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Amirova A, Taylor L, Volkmer B, Ahmed N, Chater AM, Fteropoulli T. Informing behaviour change intervention design using systematic review with Bayesian meta-analysis: physical activity in heart failure. Health Psychol Rev 2023; 17:456-484. [PMID: 35701235 DOI: 10.1080/17437199.2022.2090411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 06/02/2022] [Indexed: 12/11/2022]
Abstract
Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in adults with heart failure (HF) to inform behaviour change intervention. This approach helps estimate and quantify the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative studies. Qualitative evidence was annotated using the Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) for the probability distribution for the log OR was used to estimate the relationship between physical activity and each determinant according to qualitative, quantitative, and qualitative and quantitative evidence combined. The probability distribution dispersion (SD) was used to evaluate uncertainty in the evidence. Three qualitative and 16 quantitative studies were included (N = 2739). High pro-b-type natriuretic peptide (MAP = -1.16; 95%CrI: [-1.21; -1.11]) and self-reported symptoms (MAP = - 0.48; 95%CrI: [ -0.40; -0.55]) were suggested as barriers to physical activity with low uncertainty (SD = 0.18 and 0.19, respectively). Modifiable barriers were symptom distress (MAP = -0.46; 95%CrI: [-0.68; -0.24], SD = 0.36), and negative attitude (MAP = -0.40; 95%CrI: [-0.49; -0.31], SD = 0.26). Modifiable enablers were social support (MAP = 0.56; 95%CrI: [0.48; 0.63], SD = 0.26), self-efficacy (MAP = 0.43; 95%CrI: [0.32; 0.54], SD = 0.37), positive physical activity attitude (MAP = 0.92; 95%CrI: [0.77; 1.06], SD = 0.36).
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Affiliation(s)
- Aliya Amirova
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lauren Taylor
- Department of Psychology, University of Surrey, Guildford, UK
| | - Brittannia Volkmer
- Psychology department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nafiso Ahmed
- Mental Health Policy Research Unit, UCL Division of Psychiatry, London, UK
| | - Angel M Chater
- Centre for Behaviour Change, Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, UCL, London, UK
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK
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Asztalos Morell I, De S, Johansson C, Gustafsson LK. Middle-class older adults living alone in urban India: Older adults’ understandings of ageing alone. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2023. [DOI: 10.1080/15528030.2022.2164395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | - Santa De
- Science in Nursing, RN RM, Sandra Shroff ROFEL College of Nursing, Vapi, India
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Sumaqa YA, Hayajneh FA, Alhamory S, Rayan A, Alnaeem M, Al Tarawneh TR, Assaf Alrida NA, Abu-abbas M, Suhemat A, Ayasreh IR. Consequences of Psychological Aspects: From Jordanian Heart Failure Patients' Beliefs. SAGE Open Nurs 2023; 9:23779608231189128. [PMID: 37528905 PMCID: PMC10387668 DOI: 10.1177/23779608231189128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF. Objective This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF. Methods This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews. Results The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system. Conclusion The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.
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Affiliation(s)
| | | | | | - Ahmad Rayan
- Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | | | | | | | | | - Aida Suhemat
- Faculty of Nursing, University of Mutah, Alkarak, Jordan
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4
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Amirova A, Lucas R, Cowie MR, Haddad M. Perceived barriers and enablers influencing physical activity in heart failure: A qualitative one-to-one interview study. PLoS One 2022; 17:e0271743. [PMID: 35925964 PMCID: PMC9352074 DOI: 10.1371/journal.pone.0271743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/06/2022] [Indexed: 11/27/2022] Open
Abstract
In heart failure (HF), increased physical activity is associated with improved quality of life, reduced hospitalisation, and increased longevity and is an important aim of treatment. However, physical activity levels in individuals living with HF are typically extremely low. This qualitative study with one-to-one interviews systematically explores perceived clinical, environmental, and psychosocial barriers and enablers in older adults (≥70 years old) living with HF. Semi-structured interviews (N = 16) based on the Theoretical Domains Framework elicited 39 belief statements describing the barriers and enablers to physical activity. Theoretical domains containing these beliefs and corresponding constructs that were both pervasive and common were deemed most relevant. These were: concerns about physical activity (Beliefs about Consequences), self-efficacy (Beliefs about Capabilities), social support (Social Influences), major health event (Environmental Context and Resources), goal behavioural (Goal), action planning (Behavioural Regulation). This work extends the limited research on the modifiable barriers and enablers for physical activity participation by individuals living with HF. The research findings provide insights for cardiologists, HF-specialist nurses, and physiotherapists to help co-design and deliver a physical activity intervention more likely to be effective for individuals living with HF.
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Affiliation(s)
- Aliya Amirova
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Guy’s Hospital, London, United Kingdom
- * E-mail:
| | - Rebecca Lucas
- St Raphael’s Hospice Hospital & Health Care, Sutton, United Kingdom
| | - Martin R. Cowie
- Royal Brompton Hospital, London, United Kingdom
- School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Mark Haddad
- Health Services Research and Management, School of Health Sciences, City University of London, London, United Kingdom
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5
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Physical Activity and Exercise in Cardiovascular Disease. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1063539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Alonso WW, Kupzyk K, Norman J, Bills SE, Bosak K, Dunn SL, Deka P, Pozehl B. Negative Attitudes, Self-efficacy, and Relapse Management Mediate Long-Term Adherence to Exercise in Patients With Heart Failure. Ann Behav Med 2021; 55:1031-1041. [PMID: 33580663 DOI: 10.1093/abm/kaab002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Exercise is safe and provides considerable benefits for patients with heart failure (HF) including improved function, quality of life, and symptoms. However, patients with HF have difficulty initiating and adhering to an exercise regimen. To improve adherence, our team developed Heart Failure Exercise and Resistance Training (HEART) Camp, a multicomponent, theory-driven intervention that was efficacious in a randomized controlled trial of long-term adherence to exercise in patients with HF. Identifying active components of efficacious interventions is a priority. PURPOSE The purpose of this study is to use mediation analysis to determine which interventional components accounted for long-term adherence to exercise in patients with HF. METHODS This study included 204 patients with HF enrolled in a randomized controlled trial. Instruments measuring interventional components were completed at baseline, 6, 12, and 18 months. Hierarchical linear models generated slope estimates to be used as predictors in logistic regression models. Significant variables were tested for indirect effects using path analyses with 1,000 bootstrapped estimates. RESULTS Significant mediation effects were observed for the interventional components of negative attitudes (β NA = 0.368, s.e. = 0.062, p < .001), self-efficacy (β SE = 0.190, s.e. = 0.047, p < .001), and relapse management (β RM = 0.243, s.e. = 0.076, p = .001). CONCLUSIONS These findings highlight improving attitudes, self-efficacy, and managing relapse as key interventional components to improve long-term adherence to exercise in patients with HF. Future interventions targeting adherence to exercise in patients with HF and other chronic illnesses should consider the incorporation of these active components.
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Affiliation(s)
- Windy W Alonso
- University of Nebraska Medical Center, College of Nursing, Nebraska Medical Center, Omaha, NE
| | - Kevin Kupzyk
- University of Nebraska Medical Center, College of Nursing, Nebraska Medical Center, Omaha, NE
| | - Joseph Norman
- University of Nebraska Medical Center, College of Allied Health, Omaha, NE
| | - Sara E Bills
- University of Nebraska Medical Center, College of Allied Health, Omaha, NE
| | - Kelly Bosak
- University of Kansas Medical Center, School of Nursing, Kansas City, KS
| | - Susan L Dunn
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI
| | - Bunny Pozehl
- University of Nebraska Medical Center, College of Nursing, Nebraska Medical Center, Omaha, NE
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Deka P, Almenar L, Pathak D, Klompstra L, López-Vilella R, Marques-Sule E. Depression mediates physical activity readiness and physical activity in patients with heart failure. ESC Heart Fail 2021; 8:5259-5265. [PMID: 34523268 PMCID: PMC8712809 DOI: 10.1002/ehf2.13609] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 12/28/2022] Open
Abstract
Aims Although physical activity (PA) and exercise are essential for patients with heart failure (HF), adherence to the recommended guidelines is low. Not much is known about the mediating effect of HF patients' mental state with their readiness for PA and reported activity levels. The purpose of this study is to investigate the mediatory effect of depression on PA readiness (physical limitation and psychological readiness) and self‐reported PA in patients with HF. Methods and results In this cross‐sectional study, 163 New York Heart Association Class I and II HF patients, during their clinic visit, reported on their physical limitation (PAR‐Q) and psychological readiness [self‐efficacy (ESES) and motivation (RM 4‐FM)] for PA, depression (HADS‐D), and PA (s‐IPAQ). Mediation analysis was performed to test the mediating effect of depression on PA readiness (physical limitation and psychological readiness) and self‐reported PA following the steps described by Baron and Kenny (1986). Hierarchical regression models were tested for their effects. The Self‐Efficacy Theory and Self‐Determination theory provided the theoretical platform for the study. Depression completely mediated the effect of physical limitation (βdep = 268.57; P < 0.0001) and partially mediated the effect of self‐efficacy on PA (βdep = 344.16; P < 0.0001). Both intrinsic (P < .0001) and extrinsic motivation (P < .0001) for PA had an independent and significant effect on PA, not mediated by depression. Conclusions Patients with HF should be screened for depression throughout the trajectory of the disease as it can impact their physical and psychological readiness to perform PA.
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Affiliation(s)
- Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Luis Almenar
- Heart Failure and Transplants Unit, Department of Cardiology, Universitary and Politecnic La Fe Hospital, Valencia, Spain.,CIBERCV, University of Valencia, Valencia, Spain
| | - Dola Pathak
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Raquel López-Vilella
- Heart Failure and Transplants Unit, Department of Cardiology, Universitary and Politecnic La Fe Hospital, Valencia, Spain
| | - Elena Marques-Sule
- Heart Failure and Transplants Unit, Department of Cardiology, Universitary and Politecnic La Fe Hospital, Valencia, Spain.,Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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8
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Kim YJ, Swift DL, Houmard JA. Comparison of Activity and Participation, and Mental and Physical Functions of Immediate Post-Acute and Distant Post-Acute Adults with Chronic Cardiac Conditions. Occup Ther Health Care 2021; 35:380-396. [PMID: 34255989 DOI: 10.1080/07380577.2021.1943767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study compared activity participation, and mental and physical functions of two different groups of adults with chronic cardiac conditions. Eleven participants were assessed at the immediate post-acute stage and 26 participants were at the distant post-acute stage. Participants at distant post-acute were significantly more physically active (p < .001), more activity-limited in cognition-related activities (p = .035) and reported more depressive symptoms than immediate post-acute (p = .046). No significant difference in participation level was found. More attention to functional cognition and depressive symptoms at immediate post-acute and individualized approaches to remove participation barriers in complex activities at distant post-acute are likely needed for adults with chronic cardiac conditions.
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Affiliation(s)
- Young Joo Kim
- Department of Occupational Therapy, East Carolina University, Greenville, NC, USA
| | - Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - Joseph A Houmard
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
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9
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Negarandeh R, Aghajanloo A, Seylani K. Barriers to Self-care Among Patients with Heart Failure: A Qualitative Study. J Caring Sci 2020; 10:196-204. [PMID: 34849365 PMCID: PMC8609122 DOI: 10.34172/jcs.2020.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: Heart failure is the most prevalent cardiovascular disease. It is the end stage of most cardiovascular diseases and is characterized by the reduced ability of the heart to pump enough blood to fulfill the metabolic needs of the body. Self-care is the basis of the management of chronic diseases such as heart failure. The aim of this study was to explore the barriers to self-care among patients with heart failure. Methods: This was a qualitative content analysis. Participants were fourteen patients with heart failure and three healthcare providers who were purposively recruited from cardiac care centers in Zanjan, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional qualitative content analysis approach proposed by Elo and Kyngäs. Results: Self-care barriers -care among patients with HF were categorized into three main categories, namely personal factors, disease burden, and inefficient support system. Each category had three subcategories which were respectively lack of self-care knowledge, heart failure-related negative emotions, the difficulty of changing habits, progressive physical decline, comorbid conditions, financial strain, inadequate social support, healthcare providers' inattention to self-care, and limited access to healthcare providers. Conclusion: Patients with heart failure face different personal, disease-related, and support-related barriers to self-care. Based on these barriers, healthcare providers can develop interventions for promoting self-care among patients with heart failure.
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Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
| | - Ali Aghajanloo
- Critical Care Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Seylani
- Critical Care Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Sutantri S, Cuthill F, Holloway A. "I just can't sit around and do nothing!": A qualitative study of Indonesian women's experiences diagnosed with heart disease. Nurs Health Sci 2020; 22:1047-1055. [PMID: 32713133 DOI: 10.1111/nhs.12764] [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: 11/20/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
Research into cardiovascular disease and its management in Indonesia, where it currently accounts for 67% of all deaths, has heavily emphasized the biomedical aspects; little is known about the individual's experience of the disease, especially for Indonesian women. This study aimed to understand how gender shapes Indonesian women's experiences of living with heart disease in their daily lives. Twenty-six women aged 30-67 years were interviewed, and the transcriptions analyzed using a qualitative framework informed by intersectional approaches to gender and culture. Three major themes emerged: (i) the effect of cardiovascular disease on women's day-to-day activities, (ii) its effects on women's family relationships, and (iii) the women's coping strategies. The inability to fulfill their required social roles as mother or wife undermined the women's sense of self, a problem particularly acute in a cultural context where responsibility for maintaining harmony in the home and society is ascribed to women. Healthcare professionals should be aware of the ethnic and cultural backgrounds of women with cardiovascular disease, in order to deliver services that meet female patients' social, spiritual, and cultural needs.
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Affiliation(s)
- Sutantri Sutantri
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Jln. Brawijaya, Tamantirto, Kasihan, Bantul, Yogyakarta, Indonesia.,Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Fiona Cuthill
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Aisha Holloway
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
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11
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Rahmani B, Aghebati N, Esmaily H, Florczak KL. Nurse-led Care Program with Patients with Heart Failure Using Johnson's Behavioral System Model: A Randomized Controlled Trial. Nurs Sci Q 2020; 33:204-214. [PMID: 32605492 DOI: 10.1177/0894318420932102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with heart failure experience system imbalance and have multiple symptoms. A nurse-led care program based on Johnson's behavioral system model was used to improve the balance of the behavioral system of heart failure patients. One hundred and fifty patients were randomly assigned into two groups. In the experimental group, the patient's status was evaluated by a behavioral subsystem assessment tool related to the level of imbalance. The patients in the intervention group received care individually based on their worst subsystem scores over a period of 2 weeks. The results showed significant improvement in restorative, ingestive, eliminative, aggressive/protective, dependency, and achievement (p < .05) subsystems in the experimental group. However, no significant difference was seen in sexual and affiliative (p > .05) subsystems.
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Affiliation(s)
- Behnoush Rahmani
- MSc Student, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Aghebati
- Assistant professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Professor, Department of Biostatistics and Epidemiology, Social Determinants of Health
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Perceptions of transnational family responsibilities’ effects on subjective health and wellness – voices of Thai immigrant women. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2020. [DOI: 10.1108/ijmhsc-12-2019-0104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Globalisation provides new opportunities for immigrant women to supply financial benefits transnationally to uphold their families in their home countries. The purpose of this study is to explore the experiences of Thai immigrant women regarding transnational family responsibilities effects on their health and wellness.
Design/methodology/approach
Qualitative data were collected using semi-structured interviews with 40 Thai immigrant women, of which 34 described having transnational family responsibilities. The transcribed data were analysed using a phenomenographic approach.
Findings
The findings revealed five structural aspects of transnational family responsibilities of Thai immigrant women: being a dutiful daughter, being a caring mother, being a kind relative, being a “giving” person and striving for a wealthy life. The interviewees seldom encountered enough support from the spouse in handling their transnational family responsibilities. In general, a transnational marriage includes family responsibilities that are continuous and that often is the cause of migration.
Practical implications
This paper illuminates the transnational responsibilities of marriage migration and argues for women’s rights of culturally congruent health care.
Originality/value
Traditionally Thai women’s values are based on how they handle family responsibilities and acknowledging own health needs are not. These interviewees perceived doubled burden in terms of family responsibilities and workload in employed work, which contributed to poor health and wellness.
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Taniguchi N, Hosono M, Kuwauchi S, Yasumoto H, Kawazoe K. Trunk Muscle Cross-Sectional Area as a Predictive Factor for Length of Postoperative Hospitalization after Surgical Aortic Valve Replacement. Ann Thorac Cardiovasc Surg 2020; 26:151-157. [PMID: 31996509 PMCID: PMC7303319 DOI: 10.5761/atcs.oa.19-00261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: We investigated the utility of trunk muscle cross-sectional area to predict length of hospitalization after surgical aortic valve replacement (AVR) for aortic stenosis (AS). Methods: Adult AS patients who underwent isolated AVR at a single institution were studied. The cross-sectional area of the erector spinae muscles (ESM) at the first and second lumbar vertebrae and that of the psoas muscle (PM) at the third and fourth lumbar vertebrae were measured on preoperative computed tomography (CT). Each was indexed to body surface area. Risk factors for prolonged postoperative hospitalization (>3 weeks) were assessed using multivariate regression analyses. Results: Of 56 patients (mean age 76 ± 9 years; 25 men), 20 (35.7%) patients required prolonged hospitalization. A smaller indexed ESM cross-sectional area at the first lumbar vertebra (per 1 cm/m2, odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.57–0.88, P <0.01) and lower preoperative serum albumin level (per 0.1 g/dL, OR = 0.83, 95% CI = 0.70–0.99, P <0.05) were shown as independent predictors. Indexed PM cross- sectional area was not statistically significant. Conclusion: The cross-sectional area of the trunk muscles can be used to identify patients at risk for prolonged hospitalization after AVR for adult AS.
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Affiliation(s)
- Naoki Taniguchi
- Department of Cardiovascular Surgery, Kansai Medical University Medical Center, Osaka, Osaka, Japan
| | - Mitsuharu Hosono
- Department of Cardiovascular Surgery, Kansai Medical University Medical Center, Osaka, Osaka, Japan
| | - Shintaro Kuwauchi
- Department of Cardiovascular Surgery, Kansai Medical University Medical Center, Osaka, Osaka, Japan
| | - Hiroshi Yasumoto
- Department of Cardiovascular Surgery, Kansai Medical University Medical Center, Osaka, Osaka, Japan
| | - Kohei Kawazoe
- Department of Cardiovascular Surgery, Kansai Medical University Medical Center, Osaka, Osaka, Japan
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14
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Klompstra L, Jaarsma T, Strömberg A. Self-efficacy Mediates the Relationship Between Motivation and Physical Activity in Patients With Heart Failure. J Cardiovasc Nurs 2019; 33:211-216. [PMID: 29189427 PMCID: PMC5908261 DOI: 10.1097/jcn.0000000000000456] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Motivation is necessary in patients with heart failure (HF) who are attempting to become more physically active but may not be sufficient to initiate physical activity. Self-efficacy might explain the relationship between motivation and physical activity. OBJECTIVE The aim of this study was to examine the role of exercise self-efficacy in the relationship between exercise motivation and physical activity in patients with HF. METHODS A total of 100 stable patients with HF (88% in New York Heart Association class II/III; mean age, 67 ± 13 years; 62% men) were studied. Self-efficacy was measured with the Exercise Self-Efficacy Scale; motivation, with the Exercise Motivation Index; and physical activity, with a self-report questionnaire. Logistic regression analyses were made to examine the mediation effect of exercise self-efficacy on the relationship between exercise motivation and physical activity. RESULTS Forty-two percent of the 100 patients reported engaging in less than 60 minutes per week of physical activity. Motivation predicted physical activity (b = 0.58, P < .05), but after controlling for self-efficacy, the relationship between motivation and physical activity was no longer significant (b = 0.76, P = .06), indicating full mediation. CONCLUSION Motivation to be physically active is important but not sufficient. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of self-efficacy.
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Affiliation(s)
- Leonie Klompstra
- Leonie Klompstra, PhD Post-doctoral Researcher, Division of Nursing, Department of Social and Welfare Studies, Linköping University, Sweden. Tiny Jaarsma, PhD, RN Professor, Division of Nursing, Department of Social and Welfare Studies, Linköping University, Sweden. Anna Strömberg, PhD, RN Professor, Division of Nursing, Department of Medical and Health Sciences, and Department of Cardiology, Linköping University, Sweden; and Program in Nursing Science, University of California Irvine
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15
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Gullvåg M, Gjeilo KH, Fålun N, Norekvål TM, Mo R, Broström A. Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep-disordered breathing. Scand J Caring Sci 2019; 33:750-759. [PMID: 30866061 DOI: 10.1111/scs.12672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/27/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sleep-disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep-disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self-care actions) by the patients is limited, but needed, to provide patient-centred care. AIM To explore how newly verified sleep-disordered breathing is experienced by patients with chronic heart failure. METHODS Data were collected through semi-structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41-80) diagnosed with chronic heart failure and objectively verified sleep-disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals. RESULTS Patients with chronic heart failure and newly verified sleep-disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self-care strategies were revealed, but they were based on 'common sense' and were not evidence-based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding. CONCLUSION Patients with chronic heart failure and sleep-disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep-disordered breathing, should be identified to establish proper patient-centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep-disordered breathing.
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Affiliation(s)
- Marianne Gullvåg
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Kari Hanne Gjeilo
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nina Fålun
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Tone M Norekvål
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Rune Mo
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anders Broström
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,School of Health Sciences, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
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16
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Gustafsson LK, Östlund G, Zander V, Elfström ML, Anbäcken EM. 'Best fit' caring skills of an interprofessional team in short-term goal-directed reablement: older adults' perceptions. Scand J Caring Sci 2019; 33:498-506. [PMID: 30653689 DOI: 10.1111/scs.12650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
Abstract
This paper reports a study conducted to illuminate older adults' perceptions of multiproffesional team's caring skills as success factors for health support in short-term goal-directed reablement. The fact that older adults are given perquisites to live in their own homes puts great demands on the professional care given them at home. An option offered could be short-term goal-directed reablement delivered by an interprofessional team. This means after periods in hospitals to strengthen their multidimensional health, older adults' reablement processes are supported to return to their daily life as soon as possible. Crucial in making these intentions a reality seems to be identifying the professional's approach that works as success factors for health support in the reablement process. A descriptive qualitative design with a phenomenographic approach based on interviews with 23 older persons who had received short-term goal-directed reablement at home after a period at hospital was used. The study was approved by an ethical board. The analysis revealed four major referential aspects of multiproffesional team's caring skills as success factors for health-support in short-term goal-directed reablement: a motivating caregiver, a positive atmosphere-creating caregiver, a human fellowship-oriented caregiver and a caregiver that goes beyond the expected. In this study, all caring skills in the continuum are perceived as positively loaded necessities in different situations during the reablement process. Caring skills as success factors are initially shown at a practical level, such as how the professional caregivers encourage and motivate the older persons in different training situations. At a deeper level, the caregivers open their hearts and have the capacity to go beyond the expected in the professional caregiver-patient relationship. The multiproffesional team's best fit caring skills during the home reablement process need to be addressed as evidence base in the area of elderly home care.
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Affiliation(s)
- Lena-Karin Gustafsson
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Gunnel Östlund
- Division of Social work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Viktoria Zander
- Division of Psychology, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Magnus L Elfström
- Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Els-Marie Anbäcken
- Division of Social work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
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17
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Grant JS, Graven LJ. Problems Experienced in the Second and Third Months After Discharge From a Heart Failure-Related Hospitalization. J Patient Cent Res Rev 2018; 5:311-316. [PMID: 31414017 PMCID: PMC6676769 DOI: 10.17294/2330-0698.1628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing their treatment regimens, the frequency of this problem lessened by week 12. Comorbidities emerged as a new problem in managing heart failure treatment and symptoms. Coping emerged as a new problem, as individuals with heart failure dealt with the impending morbidity of their diagnosis and how it would affect loved ones. Resource issues (ie, financial, social) became more prevalent for individuals with heart failure as potential and actual resources were depleted. Health providers should develop strategies to address these problems to improve outcomes in individuals with heart failure.
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Affiliation(s)
- Joan S. Grant
- University of Alabama at Birmingham School of Nursing, Birmingham, AL
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18
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Pozehl BJ, McGuire R, Duncan K, Kupzyk K, Norman J, Artinian NT, Deka P, Krueger SK, Saval MA, Keteyian SJ. Effects of the HEART Camp Trial on Adherence to Exercise in Patients With Heart Failure. J Card Fail 2018; 24:654-660. [PMID: 30010027 DOI: 10.1016/j.cardfail.2018.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/12/2018] [Accepted: 06/27/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Few exercise training studies in patients with heart failure (HF) report adherence to guideline-recommended 150 minutes of moderate-intensity exercise per week, and no studies have focused on a primary outcome of adherence. METHODS AND RESULTS This randomized controlled trial evaluated the effect of a multicomponent intervention, Heart Failure Exercise and Resistance Training (HEART) Camp, on adherence to exercise (after 6, 12, and 18 months) compared with an enhanced usual care (EUC) group. Patients (n = 204) were 55.4% male, overall average age was 60.4 years, and 47.5% were nonwhite. The HEART Camp group had significantly greater adherence at 12 (42%) and 18 (35%) months compared with the EUC group (28% and 19%, respectively). No significant difference (P > .05) was found at 6 months. The treatment effect did not differ based on patient's age, race, gender, marital status, type of HF (preserved or reduced ejection fraction) or New York Heart Association functional class. Left ventricular ejection fraction (LVEF) significantly moderated the treatment effect, with greater adherence at higher LVEF. CONCLUSIONS The multicomponent HEART Camp intervention showed efficacy with significant effects at 12 months and 18 months. Adherence levels remained modest, indicating a need for additional research to address methods and strategies to promote adherence to exercise in patients with HF.
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Affiliation(s)
| | - Rita McGuire
- University of Nebraska Medical Center, Lincoln, Nebraska
| | | | - Kevin Kupzyk
- University of Nebraska Medical Center, Omaha, Nebraska
| | - Joseph Norman
- University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Pallav Deka
- University of South Dakota, Sioux Falls, South Dakota
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19
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Comparison of the Effects of Benson Muscle Relaxation and Nature Sounds on the Fatigue in Patients With Heart Failure: A Randomized Controlled Clinical Trial. Holist Nurs Pract 2018; 32:27-34. [PMID: 29210875 DOI: 10.1097/hnp.0000000000000242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was conducted with the aim of comparing the effects of Benson muscle relaxation and nature sounds on fatigue in patients with heart failure. Fatigue and exercise intolerance as prevalent symptoms experienced by patients with heart failure can cause the loss of independence in the activities of daily living. It can also damage self-care and increase dependence to others, which subsequently can reduce the quality of life. This randomized controlled clinical trial was conducted in an urban area of Iran in 2016. Samples were consisted of 105 hospitalized patients with heart failure chosen using a convenience sampling method. They were assigned to relaxation, nature sounds, and control groups using a randomized block design. In addition to routine care, the Benson muscle relaxation and nature sounds groups received interventions in mornings and evenings twice a day for 20 minutes within 3 consecutive days. A 9-item questionnaire was used to collect data regarding fatigue before and after the interventions. Relaxation and nature sounds reduced fatigue in patients with heart failure in comparison to the control group. However, no statistically significant difference was observed between the interventions. Benson muscle relaxation and nature sounds are alternative methods for the reduction of fatigue in patients with heart failure. They are inexpensive and easy to be administered and upon patients' preferences can be used by nurses along with routine nursing interventions.
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20
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Grant JS, Graven LJ, Fuller K. Problems Experienced in the First Month After Discharge From a Heart Failure-Related Hospitalization. J Patient Cent Res Rev 2018; 5:140-148. [PMID: 31413998 DOI: 10.17294/2330-0698.1588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Heart failure is a global health concern with high morbidity and mortality rates. Individuals with heart failure commonly experience problems that impact daily life. However, little is known regarding which problems are most significant during the immediate posthospitalization period. Thus, the purpose of this study was to identify high-priority problems experienced by individuals the first month after discharge from an acute care facility with a diagnosis of heart failure. Methods This descriptive, exploratory study was part of a 12-week randomized controlled pilot study that examined the efficacy of a coping partnership intervention (COPE-HF Partnership) between a trained research nurse and individuals with heart failure in managing self-care and depressive symptoms. Data from participants randomized to the intervention group (N=19; 58% Caucasian, 58% male) were used in this study. Participants were provided a list of potential heart failure-related problems, from which they identified those of highest priority. Content and quantitative data analysis was conducted. Results Difficulty in managing heart failure symptoms, adhering to treatment plan, completing daily activities, and experiencing negative emotions and moods were the most common problems experienced by individuals with heart failure. Other less common problems for the group were inadequate resources and managing interpersonal issues. Conclusions Individuals with heart failure experience complex problems in the home that impact all aspects of their lives. Incorporating strategies to address these problems could assist in the development of interventions to reduce negative heart failure outcomes.
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Affiliation(s)
- Joan S Grant
- University of Alabama at Birmingham School of Nursing, Birmingham, AL
| | | | - Kelly Fuller
- Florida State University College of Nursing, Tallahassee, FL
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21
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22
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Herber OR, Bücker B, Metzendorf MI, Barroso J. A qualitative meta-summary using Sandelowski and Barroso’s method for integrating qualitative research to explore barriers and facilitators to self-care in heart failure patients. Eur J Cardiovasc Nurs 2017; 16:662-677. [DOI: 10.1177/1474515117711007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. Aim: The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. Methods: Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary. Results: A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences. Conclusion: Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.
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Affiliation(s)
- Oliver Rudolf Herber
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- School of Health and Population Sciences, University of Birmingham, Edgbaston, England
| | - Bettina Bücker
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Cochrane Metabolic and Endocrine Disorders Group, Düsseldorf, Germany
| | - Julie Barroso
- Medical University of South Carolina, College of Nursing, Charleston, USA
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23
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Workplace violence against emergency nurses in Taiwan: A phenomenographic study. Nurs Outlook 2017; 65:428-435. [PMID: 28487095 DOI: 10.1016/j.outlook.2017.04.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Workplace violence (WPV) is a serious problem in health care in Taiwan, as it is worldwide. Among all nursing staff, emergency department (ED) nurses are at the highest risk of WPV; yet, little attention has been paid to nurses as WPV victims. PURPOSE The purpose of the study was to understand ED nurses' WPV experiences and perspectives. METHODS An interpretive qualitative phenomenographic design was used to answer the following research question: what are the qualitatively different ways in which nurses in Taiwan experience WPV in the ED? Thirty ED nurses who identified as experienced with WPV were interviewed, and phenomenographic analysis was used to assess the data. FINDINGS Four categories of description emerged. WPV was seen as a continuing nightmare, a part of daily life, and a direct threat, and it had a negative impact on nurses' passion for emergency care. WPV adversely affected nurses on physical, psychological, social, personal, and professional levels. CONCLUSION The findings of this study have practical implications for in-service WPV training programs and may be used to inform potential changes to policy and legislation designed to establish a safer ED environment for staff.
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24
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Experiences of and Coping With Severe Aortic Stenosis Among Patients Waiting for Transcatheter Aortic Valve Implantation. J Cardiovasc Nurs 2017; 31:255-61. [PMID: 25658189 DOI: 10.1097/jcn.0000000000000231] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Aortic stenosis (AS) is the most common valve disease in Western countries. Transcatheter aortic valve implantation (TAVI) has made it possible to treat patients with higher surgical risks. These patients are informed about their poor prognosis with only months or a few years to live without treatment. Because of their severe symptoms, limitations, and suffering, patients awaiting TAVI need special attention. OBJECTIVE The aim of this study is to describe patients' experiences of coping with severe AS and of waiting for TAVI. METHODS Swedish participants (n = 24; 9 women, 15 men) with a mean (SD) age of 80 (7.4) years who had been offered TAVI all agreed to participate in a presurgical interview. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis. RESULTS The participants' experiences of coping with AS and awaiting TAVI were described by the main theme "living on the edge, but trying to stay in control," which comprised 3 categories: "trying to cope with physical symptoms and anxiety," "trying to preserve self and self-esteem despite life-threatening illness," and "trying to process the decision to undergo TAVI." CONCLUSIONS Patients with AS and awaiting TAVI must cope with increasing symptoms and limitations in their social lives but still wish to be seen as the people they always have been. These patients may need extra support from healthcare personnel to process their experiences, which could help them to attach personal meaning to clinical information about the condition and its treatment that they could include in their decision about whether to undergo TAVI. Listening to patients' stories could help nurses and physicians to ensure that disease and treatment are meaningfully understood by the patient.
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25
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Norberg EB, Löfgren B, Boman K, Wennberg P, Brännström M. A client-centred programme focusing energy conservation for people with heart failure. Scand J Occup Ther 2017; 24:455-467. [PMID: 28052703 DOI: 10.1080/11038128.2016.1272631] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The purpose of this study was to describe clients and occupational therapists (OTs) experiences of a home-based programme focusing energy conservation strategies (ECS) for clients with chronic heart failure (CHF). METHODS The programme, based on occupational therapy intervention process model (OTIPM), was led by two OTs in primary health care. Five clients' self-reported activities of daily living (ADL), fatigue, depression, goal achievements and use of ECS. Furthermore, both clients and OTs were individually interviewed. RESULTS The clients reported mild depression, severe fatigue and both increased and decreased independence in ADL. Most goals were achieved, and multiple ECS were used. Clients perceived that they worked collaboratively with the OTs and gained professional support to enhance daily activities. The OTs experienced knowledge and structure and found benefits from the programme, but doubted the possibility of using it in clinical practice. CONCLUSIONS This study, despite having few participants, indicates that both the OTs and the clients experienced that the specialized programme gave structure to the OTs work, provided knowledge about CHF and valuable energy conservation strategies. The programme supported the OTs in working in a more comprehensive client-centred way. However, its feasibility needs to be further evaluated.
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Affiliation(s)
- Eva-Britt Norberg
- a Department of Community Medicine and Rehabilitation , Occupational Therapy, Umeå University, Umeå , Sweden
| | - Britta Löfgren
- a Department of Community Medicine and Rehabilitation , Occupational Therapy, Umeå University, Umeå , Sweden
| | - Kurt Boman
- b Department of Public Health and Clinical Medicine , Research Unit, Medcine Skellefteå, Umeå University , Skellefteå , Sweden
| | - Patrik Wennberg
- c Department of Public Health and Clinical Medicine , Family Medicine, Umeå University , Umeå , Sweden
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26
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Bagheri H, Yaghmaei F, Ashktorab T, Zayeri F. Relationship between illness-related worries and social dignity in patients with heart failure. Nurs Ethics 2016; 25:618-627. [PMID: 27694547 DOI: 10.1177/0969733016664970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Heart failure is a major growing problem and affects not only patients but also their families and community networks and reduces the functional capacity of patients and impairs their social life. RESEARCH QUESTIONS This study was conducted to investigate relationship between illness-related worries and social dignity in patients with heart failure. DESIGN The study had a descriptive-analytic design, and data collection was carried out by means of two specific questionnaires. Participants and context: A total of 130 inpatients from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. RESULTS The highest mean score of illness-related worries was attributed to the dimension of patient's worry of physical-mental complications, and the least mean score was related to the dimension of the worry about the future of disease. The highest mean score of social dignity was associated with the dimension of social communication and support, and the least is attributed to the dimension of burden to others (economic). Pearson's statistical test showed a significant correlation (r = 0.455, p < 0.05) between the score of illness-related worries and social dignity. DISCUSSION As the result of this study showed that reducing illness-related worries in patients with heart failure can improve their social dignity, using strategies to decrease worries and promote social dignity in these patients is recommended. CONCLUSION This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. We hope these results will help to promote actions by patient-care staff that honor and support patient dignity, resulting in benefits to patients and developing the quality of care based on human rights.
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Affiliation(s)
- Hossein Bagheri
- Shahroud University of Medical Sciences, Shahroud, Iran.,Shahid Beheshti University of Medical Sciences, Iran
| | | | | | - Farid Zayeri
- Shahid Beheshti University of Medical Sciences, Iran
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27
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Abstract
BACKGROUND Identifying, maintenance, and promotion of dignity in different patients of various cultures is an ethical responsibility of healthcare workers. RESEARCH QUESTIONS This study was conducted to investigate factors related to dignity in patients with heart failure and test the validity of Dignity Model. DESIGN The study had a descriptive-correlational design, and data collection was carried out by means of four specific questionnaires. Participants and context: A total of 130 in-patients from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. FINDINGS Significant correlation showed the following: between illness related worries with dignity conserving repertoire score, between illness related worries with social dignity, between illness related worries with dignity conserving repertoire score, and between social dignity with dignity score. Goodness Fit Index and Comparative Fit Index were calculated greater than 0.9. DISCUSSION This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. CONCLUSION According to the results, the necessity of using appropriate tools to assess various aspects of patients' dignity by clinical healthcare staff and design activities with particular focus on the main factors affecting dignity such as illness related worries and social dignity is recommended. Attention to this issue in everyday clinical practice can facilitate health professionals/nurses to potentially improve their patients' dignity, develop quality of care and treatment, and improve patients' satisfaction.
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Affiliation(s)
- Hossein Bagheri
- Shahroud University of Medical Sciences, Shahroud, Iran
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Farid Zayeri
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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Olano-Lizarraga M, Oroviogoicoechea C, Errasti-Ibarrondo B, Saracíbar-Razquin M. The personal experience of living with chronic heart failure: a qualitative meta-synthesis of the literature. J Clin Nurs 2016; 25:2413-29. [DOI: 10.1111/jocn.13285] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 01/09/2023]
Affiliation(s)
| | - Cristina Oroviogoicoechea
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
| | - Begoña Errasti-Ibarrondo
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
| | - Maribel Saracíbar-Razquin
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
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29
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A Narrative Literature Review of the Experiences of Patients Living With Heart Failure. Holist Nurs Pract 2016; 29:280-302. [PMID: 26263289 DOI: 10.1097/hnp.0000000000000104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article reviews the literature on the experiences of patients with heart failure and their coping strategies and learning needs. Previous studies have consistently demonstrated that heart failure had negative impacts on the individuals who experienced it. Studies have also focused on the learning needs and the various coping strategies that patients with heart failure have adopted. However, there are limited studies that have investigated the experience of heart failure from the Asian patient's perspective. By incorporating the perspectives of patients with heart failure from the Asian context into clinical practices, research will promote patient-centered holistic care and improve patients' quality of life and satisfaction.
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30
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Nahlén Bose C, Elfström ML, Björling G, Persson H, Saboonchi F. Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure. Scand J Caring Sci 2016; 30:704-713. [DOI: 10.1111/scs.12297] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/26/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Catarina Nahlén Bose
- The Swedish Red Cross University College; Stockholm Sweden
- Department of Clinical Sciences Danderyd Hospital; Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
| | - Magnus L. Elfström
- Academy of Health; Care and Social Welfare; Mälardalen University; Eskilstuna/Västerås Sweden
| | - Gunilla Björling
- The Swedish Red Cross University College; Stockholm Sweden
- Department of Clinical Sciences Danderyd Hospital; Karolinska Institutet; Stockholm Sweden
| | - Hans Persson
- Department of Clinical Sciences Danderyd Hospital; Karolinska Institutet; Stockholm Sweden
| | - Fredrik Saboonchi
- The Swedish Red Cross University College; Stockholm Sweden
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
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31
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Seah ACW, Tan KK, Huang Gan JC, Wang W. Experiences of Patients Living With Heart Failure. J Transcult Nurs 2015; 27:392-9. [DOI: 10.1177/1043659615573840] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure.
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Affiliation(s)
| | | | | | - Wenru Wang
- National University of Singapore, Singapore
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32
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Röing M, Sanner M. A meta-ethnographic synthesis on phenomenographic studies of patients' experiences of chronic illness. Int J Qual Stud Health Well-being 2015; 10:26279. [PMID: 25690674 PMCID: PMC4331410 DOI: 10.3402/qhw.v10.26279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 01/04/2023] Open
Abstract
Phenomenography is a qualitative research approach developed within an educational framework, focusing on the qualitative experience of learning. It is also being used, to a lesser degree, in healthcare research. In the present study, we conducted a meta-ethnographic synthesis of phenomenographic studies on chronic illness, in order to give a broader perspective of how chronic illness can be experienced. Our aim was not to describe patients’ various individual experiences of illness, but instead to identify the different ways chronic illness can be experienced by patients. Our synthesis and phenomenographic interpretation of 12 selected articles found that patients’ experiences of chronic illness can be described in terms of a different lived body, a struggle with threat to identity and self-esteem, a diminished lifeworld, and a challenging reality. These experiences relate to each other in a process of recurring loops, where the different ways of experiencing continue to influence each other over time. According to these findings, the use of phenomenography as a research approach has the potential to add to the understanding of how chronic illness can be experienced. Patients may benefit from seeing that their illness can be experienced in many different ways and that it has many aspects, which then can lead to a better understanding and coping with their illness. We suggest that it may be worthwhile to expand the scope of phenomenography outside pedagogics. This presupposes a revision of the application to include a wider and more comprehensive description, for instance, of the different ways illness and healthcare phenomena can be experienced, and how these different ways are related to each other, with less focus on hierarchical relations.
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Affiliation(s)
- Marta Röing
- Department of Public Health and Caring Sciences, Health Services Research, University of Uppsala, Uppsala, Sweden;
| | - Margareta Sanner
- Department of Public Health and Caring Sciences, Health Services Research, University of Uppsala, Uppsala, Sweden
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Goodman AG, Yehle KS, Foli KJ, Griggs RR. Optimum Function in Patients With Heart Failure. Nurs Forum 2015; 51:49-54. [PMID: 25610997 DOI: 10.1111/nuf.12121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Karen S. Yehle
- College of Health and Human Sciences; Center on Aging and the Life Course; Purdue University; West Lafayette IN
| | - Karen J. Foli
- College of Health and Human Sciences; Center on Aging and the Life Course; Purdue University; West Lafayette IN
| | - Rosanne R. Griggs
- College of Health and Human Sciences; Center on Aging and the Life Course; Purdue University; West Lafayette IN
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Snöljung Å, Mattsson K, Gustafsson LK. The diverging perception among physiotherapists of how to work with the concept of evidence: a phenomenographic analysis. J Eval Clin Pract 2014; 20:759-66. [PMID: 24815563 DOI: 10.1111/jep.12167] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2014] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Changes in Sweden's municipal care have impacted the situation of physiotherapists by the adoption of practice based on research evidence. Even if physiotherapists appear to be in favour of the idea of evidence-based practice, barriers still exist that prevent many from keeping up with current research. The aim of this study was to identify and describe the different ways in which physiotherapists in municipal care perceive the concept of evidence in rehabilitation. METHODS A phenomenographic design with semi-structured interviews was carried out with physiotherapists working with frail older people in three municipal care units in two neighbouring municipalities in Sweden. The physiotherapists' perceptions of evidence were explored in 12 interviews. RESULTS Distinct perceptions of the concept of evidence are identified in three categories: 'Confidence with the concept of evidence in relation to measurement instruments'; 'Perception of evidence-based practice as a duty, condition and demand of the profession'; and 'Evidence-based work as a separate rather than directly patient-oriented activity'. CONCLUSIONS Physiotherapists take full responsibility to comply with what they perceive to be the demands of their profession. However, what evidence actually meant, and therefore what the practical element of this responsibility consisted of, was not as clear.
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Affiliation(s)
- Åsa Snöljung
- Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden
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Pozehl BJ, Duncan K, Hertzog M, McGuire R, Norman JF, Artinian NT, Keteyian SJ. Study of adherence to exercise in heart failure: the HEART camp trial protocol. BMC Cardiovasc Disord 2014; 14:172. [PMID: 25433674 PMCID: PMC4280683 DOI: 10.1186/1471-2261-14-172] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/05/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adherence to the Heart Failure Society of America (HFSA) 2010 guidelines recommending 30 minutes of supervised moderate intensity exercise five days per week is difficult for patients with heart failure (HF). Innovative programs are needed to assist HF patients to adhere to long-term exercise. The objective of this prospective randomized two-group repeated measures experimental design is to determine the efficacy of a behavioral exercise training intervention on long-term adherence to exercise at 18 months in patients with heart failure. METHODS/DESIGN A sample size of 246 subjects with heart failure will be recruited over a 3 year period. All subjects receive a cardiopulmonary exercise test and 9 supervised exercise training sessions during a 3 week run-in period prior to randomization. Subjects completing at least 6 of 9 training sessions are randomized to the HEART Camp Intervention group (HC) or to a standard care (SC) exercise group. The HC intervention group receives cognitive-behavioral strategies that address the intervention components of knowledge, attitudes, self-efficacy, behavioral self-management skills and social support. The SC group is provided access to the exercise facility and regular facility staff for the 18 month study period. The primary aim is to evaluate the effect of HEART Camp on adherence to exercise, with our central hypothesis that the HC group will have significantly better adherence to exercise at 18 months. Secondary aims include evaluating which components of the HEART Camp intervention mediate the effects of the intervention on adherence; evaluating the effect of HEART Camp on specific health outcomes; exploring selected demographic variables (race, gender, age) as potential moderators of the effect of the HEART Camp intervention on adherence; and exploring the perceptions and experiences that contextualize exercise adherence. DISCUSSION The HEART Camp intervention is the first to test a multi-component intervention designed to improve long-term adherence to exercise behavior in patients with HF. Improving long-term adherence to exercise is the logical first step to ensure the required dose of exercise that is necessary to realize beneficial health outcomes and reduce costs in this burdensome chronic illness. TRIAL REGISTRATION Clincaltrials.gov NCT01658670.
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Affiliation(s)
- Bunny J Pozehl
- />University of Nebraska Medical Center, College of Nursing, 1230 O Street, Suite 131, Lincoln, NE USA
| | - Kathleen Duncan
- />Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE USA
| | - Melody Hertzog
- />Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE USA
| | - Rita McGuire
- />Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE USA
| | - Joseph F Norman
- />Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE USA
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Norberg EB, Boman K, Löfgren B, Brännström M. Occupational performance and strategies for managing daily life among the elderly with heart failure. Scand J Occup Ther 2014; 21:392-9. [PMID: 24878004 DOI: 10.3109/11038128.2014.911955] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to describe experiences of limitations in occupational performance and strategies for managing daily activities among the elderly with chronic heart failure (CHF). METHODS Ten participants from primary healthcare with a confirmed diagnosis of CHF were interviewed. The interviews were analysed using qualitative content analysis. RESULTS The first theme, "Redefining an active life, aware of one's impaired body", was based on four sub-themes: realizing one's limited activity ability; striving to preserve an active life; focusing on meaningful activities; and changing vs. not changing habits and roles. The second theme, "Planning activities and balancing the degree of effort", was based on three sub-themes: limiting, organizing, and rationalizing activities; adjusting activities to today's ability; and using technology and adapting the environment. CONCLUSIONS Elderly people with CHF are struggling with an ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability. This highlights a need for information on strategies from a holistic perspective and client-centred occupational therapy interventions.
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Affiliation(s)
- Eva-Britt Norberg
- Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University , Umeå , Sweden
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Makowska A, Rydlewska A, Krakowiak B, Kuczyńska A, Sorokowski P, Danel D, Pawłowski B, Banasiak W, Ponikowski P, Jankowska EA. Psychological Gender of Men With Systolic Heart Failure. Am J Mens Health 2013; 8:249-57. [DOI: 10.1177/1557988313508429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diminished exercise capacity is a fundamental symptom of heart failure (HF), which is particularly disadvantageous for men for whom exercise capacity contributes significantly to their gender identity, self-esteem, and quality of life. In this study, we aimed to examine whether psychological gender would be different in men with systolic HF as compared with their healthy peers. The authors examined 48 men with systolic HF (age = 64 ± 10 years; body mass index = 28.3 ± 3.4 kg/m2; NYHA I/II/III [%] = 25/65/10; left ventricular ejection fraction [LVEF] = 32.1 ± 7.8%) and 15 age-matched healthy men. Based on the results of the Polish version of the Bem Sex Role Inventory, the examined men were divided into four types of psychological gender: “masculine” (M), “feminine” (F), “unspecified” (U), and “androgynous” (A). None of the men with HF presented M type of psychological gender, whereas this type was found in 27% of the healthy men ( p = .0002). The prevalence of both A (38% vs. 47%) and F (10% vs. 20%, both p > .05) types of psychological gender was similar between men with HF versus without HF. More men with HF fulfilled the criteria of the U type of psychological gender as compared with healthy peers (51% vs. 7%, p = .002). Men with HF and the F type of psychological gender were treated with spironolactone more frequently than those classified with the U and A types (both p < .05). The lack of “psychologically masculine” and the overrepresentation of “psychologically unspecified” gender types in the HF group suggests that psychological gender may be affected among men with HF.
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Affiliation(s)
- Agata Makowska
- Students’ Scientific Association, Laboratory for Applied Research on Cardiovascular System
| | - Agnieszka Rydlewska
- Department of Cardiology, Centre for Heart Disease, Military Hospital, Wroclaw, Poland
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Krakowiak
- Department of Cardiology, Centre for Heart Disease, Military Hospital, Wroclaw, Poland
| | | | | | - Dariusz Danel
- Polish Academy of Sciences, Anthropology Unit in Wroclaw, Wroclaw, Poland
| | - Bogusław Pawłowski
- Polish Academy of Sciences, Anthropology Unit in Wroclaw, Wroclaw, Poland
- Department of Human Biology, University of Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Disease, Military Hospital, Wroclaw, Poland
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa A. Jankowska
- Polish Academy of Sciences, Anthropology Unit in Wroclaw, Wroclaw, Poland
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Fayazi S, Zarea K, Abbasi A, Ahmadi F. Effect of home-based walking on performance and quality of life in patients with heart failure. Scand J Caring Sci 2012; 27:246-52. [PMID: 22686421 DOI: 10.1111/j.1471-6712.2012.01020.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: 11/27/2022]
Abstract
INTRODUCTION Chronic heart failure defined as the inability of the heart to meet the demands of the tissues, which results in symptoms of fatigue or dyspnoea on energy progressing to dyspnoea at rest. The inability to perform the exercise without discomfort and poor quality of life may be one of the first symptoms experienced by patients with heart failure and is often the principal reason for seeking medical care. OBJECTIVES The aim of the study was to find the effect of a home walking programme on the performance and quality of life in the patients with heart failure. METHODS AND RESULTS Sixty patients with New York Heart Association class II and III heart failure were divided into two matched and equal groups. The quality of life scores and 6-minute walking scores were measured for each patient at entry and after 8 weeks. Both groups were followed for 8 weeks. The results showed between mean walking distance on the 6 minutes at entry and after 8 weeks in the training group (p < 0.001), but no significance was seen between the control groups (p = 0.351). Furthermore, results showed a significant difference between mean of quality of life scores at entry and after 8 weeks in the training group, but such significance was not reported between before and after control group scores. CONCLUSION The home-based walking showed improvement in the performance, exercise tolerance time and quality of life in heart failure patients. Therefore, Nurses should employ alternatives such as home exercises in the caring of heart failure patients.
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Affiliation(s)
- Sedigheh Fayazi
- School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Bagheri H, Yaghmaei F, Ashktorab T, Zayeri F. Patient dignity and its related factors in heart failure patients. Nurs Ethics 2012; 19:316-27. [DOI: 10.1177/0969733011425970] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maintenance and promotion of patient dignity is an ethical responsibility of healthcare workers. The aim of this study was to investigate patient dignity and related factors in patients with heart failure. In this qualitative study, 22 patients with heart failure were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. Factors related to patient dignity were divided into two main categories: patient/care index and resources. Intrapersonal features (inherent characteristics and individual beliefs) and interpersonal interactions (communication, respect, enough information, privacy, and authority) were classified as components of the patient/care index category. Human resources (management and staff) and environmental resources (facilities and physical space) were classified as components of the resources category. The results will increase healthcare staff's understanding of patient dignity and its related factors, and provide information regarding the development of systems and processes that support patients in ways that are consistent with these values.
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Affiliation(s)
| | | | | | - Farid Zayeri
- Shahid Beheshti University of Medical Sciences, Iran
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Pihl E, Cider A, Strömberg A, Fridlund B, Mårtensson J. Exercise in elderly patients with chronic heart failure in primary care: effects on physical capacity and health-related quality of life. Eur J Cardiovasc Nurs 2011; 10:150-8. [PMID: 21470913 DOI: 10.1016/j.ejcnurse.2011.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 02/28/2011] [Accepted: 03/03/2011] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). AIM The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care. METHODS An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12months. RESULTS Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. CONCLUSION This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population.
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Affiliation(s)
- Emma Pihl
- Department of Nursing, School of Health Sciences, Jönköping University, Sweden.
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