertaining to health system and patient and clinical characteristics. Of note, participation rates of patients following percutaneous coronary intervention (PCI) are low. AIM The aim of this study was to examine the psychometric properties of the Revised Cardiac Rehabilitation Preference Form (CRPF-R) in an Australian sample following a PCI and to determine the preferences of PCI patients in relation to CR. METHODS One hundred forty participants who had PCI completed the self-administered CRPF-R scale. Principal component factor analysis was performed to detect underlying dimensionality of the scale. The internal consistency of the total scale and the subscales was tested with the Cronbach alpha analysis. Comparison for differences in CRPF-R scores, as well as demographic characteristics and CR attendance, was performed. RESULTS Factor analysis revealed 2 distinct factors, supporting the validity of a 2-factor structure CRPF-R. Cronbach alpha coefficient values were high, with .87 for the total CRPF-R, .85 for factor 1 (program features), and .81 for factor 2 (convenience features). Women were more likely to place greater importance in the convenience features of a CR program than men. Those who were recommended by a healthcare professional to attend CR were more likely to place greater importance in the program features than those who were not. CONCLUSIONS This study has demonstrated the acceptability and utility of the CRPF-R in the Australian setting. In addition, the study also identified important considerations in the structuring and delivery of CR programs.
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Fernandez RS, Davidson P, Salamonson Y, Griffiths R, Juergens C. The health-related quality of life trajectory in patients after percutaneous coronary intervention. J Cardiopulm Rehabil Prev 2007; 27:223-6. [PMID: 17667018 DOI: 10.1097/01.hcr.0000281767.59781.a1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to describe the trajectory of cardiac patient's perceptions of health-related quality of life (HRQoL) during a 24-month period in a community-based population. METHODS After obtaining informed consent, a self-administered questionnaire was mailed to participants. Using the MacNew questionnaire, which assesses the emotional, physical, social, and global domains, HRQoL outcomes were assessed. RESULTS Completed questionnaires were received from 202 participants (75%). Improvements in the emotional, physical, social, and global HRQoL scores were observed until 15 to 17 months after the index percutaneous coronary intervention, after which a decline was observed. However, the scores in all HRQoL domains remained high when compared with the scores at 12 months. No clinical or sociodemographic predictors for HRQoL were identified. CONCLUSIONS The information obtained from this study will enable clinicians to further understand the process of recovery and adjustment of patients after percutaneous coronary intervention and the development of tailored strategies for patient management.
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Affiliation(s)
- Ritin S Fernandez
- South Western Sydney Centre for Applied Nursing Research, NSW, Australia.
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