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Sentandreu-Mañó T, Deka P, Almenar L, Tomás JM, Ferrer-Sargues FJ, López-Vilella R, Klompstra L, Marques-Sule E. Kinesiophobia and associated variables in patients with heart failure. Eur J Cardiovasc Nurs 2024; 23:221-229. [PMID: 37534763 DOI: 10.1093/eurjcn/zvad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
AIMS Patients with heart failure (HF) can exhibit kinesiophobia, an excessive, debilitating, and irrational fear of movement. This study aimed to enhance the understanding of kinesiophobia in patients with HF by analysing associations with the following variables: musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, frailty, sex, and age. METHODS AND RESULTS In this cross-sectional study, 107 participants were included, with ages ranging from 28 to 97 years (57% men, mean age 73.18 ± 12.68 years). Multiple regression analyses were performed with all variables, including polynomial regressions for variables with a non-linear relationship. Kinesiophobia was significantly correlated (P < 0.01) with musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, and being at risk of frailty, while age and sex were not statistically significant. Frailty disability and musculoskeletal pain intensity were variables linearly associated with kinesiophobia, while quality of sleep and disability had a non-linear relationship with kinesiophobia. CONCLUSION Kinesiophobia needs to be evaluated and better understood in patients with HF to improve physical activity and exercise adherence. This study found that musculoskeletal pain intensity, quality of sleep, disability, and frailty risk have a significant association with kinesiophobia in patients with HF. Our results suggest multi-dimensional associations of kinesiophobia in patients with HF, which require further examination and understanding.
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Affiliation(s)
- Trinidad Sentandreu-Mañó
- Department of Physiotherapy, Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, Valencia, Spain
| | - Pallav Deka
- College of Nursing, Michigan State University, 1355 Bogue Street, East Lansing C247, MI, USA
| | - Luis Almenar
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain
- CIBERCV, Valencia, Spain
- University of Valencia, Valencia, Spain
| | - José M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Francisco-José Ferrer-Sargues
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, Valencia, Spain
| | - Raquel López-Vilella
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Stallman HM, Lushington K, Varcoe TJ. Feasibility of a brief, in-patient coping and sleep intervention to reduce potentially preventable readmission of cardiac patients to hospital. Contemp Clin Trials Commun 2023; 36:101230. [PMID: 38034841 PMCID: PMC10684365 DOI: 10.1016/j.conctc.2023.101230] [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: 08/03/2023] [Revised: 10/16/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
Background Psychological distress is prevalent amongst hospital in-patient and may predispose patients to potentially preventable readmissions after discharge. A particularly vulnerable group are patients with cardiac disorders. This study tested the feasibility of a brief cognitive behavioural therapy consisting of an in-hospital coping session and a post-discharge healthy sleep session. Methods Standardised questionnaire were used to assess sleep, coping/distress and wellbeing at baseline (pre-intervention) and one-month post-discharge (post-intervention). Treatment fidelity and acceptability were assessed at follow-up. Participants included 72 inpatients admitted with a cardiac disorder or reported to have a cardiac problem whilst in hospital from a single Australian public hospital. Results Most (83 %) participants found the intervention helpful/very helpful. At baseline prior to admission, almost half of participants (46 %) reported poor wellbeing, 19 % high levels of distress and poor coping, and 47 % sleeping less than 7 h per night. Following the intervention, 45 % of participants with poor wellbeing at baseline had reliable change in wellbeing at follow-up. Conversely, only 22 % of patients with high levels of coping/distress at baseline demonstrated improved coping/distress at follow-up suggesting smaller gains. On average a large 43 min gain in sleep duration was observed post-treatment in patients with poor sleep at baseline. Fourteen percent of participants were readmitted to hospital within 34-days of discharge. Conclusions The coping and sleep intervention was well received with positive outcomes in patients especially those reporting high levels of distress for sleep and to lesser extent coping and wellbeing. Future studies to assess the efficacy of the brief intervention at reducing hospital readmissions are needed.
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Affiliation(s)
- Helen M. Stallman
- South Australian Medical and Health Research Institute, Adelaide, South Australia, 5000, Australia
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, South Australia, Australia
| | - Kurt Lushington
- Justice and Society, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Tamara J. Varcoe
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, South Australia, Australia
- Justice and Society, University of South Australia, Adelaide, South Australia, 5000, Australia
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Gharaibeh B, Al-Absi I, Abuhammad S, Gharaibeh M. Dimensions of sleep characteristics and predictors of sleep quality among heart failure patients: A STROBE compliant cross-sectional study in Jordan. Medicine (Baltimore) 2022; 101:e32585. [PMID: 36596068 PMCID: PMC9803448 DOI: 10.1097/md.0000000000032585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Awareness of poor sleep quality and sleep disturbances, as some of the factors that affect negatively quality of life for patients with the different classes of heart failure (HF) would enable health care providers to offer more comprehensive care. The purposes of this study were to describe sleep quality and predictors of disturbances in sleep in heart failure patients in Jordan. An explanatory cross- sectional design was employed to examine sleep quality, dimensions of sleep characteristics, types of disturbances in sleep within the different classes of HF in Jordan. Data were collected from 2 cardiac clinics and 2 medical clinics at 3 hospitals in Jordan. The most common types of disturbances in sleep in all classes of HF were waking up for urination, waking in the middle of the night or early morning, waking up due to cough and snoring, and difficulty to fall asleep within the 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Regression analysis revealed that significant correlations were found between sleep quality and gender, disease duration, number of medications currently taken and ejection fraction (P < .05). Our findings indicated that sleep quality and disturbances in sleep were worsening with the increase of the New York heart association functional classification sheet class. Moreover, sleep quality had a significant association with gender, disease duration, ejection fraction, and the number of medications currently taken.
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Affiliation(s)
- Besher Gharaibeh
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- * Correspondence: Besher Gharaibeh, Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan (e-mail: )
| | - Ilham Al-Absi
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Sawsan Abuhammad
- Maternal and Child Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Monther Gharaibeh
- Department of Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
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4
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Gharaibeh B, Al-Absi I, Abuhammad S, Gharaibeh M, Jarrah M. Sleep quality among different classes of heart failure patients in Jordan: A STROBE compliant cross-sectional study. Medicine (Baltimore) 2022; 101:e32069. [PMID: 36482595 PMCID: PMC9726338 DOI: 10.1097/md.0000000000032069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Many researchers emphasize the importance of studying sleep quality among patients with heart failure (HF). Because of the importance of this topic, many studies have been conducted to address the different aspects of sleep-in various populations of patients with HF. The purposes of our study were: to assess the types of disturbances in sleep within the different classes of HF, and to assess whether there were differences in the levels of sleep quality and types of disturbances in sleep within the different classes in non-hospitalized Jordan patients with HF. Data were gathered from 2 cardiac clinics and 2 medical clinics at 3 Jordan hospitals. A minimum sample of 200 people was recruited to participate in this study based on these criteria and factors. The prevalence of low sleep quality and types of disturbances in sleep were increased with the increase in New York Heart Association class. Nearly 3 quarters of the study sample had poor sleep quality 73.5% (n = 147). Using a score of 5 as a cut point, 147 patients with HF in our study sample had poor sleep quality. The most common types in all classes were waking up for urination, waking in the middle of the night or early morning, waking up due to coughing and snoring, and difficulty falling asleep within 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Poor sleep quality negatively affects the quality of life in patients with HF by decreasing physical cognitive and psychosocial performance in those patients. This is the first study in literature study sleep quality in the different New York Heart Association functional classes.
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Affiliation(s)
- Besher Gharaibeh
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- * Correspondence: Besher Gharaibeh, Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Postal Code 3030, Irbid 22110, Jordan (e-mail: )
| | - Ilham Al-Absi
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Sawsan Abuhammad
- Maternal and Child Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Monther Gharaibeh
- Department of Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Mohamad Jarrah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Olivares MJ, Toledo C, Ortolani D, Ortiz FC, Díaz HS, Iturriaga R, Del Río R. Sleep dysregulation in sympathetic-mediated diseases: implications for disease progression. Sleep 2022; 45:6649852. [DOI: 10.1093/sleep/zsac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/18/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
The autonomic nervous system (ANS) plays an important role in the coordination of several physiological functions including sleep/wake process. Significant changes in ANS activity occur during wake-to-sleep transition maintaining the adequate cardiorespiratory regulation and brain activity. Since sleep is a complex homeostatic function, partly regulated by the ANS, it is not surprising that sleep disruption trigger and/or evidence symptoms of ANS impairment. Indeed, several studies suggest a bidirectional relationship between impaired ANS function (i.e. enhanced sympathetic drive), and the emergence/development of sleep disorders. Furthermore, several epidemiological studies described a strong association between sympathetic-mediated diseases and the development and maintenance of sleep disorders resulting in a vicious cycle with adverse outcomes and increased mortality risk. However, which and how the sleep/wake control and ANS circuitry becomes affected during the progression of ANS-related diseases remains poorly understood. Thus, understanding the physiological mechanisms underpinning sleep/wake-dependent sympathetic modulation could provide insights into diseases involving autonomic dysfunction. The purpose of this review is to explore potential neural mechanisms involved in both the onset/maintenance of sympathetic-mediated diseases (Rett syndrome, congenital central hypoventilation syndrome, obstructive sleep apnoea, type 2 diabetes, obesity, heart failure, hypertension, and neurodegenerative diseases) and their plausible contribution to the generation of sleep disorders in order to review evidence that may serve to establish a causal link between sleep disorders and heightened sympathetic activity.
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Affiliation(s)
- María José Olivares
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Camilo Toledo
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Domiziana Ortolani
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Fernando C Ortiz
- Mechanisms of Myelin Formation and Repair Laboratory, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile , Santiago , Chile
| | - Hugo S Díaz
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Rodrigo Iturriaga
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
| | - Rodrigo Del Río
- Department of Physiology, Laboratory of Cardiorespiratory Control, Pontificia Universidad Católica de Chile , Santiago , Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes , Punta Arenas , Chile
- Centro de Envejecimiento y Regeneración (CARE), Pontificia Universidad Católica de Chile , Santiago , Chile
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Sharma D, Prashar A. Associations between the gut microbiome, gut microbiology and heart failure: Current understanding and future directions. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 17:100150. [PMID: 38559891 PMCID: PMC10978367 DOI: 10.1016/j.ahjo.2022.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/19/2022] [Accepted: 06/06/2022] [Indexed: 04/04/2024]
Abstract
The role of the gut microbiome in pathophysiology, prognostication and clinical management of heart failure (HF) patients is of great clinical and research interest. Both preclinical and clinical studies have shown promising results, and the gut microbiome has been implicated in other cardiovascular conditions that are risk factors for HF. There is an increasing interest in the use of biological compounds produced as biomarkers for prognostication as well as exploration of therapeutic options targeting the various markers and pathways from the gut microbiome that are implicated in HF. However, study variations exist, and targeted research for individual putative biomarkers is necessary. There is also limited evidence pertaining to decompensated HF in particular. In this review, we synthesize current understandings around pathophysiology, prognostication and clinical management of heart failure (HF) patients, and also provide an outline of potential areas of future research and scientific advances.
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Affiliation(s)
| | - Abhisheik Prashar
- University of New South Wales, Sydney, NSW 2052, Australia
- Department of Cardiology, St George Hospital, Sydney, NSW 2217, Australia
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Karaman Özlü Z, Özer N. The effect of enhancing environmental factors on the quality of patients’ sleep in a cardiac surgical intensive care unit. BIOL RHYTHM RES 2016. [DOI: 10.1080/09291016.2016.1232462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Mudge AM, Denaro CP, Scott AC, Atherton JJ, Meyers DE, Marwick TH, Adsett JA, Mullins RW, Suna JM, Scuffham PA, O'Rourke PK. Exercise training in recently hospitalized heart failure patients enrolled in a disease management programme: design of the EJECTION-HF randomized controlled trial. Eur J Heart Fail 2011; 13:1370-5. [PMID: 22065870 DOI: 10.1093/eurjhf/hfr139] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
AIMS The Exercise Joins Education: Combined Therapy to Improve Outcomes in Newly-discharged Heart Failure (EJECTION-HF) study will evaluate the impact of a supervised exercise training programme (ETP) on clinical outcomes in recently hospitalized heart failure patients attending a disease management programme (DMP). Methods This multisite, pragmatic randomized controlled trial enrols patients discharged from participating hospitals with clinical evidence of heart failure who are willing and able to participate in a DMP and considered clinically safe to exercise. Enrolment includes participants with impaired and preserved left ventricular systolic function. Baseline assessment and programme commencement occur within 6 weeks of hospital discharge. The control group DMP includes individualized education and follow-up from a multidisciplinary heart failure team; a weekly education programme for 12 weeks; self-management advice; and medical follow-up. Home exercise is recommended for all participants. In addition, intervention participants are offered 36 supervised, structured gym-based 1 h exercise sessions over 24 weeks. Sessions are tailored to exercise capacity and include aerobic, resistance, and balance exercises. Enrolment target is 350 participants. Primary outcome is 12-month mortality and readmissions. Secondary outcomes include blinded evaluation of depressive symptoms, sleep quality, cognition, and functional status (activities of daily living, 6 min walk distance, grip strength) at 3 and 6 months. A cost-utility analysis will be conducted. CONCLUSION This study will enrol a representative group of hospitalized heart failure patients and measure a range of patient and health service outcomes to inform the design of post-hospital DMPs for heart failure. Enrolment will be completed in 2013. ACTRN12608000263392.
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Affiliation(s)
- Alison M Mudge
- Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia.
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Yang JY, Huang JW, Kao TW, Peng YS, Lu CS, Chen DL, Yang CS, Yang CC, Tsai DM, Liao CS, Chang HW, Wu WC, Wu MS, Wu KD, Chang CJ, Tsai TJ, Chen WY. Impact of spiritual and religious activity on quality of sleep in hemodialysis patients. Blood Purif 2008; 26:221-5. [PMID: 18305384 DOI: 10.1159/000118845] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 11/30/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sleep disorders are common in hemodialysis (HD) patients. This study examined the relationship between quality of sleep (QoS) and religious/spiritual activity in HD patients. METHODS The study subjects were 861 HD patients from 14 dialysis clinics in Taiwan. QoS and religious/spiritual activity were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Royal Free Questionnaire respectively. RESULTS There was no difference in clinical parameters between the good and poor sleepers. Although total scores of religious and spiritual activity did not correlate with global PSQI score, patients who held strong 'spiritual' beliefs reported more problems in 'sleep disturbances', while those who exercised religious beliefs more strongly reported less trouble in 'daytime dysfunction'. CONCLUSION There is no significant correlation between QoS and religious/spiritual activity globally. However, the spiritual and religious activity did associate with different components of QoS.
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Affiliation(s)
- Ju-Yeh Yang
- Department of Internal Medicine, Far Eastern Memorial Hospital, Panchiao, Taiwan
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Abstract
Approximately 10% to 70% of people living with chronic heart failure (HF) experience significant sleep disturbances, which have been shown to impair their health-related quality of life and overall functional performance. Research findings, however, report inconsistent conclusions about sleep disturbances and their adverse effects on HF. The purpose of this article is to review several research studies addressing sleep disturbances in patients with HF and to highlight contradictory and inconsistent findings. Further nursing research about the phenomena related to sleep disturbances in people with HF is warranted so that evidence-based assessments and interventions can be tested in the future.
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Affiliation(s)
- Hsing-Mei Chen
- School of Nursing, The University of Texas at Austin, Austin, TX 78701, USA.
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Abstract
Heart failure is reaching epidemic proportions in the United States, causing a constellation of disabling symptoms. Cognitive impairment in people with heart failure may be more common than previously known with multiple etiologies from both the disease process and the treatment. Exemplars from a research study are used to illustrate the perspective of heart failure patients. Given the critical importance of memory deficits on patient education, potential nursing interventions to address the issue of cognitive impairment are described.
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Affiliation(s)
- Angela P Clark
- University of Texas at Austin School of Nursing, 78701, USA.
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