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Adhiambo HF, Cook P, Erlandson KM, Jankowski C, Oliveira VHF, Do H, Khuu V, Davey CH, Webel AR. Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study. J Cardiovasc Nurs 2024:00005082-990000000-00173. [PMID: 38447065 DOI: 10.1097/jcn.0000000000001082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND The benefits of physical activity (PA), specifically exercise, among older adults in general are well known. Yet globally, there is concern regarding limited engagement in PA, increased obesity, and frailty among older people with human immunodeficiency virus related to low levels of PA. METHODS We conducted in-depth interviews among 30 older, sedentary people with human immunodeficiency virus participating in the ongoing High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH study, NCT04550676) between February 2021 and August 2022. A semistructured interview guide, informed by two minds theory, which frames behavior change as an intention-behavior gap between 2 neurocognitive systems, was used to elicit data from participants. Interviews explored general exercise perceptions, self-efficacy for exercise, mobile health intervention tailoring, outcome expectations, and PA goals. Thirty interviews from 33 participants were recorded and transcribed verbatim, and deductive and inductive thematic analysis were used using Dedoose. RESULTS Physical activity was defined as maintaining daily living activities and addressing health goals. Previous experiences with PA varied among participants and were influenced by chronic illnesses, including human immunodeficiency virus; motivation; work commitments; interest; and social support. Reported barriers to PA included antiretroviral adverse effects, comorbidities, aging, and the COVID-19 pandemic. Changes in health status, body changes, and relationships were identified as benefits of PA. Conversations with healthcare providers supporting exercise goals were perceived to be important but rarely received by the participants. CONCLUSION Understanding how older people with human immunodeficiency virus perceive PA is crucial to developing tailored strategies and structuring service delivery within the healthcare setting to promote a physically active life.
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Höppchen I, Wurhofer D, Meschtscherjakov A, Smeddinck JD, Kulnik ST. Targeting behavioral factors with digital health and shared decision-making to promote cardiac rehabilitation-a narrative review. Front Digit Health 2024; 6:1324544. [PMID: 38463944 PMCID: PMC10920294 DOI: 10.3389/fdgth.2024.1324544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024] Open
Abstract
Cardiac rehabilitation (CR) represents an important steppingstone for many cardiac patients into a more heart-healthy lifestyle to prevent premature death and improve quality of life years. However, CR is underutilized worldwide. In order to support the development of targeted digital health interventions, this narrative review (I) provides understandings of factors influencing CR utilization from a behavioral perspective, (II) discusses the potential of digital health technologies (DHTs) to address barriers and reinforce facilitators to CR, and (III) outlines how DHTs could incorporate shared decision-making to support CR utilization. A narrative search of reviews in Web of Science and PubMed was conducted to summarize evidence on factors influencing CR utilization. The factors were grouped according to the Behaviour Change Wheel. Patients' Capability for participating in CR is influenced by their disease knowledge, awareness of the benefits of CR, information received, and interactions with healthcare professionals (HCP). The Opportunity to attend CR is impacted by healthcare system factors such as referral processes and HCPs' awareness, as well as personal resources including logistical challenges and comorbidities. Patients' Motivation to engage in CR is affected by emotions, factors such as gender, age, self-perception of fitness and control over the cardiac condition, as well as peer comparisons. Based on behavioral factors, this review identified intervention functions that could support an increase of CR uptake: Future DHTs aiming to support CR utilization may benefit from incorporating information for patients and HCP education, enabling disease management and collaboration along the patient pathway, and enhancing social support from relatives and peers. To conclude, considerations are made how future innovations could incorporate such functions.
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Affiliation(s)
- Isabel Höppchen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- Department of Artificial Intelligence and Human Interfaces, Human Computer Interaction Division, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Daniela Wurhofer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Alexander Meschtscherjakov
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- Department of Artificial Intelligence and Human Interfaces, Human Computer Interaction Division, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Jan David Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
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Al-Mutawtah M, Campbell E, Kubis HP, Erjavec M. Women's experiences of social support during pregnancy: a qualitative systematic review. BMC Pregnancy Childbirth 2023; 23:782. [PMID: 37950165 PMCID: PMC10638802 DOI: 10.1186/s12884-023-06089-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Social support during pregnancy can alleviate emotional and physical pressures, improving the well-being of mother and child. Understanding women's lived experiences and perceptions of social support during pregnancy is imperative to better support women. This systematic review explores and synthesises the qualitative research on women's experiences of social support during pregnancy. METHODS Databases PubMed, CINAHL, MEDLINE, APA PsycInfo and Scopus were searched with no year limit. Eligible studies included pregnant women or women who were up to one year postpartum and were assessed on their experiences of social support during pregnancy. The data were synthesised using the thematic synthesis approach. RESULTS Fourteen studies were included with data from 571 participating women across ten countries; two studies used focus groups, and 12 used interviews to collect their data. Four main themes were developed ('a variety of emotional support', 'tangible and intangible instrumental support', 'traditional rituals and spiritual support', and 'the all-encompassing natal home'), and six sub-themes ('female network connections', 'care and affection from the husband', 'dissatisfaction with relationships', 'financial support from the husband and family', 'practical support from family and friends', 'health information support'). CONCLUSIONS This systematic review sheds light on women's experiences of social support during pregnancy. The results indicate a broad variety of emotional support experienced and valued by pregnant women from different sources. Additionally, women expressed satisfaction and dissatisfaction with tangible and intangible support forms. It was also highlighted that spirituality played an essential role in reducing stress and offering coping mechanisms for some, whereas spirituality increased stress levels for others.
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Affiliation(s)
- Mona Al-Mutawtah
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK.
- Community Medicine- Clinical Psychology, Kuwait University, Kuwait City, Kuwait.
| | - Emma Campbell
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Hans-Peter Kubis
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Mihela Erjavec
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
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Hedbom T, Liljeroos M, Thylén I, Orwelius L, Jaarsma T, Strömberg A. Expectations of Tele-Yoga in Persons With Long-Term Illness: Qualitative Content Analysis. J Med Internet Res 2023; 25:e36808. [PMID: 37703082 PMCID: PMC10534282 DOI: 10.2196/36808] [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] [Received: 01/26/2022] [Revised: 03/08/2023] [Accepted: 06/19/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Yoga is a mind-body exercise that has demonstrated its feasibility and safety even for individuals with severe long-term illness. Engaging in yoga has the potential to yield positive effects on both physical and mental well-being. Tele-yoga is a novel approach to rehabilitation in which participants practice group yoga with a live-streamed yoga instructor digitally via a tablet. This is especially beneficial for individuals who may find it difficult to leave their homes to participate in an exercise session. As part of our ongoing evaluation of the tele-yoga intervention in individuals with long-term illness, we have undertaken an exploration of participants' expectations regarding yoga in general and tele-yoga specifically. Understanding these expectations is crucial, as they can significantly impact their satisfaction with treatment and care and influence overall intervention outcomes. OBJECTIVE This study aims to explore the expectations of tele-yoga among individuals with long-term illness before starting a tele-yoga intervention. METHODS The study employed an inductive qualitative design and is part of a process evaluation within an ongoing randomized controlled trial. A total of 89 participants were interviewed before the start of the tele-yoga intervention. The interview guide encompassed questions about their general perceptions of yoga and the specific expectations they held for the upcoming tele-yoga sessions. The interviews were transcribed and analyzed using inductive qualitative content analysis. RESULTS Participants expressed their expectations for tele-yoga, focusing on the anticipated improvements in physical function and overall health. These expectations included hopes for reduced respiratory issues; relief from discomfort, aches, and pains; as well as increased physical flexibility, coordination, and overall well-being. Besides, they expected to achieve improved psychological well-being and performance; to acquire strategies to manage stress, anger, and anxiety; and to have their motivational drive strengthened and influence other activities. Participants described tele-yoga as a new and exciting technical solution that would facilitate the delivery of yoga. A few participants remained a little hesitant toward the use of technology, with some expectations based on previous experiences. When asked about expectations, some had no idea about what to expect. Participants also had varying perspectives on yoga, with some finding it mysterious and difficult to understand. Participants expressed thoughts that they found the idea of tele-yoga taking place in groups exciting and enjoyable. They also had expectations that being part of a group would provide opportunities for mutual inspiration and encouragement among the group members. CONCLUSIONS Expectations before an intervention can provide valuable insights into understanding the factors influencing adherence to tele-yoga and its outcomes. Our findings provide a wide range of expectations for tele-yoga, spanning both physical and mental aspects. Moreover, the technology's potential to facilitate yoga delivery and the supportive nature of digital group interactions were evident from the results. TRIAL REGISTRATION ClinicalTrials.gov NCT03703609; https://clinicaltrials.gov/ct2/show/NCT03703609.
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Affiliation(s)
- Towe Hedbom
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Ingela Thylén
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
- Department of Cardiology, Linkoping University, Linkoping, Sweden
| | - Lotti Orwelius
- Department of Anaesthesia and Intensive Care, Linkoping University, Linkoping, Sweden
- Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
- Department of Cardiology, Linkoping University, Linkoping, Sweden
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Yu T, Gao M, Sun G, Graffigna G, Liu S, Wang J. Cardiac rehabilitation engagement and associated factors among heart failure patients: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:447. [PMID: 37697249 PMCID: PMC10496326 DOI: 10.1186/s12872-023-03470-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Chronic Heart Failure (CHF) still affects millions of people worldwide despite great advances in therapeutic approaches in the cardiovascular field. Cardiac rehabilitation (CR) is known to improve disease-related symptoms, quality of life and clinical outcomes, yet implementation is suboptimal, a frequently low engagement in rehabilitation programs has been found globally. OBJECTIVE To quantify diverse CR-engaged processes and elucidate associated factors of the various levels of CR engagement in CHF patients. METHODS Discharged patients admitted from cardiology departments between May 2022 to July 2022 were enrolled by mobile phone text messaging, CHF patients from same department between August 2022 to December 2022 were enrolled by face-to-face. Individuals who met the inclusion criteria filled the questionnaires, including the generalized anxiety disorders scale, patient health questionnaire, cardiac rehabilitation inventory, patient activation measure, Tampa scale for kinesiophobia heart, social frailty, Patient Health Engagement Scale (PHE-s®). We obtained sociodemographic characteristics and clinical data from medical records. Chi-square tests and multivariable logistic regression analyses were performed to examine the factors associated with CR engagement phases. RESULTS A total of 684 patients were included in the study. 52.49% patients were in the Adhesion phase. At the multivariate level, compared with the blackout phase process anxiety, monthly income (RMB yuan) equal to or more than 5,000 were the most important factor impacting CHF patients CR engagement. Compared with the Blackout phase, regular exercise or not, severe depression, previous cardiac-related hospitalizations 1 or 2 times, Age influenced patient CR engagement in the Arousal phase. Besides, compared with the Blackout phase, outcome anxiety and activation level were independent factors in the Eudaimonic Project phase. CONCLUSION This study characterized CR engagement, and explored demographic, medical, and psychological factors-with the most important being process anxiety, monthly income, patient activation, severe depression, and previous cardiac-related hospitalizations. The associated factors of CR engagement were not identical among different phases. Our findings suggested that factors could potentially be targeted in clinical practice to identify low CR engagement patients, and strategies implemented to strengthen or overcome these associations to address low CR engagement in CHF patients.
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Affiliation(s)
- Tianxi Yu
- School of Nursing, Nanjing Medical University, No.140 Han Zhong Road, Gu Lou District, Nanjing City, Jiangsu Province, China
| | - Min Gao
- Cardiology Department, The First Affiliated Hospital of Nanjing Medical University, No.300 Guang Zhou Road, Gu Lou District, Nanjing City, Jiangsu Province, China
| | - Guozhen Sun
- School of Nursing, Nanjing Medical University, No.140 Han Zhong Road, Gu Lou District, Nanjing City, Jiangsu Province, China.
| | | | - Shenxinyu Liu
- School of Nursing, Nanjing Medical University, No.140 Han Zhong Road, Gu Lou District, Nanjing City, Jiangsu Province, China
| | - Jie Wang
- School of Nursing, Nanjing Medical University, No.140 Han Zhong Road, Gu Lou District, Nanjing City, Jiangsu Province, China
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Blank L, Cantrell A, Sworn K, Booth A. Factors which facilitate or impede patient engagement with pulmonary and cardiac rehabilitation: a rapid evaluation mapping review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-59. [PMID: 37464900 DOI: 10.3310/klwr9463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Background There is a considerable body of systematic review evidence considering the effectiveness of rehabilitation programmes on clinical outcomes. However, much less is known about effectively engaging and sustaining patients in rehabilitation. There is a need to understand the full range of potential intervention strategies. Methods We conducted a mapping review of UK review-level evidence published 2017-21. We searched MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health (CINAHL) and conducted a narrative synthesis. Included reviews reported factors affecting commencement, continuation or completion of cardiac or pulmonary rehabilitation, or an intervention to facilitate these factors. Study selection was undertaken independently by two reviewers. Results In total, we identified 20 review papers that met our inclusion criteria. There was a bias towards reviews considering cardiac rehabilitation, with these numbering 16. An additional 11 unpublished interventions were also identified through internet searching of key websites. The reviews included 60 identifiable UK primary studies that considered factors which affected attendance at rehabilitation; 42 considered cardiac rehabilitation and 18 considering pulmonary rehabilitation. They reported on factors from the patients' point of view, as well as the views of professionals involved in referral or treatment. It was more common for factors to be reported as impeding attendance at rehabilitation rather than facilitating it. We grouped the factors into patient perspective (support, culture, demographics, practical, health, emotions, knowledge/beliefs and service factors) and professional perspective (knowledge: staff and patient, staffing, adequacy of service provision and referral from other services, including support and wait times). We found considerably fewer reviews (n = 3) looking at interventions to facilitate participation in rehabilitation. Although most of the factors affecting participation were reported from a patient perspective, most of the identified interventions were implemented to address barriers to access in terms of the provider perspective. The majority of access challenges identified by patients would not therefore be addressed by the identified interventions. The more recent unevaluated interventions implemented during the COVID-19 pandemic may have the potential to act on some of the patient barriers in access to services, including travel and inconvenient timing of services. Conclusions The factors affecting commencement, continuation or completion of cardiac or pulmonary rehabilitation consist of a web of complex and interlinked factors taking into consideration the perspectives of the patients and the service providers. The small number of published interventions we identified that aim to improve access are unlikely to address the majority of these factors, especially those identified by patients as limiting their access. Better understanding of these factors will allow future interventions to be more evidence based with clear objectives as to how to address the known barriers to improve access. Limitations Time limitations constrained the consideration of study quality and precluded the inclusion of additional searching methods such as citation searching and contacting key authors. This may have implications for the completeness of the evidence base identified. Future work High-quality effectiveness studies of promising interventions to improve attendance at rehabilitation, both overall and for key patient groups, should be the focus moving forward. Funding This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HSDR programme or the Department of Health. Study registration The study protocol is registered with PROSPERO [CRD42022309214].
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Affiliation(s)
- Lindsay Blank
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anna Cantrell
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katie Sworn
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Raisi A, Piva T, Myers J, Zerbini V, Mandini S, Zappaterra T, Mazzoni G, Tonet E, Pavasini R, Campo G, Grazzi G, Visintin EP. Experience and Perceptions among Older Outpatients after Myocardial Infarction following an Exercise Intervention: A Qualitative Analysis from the PIpELINe Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2196. [PMID: 36767563 PMCID: PMC9915135 DOI: 10.3390/ijerph20032196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Traditional cardiac rehabilitation (CR) programs effectively improve physical performance and outcomes after myocardial infarction (MI). However, older patients are less likely to participate in such programs. The aim of this qualitative analysis was to investigate experiences and perceptions of cardiac outpatients enrolled in an innovative and exercise-based CR program and to identify possible barriers to improving adherence and quality of life. Semi-structured interviews were conducted on a sample of 31 patients (84% male; age 76 ± 6 years) from the Physical Activity Intervention in Elderly after Myocardial Infarction (PIpELINe) trial, after about six months of the event. Three main themes were identified: Personal feelings after the event; lifestyle change and perception of barriers; and relationships with familiars. Participants perceived sensations of fear at the time of their diagnosis and showed awareness of the importance of following specific health suggestions. They reported a significative change in previous habits and highlighted the need for periodic controls. Few of them felt insecure in carrying out daily activities or practicing exercise and reported an unnecessary protection from the family members. These findings will provide valuable insights for the development of a more feasible patient-centered CR model of intervention.
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Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Tommaso Piva
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Jonathan Myers
- Division of Cardiology, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
- Department of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Valentina Zerbini
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Tamara Zappaterra
- Department of Humanities, University of Ferrara, 44121 Ferrara, Italy
| | - Gianni Mazzoni
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
- Public Health Department, AUSL Ferrara, 44121 Ferrara, Italy
| | - Elisabetta Tonet
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Rita Pavasini
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, University of Illinois at Chicago, Chicago, IL 60612, USA
- Public Health Department, AUSL Ferrara, 44121 Ferrara, Italy
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Yang W, Cao Y, Li Y, Zhang X, Li X, Jiang S, Lv Q, Cheng M, Zhang X, Zang X. Effectiveness of a family customised online FOCUS programme aimed on building resiliency in dyad relationship to support dyadic illness management in persons with heart failure and their informal caregiver: a randomised clinical trial protocol. BMJ Open 2022; 12:e061405. [PMID: 35896302 PMCID: PMC9335032 DOI: 10.1136/bmjopen-2022-061405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Living with heart failure (HF), is a shared journey and arduous work for patients and their informal family caregivers. Given the key role and limited evidence of dyad illness management in improving dyad health in the context of HF, we developed a customisable, relationship focused, family online dynamic disease management programme-FOCUS programme-to improve dyad health for HF patients and their informal caregivers in China. METHODS AND ANALYSIS Based on the Theory of Dyadic Illness Management and the Systemic Transactional Model of Stress and Coping, the family customised online FOCUS programme has five modules: (1) family participatory; (2) open communication; (3) coping effectiveness; (4) uncertainty reduction and 5) shared dyad life stories. HF family dyads will be recruited in the cardiology wards of four university-affiliated hospitals in China. The dyads (N=142) will be randomly allocated to the intervention group that will receive the family customised online FOCUS programme, and the attention control group that will not receive elements of the FOCUS programme. Dyadic coping, HF somatic perception, self-care, anxiety and depression for patients and family caregivers and all-cause mortality and hospital admission for patients will be measured at baseline, 4 weeks (after the discharge, T1), 12 weeks (after the discharge, T2) and 24 weeks (after the discharge, T3). Statistical analysis will be performed using SPSS V. 22.0 software. ETHICS AND DISSEMINATION The study protocol was approved by the ethics committees of Tianjin Medical University (Reference number TMUHEC2019002) that covers all the centres enrolled in this study. The findings of this study will be published in scientific journals and will be presented at scientific conferences. TRIAL REGISTRATION NUMBER ChiCTR2100053168.
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Affiliation(s)
- Weiling Yang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yongjun Cao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yanting Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xuedong Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Sixuan Jiang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Qingyun Lv
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Mei Cheng
- Institute of Health and Disease, Binzhou Medical University - Yantai Campus, Yantai, China
| | - Xin Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, Tianjin, China
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How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031482. [PMID: 35162504 PMCID: PMC8834758 DOI: 10.3390/ijerph19031482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023]
Abstract
Background. Adherence to cardiac rehabilitation remains a challenge despite established evidence that engaging in regular exercise is a strong preventive measure to experiencing a second cardiac event. A recent study found a six-month cardiac rehabilitation program to be effective for facilitating regular exercise behavior among patients diagnosed with acute coronary syndrome. The purpose of this study was to conduct a phenomenological investigation using Colaizzi’s descriptive technique to understand mechanisms responsible for behavior change. Methods. Data were collected and analyzed among patients with acute coronary syndrome at a cardiac rehabilitation using semi-structured interviews that were conducted over the phone across three months. Conclusion. Thematic analysis of 15 semi-structured interviews resulted in 124 statements that were analyzed. The data yielded seven themes that included “motivation to follow prescribed exercise program”, “volitional decision”, “capability of performing exercise”, “connectedness to peers”, “planning”, “habit formation”, and “adopting healthy behaviors beyond exercise”. The emerged themes align with construct definitions of the self-determination theory, which include the three psychological needs (autonomy, competence, and relatedness), in addition to autonomous motivation, which represents internally driven reasons to participate in exercise. Planning and habit formation themes support contemporary research that identifies these constructs responsible for behavioral maintenance. While these themes help explain exercise participation, the final theme, adopting healthy behaviors beyond exercise, reflects the impact of the program on having a change towards a healthier lifestyle. The findings highlight the complexity of exercise behavior, and that long-term participation is likely explained by amalgamating the self-determination theory.
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Hanson CL, Neubeck L, Kyle RG, Brown N, Gallagher R, Clark RA, McHale S, Dawkes S. Gender Differences in Uptake, Adherence and Experiences: A Longitudinal, Mixed-Methods Study of a Physical Activity Referral Scheme in Scotland, UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041700. [PMID: 33578836 PMCID: PMC7916623 DOI: 10.3390/ijerph18041700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Abstract
Physical activity referral schemes (PARS) are implemented internationally to increase physical activity (PA), but evidence of effectiveness for population subgroups is equivocal. We examined gender differences for a Scottish PARS. This mixed-methods, concurrent longitudinal study had equal status quantitative and qualitative components. We conducted 348 telephone interviews across three time points (pre-scheme, 12 and 52 weeks). These included validated self-reported PA and exercise self-efficacy measures and open-ended questions about experiences. We recruited 136 participants, of whom 120 completed 12-week and 92 completed 52-week interviews. PARS uptake was 83.8% (114/136), and 12-week adherence for those who started was 43.0% (49/114). Living in less deprived areas was associated with better uptake (p = 0.021) and 12-week adherence (p = 0.020), and with male uptake (p = 0.024) in gender-stratified analysis. Female adherers significantly increased self-reported PA at 12 weeks (p = 0.005) but not 52 weeks. Males significantly increased exercise self-efficacy between baseline and 52 weeks (p = 0.009). Three qualitative themes and eight subthemes developed; gender perspectives, personal factors (health, social circumstances, transport and attendance benefits) and scheme factors (communication, social/staff support, individualisation and age appropriateness). Both genders valued the PARS. To increase uptake, adherence and PA, PARS should ensure timely, personalised communication, individualised, affordable PA and include mechanisms to re-engage those who disengage temporarily.
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Affiliation(s)
- Coral L. Hanson
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4DN, UK; (L.N.); (N.B.); (S.M.); (S.D.)
- Correspondence: ; Tel.: +44-131-455-3457
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4DN, UK; (L.N.); (N.B.); (S.M.); (S.D.)
- Sydney Nursing School, Charles Perkins Centre, Johns Hopkins Road, University of Sydney, Sydney, NSW 2006, Australia;
| | - Richard G. Kyle
- Research & Evaluation Division, Knowledge Directorate, Public Health Wales, Cardiff CF10 4BZ, UK;
| | - Norrie Brown
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4DN, UK; (L.N.); (N.B.); (S.M.); (S.D.)
| | - Robyn Gallagher
- Sydney Nursing School, Charles Perkins Centre, Johns Hopkins Road, University of Sydney, Sydney, NSW 2006, Australia;
| | - Robyn A. Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5001, Australia;
| | - Sheona McHale
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4DN, UK; (L.N.); (N.B.); (S.M.); (S.D.)
| | - Susan Dawkes
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4DN, UK; (L.N.); (N.B.); (S.M.); (S.D.)
- School of Nursing, Midwifery and Paramedic Practice, Garthdee Campus, Robert Gordon University, Aberdeen AB10 7QE, UK
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