Coronary artery bypass graft patients' perception about the risk factors of illness: Educational necessities of second prevention

Patients' preferences for secondary prevention following a coronary event

Objective

Despite clear evidence on the effectiveness of secondary prevention, patients with coronary artery disease frequently fail to reach guideline-based risk factor targets. Integrating patients' preferences into treatment decisions has been recommended to reduce this gap. However, this requires knowledge about patient treatment preferences. Therefore, through a survey study, we aimed to explore which risk factors patients self-perceived, prioritised for improvement, and needed support with after a recent hospitalisation for coronary heart disease.

Methods

A digital questionnaire was presented to patients > 18 years recently discharged (≤3 months) from an acute coronary care unit in the Netherlands (Europe). Patients could select from eight cardiovascular risk factors that they (1) self-perceived, (2) prioritised for improvement, and (3) needed support to improve. Patients' perceived risk factors were compared to those documented in the medical records.

Results

Respondents (N = 254, 26 % women), mean age 64 (SD 10) years, identified 'physical inactivity' more frequently than their medical records (140 patients vs. 91 records, p < 0.001), while three other risk factors were reported with equal and four with lower frequency. 'Physical inactivity', 'overweight' and 'stress' were most frequently prioritised for improvement (82 %, 88 % and 78 %) and professional support (64 %, 50 % and 58 %), with 87 % preferring lifestyle optimisation if this would reduce drug use.

Conclusions

Patients with a recent coronary event show significant disparities in identifying risk factors compared to their medical records. They tend to prefer improving lifestyle- over drug-modifiable risk factors, particularly physical inactivity, overweight and stress, and indicate the need for support in improving these factors.

Behavioral Weight Loss Interventions for Overweight and Obese Cardiac Rehabilitation Patients: A Systematic Review

The purpose of this systematic review was to identify evidence pertaining to the effectiveness of behavioral weight loss interventions for overweight and obese cardiac rehabilitation participants. A database search of PUBMED, CINAHL, PsycINFO, and PROSPERO yielded 10 eligible studies. Quantitative studies implementing behavioral weight loss interventions for overweight and obese adult cardiac rehabilitation participants were reviewed. Evidence supported the usefulness and effectiveness of behavioral weight loss interventions for overweight cardiac rehabilitation participants. With the limited number of studies and inclusion of quasi-experimental studies with comparative groups, it was not possible to determine the relative power of behavioral weight loss interventions across studies. In conclusion, behavioral weight loss interventions can be incorporated into cardiac rehabilitation or offered following cardiac rehabilitation to improve weight loss of overweight and obese cardiac rehabilitation participants. Findings reinforce national guidelines emphasizing the role of cardiac rehabilitation to address secondary cardiovascular disease risk factor modification, including integrating behavioral weight loss programs in cardiac rehabilitation, or referring overweight patients to weight management programs following completion of cardiac rehabilitation.

Risk perception of cardiovascular disease among Turkish adults: a cross-sectional study

AIM

The aim of the study was to determine in adults the risk perception for cardiovascular disease (CVD) and the associated factors.

BACKGROUND

CVDs are the leading cause of death globally. In adults, perceptions related to the risk for CVDs have a considerable effect on decision-making processes related to one's own health.

METHODS

A cross-sectional study was conducted with 453 adult people from April to June 2019 in İzmir, Turkey. Data were collected with a sociodemographic characteristics questionnaire, perception of risk of heart disease scale (PRHDS), and health perception.

FINDINGS

The mean PRHDS score of adults was 48.88 ± 8.12. The risk perception for CVD was influenced by variables that were age, gender, education, marital status, employment status, health perception, familial cardiovascular disease history, chronic disease status, smoking status, and body mass index. Although CVDs are the most prominent cause of disease-related death in the world, risk perception for CVD was found to be low among the individuals included in this study. This finding indicates the importance of informing individuals about CVD risk factors, raising awareness, and training.

How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology

A key factor to successful secondary prevention of cardiovascular disease (CVD) is optimal patient adherence to treatment. However, unsatisfactory rates of adherence to treatment for CVD risk factors and CVD have been observed consistently over the last few decades. Hence, achieving optimal adherence to lifestyle measures and guideline-directed medical therapy in secondary prevention and rehabilitation is a great challenge to many healthcare professionals. Therefore, in this European Association of Preventive Cardiology clinical consensus document, a modern reappraisal of the adherence to optimal treatment is provided, together with simple, practical, and feasible suggestions to achieve this goal in the clinical setting, focusing on evidence-based concepts.

Analysis on Influencing Factors of Knowledge-Based Attitude and Behavior Change of Cardiovascular Disease Nurses

The study explores the influencing factors of knowledge, attitude, and behavior of cardiovascular disease nurses. A total of 500 CVD nurses from 10 hospitals in the province from January 2020 to 2021 are selected as the survey subjects. After reviewing the literature, a questionnaire is developed to investigate the knowledge, belief, and practice level of cardiovascular disease nurses. The demographic information, job information and knowledge, attitude, and behavior of cardiovascular disease nurses are investigated in the form of questionnaires. Univariate analysis is made on the knowledge, attitude, and behavior scores of the nurses with cardiovascular diseases in demographic characteristics and job characteristics, and multivariate stepwise analysis is made on the factors affecting the knowledge, attitude, and behavior of the nurses with cardiovascular diseases. Cardiovascular disease nurses' knowledge, attitude, and behavior are the medium level, should be regular training activities and psychological counseling, and cultivate high title, long working life, older nursing staff, and practice level.

A Systematic Review of the Instruments Used for Evaluating Causal Beliefs and Perceived Heart Risk Factors

Background: The etiologies and causal beliefs of heart disease are considered one of the 5 dimensions of health self-regulatory model. Thus, the present study aimed to review the literature and screen the appropriate tools for evaluating the causal beliefs and perceived heart risk factors (PHRFs). Methods: The review samples encompassed all published articles from 1992 to March 2017. A systematic search was conducted across 6 databases: the Web of Science, Scopus, Medline, EBSCO, ProQuest, PsycINFO, and Google Scholar. The qualitative evaluation of the articles was examined using the checklists of the Critical Appraisal Skills Programme (CASP) by 2 independent investigators. After the application of the criteria for inclusion in the study, 22 studies were obtained according to the PRISMA guidelines. Results: A total of 10 504 (50.5% male) patients at an average age of 57.85±10.75 years participated in 22 studies under review. The results of the systematic review showed that 22 tools were available to measure PHRFs. The instruments were categorized into 4 groups of valid scales (6 studies), invalid questionnaires (6 studies), checklists (3 studies), and open-ended single items (7 studies). Only 23.2% of the measuring instruments were sufficiently valid. Conclusion: The results of this systematic review showed that a limited number of valid tools were available to measure PHRFs. Considering the importance of studying cardiac patients' perception of the etiology of disease and the paucity of standards and valid grading scales, it seems necessary to design and provide tools with broader content that can cover all aspects of patients' beliefs.

Development and validation of dust exposure prevention questionnaire for cardiovascular patients based on the health belief model

BACKGROUND

Many cardiovascular patients suffer from respiratory failure. Environmental conditions can exacerbate symptomatology. It is necessary to prevent exposure to dust by taking educational steps to identify and modify patient behavior. This study aimed to develop and validate a dust exposure behavior questionnaire based on the Health Belief Model.

METHODS

A mixture of qualitative and quantitative methods was employed to design and develop the desired tool. Qualitative methods were used to identify the preventive behaviors needed by cardiovascular patients at risk of dust exposure using the opinions of two expert panels and a literature review. The quantitative phase of the research was performed to evaluate the psychometric properties of the research tool. The research population comprised 417 people with cardiovascular disease referred to a heart hospital in Bushehr, Iran in 2018. Consenting participants entered the study through consecutive sampling.

RESULTS

The final version of the questionnaire included 27 items across six domains, namely perceived susceptibility, perceived barriers, perceived severity, perceived benefits, cues to action, and self-efficacy. The mean values of the content validity ratio and content validity index were 0.93 and 0.9, respectively. In addition, all items had a good correlation with the total score of their parent domain (P < 0.01). The model fit was initially unsuitable, according to the related indices. Hence, to achieve a better model fit, the model was improved by releasing some parameters based on the modifications suggested by the AMOS software. The modified model featured an acceptable fit (χ2/df = 2.2, P < 0.001). Cronbach's alpha coefficients also confirmed appropriate reliability for all six domains.

CONCLUSION

The Dust Exposure Prevention questionnaire has desirable psychometric properties and appropriate validity to determine the behavioral factors involved in harm from dust exposure among cardiovascular disease patients. This marks an effective step toward evaluating the factors effective in preventing complications related to dust exposure among such patients.

Cardiovascular disease risk perception in a Hungarian community sample: psychometric evaluation of the ABCD Risk Perception Questionnaire

OBJECTIVES

Reliable and valid assessment of subjective risk perception is a crucial part of cardiovascular disease (CVD) prevention and rehabilitation. Since the recently developed Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire complies with these requirements, the aim of the present study was to investigate the psychometric properties of the Hungarian version of the measure.

DESIGN AND SETTING

Community-based cross-sectional observational study PARTICIPANTS: In sum, 410 (M=49.53 years, SD=8.09) Hungarian adults (inclusion criteria: aged 35 and above, not under treatment with a psychiatric disorder) were included in the present study (female: n=277, 67.6%; college or university-level education: n=247, 60.2%).

METHODS

We translated the ABCD Risk Questionnaire into Hungarian and checked its psychometric properties and validity indices.

PRIMARY OUTCOME MEASURES

Internal consistency, explorative and confirmative factorial validity. Associations with sociodemographic and health-related characteristics, as well as with measures of mental health (depressive symptoms, perceived stress and well-being).

RESULTS

Exploratory and confirmatory factor analyses supported a three-factor solution, corresponding to the original subscales of Risk Perception, Perceived Benefits and Healthy Eating Intentions, with a moderate correlation between the latent constructs. The respondents' level of knowledge on CVD risk factors was largely independent of their subjective risk perception. The results also provided evidence on the weak-to-medium associations between mental health indices and CVD-related perceptions. Based on the results, a shortened scale version was also suggested.

CONCLUSION

This study confirms the factorial structure, internal consistency and validity of the Hungarian version of the ABCD Risk Questionnaire in a non-English-speaking community sample. The ABCD Risk Perception Questionnaire is a parsimonious and psychometrically adequate measure to assess CVD-related attitudes and knowledge in the general population. Further research is needed in socioeconomically more diverse and in clinical samples, as well as in longitudinal intervention studies.

Is enneagram personality system able to predict perceived risk of heart disease and readiness to lifestyle modification?

Background:

Studying personality traits and patterns is of significant importance in adopting healthy behaviors. Therefore, the current study investigates the relationship between Enneagram personality types and perceived risk of heart disease and readiness to lifestyle modification.

Methods:

In this cross-sectional study, 190 noncardiac patients (82.3% female) in an outpatient clinic in western Iran were selected using a simple random sampling method to fill out standard questionnaires. The obtained data were analyzed using Pearson's correlation coefficient and linear regression analysis.

Results:

The findings show that the performer personality (Type 3) can directly predict increasing readiness to lifestyle modification (P < 0.001). In contrast, there is a reverse significant relationship between the challenger personality (Type 8) and readiness to lifestyle modification (P = 0.019). Moreover, the helper personality (Type 6) is able to directly predict increasing the perceived risk of heart disease (P = 0.012).

Conclusions:

In the Enneagram system, unique personality types possess a unique risk perception and readiness to adopt healthy behaviors. The results of the current study can provide valuable information for healthy lifestyle programs professionals with regard to preventing cardiovascular diseases.

Cardiovascular surgery experience does not significantly improve patients' response to stroke

OBJECTIVES

Patients with a history of cardiovascular surgery are at risk of stroke, and immediately calling emergency medical services (EMS) after stroke onset is crucial to receiving effective reperfusion therapy. We aimed to determine the effect of a history of cardiovascular surgery on patients' ability to recognize stroke and intent to call EMS.

METHODS

We performed a cross-sectional community-based study from January 2017 to May 2017. A total population of 186,167 individuals, recruited from 69 administrative areas across China, was analyzed. Different multivariable logistic regression models were performed to identify the associations between cardiovascular surgical history and stroke recognition or intent to call EMS, respectively.

RESULTS

0.1% of the total population had a history of cardiovascular surgery. In the surgery group, the estimated stroke recognition rate (SRR) and correct action rate (CAR) were 84.9% and 74.7%, respectively. The prevalence of cardiovascular risk factors was significantly higher in the surgery group. Cardiovascular surgical history was not associated with recognition of stroke across different models. The surgery group was more likely to call EMS, but the difference was not significant after full adjustment (OR: 1.40, 95% CI: 0.99-1.98, p = .0572).

CONCLUSIONS

Cardiovascular surgical history does not influence patients' likelihood of calling EMS more often at stroke onset. Patients receiving cardiovascular surgeries should be counseled regarding stroke recognition, proper response to stroke, and the importance of controlling risk factors.

A Predictive Model of Perceived Susceptibility during the Year before Coronary Artery Bypass Grafting

Background: Based on the protective health model, one of the most important components of etiological factors leading to protective health behaviors is perceived risk or perceived susceptibility. Accordingly, the present study was conducted to assess the uncontrolled and controlled effects of some factors in predicting perceived susceptibility among coronary artery bypass graft (CABG) patients.

Methods: The data for the present cross-sectional study were gathered via assessment of 1052 CABG patients who referred to an outpatient cardiac rehabilitation clinic in a hospital in Iran between 2010 and 2014. The patients completed a checklist containing demographics, risk factors, and a single closed-ended question regarding perceived susceptibility at the beginning of their rehabilitation program. Binary logistic regression analysis was applied to identify the demographic and clinical correlations related to perceived susceptibility.

Results: Totally, 776 (73.8%) of the 1052 participants were male. The mean age of the patients was 58.0 ± 9.1 years. The results revealed that only 13.7% of the patients had perceived susceptibility; in addition, higher age (p value = 0.003) and family history of cardiac diseases (p value = 0.001) were able to significantly predict perceived susceptibility. When the demographic variables were controlled, once again age and family history of cardiac diseases were able to significantly increase perceived susceptibility by approximately 1.04 and 29.6 times, respectively.

Conclusion: Our results revealed that higher age and family history of cardiac diseases were able to significantly predict perceived susceptibility among our CABG patients.