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Monfared A, Javadi-Pashaki N, Dehghan Nayeri N, Jafaraghaee F. Barriers and facilitators of readiness for hospital discharge in patients with myocardial infarction: a qualitative study: quality improvement study. Ann Med Surg (Lond) 2024; 86:1967-1976. [PMID: 38576922 PMCID: PMC10990328 DOI: 10.1097/ms9.0000000000001706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/31/2023] [Indexed: 04/06/2024] Open
Abstract
Background Readiness for hospital discharge (RHD) in patients with myocardial infarction (MI) is a key concept in the discharge process. This study was conducted to explain the barriers and facilitators of preparation for discharge in patients with MI. Materials and methods A qualitative study was conducted using conventional content analysis from April 2021 to 2022. Data collection was done in a targeted manner through semi-structured interviews until the data saturation stage. Nineteen participants (11 patients, 3 family members, and 5 healthcare team) were interviewed. Data analysis was done in eight steps according to the suggested steps of Graneheim and Lundman. MAXQDA18 software was used for coding. Results From the interviews, 348 primary codes, 11 sub-categories, and 5 categories were extracted. Finally, after continuous analysis and comparison of interviews, codes, and categories, two themes including "supporting platform" and "caring atmosphere" were extracted, which were the result of the participants' experience and understanding of the barriers and facilitators of RHD. The supporting platform included "family support" and "social support" and the caring atmosphere included "care gaps" and "professional healthcare team performance". Conclusion The results of this study indicate several factors affecting RHD in heart attack patients. According to the results of the study, the participation of the patient, family, healthcare team, and community in creating RHD is recommended. It is also suggested to pay attention to these factors in care and treatment planning to help improve health and control complications and prevent re-hospitalization in these patients.
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Affiliation(s)
- Arezoo Monfared
- School of Nursing and Midwifery, Guilan University of Medical Sciences
| | - Nazila Javadi-Pashaki
- School of Nursing and Midwifery, Guilan University of Medical Sciences
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Evaluating Levels of Community Participation in a University-Community Partnership: The Jackson Heart Study. Diseases 2022; 10:diseases10040068. [PMID: 36278567 PMCID: PMC9589967 DOI: 10.3390/diseases10040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This research was designed to evaluate the perceptions of the Jackson Heart Study (JHS) community relating to their levels of involvement in JHS activities that were developed to address health disparities and promote health education and health promotion. Methods: The participants for this study comprised 128 community members, who included JHS participants, as well as family members and other friends of the JHS who resided in the JHS community of Hinds, Madison, and Rankin Counties in Mississippi and attended the JHS Annual Celebration of Life. We used the Chi-Square test to analyze the participants’ responses to the survey questions developed to address the six areas of focus: (1) ways to increase participation in community outreach activities; (2) reasons for participating in community outreach activities; (3) interest in research participation; (4) factors influencing engagement; (5) Participants’ preferences for communicating; (6) Chronic disease prevalence. Results: Participants residing in rural counties perceived television and radio as a medium to increase participation; More female respondents cited trust working with the JSU JHS Community Outreach Center (CORC) as a reason for remaining engaged in the community outreach activities; younger participants under 66 years of age recommended social media as a way to increase participation; participants residing in the rural areas saw their participation in the community outreach activities as a way to address community health problems. Conclusions: The knowledge gained from the details provided by the JHS community members can be used to refine research studies in existence, while promoting their sustainability.
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Sagris M, Antonopoulos AS, Theofilis P, Oikonomou E, Siasos G, Tsalamandris S, Antoniades C, Brilakis ES, Kaski JC, Tousoulis D. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res 2022; 118:2281-2292. [PMID: 34358302 DOI: 10.1093/cvr/cvab264] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 08/03/2021] [Indexed: 12/18/2022] Open
Abstract
Myocardial infarction (MI) among young adults (<45 years) represents a considerable proportion of the total heart attack incidents. The underlying pathophysiologic characteristics, atherosclerotic plaque features, and risk factors profile differ between young and older patients with MI. This review article discusses the main differences between the younger and elderly MI patients as well as the different pathogenic mechanisms underlying the development of MI in the younger. Young patients with MI often have eccentric atherosclerotic plaques with inflammatory features but fewer lesions, and are more likely to be smokers, obese, and have poor lifestyle, such as inactivity and alcohol intake. Compared to older MI patients, younger are more likely to be men, have familial-combined hyperlipidaemia and increased levels of lipoprotein-a. In addition, MI in younger patients may be related to use of cannabis, cocaine use, and androgenic anabolic steroids. Genomic differences especially in the pathways of coagulation and lipid metabolism have also been identified between young and older patients with MI. Better understanding of the risk factors and the anatomic and pathophysiologic processes in young adults can improve MI prevention and treatment strategies in this patient group. Awareness could help identify young subjects at increased risk and guide primary prevention strategies. Additional studies focusing on gene pathways related to lipid metabolism, inflammation, and coagulation are needed.
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Affiliation(s)
- Marios Sagris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Alexios S Antonopoulos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Panagiotis Theofilis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Evangelos Oikonomou
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Gerasimos Siasos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Sotirios Tsalamandris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Centre of Research Excellence, British Heart Foundation, Oxford, OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, OX3 9DU, UK
| | - Emmanouil S Brilakis
- Division of Cardiovascular Medicine, Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
| | - Juan C Kaski
- Division of Cardiovascular Medicine, Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK
| | - Dimitris Tousoulis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
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Socioeconomic inequity in incidence, outcomes and care for acute coronary syndrome: A systematic review. Int J Cardiol 2022; 356:19-29. [DOI: 10.1016/j.ijcard.2022.03.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/17/2022] [Accepted: 03/24/2022] [Indexed: 12/17/2022]
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Moxon NR, Wang A, Margo CE, Greenberg PB, French DD. THE ASSOCIATION BETWEEN COMPLEX CATARACT SURGERY AND SOCIAL DETERMINANTS OF HEALTH IN FLORIDA. Ophthalmic Epidemiol 2021; 29:279-285. [PMID: 34139932 DOI: 10.1080/09286586.2021.1939888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To analyze differences between rates of complex and routine cataract surgery based on demographics and social determinants of health (SDOH) at the community level. METHODS Data from adults ages 18 to 84 relevant to cataract surgery billing codes were extracted from the 2017 Florida Ambulatory Surgery dataset from the Agency for Healthcare Research and Quality merged with SDOH measures from the American Community Survey. A multivariable logistic regression model was used to determine associations between complex cataract surgery and SDOH according to patient ZIP code. Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS A total of 171,754 and 11,340 patients received routine and complex cataract surgeries, respectively; females received the majority of routine surgeries (58.87%); most common age group (79.11%) was from 65 to 84 years. Male (odds ratio [OR] 2.034; p < 0.0001) and black patients (OR 1.998; p < 0.0001) more likely received complex surgery. Compared to Medicare patients, patients insured with Medicaid (OR 2.058; p < 0.0001), private insurance (OR 1.057; p = 0.0182), or self-pay (OR 1.570; p < 0.0001) were more likely to receive a complex surgery. ZIP codes with higher adult poverty (OR 2.614; p < 0.001) were more likely complex surgery patients, whereas those with higher rates of high school attendance (OR 0.487; p = 0.0193) and home occupancy (OR 0.704; p = 0.0047) were less likely to be complex. CONCLUSIONS Selected patient- and community-level factors including being male, Black, Asian, Hispanic, non-Medicare, or within lower education, higher poverty ZIP codes were associated with a higher likelihood of receiving complex cataract surgery.
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Affiliation(s)
- Nathaniel R Moxon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Andrew Wang
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Center for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Curtis E Margo
- Morsani College of Medicine, Department of Ophthalmology, University of South Florida, Tampa, Florida, USA
| | - Paul B Greenberg
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Dustin D French
- Department of Ophthalmology and Center for Health Services and Outcomes Research, Northwestern University, Chicago, Illinois, USA.,Department of Veterans Affairs, Health Services Research and Development Service, Chicago, Illinois, USA
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Addison C, Campbell Jenkins BW, White M, Thigpen-Odom D, Fortenberry M, Wilson G, McCoy P, Young L, Woodberry C, Herron K, Clark J, Payton M, LaVigne DA. Twenty Years of Leading the Way among Cohort Studies in Community-Driven Outreach and Engagement: Jackson State University/Jackson Heart Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020696. [PMID: 33467408 PMCID: PMC7830722 DOI: 10.3390/ijerph18020696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/26/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022]
Abstract
Background: History has recorded the tremendous concerns and apprehension expressed by African Americans about participating in research studies. This review enumerates the collaborative techniques that were utilized by the Jackson State University (JSU) Jackson Heart Study (JHS) community-focused team to facilitate recruitment and retention of the JHS cohort and to implement health education and health promotion in the JHS communities. Methods: This review describes the evolution of the JSU JHS community initiatives, an innovative community-driven operation, during the period 1999–2018. Results: JSU JHS community-focused investigators published approximately 20 manuscripts, including community-led research and publications with community lead authors and co-authors, research and publications in collaboration with other JHS staff, through other JSU-funded projects. The JSU JHS community-focused unit also initiated the JHS Community Training Activities, developed the Community Health Advisory Network (CHAN), and trained and certified 137 Community Health Advisors. In addition, the JSU JHS community-focused unit developed the Collaborative Community Science Model (CCSM) that symbolized its approach to community engagement and outreach, and a Trust Scale for ascertaining African Americans’ willingness to engage in biomedical research collaborations. Conclusion: This review offers educators, public health professionals, and research investigators a useful starting point for the development, selection, or improvement of techniques to motivate, inspire, and engage community residents in a community–academia partnership that yielded maximum benefits in the areas of health education, health promotion and interventions, and biomedical research. Substantial, meaningful community engagement is possible when prioritizing elimination of health disparities and long-term improvement in health care access in the target populations.
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Affiliation(s)
- Clifton Addison
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
- Correspondence: ; Tel.: +1-601-979-8765
| | - Brenda W. Campbell Jenkins
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Monique White
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Darcel Thigpen-Odom
- Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS 39213, USA;
| | - Marty Fortenberry
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Gregory Wilson
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Pamela McCoy
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Lavon Young
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Clevette Woodberry
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Kathryn Herron
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Jermal Clark
- Jackson Heart Study, Community Outreach Center, Community Representative, Jackson State University, Jackson, MS 39213, USA;
| | - Marinelle Payton
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
| | - Donna Antoine LaVigne
- Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA; (B.W.C.J.); (M.W.); (M.F.); (G.W.); (P.M.); (L.Y.); (C.W.); (K.H.); (M.P.); (D.A.L.)
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Odoi EW, Nagle N, Zaretzki R, Jordan M, DuClos C, Kintziger KW. Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida. J Am Heart Assoc 2020; 9:e012712. [PMID: 32427043 PMCID: PMC7428988 DOI: 10.1161/jaha.119.012712] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Identifying social determinants of myocardial infarction (MI) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005-2014 period and calculated age- and sex-adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age- and sex-adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [RR]=1.033, P<0.0001) and high divorce rate (RR, 0.995; P=0.018). However, they were significantly lower in counties with high proportions of rural (RR, 0.996; P<0.0001), black (RR, 1.026; P=0.032), and uninsured populations (RR, 0.983; P=0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically (P for non-stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (RR for <high school education, 1.036-1.041; RR for uninsured rate, 0.971-0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
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Affiliation(s)
- Evah Wangui Odoi
- Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
| | - Nicholas Nagle
- Department of Geography The University of Tennessee Knoxville TN
| | - Russell Zaretzki
- Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
| | - Melissa Jordan
- Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | - Chris DuClos
- Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
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