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Qiu X. Nurse-led intervention in the management of patients with cardiovascular diseases: a brief literature review. BMC Nurs 2024; 23:6. [PMID: 38163878 PMCID: PMC10759353 DOI: 10.1186/s12912-023-01422-6] [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: 07/15/2022] [Accepted: 07/26/2023] [Indexed: 01/03/2024] Open
Abstract
Coronary artery disease (CAD) is one among the major causes of mortality in patients all around the globe. It has been reported by the World Health Organization (WHO) that approximately 80% of cardiovascular diseases could be prevented through lifestyle modifications. Management of CAD involves the prevention and control of cardiovascular risk factors, invasive and non-invasive treatments including coronary revascularizations, adherence to proper medications and regular outpatient follow-ups. Nurse-led clinics were intended to mainly provide supportive, educational, preventive measures and psychological support to the patients, which were completely different from therapeutic clinics. Our review focuses on the involvement and implication of nurses in the primary and secondary prevention and management of cardiovascular diseases. Nurses have a vital role in Interventional cardiology. They also have major roles during the management of cardiac complications including congestive heart failure, atrial fibrillation and heart transplantation. Today, the implementation of a nurse-led tele-consultation strategy is also gaining positive views. Therefore, a nurse-led intervention for the management of patients with cardiovascular diseases should be implemented in clinical practice. Based on advances in therapy, more research should be carried out to further investigate the effect of nurse-led clinics during the long-term treatment and management of patients with cardiovascular diseases.
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Affiliation(s)
- Xiaoqin Qiu
- Department of Nursing, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-Sen University, Qingxiu, Nanning, Guangxi, 530022, P.R. China.
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Suwanno J, Phonphet C, Mayurapak C, Ninla-Aesong P, Thaimwong L. Exploring factors associated with hypertension self-care in primary care: The role of nurse education levels and patient-related factors. Int J Nurs Pract 2023:e13208. [PMID: 37797953 DOI: 10.1111/ijn.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/12/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023]
Abstract
AIM To explore the association between nurse education levels and patient-related factors with hypertension self-care. BACKGROUND Although self-care development is recognized as a healthcare provider-patient encounter, the attribution of nurse education level to hypertension self-care is not well addressed. DESIGN A cross-sectional study. METHODS Hypertensive patients from 15 primary care facilities were sampled, and self-care was assessed using the Self-Care of Hypertension Inventory version 2.0, with standardized scores ≥70 indicating adequate self-care. Data on patient-related factors were obtained from electronic health records, self-reports and laboratory tests, while nurse education levels were categorized as standard (baccalaureate-prepared) or higher (post-baccalaureate specialty). RESULTS A total of 1493 participants were included in this study, with a median age of 66 years and 77.7% being female. Approximately 10% of participants had adequate self-care, and 66% received care from higher educated nurses. The study showed the relation between nurse education levels and the self-care of the patients. Adequate hypertension self-care was significantly associated with higher educated nurse providers and patient-related factors, including intermediate to higher education, non-overweight/obese and the absence of age-related comorbidities. CONCLUSIONS Hypertensive patients who had been provided care by higher educated nurses and their favourable sociodemographic, lower cardiometabolic risk and no concomitant disease were more likely to demonstrate adequate self-care.
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Affiliation(s)
- Jom Suwanno
- School of Nursing, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Chennet Phonphet
- School of Nursing, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | | | - Putrada Ninla-Aesong
- School of Medicine, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Ladda Thaimwong
- College of Nursing, University of Central Florida, Orlando, Florida, USA
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Bruninx A, Scheenstra B, Dekker A, Maessen J, van 't Hof A, Kietselaer B, Bermejo I. Using clinical prediction models to personalise lifestyle interventions for cardiovascular disease prevention: A systematic literature review. Prev Med Rep 2022; 25:101672. [PMID: 35127352 PMCID: PMC8800044 DOI: 10.1016/j.pmedr.2021.101672] [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: 04/09/2021] [Revised: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to systematically review the use of clinical prediction models (CPMs) in personalised lifestyle interventions for the prevention of cardiovascular disease. We searched PubMed and PsycInfo for articles describing relevant studies published up to August 1, 2021. These were supplemented with items retrieved via screening references of citations and cited by references. In total, 32 studies were included. Nineteen different CPMs were used to guide the intervention. Most frequently, a version of the Framingham risk score was used. The CPM was used to inform the intensity of the intervention in five studies (16 %), and the intervention's type in 31 studies (97 %). The CPM was supplemented with relative risk estimates for additional risk factors in three studies (9 %), and relative risk estimates for intervention effects in four (13 %). In addition to the estimated risk, the personalisation was determined using criteria based on univariable risk factors in 18 studies (56 %), a lifestyle score in three (9 %), and a physical examination index in one (3 %). We noted insufficient detail in reporting regarding the CPM's use in 20 studies (63 %). In 15 studies (47 %), the primary outcome was a CPM estimate. A statistically significant effect favouring the intervention to the comparator arm was reported in four out of eight analyses (50 %), and a statistically significant improvement compared to baseline in five out of seven analyses (71 %). Due to the design of the included studies, the effect of the use of CPMs is still unclear. Therefore, we see a need for future research.
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Affiliation(s)
- Anke Bruninx
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Bart Scheenstra
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Jos Maessen
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Arnoud van 't Hof
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, the Netherlands
| | - Bas Kietselaer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, the Netherlands
| | - Iñigo Bermejo
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
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Mueller SD. The impact of nursing assessment on cardiovascular health behaviour: a scoping review. Contemp Nurse 2021; 57:128-139. [PMID: 33794745 DOI: 10.1080/10376178.2021.1912618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Assessment represents a critical first opportunity for nurses to influence individual changes in health behaviour. As the global prevalence of cardiovascular disorders rises, so does the role of nurses in cardiovascular health promotion. This review applies Pender's Health Promotion Model (HPM) to an evaluation of the current research on the role of nursing assessment as an intervention to impact cardiovascular health. METHODS This scoping review was conducted using the PRISMA-ScR framework for scoping reviews. A search of electronic databases (CINAHL, psychINFO, Medline) resulted in 335 records, which were then screened for eligibility for inclusion using the criteria (a) English language, (b) publication between 2009 and 2019, and (c) nursing intervention studies. A total of ten articles met criteria and are included in this scoping review. RESULTS Half (n = 5) of the articles cited a theoretical framework. While none of the articles explicitly used the HPM, all involved measurement of HPM constructs: perceived benefits of action, perceived barriers to action, perceived self-efficacy, interpersonal influences, and situational influences. The focus and methodology of the included articles was heterogeneous. Assessment tools used were self-report surveys, biometric data, qualitative interviews, or a combination of these measures. Results were generally positive and indicated that nursing assessment is effective at altering health promotion behaviour and attitudes. CONCLUSIONS This scoping review demonstrated that the current body of literature on the impact of nursing assessment on cardiovascular health promotion behaviour is limited but consistent. Future research would benefit from thorough integration of the HPM into research design in order to more fully explain the causative mechanisms underlying behaviour change as a result of nursing assessment.
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Affiliation(s)
- Susan D Mueller
- Decker College of Nursing and Health Sciences, Binghamton University, Binghamton, NY, USA
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Carrington MJ, Zimmet PZ. Nurse co-ordinated health and lifestyle modification for reducing multiple cardio-metabolic risk factors in regional adults: outcomes from the MODERN randomized controlled trial. Eur J Cardiovasc Nurs 2021; 21:26-35. [PMID: 33899090 DOI: 10.1093/eurjcn/zvab042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/16/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Nurse-led health and lifestyle modification programmes can prevent cardio-metabolic diseases and be advantageous where health disparities exist. AIMS To assess the effectiveness of a nurse-driven health and lifestyle modification programme in improving cardio-metabolic risk parameters for higher-risk regional residing adults. METHODS We conducted an open, parallel-group randomized controlled trial in two sites. Participants were aged 40-70 years with no prior cardiovascular disease who had any three or more of; central obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure (BP) and dysglycaemia. Intervention participants received individual face-to-face and telephone coaching for improving cardio-metabolic risk. Control group participants received standard care and general information about risk factor management. The primary endpoint was the percentage of participants who achieved the target risk factor thresholds or clinically significant minimum changes for any three or more cardio-metabolic risk factors during 24 months of follow-up. RESULTS Participant average age was 57.6 (SD 7.6) years, 61% were female and 71% were employed. The primary endpoint was achieved by 76% intervention (97 of 127) and 71% usual care (92 of 129) participants [adjusted risk ratio (RR): 1.08; 95% CI 0.94, 1.24; P = 0.298]. Improved BP in the intervention group was more likely than in the control group (84% vs. 65%) (adj. RR: 1.28; 95% CI 1.11, 1.48; P = 0.001) but no other cardio-metabolic component. CONCLUSION Nurse intervention to modify cardio-metabolic risk parameters had no enhanced effectiveness compared with usual care. However, participation was associated with improvements in cardio-metabolic abnormalities, with particular emphasis on BP. TRIAL REGISTRATION Registered with the Australian New Zealand Clinical Trial Registry (ACTRN12616000229471).
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Affiliation(s)
- Melinda J Carrington
- Pre-Clinical Disease and Prevention Unit, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004, Australia
| | - Paul Z Zimmet
- Department of Diabetes, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne VIC 3004, Australia
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Tan SM, Han E, Quek RYC, Singh SR, Gea-Sánchez M, Legido-Quigley H. A systematic review of community nursing interventions focusing on improving outcomes for individuals exhibiting risk factors of cardiovascular disease. J Adv Nurs 2019; 76:47-61. [PMID: 31588578 DOI: 10.1111/jan.14218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/06/2019] [Accepted: 08/13/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals exhibiting risk factors of cardiovascular disease (CVD). DESIGN A systematic review and narrative synthesis. DATA SOURCES Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR, and WPRIM) were searched from inception to 16 March 2018. REVIEW METHODS This review included outcomes from studies that were led by or delivered primarily by nurses for individuals exhibiting risk factors of CVD in community settings. At least two independent reviewers performed study selection, data extraction and risk of bias. RESULTS 46 studies met the eligibility criteria. Community nursing interventions were found to be effective in improving clinical outcomes of symptom control, symptom awareness, symptom management, and social outcomes. Effective interventions were found to be facilitated by a community-centric approach, participant empowerment, reinforcement strategies, a targeted approach towards underserved populations, and home visits. These resulted in positive outcomes such as significant reductions in HbA1c for diabetic patients, attainment of blood pressure targets for hypertensive patients and greater improvement in self-reported dietary intake for patients with hyperlipidaemia. CONCLUSION Community-based nurse-led interventions can result in positive outcomes for patients with risk factors of CVD. However, the success of such interventions needs to be facilitated by appropriate funding, thoughtful intervention design and training opportunities for nurses. IMPACT Community-based nursing interventions are largely effective in improving clinical and social outcomes for community-dwelling individuals with risk factors of CVD.
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Affiliation(s)
- See M Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rina Yu Chin Quek
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Montserrat Gea-Sánchez
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain.,Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
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Carrington MJ, Zimmet P. Nurse health and lifestyle modification versus standard care in 40 to 70 year old regional adults: study protocol of the Management to Optimise Diabetes and mEtabolic syndrome Risk reduction via Nurse-led intervention (MODERN) randomized controlled trial. BMC Health Serv Res 2017; 17:813. [PMID: 29212477 PMCID: PMC5719565 DOI: 10.1186/s12913-017-2769-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background Metabolic syndrome (MetS), the clustering of multiple leading risk factors, predisposes individuals to increased risk for developing type 2 diabetes and/or cardiovascular disease (CVD). Cardio-metabolic disease risk increases with greater remoteness where specialist services are scarce. Nurse-led interventions are effective for the management of chronic disease. The aim of this clinical trial is to determine whether a nurse-implemented health and lifestyle modification program is more beneficial than standard care to reduce cardio-metabolic abnormalities and future risk of CVD and diabetes in individuals with MetS. Methods MODERN is a multi-centre, open, parallel group randomized controlled trial in regional Victoria, Australia. Participants were self-selected and individuals aged 40 to 70 years with MetS who had no evidence of CVD or other chronic disease were recruited. Those attending a screening visit with any 3 or more risk factors of central obesity, dyslipidemia (high triglycerides or low high density lipoprotein cholesterol) elevated blood pressure and dysglycemia were randomized to either nurse-led health and lifestyle modification (intervention) or standard care (control). The intervention included risk factor management, health education, care planning and scheduled follow-up commensurate with level of risk. The primary cardio-metabolic end-point was achievement of risk factor thresholds to eliminate MetS or minimal clinically meaningful changes for at least 3 risk factors that characterise MetS over 2 year follow-up. Pre-specified secondary endpoints to evaluate between group variations in cardio-metabolic risk, general health and lifestyle behaviours and new onset CVD and type 2 diabetes will be evaluated. Key outcomes will be measured at baseline, 12 and 24 months via questionnaires, physical examinations, pathology and other diagnostic tests. Health economic analyses will be undertaken to establish the cost-effectiveness of the intervention. Discussion The MODERN trial will provide evidence for the potential benefit of independent nurse-run clinics in the community and their cost-effectiveness in adults with MetS. Findings will enable more nurse-led clinics to be adopted outside of major cities and encompassing other chronic diseases as a key primary preventative initiative. Trial registration MODERN is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000229471) on 19 February 2016 (retrospectively registered). Secondary identifiers: MODERN is an investigator-initiated trial funded by the National Health and Medical Research Council of Australia from 2014 to 2017 via a Project Grant (ID No. APP1069043) and was approved by the Australian Catholic University Human Research Ethics Committee (Project No: 2014 244 V) and the Department of Health Human Research Ethics Committee (Project No:38/2014) for the release of Medicare claims information.
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Affiliation(s)
- Melinda J Carrington
- Pre-Clinical Disease and Prevention Unit, Baker Heart and Diabetes Institute, PO Box 6492, Melbourne, Victoria, 3004, Australia. .,Centre for Primary Care and Prevention, MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Paul Zimmet
- Department of Diabetes, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Alston LV, Peterson KL, Jacobs JP, Allender S, Nichols M. A systematic review of published interventions for primary and secondary prevention of ischaemic heart disease (IHD) in rural populations of Australia. BMC Public Health 2016; 16:895. [PMID: 27567666 PMCID: PMC5002213 DOI: 10.1186/s12889-016-3548-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD) than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD) in adults. METHODS Systematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1) rural; (2) ischaemic heart disease; (3) Australia and; (4) intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels. RESULTS Of 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both primary and secondary intervention strategies. Two interventions were focussed exclusively on Aboriginal and Torres Strait Islander (Australian Indigenous) populations. CONCLUSIONS Few interventions were identified that exclusively focussed on IHD prevention in rural communities, despite these populations being at increased risk of IHD in Australia, and this is consistent with comparable countries, internationally. Although limited, available evidence shows that primary and secondary interventions targeted at IHD and related risk factors can be effective in a rural setting.
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Affiliation(s)
- Laura V. Alston
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, VIC 3220 Australia
| | - Karen L. Peterson
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, VIC 3220 Australia
| | - Jane P. Jacobs
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, VIC 3220 Australia
| | - Steven Allender
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, VIC 3220 Australia
| | - Melanie Nichols
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, VIC 3220 Australia
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Yang SO, Kim SJ, Lee SH. Effects of a South Korean Community-Based Cardiovascular Disease Prevention Program for Low-Income Elderly with Hypertension. J Community Health Nurs 2016; 33:154-67. [DOI: 10.1080/07370016.2016.1191872] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wiley JF, Carrington MJ. A metabolic syndrome severity score: A tool to quantify cardio-metabolic risk factors. Prev Med 2016; 88:189-95. [PMID: 27095322 DOI: 10.1016/j.ypmed.2016.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/01/2016] [Accepted: 04/12/2016] [Indexed: 11/30/2022]
Abstract
Metabolic syndrome is a cluster of cardio-metabolic risk factors and is associated with increased mortality. There is no standard, validated way to assess the severity of aggregated metabolic syndrome risk factors. Cardiovascular and diabetes risk factor data came from two studies conducted in Australia from 2006 to 2010 in adults aged 18 or above. In medication free adults, sex-specific clinical thresholds and Principal Component Analysis were used to develop a formula to calculate a metabolic syndrome severity score (MetSSS). These scores were compared to scores derived using the same process in subgroups by sex, age, medication status, and time. We also examined the MetSSS in relation to other known risk factors. In 2125 adults (57.6±14.7years of age), the MetSSS ranged from 0 to 8.7 with a mean of 2.6. There were strong correlations (.95-.99) between the MetSSS in medication free adults and the MetSSS calculated from subgroups. MetSSS predicted medication initiation for hypertension, hyperlipidemia and hyperglycemia over six months (OR=1.31, 95% CI [1.00-1.70], per MetSSS unit, p=.043). Lower education, medication prescription, history of smoking and age were associated with higher MetSSS (all p<.05). Higher physical but not mental health quality of life was associated with lower MetSSS (p<.001). A standardized formula to measure cardio-metabolic risk factor severity was constructed and demonstrated expected relations with known risk factors. The use of the MetSSS is recommended as a measure of change within individuals in cardio-metabolic risk factors and to guide treatment and management.
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Affiliation(s)
- Joshua F Wiley
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Melinda J Carrington
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
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Stewart S, Riegel B, Thompson DR. Addressing the conundrum of multimorbidity in heart failure: Do we need a more strategic approach to improve health outcomes? Eur J Cardiovasc Nurs 2015; 15:4-7. [PMID: 26362926 DOI: 10.1177/1474515115604794] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is clear evidence across the globe that the clinical complexity of patients presenting to hospital with the syndrome of heart failure is increasing - not only in terms of the presence of concurrent disease states, but with additional socio-demographic risk factors that complicate treatment. Management strategies that treat heart failure as the main determinant of health outcomes ignores the multiple and complex issues that will inevitably erode the efficacy and efficiency of current heart failure management programmes. This complex problem (or conundrum) requires a different way of thinking around the complex interactions that underpin poor outcomes in heart failure. In this context, we present the COordinated NUrse-led inteNsified Disease management for continuity of caRe for mUltiMorbidity in Heart Failure (CONUNDRUM-HF) matrix that may well inform future research and models of care to achieve better health outcomes in this rapidly increasing patient population.
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Affiliation(s)
- Simon Stewart
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Biobehavioral and Health Sciences Department, Philadelphia, Pennsylvania USA
| | - David R Thompson
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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