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Rasmussen B, Maribo T, Skovsby Toft B. The content and characteristics of face-to-face interventions to encourage patients' enrollment in cardiac rehabilitation; a scoping review. Disabil Rehabil 2024; 46:2734-2746. [PMID: 37480155 DOI: 10.1080/09638288.2023.2236014] [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: 02/28/2023] [Accepted: 07/07/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE To provide an overview of the content and characteristics of face-to-face interventions to encourage enrollment in exercise-based cardiac rehabilitation (CR). METHODS Following a published protocol describing the methods, six databases were searched. The search was limited to studies published from January 2000 to December 2021. Two reviewers independently performed study selection and data extraction. RESULTS 5583 studies were identified and 20 studies with a variety of study designs met the inclusion criteria. Eight studies specified important content in face-to-face interventions to be: Education, problem-solving, support of autonomy, exploring reasons for change, emotional and cognitive support while showing understanding. Studies targeting patients' experiences used motivational interviewing and addressed worries and anticipated difficulties. Intention to attend, CR barriers, practical barriers, exercise self-efficacy, and patients asking questions supported enrollment. Reassurance could lead to nonattendance if patients had a high degree of worry and distress. CONCLUSION Face-to-face interventions are important to support patients' enrollment in CR and should integrate a person-centered dialogue exploring reasons for change and providing support to overcome barriers. Focus on the patients' perspectives, the mechanisms of change, and the evaluation of the intervention to inform implementation should be further explored.Implications for RehabilitationIn-hospital face-to-face interventions support enrollment in cardiac rehabilitation (CR) in patients with ischemic heart disease.This study suggests that individual worries and barriers toward CR should be jointly explored while considering patients' capacity for making choices as well as their vulnerability.Patients should be encouraged to ask questions.A too strong focus on reassurance and problem-solving can impede enrollment.
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Affiliation(s)
- Birgit Rasmussen
- Department of Physio- and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social & Health Services and Labour Market, Corporate Quality, Aarhus, Denmark
| | - Bente Skovsby Toft
- Research Centre for Patient Involvement, Aarhus University Hospital, Aarhus, Denmark
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2
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Brust M, Gebhardt WA, van Bruggen S, Janssen V, Numans ME, Kiefte-de Jong JC. Making sense of a myocardial infarction in relation to changing lifestyle in the five months following the event: An interpretative phenomenological analysis. Soc Sci Med 2023; 338:116348. [PMID: 37922741 DOI: 10.1016/j.socscimed.2023.116348] [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: 01/18/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Previous research has shown that experiencing an acute cardiac event, such as a myocardial infarction (MI), can lead to lifestyle changes. This study aimed to explore the potential of a MI as a 'teachable moment' (TM) for positive lifestyle changes and to identify psychosocial sensemaking processes that facilitate or hinder the presence of a TM. METHOD We conducted semi-structured interviews with 14 patients who suffered their first MI and were hospitalized in a larger Dutch city. Participants were interviewed twice, respectively one and five months after their hospitalization. They were encouraged to explain how they experienced their MI and how this had affected their lifestyle. We used an Interpretative Phenomenological Analysis approach to the data collection and analysis. FINDINGS The participants varied in their willingness to adopt a healthy lifestyle due to their MI. Most participants experienced their event as a TM for changing specific health behaviors, for example facilitated by reflecting on self-concept or social roles and by constructing and comprehending a personal narrative of their MI. Some participants struggled to follow through on their intentions to change their behavior, for example because of a negative attitude towards a healthy behavior or because they perceived it as incongruent to their identity. Only three participants maintained most former health behaviors, for example because they failed to acknowledge their MI as severe or because of earlier life events that elicited more blunted cognitive responses. CONCLUSION Cardiac patients may experience a TM, which is the consequence of interrelated processes of psychosocial sensemaking. As this does not occur at a singular time point, we suggest using the term 'teachable window' rather than 'moment'. Given these findings, there is a window of opportunity to provide continuous psychosocial and lifestyle support during and after hospitalization for acute cardiac events.
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Affiliation(s)
- Michelle Brust
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
| | - Winifred A Gebhardt
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.
| | - Sytske van Bruggen
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands; Haaglandse Dokters, The Hague, the Netherlands.
| | - Veronica Janssen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Mattijs E Numans
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
| | - Jessica C Kiefte-de Jong
- Health Campus the Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, the Netherlands.
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Bandelin-Franke L, Schenk L, Baer NR. To Eat or Not to Eat-A Qualitative Exploration and Typology of Restrictive Dietary Practices among Middle-Aged and Older Adults. Nutrients 2023; 15:nu15112466. [PMID: 37299430 DOI: 10.3390/nu15112466] [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: 04/23/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Favorable diets often include restrictive practices that have proven health benefits, even if initiated later in life. The aim of this qualitative study is to gain a comprehensive understanding of Restrictive Dietary Practices (RDPs) among a sample of middle-aged and older German adults (aged 59-78 years). We conducted 24 narrative in-depth interviews and analyzed the data using qualitative content analysis (Kuckartz). Following an inductive thematic approach, a typology was reconstructed comprising four typical RDP characteristics: I. The Holistically Restraining Type, II. The Dissonant-savoring Restraining Type, III. The Reactively Restraining Type, and IV. The Unintentionally Restraining Type. These types differed regarding the practical implementation of, e.g., restrictive food choice into everyday routines, barriers to do so, as well as with respect to attitudes and motives underlying RDPs. The major motives for adopting a RDP involved health, well-being, ethical, and ecological concerns. The most prominent barriers to a 'successful' adoption of RDPs were the enjoyment of food and the desire for spontaneity and freedom of (food) choice. Our study offers an in-depth understanding of the aspects that shape the widespread practice of dietary restriction among middle-aged and older adults. Lifeworld-related changes in RDPs and possible 'type shiftings' are discussed as well as the meaning and chances of RDPs for public health promotion.
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Affiliation(s)
- Lena Bandelin-Franke
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Nadja-Raphaela Baer
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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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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Birtwistle SB, Jones I, Murphy R, Gee I, Watson PM. "Do what you can with a happy heart": a longitudinal study of patient and family members' lived experiences of physical activity post-myocardial infarction. Disabil Rehabil 2021; 44:3661-3670. [PMID: 33646893 DOI: 10.1080/09638288.2021.1878560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Physical activity (PA) post-myocardial infarction (MI) can reduce risk of reoccurrence and mortality. Yet uptake of PA through cardiac rehabilitation (CR) is poor, and little is known about the long-term PA behaviour of cardiac patients. This study aimed to explore the lived experiences of patients' engagement with PA post-MI, together with the experiences of their family. METHODS Longitudinal interviews with six family-dyads were conducted which drew on interpretative phenomenology to understand the lived experiences of PA for post-MI patients and family members. RESULTS Participants described a journey that involved leaving "normality" (doing what PA they wanted and when) and transitioning to a new "normality" (being active within post-MI parameters). This journey was expressed through feelings of "I can't do what I was doing before," "finding my way," and "accepting this way". CONCLUSION The role of family within the patient's journey was complex, with PA identity, beliefs, and fear of MI re-occurrence influencing PA support both positively and negatively. PA engagement post-MI is a dynamic and interactive process within which the family can have an important influence.IMPLICATIONS FOR REHABILITATIONThe process of (re-)engaging in physical activity post-myocardial infarction involves a complex journey towards acceptance of a new "normality".Family play an important role in regulating and supporting patients' physical activity during the rehabilitation process.Promoting positive health beliefs and helping families understand what, how and when patients should be physically active may optimise the rehabilitation journey for post-myocardial infarction patients.
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Affiliation(s)
- Sarah B Birtwistle
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian Jones
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Rebecca Murphy
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ivan Gee
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Paula M Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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African American Women's Perceptions of Cardiovascular Disease After Myocardial Infarction: A Phenomenological Inquiry. J Cardiovasc Nurs 2020; 34:503-510. [PMID: 31498163 DOI: 10.1097/jcn.0000000000000614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The primary cause of death among African American women older than 50 years is cardiovascular disease. Cardiovascular disease affects more than 16.8 million Americans and occurs when plaque builds up in the arteries that provide blood to the heart. This often leads to a partial or complete blockage, causing a myocardial infarction (heart attack). There is limited research regarding the lived experiences of African American women before and after a myocardial infarction. OBJECTIVE The purpose of this qualitative study was to explore the experiences of African American women living in the southern region of the United States who have experienced a myocardial infarction. METHODS A hermeneutic phenomenological framework guided the study. Semistructured, audiotaped interviews were conducted to elicit narratives from 7 participants. Interview data were transcribed verbatim and then coded and analyzed using Colaizzi's phenomenological analysis framework. RESULTS The findings revealed 6 major themes: life before myocardial infarction, causes of my myocardial infarction, myocardial infarction warning signs, life after myocardial infarction, cardiac rehabilitation, and family support. Lifestyle changes must be implemented to prevent a second blockage. Attending cardiac rehabilitation and incorporating regular physical exercise are recommended to help prevent further heart damage and to improve quality of life.
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7
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Dilla D, Ian J, Martin J, Michelle H, Felicity A. “I don’t do it for myself, I do it for them”: A grounded theory study of South Asians’ experiences of making lifestyle change after myocardial infarction. J Clin Nurs 2020; 29:3687-3700. [DOI: 10.1111/jocn.15395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/17/2020] [Accepted: 06/21/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Davis Dilla
- School of Health and Society University of Salford Manchester UK
| | - Jones Ian
- School of Nursing and Allied Health Liverpool John Moores University Liverpool UK
- Liverpool Centre for Cardiovascular Science Liverpool Health Partners Liverpool UK
| | - Johnson Martin
- School of Health and Society University of Salford Manchester UK
| | - Howarth Michelle
- School of Health and Society University of Salford Manchester UK
| | - Astin Felicity
- School of Human and Health Sciences University of Huddersfield Huddersfield UK
- Research and Development Huddersfield Royal Infirmary Huddersfield UK
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Personalized eHealth Program for Life-style Change: Results From the "Do Cardiac Health Advanced New Generated Ecosystem (Do CHANGE 2)" Randomized Controlled Trial. Psychosom Med 2020; 82:409-419. [PMID: 32176191 DOI: 10.1097/psy.0000000000000802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Unhealthy life-style factors have adverse outcomes in cardiac patients. However, only a minority of patients succeed to change unhealthy habits. Personalization of interventions may result in critical improvements. The current randomized controlled trial provides a proof of concept of the personalized Do Cardiac Health Advanced New Generation Ecosystem (Do CHANGE) 2 intervention and evaluates effects on a) life-style and b) quality of life over time. METHODS Cardiac patients (n = 150; mean age = 61.97 ± 11.61 years; 28.7% women; heart failure, n = 33; coronary artery disease, n = 50; hypertension, n = 67) recruited from Spain and the Netherlands were randomized to either the "Do CHANGE 2" or "care as usual" group. The Do CHANGE 2 group received ambulatory health-behavior assessment technologies for 6 months combined with a 3-month behavioral intervention program. Linear mixed-model analysis was used to evaluate the intervention effects, and latent class analysis was used for secondary subgroup analysis. RESULTS Linear mixed-model analysis showed significant intervention effects for life-style behavior (Finteraction(2,138.5) = 5.97, p = .003), with improvement of life-style behavior in the intervention group. For quality of life, no significant main effect (F(1,138.18) = .58, p = .447) or interaction effect (F(2,133.1) = 0.41, p = .67) was found. Secondary latent class analysis revealed different subgroups of patients per outcome measure. The intervention was experienced as useful and feasible. CONCLUSIONS The personalized eHealth intervention resulted in significant improvements in life-style. Cardiac patients and health care providers were also willing to engage in this personalized digital behavioral intervention program. Incorporating eHealth life-style programs as part of secondary prevention would be particularly useful when taking into account which patients are most likely to benefit. TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT03178305.
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Mentrup S, Harris E, Gomersall T, Köpke S, Astin F. Patients' Experiences of Cardiovascular Health Education and Risk Communication: A Qualitative Synthesis. QUALITATIVE HEALTH RESEARCH 2020; 30:88-104. [PMID: 31729937 DOI: 10.1177/1049732319887949] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Coronary heart disease (CHD) has no cure, and patients with myocardial infarction are at high risk for further cardiac events. Health education is a key driver for patients' understanding and motivation for lifestyle change, but little is known about patients' experience of such education. In this review, we aimed to explore how patients with CHD experience health education and in particular risk communication. A total of 2,221 articles were identified through a systematic search in five databases. 40 articles were included and synthesized using thematic analysis. Findings show that both "what" was communicated, and "the way" it was communicated, had the potential to influence patients' engagement with lifestyle changes. Communication about the potential of lifestyle change to reduce future risk was largely missing causing uncertainty, anxiety, and, for some, disengagement with lifestyle change. Recommendations for ways to improve health education and risk communication are discussed to inform international practice.
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Affiliation(s)
| | - Emma Harris
- University of Huddersfield, Huddersfield, United Kingdom
| | - Tim Gomersall
- University of Huddersfield, Huddersfield, United Kingdom
| | | | - Felicity Astin
- University of Huddersfield, Huddersfield, United Kingdom
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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Bjørnnes AK, Moons P, Parry M, Halvorsen S, Tønnessen T, Lie I. Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies. BMJ Open 2019; 9:e032751. [PMID: 31719093 PMCID: PMC6858143 DOI: 10.1136/bmjopen-2019-032751] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To provide a comprehensive synthesis of informal caregivers' experiences of caring for a significant other following discharge from cardiac surgery. DESIGN Systematic integrated review without meta-analysis. DATA SOURCES A bibliographic search for publications indexed in six databases (Cochrane Library, CINAHL, MEDLINE, EMBASE, AMED and PsycINFO), including a scan of grey literature sources (GreyNet International, Google Scholar, Web of Science, WorldCat and the Clinical Trials Registry) was conducted in October 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were included if they described views and perspectives of informal caregivers of cardiac surgery patients (non-intervention studies (qualitative and quantitative)), and the effectiveness of interventions to evaluate support programme for informal caregivers of cardiac surgery patients (intervention studies). RESULTS Of the 4912 articles identified in searches, 42 primary research studies were included in a narrative synthesis with 5292 participants, including 3231 (62%) caregivers of whom 2557 (79%) were women. The median sample size across studies was 96 (range 6-734). Three major themes emerged from the qualitative study data: (1) caregiver information needs; (2) caregiver work challenges and (3) caregivers adaption to recovery. Across the observational studies (n=22), similar themes were found. The trend across seven intervention studies focused on caregiver information needs related to patient disease management and symptom monitoring, and support for caregivers to reduce symptoms of emotional distress. CONCLUSION Informal caregivers want to assist in the care of their significant others after hospital discharge postcardiac surgery. However, caregivers feel insecure and overwhelmed and they lack clear/concise discharge information and follow-up support during the early at-home recovery period. The burden of caregiving has been recognised and reported since the early 1990s, but there remains a limited number of studies that assesses the effectiveness of caregiver interventions. PROSPERO REGISTRATION NUMBER CRD42018096590.
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Affiliation(s)
- Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven-University, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sigrun Halvorsen
- Department of Cardiology, Division of Medicine, Oslo University Hospital Ullevål, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Theis Tønnessen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital Ullevaal, Oslo, Norway
| | - Irene Lie
- Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital Ullevaal, Oslo, Norway
- Center for Patient-centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
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Affiliation(s)
- Felicity Astin
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, West Yorkshire, UK.,Calderdale & Huddersfield NHS Foundation Trust, Research and Development Department, Huddersfield, West Yorkshire, UK
| | - Mike Lucock
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, West Yorkshire, UK
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Ragusa AT, Crampton A. Doctor Google, Health Literacy, and Individual Behavior: A Study of University Employees’ Knowledge of Health Guidelines and Normative Practices. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1590259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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13
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Strömbäck U, Engström Å, Wälivaara BM. Realising the seriousness – The experience of suffering a second myocardial infarction: A qualitative study. Intensive Crit Care Nurs 2019; 51:1-6. [DOI: 10.1016/j.iccn.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/20/2018] [Accepted: 12/09/2018] [Indexed: 12/13/2022]
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14
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Mehrpoya A, Jalali R, Jalali A, Namdari M. Patient experiences of living with coronary stent. JOURNAL OF VASCULAR NURSING 2018; 36:181-185. [PMID: 30458939 DOI: 10.1016/j.jvn.2018.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Arezoo Mehrpoya
- Psychiatric Nurse, Lorestan University of Medical Sciences, KhorramAbad, Iran
| | - Rostam Jalali
- Nursing, Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Amir Jalali
- Nursing, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehrdad Namdari
- Cardiologist, Lorestan University of Medical Sciences, KhorramAbad, Iran
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Hellem E, Bruusgaard KA. "When what is taken for granted disappears": women's experiences and perceptions after a cardiac event. Physiother Theory Pract 2018; 36:1107-1117. [PMID: 30474458 DOI: 10.1080/09593985.2018.1550829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE On entering Cardiac Rehabilitation (CR), the female cardiac population shows greater fear of overexertion and sense of uncertainty than similarly affected men. The purpose of this study was to explore how women experienced the recovery process after a cardiac event and what impact the event had on bodily experiences. METHODS A qualitative, descriptive design, inspired by a phenomenological approach. Information was collected from 20 women through focus groups and individual in-depth interviews. The material was analyzed with a method of systematic text condensation. RESULTS The women's recovery after a CE could be a lonely and difficult process. Their own perspectives on what they need in the process is often overlooked, focus being on medical care and clinical recovery in the early phase. Returning home, the women suffered vulnerability, fragility, and insecurity, affecting well-being as well as activity levels. Lack of support and follow-up post-discharge seemed to disturb the progress of the recovery process. CONCLUSIONS Helping the women regain confidence in their new bodies, supporting the personal recovery processes, and bridging the gap between discharge and enrolling in a CR-program could reduce personal stress and withdrawal, thereby empowering more women to start and complete CR programs.
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Affiliation(s)
- Elisabet Hellem
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University , Oslo, Norway
| | - Kari Anette Bruusgaard
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University , Oslo, Norway
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Abstract
Cardiovascular disease accounts for 17,500 deaths globally, representing nearly half of all non-communicable disease deaths. The World Health Organization has set nine lifestyle, risk factor and medicines targets to achieve by 2025 with the aim of reducing premature mortality from non-communicable diseases by 25%. In order to succeed in this, we need to equip our global health professional workforce with the skills to support patients and their families with making lifestyle changes and being in concordance with cardioprotective medication regimes at every opportunity. Success depends on collegiate working through effective interdisciplinary team-based care characterised by shared goals, clear roles, mutual trust, effective communication and measurable processes and outcomes, with the patient and family at the centre of care. Nurses are the largest sector of the health professional workforce and their role in prevention should be optimised. Nurse coordinated care is proven to be effective, especially where they work in an interdisciplinary way with other health professionals such as doctors, pharmacists and psychologists, who provide equally important expertise for supporting holistic care. Successful care models are those that comprehensively target all adverse lifestyles and risk factors that are responsible for the development of cardiovascular disease. These characteristics should be reflected in the standards and core components of prevention and rehabilitation programmes.
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Affiliation(s)
- Catriona Jennings
- 1 National Heart and Lung Institute, Imperial College London, London, UK
| | - Felicity Astin
- 2 Centre for Applied Research in Health, School of Human and Health Sciences, University of Huddersfield and Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, UK
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Angus JE, Dale CM, Nielsen LS, Kramer-Kile M, Lapum J, Pritlove C, Abramson B, Price JA, Marzolini S, Oh P, Clark A. Gender matters in cardiac rehabilitation and diabetes: Using Bourdieu's concepts. Soc Sci Med 2018; 200:44-51. [PMID: 29421471 DOI: 10.1016/j.socscimed.2018.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 12/30/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Habitual practices are challenged by chronic illness. Cardiac rehabilitation (CR) involves changes to habits of diet, activity and tobacco use, and although it is effective for people with diabetes and cardiovascular disease (CVD), some participants are reportedly less likely to complete programs and adopt new health related practices. Within the first three months of enrolling in CR, attrition rates are highest for women and for people with diabetes. Previous studies and reviews indicate that altering habits is very difficult, and the social significance of such change requires further study. PURPOSE The purpose of the study was to use Bourdieu's concepts of habitus, capital and field to analyse the complexities of adopting new health practices within the first three months after enrolling in a CR program. We were particularly interested in gender issues. METHODS Thirty-two men and women with diabetes and CVD were each interviewed twice within the first three months of their enrolment in one of three CR programs in Toronto, Canada. RESULTS Attention to CR goals was not always the primary consideration for study participants. Instead, a central concern was to restore social dignity within other fields of activity, including family, friendships, and employment. Thus, study participants evolved improvised tactical approaches that combined both physical and social rehabilitation. These improvised tactics were socially embedded and blended new cultural capital with existing (often gendered) cultural capital and included: concealment, mobilizing cooperation, re-positioning, and push-back. CONCLUSIONS Our findings suggest that success in CR requires certain baseline levels of capital - including embodied, often gendered, cultural capital - and that efforts to follow CR recommendations may alter social positioning.
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Affiliation(s)
- Jan E Angus
- University of Toronto, Toronto, Ontario, Canada.
| | - Craig M Dale
- University of Toronto, Toronto, Ontario, Canada.
| | | | | | | | | | | | | | | | - Paul Oh
- University Health Network, Toronto, Canada.
| | - Alex Clark
- University of Alberta, Edmonton, Alberta, Canada.
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Ammouri AA, Kamanyire JK, Abu Raddaha AH, Achora S, Obeidat AA. Another Chance at Life: Jordanian Patients' Experience of Going Through a Myocardial Infarction. Res Theory Nurs Pract 2017; 31:334-348. [PMID: 29137693 DOI: 10.1891/1541-6577.31.4.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Myocardial infarction (MI) is a life-threatening health condition that has physical, spiritual, emotional, and social changes. Understanding feelings and thoughts of patients who suffered MI attacks is essential to recovery. Among Jordanian patients who suffered an acute attack of MI, the aim of the study was to describe the experiences and the varied meanings that they assign to their experiences. METHODS A qualitative hermeneutic phenomenological research design was used. Five participants were engaged in in-depth semistructured interviews. The participants were identified using a purposeful sampling technique, after being admitted at a coronary care unit in a university hospital located in Amman, the capital city of Jordan. The hospital provides a full range of cardiovascular medical and surgical care for patients admitted from different socioeconomic levels. Transcribed data were analyzed following inductive qualitative content analysis method. RESULTS The experience of MI was a traumatizing event characterized by life-threatening symptoms, and participants feared they would not come back home. However, cultural values and religiosity among the Jordanian patients played a major role in facilitating their positive coping during and after the MI attack. The participants' recount of their experience was summed-up into 5 major themes: frightening experience, needed support, religiosity, experiencing changes, and lifestyle modifications. After the MI attack, most of the participants felt that they had given another chance to live, showing a pressing need to make healthier lifestyle modifications to avoid another MI attack. IMPLICATIONS FOR PRACTICE Health care workers should need not only pay attention on physical and physiological caring aspects but should also consider other patients' needs, while supporting the patients and their family members.
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Affiliation(s)
- Felicity Astin
- 1 Centre for Applied Health Research, School of Human and Health Sciences, University of Huddersfield, UK.,2 Research and Development, Huddersfield Royal Infirmary, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK
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Langdridge D. Recovery From Heart Attack, Biomedicalization, and the Production of a Contingent Health Citizenship. QUALITATIVE HEALTH RESEARCH 2017; 27:1391-1401. [PMID: 27634296 DOI: 10.1177/1049732316668818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this article, I explore the experience of recovery from a heart attack through an analytic autoethnography. I discuss the tensions inherent in biomedical subjectivities of health and ill-health during cardiac recovery through three key themes: (a) the transfer of responsibility and becoming a subject "at risk," (b) technologies of biomedicine and the disciplining of subjectivities, and (c) the transformation of a body toward a new pharmaceuticalized bodily normal. Through an analysis driven by the biomedicalization thesis of Clarke, alongside work on biopower and the governmentality of health by Foucault, Rose, and Rabinow, I seek to provide new insights into the process of cardiac recovery and the relationship between individual experience and broader socio-political processes. Key to this analysis is a focus on the contingent subjectivities brought into being through biomedicalization that constitute a new form of health citizenship that is otherwise not accounted for in narratives of recovery.
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Carmona-Terés V, Moix-Queraltó J, Pujol-Ribera E, Lumillo-Gutiérrez I, Mas X, Batlle-Gualda E, Gobbo-Montoya M, Jodar-Fernández L, Berenguera A. Understanding knee osteoarthritis from the patients' perspective: a qualitative study. BMC Musculoskelet Disord 2017; 18:225. [PMID: 28558738 PMCID: PMC5450398 DOI: 10.1186/s12891-017-1584-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No studies of Health Coach Interventions for knee OA sufferers that include patients' perspectives have been published. The study assesses current clinical practice and primary care professionals' advice from the patients' perspective, in order to obtain a participative design for a complex intervention based on coaching psychology. Moreover, wants to analyse the experiences, perceptions, cognitive evaluation, values, emotions, beliefs and coping strategies of patients with knee osteoarthritis, and secondly the impact of these factors in the Self-management of this condition. METHODS It is an interpretative qualitative study. The study included patients with diagnosis of knee osteoarthritis (OA) from 4 primary health care centres in Barcelona. A theoretical sampling based on a prior definition of participants' characteristics was carried out. Ten semi-structured interviews with knee OA patients were carried out. A content thematic analysis was performed following a mixed-strategy text codification in Lazarus framework and in emerging codes from the data. RESULTS The results are structured in two blocks: Experiences and perceptions of informants and Experiences of knee osteoarthritis according to the Lazarus model. Regarding experiences and perceptions of informants: Some participants reported that the information was mostly provided by health professionals. Informants know which food they should eat to lose weight and the benefits of weight loss. Moreover, participants explained that they like walking but that sometimes it is difficult to put into practice. Regarding experiences of knee osteoarthritis according Lazarus model: Cognitive evaluation is influenced by cognitive distortions such as obligation, guilt, dramatization and catastrophism. VALUES Family is the value most associated with wellbeing. Helping others is another recurring value. Emotions: Most participants explain that they feel anxiety, irritability or sadness. Beliefs: To some, physiotherapy helps them feel less pain. However, others explain that it is of no use to them. Participants are aware of the association overweight- pain. Coping strategies: The strategies for coping with emotions aim to reduce psychological distress (anxiety, sadness, anger) and some are more active than others. CONCLUSIONS The study highlights that patients with knee osteoarthritis require a person-centered approach that provides them with strategies to overcome the psychological distress caused by this condition.
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Affiliation(s)
- Victoria Carmona-Terés
- Department of Basic, Evolutionary and Educational Psychology, Universitat Autònoma de Barcelona; Psychology Faculty, Building B. UAB Campus, Bellaterra, Barcelona, 08193 Spain
| | - Jenny Moix-Queraltó
- Department of Basic, Evolutionary and Educational Psychology, Universitat Autònoma de Barcelona; Psychology Faculty, Building B. UAB Campus, Bellaterra, Barcelona, 08193 Spain
| | - Enriqueta Pujol-Ribera
- Primary Care University Research Institute (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, Barcelona, 08007 Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Iris Lumillo-Gutiérrez
- Primary Care Centre Can Bou, Ciutat de Màlaga, 18-20, Castelldefels, Barcelona, 08860 Spain
| | - Xavier Mas
- Primary Care Centre Amadeu Torner, Amadeu Torner, 63, l’Hospitalet de Llobregat, Barcelona, 08902 Spain
| | - Enrique Batlle-Gualda
- San Juan de Alicante University Hospital; Rheumatology Unit, Ctra N-332, Sant Joan d’Alacant, Alicante-Valencia, 03550 Spain
| | - Milena Gobbo-Montoya
- Psychology of pain and rheumatological diseases, Av. Presidente Carmona, 10 bis 1°A, Madrid, 28020 Spain
| | - Lina Jodar-Fernández
- Primary Care Centre Sant Ildefons, Avda República Argentiana s/n, Cornellà de Llobregat, Barcelona, 08940 Spain
| | - Anna Berenguera
- Primary Care University Research Institute (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, àtic, Barcelona, 08007 Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Berenguera A, Pons-Vigués M, Moreno-Peral P, March S, Ripoll J, Rubio-Valera M, Pombo-Ramos H, Asensio-Martínez A, Bolaños-Gallardo E, Martínez-Carazo C, Maderuelo-Fernández JÁ, Martínez-Andrés M, Pujol-Ribera E. Beyond the consultation room: Proposals to approach health promotion in primary care according to health-care users, key community informants and primary care centre workers. Health Expect 2017; 20:896-910. [PMID: 28116774 PMCID: PMC5600227 DOI: 10.1111/hex.12530] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 01/24/2023] Open
Abstract
Background Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities. Objective To identify proposals to approach HP in the context of primary care according to health‐care users aged 45‐75 years, key community informants and primary care centre (PCC) workers. Methods Descriptive‐interpretive qualitative research with 276 participants from 14 PCC of seven Spanish regions. A theoretical sampling was used for selection. A total of 25 discussion groups, two triangular groups and 30 semi‐structured interviews were carried out. A thematic interpretive contents analysis was carried out. Results Participants consider that HP is not solely a matter for the health sector and they emphasize intersectoral collaboration. They believe that it is important to strengthen community initiatives and to create a healthy social environment that encourages greater responsibility and participation of health‐care users in decisions regarding their own health and better management of public services and resources. HP, care in the community and demedicalization should be priorities for PHC. Participants propose organizational changes in the PCC to improve HP. PCC workers are aware that HP falls within the scope of their responsibilities and propose to increase their training, motivation, competences and knowledge of the social environment. Informants emphasize that HP should be person‐centred approach and empathic communication. HP activities should be appealing, ludic and of proven effectiveness. Conclusions According to a socio‐ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions.
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Affiliation(s)
- Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain.,Universitat de Girona, Girona, Spain
| | - Patricia Moreno-Peral
- Instituto de Investigación Biomédica de Málaga (IBIMA), Distrito Sanitario Málaga-Guadalhorce, Málaga, Spain
| | - Sebastià March
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | - Joana Ripoll
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Spain.,Instituto de Investigación Sanitaria de Palma, Palma, Spain
| | - Maria Rubio-Valera
- Research and Development Unit, Fundació Sant Joan de Déu, Barcelona, Spain.,School of Pharmacy, Universitat de Barcelona, Barcelona, Spain
| | - Haizea Pombo-Ramos
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Palma de Mallorca, Spain
| | - Angela Asensio-Martínez
- Aragon Institute for Health Research (IIS Aragon), Aragón, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Catalina Martínez-Carazo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Palma de Mallorca, Spain
| | - José Ángel Maderuelo-Fernández
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service, SACYL, REDIAPP, IBSAL, Salamanca, Spain
| | - Maria Martínez-Andrés
- Social and Health Care Research Center, University of Castilla-La Mancha, Castilla-la-Mancha, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain.,Universitat de Girona, Girona, Spain
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Ngooi BX, Packer TL, Warner G, Kephart G, Koh KWL, Wong RCC, Lim SP. How adults with cardiac conditions in Singapore understand the Patient Activation Measure (PAM-13) items: a cognitive interviewing study. Disabil Rehabil 2016; 40:587-596. [PMID: 27973921 DOI: 10.1080/09638288.2016.1261413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Validation studies of the PAM-13 have found differences in scale performance, suggesting that health beliefs embedded in different cultures and/or self-management needs of different client groups influence how people respond to the items. The purpose of this study was to examine how adults with cardiac conditions in Singapore interpreted and responded to the PAM-13, to investigate possible reasons for differences in responses and to propose solutions to overcome them. METHODS We conducted retrospective cognitive interviews with 13 participants in an out-patient heart center. Interviews were transcribed and analyzed based on the framework approach to qualitative analysis. The four stages from Tourangeau's cognitive model were used as a framework to index the data from each item. RESULTS There was variation in comprehension of questions leading to variation in responses. Comprehension issues were due to terms perceived by participants to be vague and the use of English terms uncommon in Singapore. Cultural influences impacted decision processes and problems with response processes of the self-rating Likert scale surfaced. CONCLUSIONS This study reinforces the need to culturally adapt the tool, even when language translation is not necessary. Providing Likert scales with a larger number of may widen the relevance of PAM-13 in Singapore. Implications for rehabilitation Need to culturally adapt assessment tool, even when language translation is not necessary. Consider using Likert scales with a larger number of categories when using in Asian countries such as Singapore. Caution must be taken when using PAM-13 levels to decide interventions for each individual.
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Affiliation(s)
- Bi Xia Ngooi
- a Department of Rehabilitation , National University Hospital , Singapore , Singapore.,b School of Occupational Therapy, Dalhousie University , Halifax , NS , Canada
| | - Tanya L Packer
- b School of Occupational Therapy, Dalhousie University , Halifax , NS , Canada
| | - Grace Warner
- b School of Occupational Therapy, Dalhousie University , Halifax , NS , Canada
| | - George Kephart
- c Department of Community Health and Epidemiology , Dalhousie University , Halifax , NS , Canada
| | - Karen Wei Ling Koh
- d Department of Nursing , National University Hospital , Singapore , Singapore
| | | | - Serene Peiying Lim
- a Department of Rehabilitation , National University Hospital , Singapore , Singapore
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Vahedparast H, Mohammadi E, Ahmadi F. From threat to gradual lifestyle changes: Iranians' experiences with chronic illnesses. Int Nurs Rev 2016; 64:405-412. [PMID: 27896801 DOI: 10.1111/inr.12319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to explore and describe the experience of making a healthy lifestyle change among the patients with chronic illness. BACKGROUND Despite the existence of different evidence on the critical role of lifestyle in the prevention and management of chronic diseases, many people face challenges in terms of starting and maintaining a healthy lifestyle. METHODS A descriptive qualitative study with in-depth semi-structured interviews was carried out in 2015 in Iran. Thirty-four patients with common chronic illnesses were invited to the study using purposive sampling. The collected data were analysed by content analysis. FINDINGS The main themes were: trying to remove the perceived threat, considering and trying to do physical activities, considering and planning for a healthy diet, striving to manage stress and having gradual acceptance of new habits and coping with them. LIMITATIONS The participants were selected from among those with chronic illness. However, there is also a need to assess the family and healthcare providers' perspectives. CONCLUSION AND IMPLICATIONS FOR NURSING The perceived threat of the disease plays an important role in the process of changing to a healthy lifestyle in Iranian with chronic illnesses. It is necessary for healthcare providers, especially nurses, to use this threat as a golden opportunity to accelerate changes in patients' behaviours. IMPLICATIONS FOR NURSING POLICY Findings may help policy makers become aware of the need for nurses to create community-based nursing in Iran. Community nurses can remind patients of perceived threats to their health to motivate them for continued healthy behaviours. Therefore, nursing curricula should be revised and educational programs utilise a community-based health approach.
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Affiliation(s)
- H Vahedparast
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - E Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - F Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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25
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Köhler AK, Nilsson S, Jaarsma T, Tingström P. Health beliefs about lifestyle habits differ between patients and spouses 1 year after a cardiac event - a qualitative analysis based on the Health Belief Model. Scand J Caring Sci 2016; 31:332-341. [PMID: 27439667 DOI: 10.1111/scs.12351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 03/04/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spousal concordance on risk factors and lifestyle habits exists and can partly be explained by patients' and spouses' health beliefs and underuse of cardiac rehabilitation. However, there have been very few qualitative comparisons of health beliefs between patients and spouses after a cardiac event. AIM To examine and qualitatively compare the health beliefs of patients with coronary heart disease and their spouses about lifestyle habits, 1 year after the cardiac event. DESIGN Explorative and descriptive. METHOD Semi-structured focus group interviews were conducted with patients (n = 14) 1 year after a cardiac event, as well as individual interviews with spouses (n = 8). The transcriptions underwent a deductive qualitative content analysis, within the framework of the Health Belief Model. FINDINGS Patients' and spouses' health beliefs about lifestyle habits qualitatively differed in most predetermined main analytical categories of the Health Belief Model. The patients relied more on their own capacity and the healthcare system than on collaboration with their spouses who instead emphasised the importance of mutual activities to establish lifestyle habits. The spouses therefore experienced problems with different family preferences compared to the patients' wishes. Moreover, only patients believed supervised exercise was beneficial for risk reduction of coronary heart disease and they related barriers for medication to a self-healing body and a meaningless life without relatives and old habits. Patients and spouses agreed that despite the severity of illness, life was captured and that normalisation to a life as usual was possible. CONCLUSION The patients' and spouses' qualitatively different health beliefs regarding health-related behaviours imply a new approach. Nurses and associated professionals need to follow-up patients' and spouses' in primary health care to support them in a tailored way, for example in problem-based sessions. Recognition and understanding of their different views and otherness could lead to compromises and goals to work with.
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Affiliation(s)
- Anita Kärner Köhler
- Department of Social and Welfare Studies Div. Nurs. Sci., Linkoping University, Linkoping, Sweden
| | - Staffan Nilsson
- Department of Medical and Health Sciences (IMH), Linkoping University, Linkoping, Sweden.,Vikbolandet Health Care Center, Primary Health Care in eastern Ostergotland, Region Ostergotland, Norrkoping, Sweden
| | - Tiny Jaarsma
- Department of Social and Welfare Studies Div. Nurs. Sci., Linkoping University, Linkoping, Sweden
| | - Pia Tingström
- Department of Medical and Health Sciences (IMH), Linkoping University, Linkoping, Sweden
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Mohammed MA, Moles RJ, Chen TF. Meta-synthesis of qualitative research: the challenges and opportunities. Int J Clin Pharm 2016; 38:695-704. [PMID: 27052213 DOI: 10.1007/s11096-016-0289-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/14/2016] [Indexed: 01/08/2023]
Abstract
Synthesis of qualitative studies is an emerging area that has been gaining more interest as an important source of evidence for improving health care policy and practice. In the last decade there have been numerous attempts to develop methods of aggregating and synthesizing qualitative data. Although numerous empirical qualitative studies have been published about different aspects of health care research, to date, the aggregation and syntheses of these data has not been commonly reported, particularly in pharmacy practice related research. This paper describes different methods of conducting meta-synthesis and provides an overview of selected common methods. The paper also emphasizes the challenges and opportunities associated with conducting meta-synthesis and highlights the importance of meta-synthesis in informing practice, policy and research.
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Affiliation(s)
| | - Rebekah J Moles
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
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Smith F, Banwell E, Rakhit R. 'I was in control of it from the start': A qualitative study of men's experiences of positive adjustment following a heart attack. J Health Psychol 2016; 22:1345-1354. [PMID: 26837689 DOI: 10.1177/1359105315627000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A qualitative design was used to explore the experience of positive adjustment following a heart attack. Ten men attending a cardiac rehabilitation programme completed in-depth semi-structured interviews. An overarching theme: 'I was in control of it from the start' emerged with six subthemes, relating to intrapersonal and interpersonal factors and processes. The subthemes reflected the importance of identifying controllable versus non-controllable factors and employing adaptive coping strategies.
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Astin F, Closs SJ, Yusuf R, Keenan C. Understanding angioplasty: An evaluation of a person-centred educational resource. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/bjca.2014.9.7.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Rifat Yusuf
- former Research Fellow, School of Healthcare, University of Leeds
| | - Chanele Keenan
- Nurse Specialist-Team Leader, Cardiac Therapy Services, Leeds Teaching Hospitals
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