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Emamzadehashemi KR, Khanghah AG, Azizi A, Paryad E, Noveiri MJS. Quality of life and activities of daily living one year after Coronary Artery Bypass Graft (CABG) surgery: a cross-sectional study. J Cardiothorac Surg 2024; 19:367. [PMID: 38915074 DOI: 10.1186/s13019-024-02848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Daily activities have been recommended to minimize the long-term complications of coronary artery bypass as one of the strategies to return to the normal activity level, the effectiveness of which needs further investigation. This study aims to determine the quality of life and activities of daily living one year after CABG. METHODS This cross-sectional study was performed on 206 patients who had undergone CABG for more than one year in 2018 in the north of Iran. The research instrument was a questionnaire including five sections, Data were analyzed using descriptive statistics and Chi2, Mann-Whitney U, Kruskal-Wallis tests, and a Logistic regression model. RESULT The mean score of quality of life was 31.7 ± 2.04 of 12 to 48 possible scores. About Activities of Daily Living results showed 99.5% and 84.7% of the samples needed help with many of these activities respectively. The mean score of quality of life was significantly different based on sex (p < 0.018) and instrumental activity of daily living (p < 0.0001). A logistic regression model was used to determine the factors related to quality of life. The final model showed cross-clamp duration (OR = 0.33,p = 0.014), length of stay(LOS)in the intensive care unit(OR = 0.42,p = 0.05), and instrumental activities of daily living (OR = 0.08,p = 0.001) predicted patients' quality of life one year after coronary artery bypass grafting. CONCLUSION Although more than half of the samples had a good average quality of life score, due to the lack of definitive treatment for coronary artery disease, it is suggested to consider predictive variables to help plan to improve the quality of life of these patients.
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Affiliation(s)
- Khashayar Rezvani Emamzadehashemi
- Department of Neurosurgery, Faculty of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center (SCHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Nursing and Midwifery Faculty of Guilan University of Medical Sciences, Daneshjoo Ave, Rasht, Iran
| | - Ali Azizi
- School of Nursing and Midwifery, Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | - Ezzat Paryad
- School of Nursing and Midwifery, Guilan University of Medical Sciences (GUMS), Rasht, Iran
- Cardiovascular Diseases Research Center, GI Cancer Screening and Prevention Research Center (GCSPRC), Department of Nursing (Medical-Surgical), Rasht, Iran
| | - Marzieh Jahani Sayad Noveiri
- Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Yang TH, Lin HH, Hsu HL, Chiou AF. Factors associated with sleep quality in patients undergoing cardiac surgery: A longitudinal study. Nurs Crit Care 2024; 29:477-485. [PMID: 38410051 DOI: 10.1111/nicc.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Poor sleep quality is associated with multiple factors in cardiac surgery patients. AIM To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery. STUDY DESIGN A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery. RESULTS The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = -0.93, p = .023) and 3 months postsurgery (B = -1.50, p < .001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = -2.59, p < .001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE-I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation. CONCLUSION Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors. RELEVANCE TO CLINICAL PRACTICE Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery.
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Affiliation(s)
- Ting-Hui Yang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hsuan-Hua Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hung-Lung Hsu
- Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Biotechnology, Ming Chuan University, Taipei, Taiwan
| | - Ai-Fu Chiou
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Chen X, Zheng R, Xu X, Wang Z, Huang G, Wu R, Hong J. Frailty and Health-Related Quality of Life in Elderly Patients Undergoing Esophageal Cancer Surgery: A Longitudinal Study. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:125-133. [PMID: 38677471 DOI: 10.1016/j.anr.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/20/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE This study aims to elucidate the longitudinal alterations in frailty and health-related quality of life experienced by elderly patients undergoing surgical treatment for esophageal cancer. Additionally, it seeks to ascertain the impact of preoperative frailty on postoperative health-related quality of life over time. METHODS 131 patients were included in the prospective study. Patients' frailty and health-related quality-of-life were assessed utilizing the Tilburg and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at preoperative, 1 week, 1 month, and 3 months, postoperatively. Statistical analyses were performed using generalized estimating equations, repeated-measures analysis of variance, and linear mixed models (LMMs). RESULTS Out of 131 patients, 28.2% had frailty before surgery, and the prevalence of frailty consistently higher after surgery compared with baseline (67.9%, 51.9%, and 39.7%). There was no significant change in frailty scores in preoperative frail patients within 3 months following surgery (p = .496, p < .999, p < .999); whereas in preoperative non-frail patients, the frailty scores increased at 1 week (p < .001) and then decreased at 1 month (p = .014), followed by no change at 3 months. In addition, preoperative frail patients had significantly worse global quality-of-life (β = -4.24 (-8.31; -.18), p = .041), physical functioning (β = -9.87 (-14.59; -5.16), p < .001), role functioning (β = -10.04 (-15.76; -4.33), p = .001), and social functioning (β = -8.58 (-15.49; -1.68), p = .015), compared with non-frail patients. CONCLUSIONS A significant proportion of participants exhibited a high prevalence of preoperative frailty. These patients, who were preoperatively frail, exhibited a marked reduction in health-related quality-of-life, a more gradual recovery across various functional domains, and an increased symptom burden during the follow-up period. Therefore, it is crucial to meticulously identify and closely monitor patients with preoperative frailty for any changes in their postoperative physiology, role, and social functioning.
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Affiliation(s)
- Xi Chen
- School of Nursing, Anhui Medical University, Hefei, China
| | - Rong Zheng
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xiuzhi Xu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Zhuzhu Wang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Guohong Huang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Rongrong Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
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Xu L, Xu Y, Li G, Yang B. Study on anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy. Eur J Med Res 2023; 28:87. [PMID: 36803425 PMCID: PMC9940320 DOI: 10.1186/s40001-023-01040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Patients with malignant tumors are more likely to have psychological problems due to their worries about their life expectancy. To understand the psychological status of elderly patients with malignant liver tumor undergoing hepatectomy better, the study was designed to investigate the current situation of anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy and to analyze its related factors. METHODS A total of 126 elderly patients with malignant liver tumor undergoing hepatectomy were selected as the research objects. The anxiety and depression of all subjects were evaluated by HADS (Hosptial Anxiety and Depression Scale). The correlation factors affecting the psychological state of elderly patients with malignant liver tumor undergoing hepatectomy were analyzed by linear regression method. RESULTS The HADS-A score of elderly patients with malignant liver tumor undergoing hepatectomy was 8.79 ± 2.56, among which 37 patients were asymptomatic, 60 patients with suspicious symptoms, and 29 patients with definite symptoms. The HADS-D score was 8.40 ± 2.97, among which 61 patients were asymptomatic, 39 patients with suspicious symptoms, and 26 patients with definite symptoms. Multivariate analysis using linear regression method showed that FRAIL score, residence, and complication were significantly associated with anxiety and depression of elderly patients with malignant liver tumor undergoing hepatectomy. CONCLUSIONS Anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy were obvious. FRAIL score, regional differences, and the complication were the risk factors for anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy. Improving frailty, reducing regional differences, and preventing complications is beneficial to alleviate the adverse mood of elderly patients with malignant liver tumor undergoing hepatectomy.
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Affiliation(s)
- Lining Xu
- grid.414252.40000 0004 1761 8894Department of General Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853 China
| | - Yingying Xu
- grid.414008.90000 0004 1799 4638Department of Internal Medicine, Henan Cancer Hospital, Zhengzhou, 450003 China
| | - Guiping Li
- Department of Radiology, Hubei Province Integrated Hospital of Chinese and Western Medicine, Wuhan, 430015 China
| | - Bo Yang
- Department of Radiology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Abstract
AIMS To clarify the risk factors for frailty to help doctors prevent diseases that cause weakness, through early interventions. METHODS We searched the PubMed, EMBASE, and Cochrane Library databases to identify all relevant studies using the items "frailty," "weak," "risk factors," and "predictive factors" and compared their results. The aging population (≥65 years old) was divided into 2 groups, a "frailty group" and a "robust control group," and then the characteristics, lifestyles, and comorbidities were compared. RESULTS We compared the influence of baseline and concomitant diseases on frailty in the elderly respectively, and the analysis of the influence of baseline on frailty found that increasing age, lower weight, female sex, living alone, low levels of exercise, polypharmacy, higher education level, smoking, drinking, malnutrition, and lower vitamin D levels were associated with aging individuals being more likely to experience frailty. The data about concomitant diseases had shown that diabetes, hearing dysfunction, cognitive impairment, poor sleep, a history of falls, pain, and depression can increase the risk of frailty among the elderly population. CONCLUSION Characteristics, comorbidities, and lifestyle factors can impact the occurrence of frailty, and relevant influencing factors should be considered.
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Affiliation(s)
- Xinrui Wang
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Jiji Hu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
| | - Diping Wu
- Department of Nursery, Gulin people’s Hospital, Sichuan, China
- *Correspondence: Diping Wu, Department of Nursery, Gulin people’s Hospital, Sichuan 646500, China (e-mail: )
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Cheng HW, Liu CY, Chen YS, Shih CC, Chen WY, Chiou AF. Assessment of preoperative frailty and identification of patients at risk for postoperative delirium in cardiac intensive care units: a prospective observational study. Eur J Cardiovasc Nurs 2021; 20:745-751. [PMID: 34472606 DOI: 10.1093/eurjcn/zvab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/24/2021] [Accepted: 08/17/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Postoperative delirium (POD) is a common complication that may occur from 24 to 72 h after cardiac surgery. Frailty is a chronic syndrome that leads to a decline in physiological reserve and to disability. The associations between frailty and POD are unclear. AIMS To investigate associations between POD and frailty in patients undergoing cardiac surgery and to analyse predictors of POD. METHODS AND RESULTS Convenience sampling was used to recruit 152 patients who underwent cardiac surgery in two medical centres in northern Taiwan. Preoperative frailty in these patients was evaluated using Fried's frailty phenotype. Delirium in patients was assessed from postoperative day 1 to day 5 using the confusion assessment method for intensive care units. A total of 152 patients who underwent cardiac surgery included 68 (44.74%) prefrail patients and 21 (13.81%) patients with frailty after the surgery. Ten patients (6.58%) developed delirium after cardiac surgery. The occurrence of delirium peaked at postoperative day 2, and the average duration of delirium was 3 days. A case-control comparison revealed a significant correlation between preoperative frailty and POD. Significant predictors of POD in patients undergoing cardiac surgery included the European System for Cardiac Operative Risk Evaluation II, preoperative arrhythmia, and preoperative anxiety and depression. CONCLUSION Preoperative frailty was correlated with POD. Preoperative arrhythmia, anxiety, and depression are predictors of POD. Nurses should perform preoperative assessments of surgical risk and physiological and psychological conditions of patients undergoing cardiac surgery and monitor the occurrence of POD.
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Affiliation(s)
- Hsiao-Wei Cheng
- Department of Nursing, National Taiwan University Hospital, No.7, Chung Shan South Road, Zhongzheng Dist., Taipei 100, Taiwan
| | - Chieh-Yu Liu
- Biostatistical Consultant Lab, Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei 112, Taiwan
| | - Yih-Sharng Chen
- Department of Surgery, Cardiovascular Surgery & Ped Cardiovascular Surgery, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No.7, Chung Shan South Road, Zhongzheng Dist., Taipei 100, Taiwan
| | - Chun-Che Shih
- Taipei Heart Institute, Taipei Medical University, No. 250 Wu-Hsing St. Taipei 110, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, No. 111, Sec.3, Xinglong Rd., Wenshan Dist., Taipei 116, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing St. Taipei 110, Taiwan.,Institute of Clinical Medicine, Department of Surgery, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan
| | - Wei-Yi Chen
- Department of Nursing, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei 112, Taiwan
| | - Ai-Fu Chiou
- College of Nursing, Institute of Clinical Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan
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