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Hadi F, Molavynejad S, Elahi N, Haybar H, Maraghi E. King's Theory of Goal Attainment: Quality of Life for People With Myocardial Infarction. Nurs Sci Q 2023; 36:250-257. [PMID: 37309158 DOI: 10.1177/08943184231169771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to evaluate the effects of a theory of goal attainment-based care plan on quality of life among patients with myocardial infarction. One hundred two patients were randomly assigned to two groups. The intervention group received a theory of goal attainment-based care plan during their hospital stay and a two-month follow-up assessment after hospital discharge. Quality of life was assessed using the Persian version of the MacNew Heart Disease Health-Related Quality of Life questionnaire. Despite no significant difference between the groups with respect to the pretest mean scores of quality of life and its dimensions (p > .05), the posttest mean scores of quality of life and its dimensions in the intervention group were significantly greater than those of the control group (p < .001). Moreover, while the mean scores of quality of life and its dimensions significantly increased in the intervention group (p < .001), they did not significantly change in the control group (p > .05), except for the mean score of physical functioning (p = .032).
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Affiliation(s)
- Fereshteh Hadi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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2
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Lorenzo E, Evangelista LS. Disparities in cardiovascular disease: examining the social determinants of health. Eur J Cardiovasc Nurs 2021; 21:187-189. [PMID: 34410365 DOI: 10.1093/eurjcn/zvab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Elizabeth Lorenzo
- School of Nursing, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA
| | - Lorraine S Evangelista
- School of Nursing, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA
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3
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Sotirakos S, Fouda B, Mohamed Razif NA, Cribben N, Mulhall C, O'Byrne A, Moran B, Connolly R. Harnessing artificial intelligence in cardiac rehabilitation, a systematic review. Future Cardiol 2021; 18:154-164. [PMID: 33860679 DOI: 10.2217/fca-2021-0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This systematic review aims to evaluate the current body of research surrounding the efficacy of artificial intelligence (AI) in cardiac rehabilitation. Presently, AI can be incorporated into personal devices such as smart watches and smartphones, in diagnostic and home monitoring devices, as well as in certain inpatient care settings. Materials & methods: The PRISMA guidelines were followed in this review. Inclusion and exclusion criteria were set using the Population, Intervention, Comparison and Outcomes (PICO) tool. Results: Eight studies meeting the inclusion criteria were found. Conclusion: Incorporation of AI into healthcare, cardiac rehabilitation delivery, and monitoring holds great potential for early detection of cardiac events, allowing for home-based monitoring, and improved clinician decision making.
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Affiliation(s)
- Sara Sotirakos
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | - Basem Fouda
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | | | | | - Cormac Mulhall
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | - Aisling O'Byrne
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | - Bridget Moran
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | - Ruairi Connolly
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland.,National Rehabilitation Hospital, Dublin, Ireland
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4
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Moons P, Lee CS. One year of methods corner: the way forward to innovate research in cardiovascular care. Eur J Cardiovasc Nurs 2021; 20:181-182. [PMID: 33855346 DOI: 10.1093/eurjcn/zvab021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 box 7001, B-3000 Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Christopher S Lee
- William F. Connell School of Nursing, Boston College, Boston, MA, USA
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5
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Dickson VV, Page SD. Using mixed methods in cardiovascular nursing research: Answering the why, the how, and the what's next. Eur J Cardiovasc Nurs 2021; 20:82-89. [PMID: 33570592 DOI: 10.1093/eurjcn/zvaa024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/31/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Mixed methods is an innovative research approach that can be applied to understand complex cardiovascular phenomena. A mixed methods study involves collecting both quantitative and qualitative data and intentionally integrating the data to provide a better understanding of the phenomena than can be achieved by using a quantitative or qualitative approach alone. Conducting a mixed methods study requires planning and careful attention to methodological rigour in the data collection, analysis, and integration phases. This paper provides an overview of the mixed methods approach and describes its application to cardiovascular nursing science.
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Affiliation(s)
- Victoria Vaughan Dickson
- Pless Center for Nursing Research, New York University Rory Meyers College of Nursing, 431 First Ave, #742, New York, NY 10010, USA
| | - Shayleigh Dickson Page
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
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6
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Abstract
Non-randomised study designs are frequently used by researchers in cardiovascular nursing and allied professions. Baseline differences between the groups to be compared may introduce bias in the results. Methods for causal inference address this issue. One such method is propensity weighting, in which two or more treatments/exposure groups are weighted to make the groups as comparable as possible. As such, it mimics a randomised controlled trial design. In this article, the Twang package is presented for propensity weighting, and its use is exemplified in a study on smoking and cannabis consumption in adults with congenital heart disease.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Belgium.,Institute of Health and Care Sciences, University of Gothenburg, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, South Africa
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7
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Östman M, Bäck-Pettersson S, Sundler AJ, Sandvik AH. Nurses' experiences of continuity of care for patients with heart failure: A thematic analysis. J Clin Nurs 2020; 30:276-286. [PMID: 33141466 DOI: 10.1111/jocn.15547] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/06/2020] [Accepted: 10/23/2020] [Indexed: 01/04/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to describe nurses' experiences of continuity of care for patients with heart failure. BACKGROUND Heart failure is a life-influencing condition that causes varying care needs over time with risks of fragmentation. Nurses play an important role in caring for patients with heart failure. However, nurses' experiences of continuity of care seem to be less explored in this context. DESIGN A qualitative study with a descriptive design. METHODS Four focus groups were chosen to collect the data, and the analysis was made by using a method for thematic analysis. A purposeful sampling of nurses (n = 14) with experiences from hospital-connected heart failure clinics, primary healthcare centres and municipal home healthcare settings was recruited. The COREQ checklist was used in this study. RESULTS The nurses' experiences of continuity of care for patients with heart failure were described in four themes: access and flexibility, responsibility and transparency, trustful and caring relationships and communication and collaboration. CONCLUSIONS The results indicate that nurses have an excellent position to act as the "hub" in caring for patients with heart failure, but they need to have the possibility of networking and establishing trusting relationships with their colleagues. From the nurses' point of view, mutual trust between the nurse, the patient and the patient's next of kin is crucial for promoting and maintaining continuity of care in patients with heart failure. RELEVANCE TO CLINICAL PRACTICE To promote continuity of care for patients with heart failure, nurses expressed the necessity of establishing trusting relationships in a continuity-promoting organisation with seamless coordination. Nurses can be the "hub" supporting a person-centred care approach based on the patients' needs. There seems to be a need for better collaboration with common guidelines across and within primary healthcare centres, hospital-connected heart failure clinics and municipal home healthcare settings.
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Affiliation(s)
- Malin Östman
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Region Västra Götaland, Närhälsan Källstorp Health Centre, Trollhättan, Sweden.,Region Västra Götaland, Research and Development Primary Health Care, R, D&E Centre Fyrbodal, Västra Götaland, Sweden
| | - Siv Bäck-Pettersson
- Region Västra Götaland, Research and Development Primary Health Care, R, D&E Centre Fyrbodal, Västra Götaland, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Ann-Helén Sandvik
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Risom SS, Zwisler AD, Sibilitz KL, Rasmussen TB, Taylor RS, Thygesen LC, Madsen TS, Svendsen JH, Berg SK. Cardiac Rehabilitation for Patients Treated for Atrial Fibrillation With Ablation Has Long-Term Effects: 12-and 24-Month Follow-up Results From the Randomized CopenHeartRFA Trial. Arch Phys Med Rehabil 2020; 101:1877-1886. [DOI: 10.1016/j.apmr.2020.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/09/2020] [Accepted: 06/30/2020] [Indexed: 12/20/2022]
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Buck HG, Shadmi E, Topaz M, Sockolow PS. An integrative review and theoretical examination of chronic illness mHealth studies using the Middle-Range Theory of Self-care of Chronic Illness. Res Nurs Health 2020; 44:47-59. [PMID: 32931601 DOI: 10.1002/nur.22073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/25/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022]
Abstract
Self-management, or self-care, by individuals and/or families is a critical element in chronic illness management as more care shifts to the home setting. Mobile device-enhanced health care, or mHealth, is being touted as a means to support self-care. Previous mHealth reviews examined the effect of mHealth on patient outcomes, however, none used a theoretical lens to examine the interventions themselves. The aims of this integrative review were to examine recent (e.g., last 10 years) chronic illness mHealth empiric studies and (1) categorize self-care behaviors engaged in the intervention according to the Middle-Range Theory of Self-care of Chronic Illness, and (2) conduct an analysis of gaps in self-care theory domains and behaviors utilized. Methods included: (1) Best practice study identification, collection, and data extraction procedures and (2) realist synthesis techniques for within and across case analysis. From a pool of 652 records, 33 primarily North American clinical trials, published between 2010 and 2019 were examined. Most mHealth interventions used apps, clinician contact, and behavioral prompts with some wireless devices. Examination found self-care maintenance behaviors were supported in most (n = 30) trials whereas self-care monitoring (n = 12) and self-care management behaviors (n = 8) were less so. Few trials (n = 2) targeted all three domains. Investigation of specific behaviors uncovered an overexamination of physical activity and diet behaviors and an underexamination of equally important behaviors. By examining chronic illness mHealth interventions using a theoretical lens we have categorized current interventions, conducted a gap analysis uncovering areas for future study, and made recommendations to move the science forward.
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Affiliation(s)
- Harleah G Buck
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Efrat Shadmi
- Department of Nursing, University of Haifa, Haifa, Israel
| | - Maxim Topaz
- School of Nursing, Columbia University, New York City, New York, USA
| | - Paulina S Sockolow
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
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10
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Affiliation(s)
- Tiny Jaarsma
- Division of Nursing, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Division of Nursing, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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11
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Patient and Professional Factors That Impact the Perceived Likelihood and Confidence of Healthcare Professionals to Discuss Implantable Cardioverter Defibrillator Deactivation in Advanced Heart Failure: Results From an International Factorial Survey. J Cardiovasc Nurs 2019; 33:527-535. [PMID: 29727378 PMCID: PMC6200367 DOI: 10.1097/jcn.0000000000000500] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Supplemental digital content is available in the text. Background: Rate of implantable cardioverter defibrillator (ICD) implantations is increasing in patients with advanced heart failure. Despite clear guideline recommendations, discussions addressing deactivation occur infrequently. Aim: The aim of this article is to explore patient and professional factors that impact perceived likelihood and confidence of healthcare professionals to discuss ICD deactivation. Methods and Results: Between 2015 and 2016, an international sample of 262 healthcare professionals (65% nursing, 24% medical) completed an online factorial survey, encompassing a demographic questionnaire and clinical vignettes. Each vignette had 9 randomly manipulated and embedded patient-related factors, considered as independent variables, providing 1572 unique vignettes for analysis. These factors were determined through synthesis of a systematic literature review, a retrospective case note review, and a qualitative exploratory study. Results showed that most healthcare professionals agreed that deactivation discussions should be initiated by a cardiologist (95%, n = 255) or a specialist nurse (81%, n = 215). In terms of experience, 84% of cardiologists (n = 53) but only 30% of nurses (n = 50) had previously been involved in a deactivation decision. Healthcare professionals valued patient involvement in deactivation decisions; however, only 50% (n = 130) actively involved family members. Five of 9 clinical factors were associated with an increased likelihood to discuss deactivation including advanced age, severe heart failure, presence of malignancy, receipt of multiple ICD shocks, and more than 3 hospital admissions during the previous year. Furthermore, nationality and discipline significantly influenced likelihood and confidence in decision making. Conclusions: Guidelines recommend that healthcare professionals discuss ICD deactivation; however, practice is suboptimal with multifactorial factors impacting on decision making. The role and responsibility of nurses in discussing deactivation require clarity and improvement.
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12
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Bollars C, Sørensen K, de Vries N, Meertens R. Exploring health literacy in relation to noncommunicable diseases in Samoa: a qualitative study. BMC Public Health 2019; 19:1151. [PMID: 31438907 PMCID: PMC6704563 DOI: 10.1186/s12889-019-7474-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/12/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Samoa is suffering from alarming rates of noncommunicable diseases (NCDs). To address this epidemic, tackling health literacy is important. A qualitative study was conducted with the aim to explore health literacy in Samoa in relation to NCDs. METHODS Six focus groups were conducted, with a total sample size of 73 participants aged over 18 years. The semi-structured interview guide was based on the conceptual model of the European Health Literacy project (HLS-EU). Data was translated, transcribed, coded, and categorized as part of the qualitative analysis. RESULTS The analysis resulted in one overarching category and seven sub-categories based on 19 themes. It revealed that health literacy in Samoa is strongly influenced by the culture. Personal responsibility is lacking. The family circle is central to health in a community where support is provided through the church and local groupings. Basic knowledge of NCDs was present in the population, but a deeper understanding of chronic disease implications was lacking. Difficulties with regards to medication adherence for chronic diseases arose as a topic, and traditional healers are still strongly embedded in the local society. Finally, the health system's performance, especially primary care services at the local level, is suffering from the high burden of NCDs and has been challenged to respond to the needs of the community it serves. CONCLUSION The findings of this study show how health literacy in Samoa is influenced by culture and suggest employing participatory, culture-sensitive, public health interventions which address the family as a whole, building on health literacy to address major public health problems like NCDs and remove barriers in the health system.
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Affiliation(s)
- Caroline Bollars
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands.
| | | | - Nanne de Vries
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands
| | - Ree Meertens
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands
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Gill FJ, Lin F, Massey D, Wilson L, Greenwood M, Skylas K, Woodard M, Tembo A, Mitchell M, Gullick J. Development of a position statement for Australian critical care nurse education. Aust Crit Care 2019; 32:346-350. [DOI: 10.1016/j.aucc.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 11/30/2022] Open
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Van Bulck L, Luyckx K, Goossens E, Apers S, Kovacs AH, Thomet C, Budts W, Sluman MA, Eriksen K, Dellborg M, Berghammer M, Johansson B, Caruana M, Soufi A, Callus E, Moons P. Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance. Eur J Cardiovasc Nurs 2019; 18:465-473. [DOI: 10.1177/1474515119834484] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries’ healthcare system performance are of importance for patient-reported outcomes. Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease. Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences. Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes. Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.
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Affiliation(s)
- Liesbet Van Bulck
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven – University of Leuven, Belgium
- UNIBS, University of the Free State, South Africa
| | - Eva Goossens
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Research Foundation Flanders (FWO), Belgium
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
| | - Silke Apers
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Adrienne H Kovacs
- Peter Munk Cardiac Centre, University of Toronto, Canada
- Knight Cardiovascular Institute, Oregon Health & Science University, USA
| | - Corina Thomet
- Center for Congenital Heart Disease, Bern University Hospital, Switzerland
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium
- Department of Cardiovascular Sciences, KU Leuven – University of Leuven, Belgium
| | - Maayke A Sluman
- Department of Cardiology, Academic Medical Center, The Netherlands
- Department of Cardiology, Jeroen Bosch Hospital, The Netherlands
- Coronel Institute for Occupational Health, Academic Medical Centre, The Netherlands
| | - Katrine Eriksen
- Department of Cardiology, Oslo University Hospital – Rikshospitalet, Norway
| | - Mikael Dellborg
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
- Adult Congenital Heart Unit, Sahlgrenska University Hospital, Sweden
- Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Malin Berghammer
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
- Department of Health Sciences, University West, Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | - Alexandra Soufi
- Department of Congenital Heart Disease, Louis Pradel Hospital, France
| | - Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, South Africa
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15
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Bjørnnes AK, Parry M, Leegaard M, Ayala AP, Lenton E, Harvey P, McFetridge-Durdle J, McGillion MH, Price J, Stinson J, Watt-Watson J. Self-Management of Cardiac Pain in Women: A Meta-Summary of the Qualitative Literature. QUALITATIVE HEALTH RESEARCH 2018; 28:1769-1787. [PMID: 29916769 DOI: 10.1177/1049732318780683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Symptom recognition and self-management is instrumental in reducing the number of deaths related to coronary artery disease (CAD) in women. The purpose of this study was to synthesize qualitative research evidence on the self-management of cardiac pain and associated symptoms in women. Seven databases were systematically searched, and the concepts of the Individual and Family Self-Management Theory were used as the framework for data extraction and analysis. Search strategies yielded 22,402 citations, from which 35 qualitative studies were included in a final meta-summary, comprising data from 769 participants, including 437 (57%) women. The available literature focused cardiac pain self-management from a binary sex and gender perspective. Ethnicity was indicated in 19 (54%) studies. Results support individualized intervention strategies that promote goal setting and action planning, management of physical and emotional responses, and social facilitation provided through social support.
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Affiliation(s)
- Ann Kristin Bjørnnes
- 1 University of Toronto, Toronto, Ontario, Canada
- 2 Oslo Metropolitan University, Oslo, Norway
| | - Monica Parry
- 1 University of Toronto, Toronto, Ontario, Canada
| | | | | | - Erica Lenton
- 1 University of Toronto, Toronto, Ontario, Canada
| | - Paula Harvey
- 3 Women's College Hospital, Toronto, Ontario, Canada
| | | | | | | | - Jennifer Stinson
- 1 University of Toronto, Toronto, Ontario, Canada
- 6 The Hospital for Sick Children, Toronto, Ontario, Canada
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Patterns of Self-care in Adults With Heart Failure and Their Associations With Sociodemographic and Clinical Characteristics, Quality of Life, and Hospitalizations: A Cluster Analysis. J Cardiovasc Nurs 2018; 32:180-189. [PMID: 26938506 DOI: 10.1097/jcn.0000000000000325] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients. OBJECTIVES The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations. METHODS This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and χ test were used to examine the characteristics of each cluster. RESULTS Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates. CONCLUSION The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients.
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17
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Kähkönen O, Saaranen T, Kankkunen P, Lamidi ML, Kyngäs H, Miettinen H. Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention. J Clin Nurs 2018; 27:989-1003. [PMID: 29098747 DOI: 10.1111/jocn.14153] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES To identify the predictors of adherence in patients with coronary heart disease after a percutaneous coronary intervention. BACKGROUND Adherence is a key factor in preventing the progression of coronary heart disease. DESIGN An analytical multihospital survey study. METHODS A survey of 416 postpercutaneous coronary intervention patients was conducted in 2013, using the Adherence of People with Chronic Disease Instrument. The instrument consists of 37 items measuring adherence and 18 items comprising sociodemographic, health behavioural and disease-specific factors. Adherence consisted of two mean sum variables: adherence to medication and a healthy lifestyle. Based on earlier studies, nine mean sum variables known to explain adherence were responsibility, cooperation, support from next of kin, sense of normality, motivation, results of care, support from nurses and physicians, and fear of complications. Frequencies and percentages were used to describe the data, cross-tabulation to find statistically significant background variables and multivariate logistic regression to confirm standardised predictors of adherence. RESULTS Patients reported good adherence. However, there was inconsistency between adherence to a healthy lifestyle and health behaviours. Gender, close personal relationship, length of education, physical activity, vegetable and alcohol consumption, LDL cholesterol and duration of coronary heart disease without previous percutaneous coronary intervention were predictors of adherence. CONCLUSIONS The predictive factors known to explain adherence to treatment were male gender, close personal relationship, longer education, lower LDL cholesterol and longer duration of coronary heart disease without previous percutaneous coronary intervention. RELEVANCE TO CLINICAL PRACTICE Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.
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Affiliation(s)
- Outi Kähkönen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Terhi Saaranen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Marja-Leena Lamidi
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Helvi Kyngäs
- Department of Health Science, University of Oulu, Oulu, Finland
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Lee G, Marques E, Vellone E, Stromberg A, Hopstock L, Tagney J, Khatib R, O’Donnell S, Hronn Svavarsdottir M, Goossens E, Andreae C. Post-Doctoral Mentorship Award – have you considered applying? Eur J Cardiovasc Nurs 2017; 16:658. [DOI: 10.1177/1474515117713852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Anna Stromberg
- Professor of Nursing Science at Linköping University and Linköping University Hospital, Sweden
| | | | - Jenny Tagney
- University Hospitals Bristol NHS Foundation Trust, UK
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Effect of goal attainment theory based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: Randomized study. Int J Nurs Stud 2017; 71:8-16. [PMID: 28279854 DOI: 10.1016/j.ijnurstu.2017.02.019] [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] [Received: 09/12/2016] [Revised: 02/19/2017] [Accepted: 02/21/2017] [Indexed: 12/14/2022]
Abstract
Effect of goal-attainment-theory-based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: randomized study BACKGROUND: The behavioral modification strategies should be explored at the time of admission to lead the maximum effect of cardiovascular risk management. AIMS This randomized study aimed to elucidate the effects of a nurse-led theory-based education program in individuals with a first episode of acute myocardial infarction on cardiovascular risks, health behaviors, and quality of life over 6 months. METHODS The study involved a convenience sample of 64 patients with acute myocardial infarction who were randomly assigned to either the education group or the control group. The goal-attainment-based education program was designed to set the mutually agreed goals of risk management and the behavioral modification strategies for achieving those goals. Those in the control group received routine management only. The participants in both groups were contacted at 6-8 weeks and at 6 months after discharge to measure outcome variables. Repeated measure ANOVA was conducted using SPSSWIN (version 20.0) to determine the significance of differences in outcome variables over 6 months between the groups. RESULTS Both groups showed significant positive changes in cardiovascular risks, health behaviors, and quality of life over 6 months. The 2-year risk of cardiovascular disease was significantly reduced in both study groups, but with no significant interaction effect (F=2.01, p=0.142). The performance and maintenance of health behaviors (F=3.75, p=0.029) and the mental component of quality of life (F=4.03, p=0.020) were significantly better in the education group than the control group. CONCLUSION Applying a goal-oriented education program at an early stage of hospital management improved and maintained blood glucose, health behaviors, and mental component of the quality of life up to six months in individuals with a first episode of myocardial infarction. Further studies are warranted to explore the role of behavioral modification mediating between cardiovascular risk management and quality of life in this population.
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Løvlien M, Mundal L, Hall-Lord ML. Health-related quality of life, sense of coherence and leisure-time physical activity in women after an acute myocardial infarction. J Clin Nurs 2016; 26:975-982. [PMID: 27239746 DOI: 10.1111/jocn.13411] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2016] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVES To examine the relationship between leisure-time physical activity, health-related quality of life and sense of coherence in women after an acute myocardial infarction, and further to investigate whether these aspects were associated with age. BACKGROUND Physical activity and health-related quality of life are vital aspects for patients after an acute myocardial infarction. DESIGN Cross-sectional. METHOD All eligible women diagnosed with acute myocardial infarction received a postal questionnaire two to three months after hospital discharge, and 142 women were included. To measure health-related quality of life and sense of coherence, The MacNew Heart disease questionnaire and the Sense of coherence-13 scale was used. RESULTS Respondents reporting at least one type of physical activity had significantly higher health-related quality of life as compared to respondents reporting no kind of physical activity. Respondents reporting physical activity for at least 30 minutes twice a week had significantly higher health-related quality of life scores than respondents being active less than twice a week. A weak association was found between physical activity level and sense of coherence. Reduction in physical activity after the acute myocardial infarction was associated with reduced health-related quality of life and sense of coherence. Sense of coherence was significantly associated with age, as respondents 75 years and older had significantly higher scores than respondents younger than 75 years. CONCLUSIONS Physical activity, even at a low level, is significantly associated with increased health-related quality of life and to some extent to sense of coherence. RELEVANCE TO CLINICAL PRACTICE Tailoring women after an acute myocardial infarction about lifestyle changes must include knowledge about the benefits of leisure-time physical activity, and that even a small amount of activity is associated with a better health-related quality of life. The utmost important assignment is to motivate the women for regular physical activity in their leisure-time. Older women need special attention.
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Affiliation(s)
- Mona Løvlien
- Norwegian University of Technology and Science, Gjøvik, Norway
| | - Liv Mundal
- Oslo University Hospital HF, Oslo, Norway
| | - Marie-Louise Hall-Lord
- Norwegian University of Technology and Science, Gjøvik, Norway.,Karlstad University, Karlstad, Sweden
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Cardiac rehabilitation versus usual care for patients treated with catheter ablation for atrial fibrillation: Results of the randomized CopenHeart RFA trial. Am Heart J 2016; 181:120-129. [PMID: 27823683 DOI: 10.1016/j.ahj.2016.08.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 08/24/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND To assess the effects of comprehensive cardiac rehabilitation compared with usual care on physical activity and mental health for patients treated with catheter ablation for atrial fibrillation. METHODS The patients were randomized 1:1 stratified by paroxysmal or persistent atrial fibrillation and sex to cardiac rehabilitation consisting of 12 weeks physical exercise and four psycho-educational consultations plus usual care (cardiac rehabilitation group) versus usual care. The primary outcome was Vo2 peak. The secondary outcome was self-rated mental health measured by the Short Form-36 questionnaire. Exploratory outcomes were collected. RESULTS 210 patients were included (mean age: 59 years, 74% men), 72% had paroxysmal atrial fibrillation prior to ablation. Compared with usual care, the cardiac rehabilitation group had a beneficial effect on Vo2 peak at four months (24.3mL kg-1 min-1 versus 20.7mL kg-1 min-1, p of main effect=0.003, p of interaction between time and intervention=0.020). No significant difference between groups on Short Form-36 was found (53.8 versus 51.9 points, P=.20). Two serious adverse events (atrial fibrillation in relation to physical exercise and death unrelated to rehabilitation) occurred in the cardiac rehabilitation group versus one in the usual care group (death unrelated to intervention) (P=.56). In the cardiac rehabilitation group 16 patients versus 7 in the usual care group reported non-serious adverse events (P=.047). CONCLUSION Comprehensive cardiac rehabilitation had a positive effect on physical capacity compared with usual care, but not on mental health. Cardiac rehabilitation caused more non-serious adverse events.
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O'Keefe LC, Frith KH, Barnby E. Nurse faculty as international research collaborators. Nurs Health Sci 2016; 19:119-125. [PMID: 27781360 DOI: 10.1111/nhs.12312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/26/2016] [Accepted: 08/28/2016] [Indexed: 11/28/2022]
Abstract
Nursing faculty who desire to expand their research portfolios will benefit from collaboration with researchers with complimentary interests from different universities across the world. International collaboration can enhance the productivity of researchers who seek to conduct studies with similar populations in different environments, and who desire a larger impact based on the findings of their studies. International collaborative teams have the potential to make important discoveries that affect the health of populations across the world. Communication is a critical step in defining the roles and professional relationships of researchers involved in international collaboration. Researchers need to be cognizant of rules affecting data security, intellectual property, data ownership, and funding sources in each country. International collaborative research can be exciting and rewarding, especially when participants are culturally aware, respect universities' policies, and are mindful of the ethical and legal principles for the countries in which the research is conducted. This article describes ways to enhance the success of nursing faculty who desire a rich experience with international research collaborators.
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Affiliation(s)
- Louise C O'Keefe
- College of Nursing, The University of Alabama in Huntsville, Huntsville, Alabama, USA
| | - Karen H Frith
- College of Nursing, The University of Alabama in Huntsville, Huntsville, Alabama, USA
| | - Elizabeth Barnby
- College of Nursing, The University of Alabama in Huntsville, Huntsville, Alabama, USA
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Kjellström B, Lee G, Khatib R, Mahrer-Imhof R, Moons P, Noureddine S, O’Donnell S, Strömberg A, Svavarsdóttir MH, Jaarsma T. The Science Committee of the Council of Cardiovascular Nursing and Allied Professions: Moving forward. Eur J Cardiovasc Nurs 2016; 15:476-477. [DOI: 10.1177/1474515116666643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Barbro Kjellström
- Department of Cardiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Geraldine Lee
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing & Midwifery, King’s College London, London, UK
| | - Rani Khatib
- Medicines Management and Cardiology Departments, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Romy Mahrer-Imhof
- School of Health Professions, Institute of Nursing, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Samar Noureddine
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Sharon O’Donnell
- School of Nursing and Midwifery, University of Dublin Trinity College, Dublin, Ireland
| | - Anna Strömberg
- Department of Medical and Health Sciences and Department of Cardiology, Linköping University, Sweden
| | - Margrét H Svavarsdóttir
- School of Health Sciences, University of Akureyri, Akureyri, Iceland
- Norwegian University of Science and Technology, Department of Nursing, Gjøvik, Norway
| | - Tiny Jaarsma
- Medical and Health Faculty, Linköping University, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Australia
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Thompson DR. Cardiovascular Nursing: From Florence to Melbourne. Heart Lung Circ 2016; 25:881-4. [PMID: 26935162 DOI: 10.1016/j.hlc.2016.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/11/2016] [Accepted: 01/17/2016] [Indexed: 11/16/2022]
Abstract
This paper, based on the 2015 CSANZ Cardiovascular Nursing Lecture, takes its title from the invitation to give this lecture in Melbourne being received when the author was visiting Florence, after whom Florence Nightingale, the founder of modern nursing, is named. Her work has indirectly shaped and influenced cardiovascular nursing, which has developed over the past 50 years. Despite its relatively short history, cardiovascular nursing has made a major contribution to improving the cardiovascular health and well-being of patients and families through health promotion, risk reduction and disease prevention. Examples include cardiac rehabilitation and secondary prevention and chronic heart failure disease management. Challenges, however, remain, including nurses practising to the full extent of their education and training, working as full partners with physicians and other health professionals in redesigning healthcare, ensuring better data collection and being more active in advocacy and policy initiatives. Cardiovascular nursing has a strong record of innovation but should always remember that it is there to serve the public and, bearing in mind the risk of potential harm versus benefit, be mindful of Florence Nightingale's wise counsel, "First, do no harm".
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Affiliation(s)
- David R Thompson
- Centre for the Heart and Mind, Mary McKillop Institute for Health Research, Australian Catholic University; Department of Psychiatry, University of Melbourne; and Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic., Australia.
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Norekvål TM, Fålun N, Fridlund B. Patient-reported outcomes on the agenda in cardiovascular clinical practice. Eur J Cardiovasc Nurs 2015; 15:108-11. [PMID: 26512075 DOI: 10.1177/1474515115614133] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Centre on Patient-reported Outcomes, Haukeland University Hospital, Bergen, Norway Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway Institute of Nursing, Department of Health and Social Sciences, University College of Bergen, Bergen, Norway
| | - Nina Fålun
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Institute of Nursing, Department of Health and Social Sciences, University College of Bergen, Bergen, Norway
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Institute of Nursing, Department of Health and Social Sciences, University College of Bergen, Bergen, Norway School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Fålun N, Fridlund B, Schaufel MA, Schei E, Norekvål TM. Patients' goals, resources, and barriers to future change: A qualitative study of patient reflections at hospital discharge after myocardial infarction. Eur J Cardiovasc Nurs 2015; 15:495-503. [PMID: 26507076 DOI: 10.1177/1474515115614712] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/26/2015] [Accepted: 10/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Myocardial infarction (MI) patients may find it challenging to adhere to lifestyle advice and medications. Understanding motivational factors and barriers to change is crucial. However, empirical evidence on patients' ability to effect lifestyle changes at the time of discharge is limited. AIM The aim of this study was to identify at the time of hospital discharge the goals, resources, and barriers to future change in MI patients. METHODS We conducted a qualitative interview study with a purposive sample of 20 MI patients (eight women) in a cardiac department at a university hospital in Norway. All interviews were conducted before hospital discharge, transcribed verbatim, and analysed using qualitative content analysis. FINDINGS Three themes suggested that, at the time of discharge, patients' views of their MI were complex and diverse. Patients were motivated to change their lifestyle and contemplated taking their life in new directions, adopting a change of life perspective. Frequently, patients struggled to understand the context of living with an MI, manage symptoms, and understand the precipitating causes of MI. There were also patients who wanted to maintain their present lifestyle and live as normal as possible. They just wanted to keep going. CONCLUSIONS AND IMPLICATIONS There is a need for a different approach to communicating with MI patients at the time of discharge. Person-centred care that allows personal narratives to emerge may enable health-care professionals to offer more individualised guidance to MI patients that will help them cope with the everyday challenges they experience after discharge.
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Affiliation(s)
- Nina Fålun
- Department of Heart Disease, Haukeland University Hospital, Norway
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Norway.,School of Health and Welfare, Jönköping University, Sweden
| | | | - Edvin Schei
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Norway.,Department of Clinical Science, University of Bergen, Norway
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Affiliation(s)
- David R Thompson
- Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Chantal F Ski
- Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Australia
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Kletsiou E, Astin F. Streamlining educational provision for cardiovascular nurses: A beginning not an end. Eur J Cardiovasc Nurs 2015; 14:188-9. [DOI: 10.1177/1474515115581745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Östman M, Ung EJ, Falk K. Health-care encounters create both discontinuity and continuity in daily life when living with chronic heart failure-A grounded theory study. Int J Qual Stud Health Well-being 2015; 10:27775. [PMID: 28229746 PMCID: PMC4490805 DOI: 10.3402/qhw.v10.27775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 12/18/2022] Open
Abstract
Living with chronic heart failure (CHF) often involves lifelong contact with health care, more or less frequently, depending on fluctuating health-generating disruptions in everyday life. To reduce the influence on continuity in life, health-care professionals should preferably focus on supporting patients in managing their daily lives, based on their perspective. The aim of this study was to describe how the interaction in health-care encounters contributes to either continuity or discontinuity in the daily life for persons with CHF. Interviews with 18 participants were carried out, using the grounded theory method, through data collection and analysis. Two core concepts were constructed from data which reveal a model that illuminates the characteristics of the encounters, the actions of health-care professionals and the normative discourse. Patient-centred agenda consists of the categories: "Experiencing a subordinate approach," "Objectifying during the encounter" and "Expected to be compliant." This describes how health-care professionals enhance discontinuity in daily life by using a paternalistic approach in the encounter. Person-centred agenda consists of the categories: "Experiencing an empowering approach," "Person-centredness during the encounter" and "Expected to be capable." It describes how participants perceive that health-care professionals enable them to deal with everyday life which enhances continuity. The findings highlight the importance of health-care professionals' attitudes and communication in encounters with patients. Health care must be designed to support and promote patients' own strategic thinking by strengthening their self-image to enhance continuity in everyday life. The experience of discontinuity is based on the prevailing health-care culture which focuses on disease and medical treatment and regards it as superior to the illness experience in an everyday life context. We therefore strongly suggest a paradigm shift in the health-care organisation and culture in order to support the patients in their efforts to live a meaningful, rich life, in spite of the chronic illness CHF.
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Affiliation(s)
- Malin Östman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan Källstorp Health Centre, Trollhättan, Sweden
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristin Falk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bjørnnes AK, Rustøen T, Lie I, Watt-Watson J, Leegaard M. Pain characteristics and analgesic intake before and following cardiac surgery. Eur J Cardiovasc Nurs 2014; 15:47-54. [PMID: 25192967 DOI: 10.1177/1474515114550441] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/18/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiac surgery is a common intervention that involves several pain-sensitive structures, and intense postoperative pain is a predictor of persistent pain. AIMS To describe pain characteristics (i.e. intensity, location, interference, relief) and analgesic intake preoperatively and across postoperative days 1 to 4 after cardiac surgery, and to explore associations between postoperative pain and demographic and clinical characteristics. METHODS Four hundred and sixteen patients (24% women) undergoing elective coronary artery bypass grafting and/or valve surgery were enrolled in a randomized controlled trial. Data were collected using standardized measures including the Brief Pain Inventory-short form. A linear mixed model analysis estimated the impact of sex, age, body mass index, analgesic intake and preoperative pain on postoperative worst pain ratings in the previous 24 hours from postoperative days 1 to 4 prior to discharge RESULTS Thirty-eight per cent of the cardiac surgery patients reported preoperative pain. Postoperative worst pain remained in the moderate to severe range for the majority of patients across day 1 (85%) to day 4 (57%), mainly around the chest incision area for the majority (70%). Mean oral morphine intake was 17 mg/24 h (day 1: 27mg; day 4: 10mg). Lower age, female sex, preoperative pain and analgesic intake had a statistically significant association with higher postoperative worst pain ratings. CONCLUSION Study findings demonstrated a high prevalence of moderate to severe pain after cardiac surgery and insufficient analgesic administration. Results indicated that patients were discharged from hospital with unrelieved pain and a potential risk for further postoperative complications.
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Affiliation(s)
- Ann Kristin Bjørnnes
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Norway Institute of Health and Society, University of Oslo, Norway
| | - Irene Lie
- Department of Cardiothoracic Surgery, Oslo University Hospital, Ullevål, Norway
| | - Judy Watt-Watson
- Lawrence S Bloomberg Faculty of Nursing, Senior Fellow, Massey College University of Toronto, Canada
| | - Marit Leegaard
- Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Institute of Nursing, Norway
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Gardner B, Broström A, Nilsen P, Hrubos Ström H, Ulander M, Fridlund B, Skagerström J, Johansson P. From ‘does it work?’ to ‘what makes it work?’: The importance of making assumptions explicit when designing and evaluating behavioural interventions. Eur J Cardiovasc Nurs 2014; 13:292-4. [DOI: 10.1177/1474515114531688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Benjamin Gardner
- Department of Epidemiology and Public Health, University College London, UK
| | - Anders Broström
- Department of Nursing Science, Jönköping University, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
| | - Per Nilsen
- Department of Health and Society, Linköping University, Sweden
| | | | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
| | - Bengt Fridlund
- Department of Nursing Science, Jönköping University, Sweden
| | | | - Peter Johansson
- Department of Cardiology, Linköping University Hospital, Sweden
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Pettersen TR, Fålun N, Norekvål TM. Improvement of in-hospital telemetry monitoring in coronary care units: an intervention study for achieving optimal electrode placement and attachment, hygiene and delivery of critical information to patients. Eur J Cardiovasc Nurs 2013; 13:515-23. [PMID: 24304659 DOI: 10.1177/1474515113515585] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In-hospital telemetry monitoring is important for diagnosis and treatment of patients at risk of developing life-threatening arrhythmias. It is widely used in critical and non-critical care wards. Nurses are responsible for correct electrode placement, thus ensuring optimal quality of the monitoring. The aims of this study were to determine whether a complex educational intervention improves (a) optimal electrode placement, (b) hygiene, and (c) delivery of critical information to patients (reason for monitoring, limitations in cellular phone use, and not to leave the ward without informing a member of staff). METHODS A prospective interventional study design was used, with data collection occurring over two six-week periods: before implementation of the intervention (n=201) and after the intervention (n=165). Standard abstraction forms were used to obtain data on patients' clinical characteristics, and 10 variables related to electrode placement and attachment, hygiene and delivery of critical information. RESULTS At pre-intervention registration, 26% of the electrodes were misplaced. Twelve per cent of the patients received information about limiting their cellular phone use while monitored, 70% were informed of the purpose of monitoring, and 71% used a protective cover for their unit. Post-intervention, outcome measures for the three variables improved significantly: use of protective cover (p<0.001), information about the purpose of monitoring (p=0.005) and information about limitations in cellular phone use (p=0.003). Nonetheless, 23% of the electrodes were still misplaced. CONCLUSION The study highlights the need for better, continued education for in-hospital telemetry monitoring in coronary care units, and other units that monitor patients with telemetry.
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Affiliation(s)
| | - Nina Fålun
- Department of Heart Disease, Haukeland University Hospital, Norway Institute of Nursing, Bergen University College, Norway
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Norway Department of Clinical Science, University of Bergen, Norway
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