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Zhao L, Zhao X, Zhuang X, Zhai M, Wang Y, Huang Y, Zhou Q, Tian P, Liang L, Huang B, Huang L, Feng J, Zhang Y, Zhang J. Hyponatremia and lower normal serum sodium levels are associated with an increased risk of all-cause death in heart failure patients. Nurs Open 2023; 10:3799-3809. [PMID: 36929057 PMCID: PMC10170941 DOI: 10.1002/nop2.1638] [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: 01/09/2022] [Revised: 10/04/2022] [Accepted: 01/19/2023] [Indexed: 03/17/2023] Open
Abstract
AIM To explore the relationship between the serum sodium level on admission and all-cause mortality in HF patients. DESIGN A single-center retrospective cohort study. METHODS Patients hospitalized with HF at the Heart Failure Center, Fuwai Hospital, from November 2008 to November 2018 were enrolled. RESULTS A total of 3649 patients were included, and the mean sodium level was 137.19 ± 4.36 mmol/L, with a range from 115.6 to 160.9 mmol/L. During a median follow-up of 1101 days, mortality occurred in 1413 (38.7%) hospital survivors. After adjustment for age, sex, and other potential confounders, patients with sodium levels <135 mmol/L (hazard ratio [HR]: 1.67; 95% confidence interval [CI]: 1.29-2.16) and 135-137 mmol/L (HR: 1.34; 95% CI: 1.01-1.78) had an increased risk of all-cause mortality compared to those with sodium levels of 139-141 mmol/L.
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Affiliation(s)
- Lang Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xuemei Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xiaofeng Zhuang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Mei Zhai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Yunhong Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Yan Huang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Qiong Zhou
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Pengchao Tian
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Lin Liang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Boping Huang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Liyan Huang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jiayu Feng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Yuhui Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
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Lindberg C, Fock J, Nilsen P, Schildmeijer K. Registered nurses' efforts to ensure safety for home-dwelling older patients. Scand J Caring Sci 2022; 37:571-581. [PMID: 36582025 DOI: 10.1111/scs.13142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/23/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND The international development of health care, an ageing population and rapid technical development mean that more care is being performed in patient homes. This care environment is often unpredictable and involves both formal and informal caregivers, making it potentially unsafe. There is sparse knowledge about how patient safety is protected in home health care in Sweden and how registered nurses work to prevent risks and promote safe care. AIM The aim of the study was to explore registered nurses' efforts to reduce perceived risks for home-dwelling older patients and ensure safe home health care. METHOD We used a qualitative design with individual interviews with 13 registered nurses working in municipalities in southeast Sweden. The narratives were analysed with inductive content analysis. FINDINGS The findings showed that the registered nurses tried to secure a safe care environment and took an active role in care, striving to stay one step ahead of the patient. These three types of efforts are likely interdependent, suggesting they are all needed to reduce perceived risks for home-dwelling older patients and ensure patient safety in home health care. CONCLUSIONS It is a challenge for registered nurses to maintain patient safety when performing care in patient homes. Continuity of care is required and must be based not only on self-reliance among registered nurses but also on trusting relationships with patients, next of kin, colleagues and other personnel, as well as on the development of organisational conditions adapted to patient needs.
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Affiliation(s)
- Catharina Lindberg
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Jenni Fock
- Centre for Healthcare Development, University Hospital Linköping, Linköping, Sweden
| | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Guo X, Wang Y, Wang L, Yang X, Yang W, Lu Z, He M. Effect of a fall prevention strategy for the older patients: A quasi-experimental study. Nurs Open 2022; 10:1116-1124. [PMID: 36178024 PMCID: PMC9834535 DOI: 10.1002/nop2.1379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/02/2022] [Accepted: 09/06/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To explore the effect of a fall prevention strategy on older patients based on the Patient Engagement Framework. DESIGN A longitudinal quasi-experimental quantitative design. METHODS Older patients who met the inclusion criteria were recruited from geriatric, oncology, neurology and cardiology departments of a teaching general hospital in China. Development of a fall prevention intervention strategy for older patients was based on the Patient Engagement Framework. Patients in the intervention group were given this fall prevention strategy (N = 58), and those in the control group were given conventional measures (N = 58). The following indicators were compared between the two groups after intervention: (a) number of falls; (b) Knowledge-Attitude-Practice (KAP) score; (c) Modified Fall Efficacy Scale score. RESULTS After the implementation of an intervention strategy in older patients, the number of falls decreased from 3 to 0; the score of KAP and Modified Fall Efficacy Scale was promoted (p < .05).
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Affiliation(s)
- Xiaobei Guo
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Ying Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Lei Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xueke Yang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Weimei Yang
- Internal Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Zhihui Lu
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Mei He
- Intensive Care Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
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Rubio R, Palacios B, Varela L, Fernández R, Camargo Correa S, Estupiñan MF, Calvo E, José N, Ruiz Muñoz M, Yun S, Jiménez-Marrero S, Alcoberro L, Garay A, Moliner P, Sánchez-Fernández L, Soria Gómez MT, Hidalgo E, Enjuanes C, Calero-Molina E, Rueda Y, San Saturnino M, Garcimartín P, López-Ibor JV, Segovia-Cubero J, Comin-Colet J. Quality of life and disease experience in patients with heart failure with reduced ejection fraction in Spain: a mixed-methods study. BMJ Open 2021; 11:e053216. [PMID: 34862295 PMCID: PMC8647550 DOI: 10.1136/bmjopen-2021-053216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To gather insights on the disease experience of patients with heart failure (HF) with reduced ejection fraction (HFrEF), and assess how patients' experiences and narratives related to the disease complement data collected through standardised patient-reported outcome measures (PROMs). Also, to explore new ways of evaluating the burden experienced by patients and caregivers. DESIGN Observational, descriptive, multicentre, cross-sectional, mixed-methods study. SETTING Secondary care, patient's homes. PARTICIPANTS Twenty patients with HFrEF (New York Heart Association (NYHA) classification I-III) aged 38-85 years. MEASURES PROMs EuroQoL 5D-5L (EQ-5D-5L) and Kansas City Cardiomyopathy Questionnaire and patient interview and observation. RESULTS A total of 20 patients with HFrEF participated in the study. The patients' mean (SD) age was 72.5 (11.4) years, 65% were male and were classified inNYHA functional classes I (n=4), II (n=7) and III (n=9). The study showed a strong impact of HF in the patients' quality of life (QoL) and disease experience, as revealed by the standardised PROMs (EQ-5D-5L global index=0.64 (0.36); Kansas City Cardiomyopathy Questionnaire total symptom score=71.56 (20.55)) and the in-depth interviews. Patients and caregivers often disagreed describing and evaluating perceived QoL, as patients downplayed their limitations and caregivers overemphasised the poor QoL of the patients. Patients related current QoL to distant life experiences or to critical moments in their disease, such as hospitalisations. Anxiety over the disease progression is apparent in both patients and caregivers, suggesting that caregiver-specific tools should be developed. CONCLUSIONS PROMs are an effective way of assessing symptoms over the most recent time period. However, especially in chronic diseases such as HFrEF, PROM scores could be complemented with additional tools to gain a better understanding of the patient's status. New PROMs designed to evaluate and compare specific points in the life of the patient could be clinically more useful to assess changes in health status.
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Affiliation(s)
| | - Beatriz Palacios
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | - Luis Varela
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | - Raquel Fernández
- Medical Department, AstraZeneca Farmacéutica Spain SA, Madrid, Spain
| | | | | | - Elena Calvo
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Nuria José
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Marta Ruiz Muñoz
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Sergi Yun
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Santiago Jiménez-Marrero
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Lidia Alcoberro
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Alberto Garay
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Pedro Moliner
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Lydia Sánchez-Fernández
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Department of Cardio-Oncology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | | | - Encarna Hidalgo
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Cristina Enjuanes
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | - Esther Calero-Molina
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
| | | | | | - Paloma Garcimartín
- Outpatients Clinics, Hospital del Mar, Barcelona, Spain
- Department of Biomedical Research in Heart Diseases, Hospital del Mar Institute for Medical Research, Barcelona, Spain
| | - Jorge V López-Ibor
- Department of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Javier Segovia-Cubero
- Department of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
- CIBER of Cardiovascular Diseases, Carlos III Health Institute, Madrid, Spain
| | - Josep Comin-Colet
- Department of Cardiology and Heart Failure Program, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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Kristinsdottir IV, Jonsson PV, Hjaltadottir I, Bjornsdottir K. Changes in home care clients' characteristics and home care in five European countries from 2001 to 2014: comparison based on InterRAI - Home Care data. BMC Health Serv Res 2021; 21:1177. [PMID: 34715850 PMCID: PMC8555210 DOI: 10.1186/s12913-021-07197-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required. Methods This descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods. Results In most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low. Conclusion Older people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.
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Affiliation(s)
- I V Kristinsdottir
- Faculty of Nursing, University of Iceland, Eiríksgata 34, 101, Reykjavík, Iceland. .,Home Care center, The Capital Area Primary Care, Álfabakki 16, 109, Reykjavík, Iceland.
| | - P V Jonsson
- Faculty of Medicine, University of Iceland, Vatnsmýrarvegur 16, 101, Reykjavík, Iceland.,Department of Geriatrics, The National University Hospital of Iceland, Túngata 26, 101, Reykjavík, Iceland
| | - I Hjaltadottir
- Faculty of Nursing, University of Iceland, Eiríksgata 34, 101, Reykjavík, Iceland.,Department of Geriatrics, The National University Hospital of Iceland, Túngata 26, 101, Reykjavík, Iceland
| | - K Bjornsdottir
- Faculty of Nursing, University of Iceland, Eiríksgata 34, 101, Reykjavík, Iceland
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