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DeGroot L, Pavlovic N, Perrin N, Gilotra NA, Miller H, Denfeld QE, McIlvennan CK, Dy SM, Davidson PM, Szanton SL, Abshire Saylor M. The Association of Unmet Palliative Care Needs and Physical Frailty With Clinical Outcomes: A Prospective Study of Adults With Heart Failure. J Cardiovasc Nurs 2024:00005082-990000000-00185. [PMID: 38635901 DOI: 10.1097/jcn.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND People with heart failure, particularly those who are physically frail, experience complex needs that can be addressed by palliative care (PC). However, we have a limited understanding of how the intersection of unmet PC needs and physical frailty contributes to health-related quality of life (HRQOL) and risk for hospitalization or mortality. OBJECTIVE In this study, we sought to examine the association of unmet PC needs and physical frailty with clinical outcomes (baseline HRQOL and hospitalizations or mortality at 6 months). METHODS We recruited a convenience sample of community-dwelling persons with heart failure from an urban hospital system who were older than 50 years and hospitalized in the last year. We measured physical frailty using the FRAIL scale (nonfrail, 0-2; frail, 3-5), PC needs using the Integrated Palliative Outcome Scale (range, 0-58; higher scores indicating higher needs), and HRQOL using the Kansas City Cardiomyopathy Questionnaire (range, 0-100; higher scores indicate higher HRQOL). We performed multivariable linear regression to test the relationships between physical frailty, PC needs, and HRQOL, and multivariable logistic regression for associations with all-cause 6-month hospitalization or mortality. We also performed an exploratory analysis of 4 PC needs/frailty groups (high PC needs/frail, high PC needs/nonfrail, low PC needs/frail, low PC needs/nonfrail) with outcomes. RESULTS In our overall sample (n = 298), mean (SD) age was 68 (9.8) years, 37% were women (n = 108), 28% identified as Black/African American (n = 84), and 65% had heart failure with preserved ejection fraction (n = 194). Mean PC needs score was 19.7, and frail participants (n = 130, 44%) had a significantly higher mean PC needs score than nonfrail participants (P < .001). Those with higher PC needs (Integrated Palliative Care Outcome Scale ≥ 20) had significantly worse HRQOL (P < .001) and increased odds of hospitalization or mortality (odds ratio, 2.5; P < .01) compared with those with lower PC needs, adjusting for covariates. Physically frail participants had significantly worse HRQOL (P < .001) and higher odds of hospitalization or mortality at 6 months (odds ratio, 2.6; P < .01) than nonfrail participants, adjusting for covariates. In an exploratory analysis, physically frail participants with high PC needs had the lowest HRQOL score, with an average score of 28.6 points lower (P < .001) and 4.6 times higher odds of hospitalization or mortality (95% confidence interval, 2.03-10.43; P < .001) than low-needs/nonfrail participants. CONCLUSION Higher unmet PC needs and physical frailty, separately and in combination, were associated with lower HRQOL and higher odds of hospitalization or mortality. Self-reported PC needs and physical frailty assessment in clinical settings may improve identification of patients at the highest risk for poor HRQOL and hospitalization or mortality amenable to PC intervention.
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Li J, Fong DYT, Lok KYW, Wong JYH, Man Ho M, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study. J Glob Health 2024; 14:04068. [PMID: 38606605 PMCID: PMC11010581 DOI: 10.7189/jogh-14-04068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Background Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Beirut, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azhar University, Cairo, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Benghazi, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, Wales, UK
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
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Currow DC, Davidson PM. Time to Call Out the Real Issues in Symptom Management: If We Can't Name and Measure It, We Can't Treat It (Why Do Dogs and Cats Get the Zoomies?). J Palliat Med 2024; 27:440-441. [PMID: 38483343 DOI: 10.1089/jpm.2024.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Affiliation(s)
- David C Currow
- Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Patricia M Davidson
- Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Koirala B, Harvey S, Bollinger RC, Davidson PM. A call for action: Need to expand the scope of women's health assessment. J Adv Nurs 2024; 80:407-409. [PMID: 37417527 PMCID: PMC10771527 DOI: 10.1111/jan.15788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Affiliation(s)
- Binu Koirala
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | | | | | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- University of Wollongong, Wollongong, New South Wales, Australia
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Shaikh F, Wynne R, L. Castelino R, Inglis SC, Davidson PM, Ferguson C. Direct oral anticoagulant use in hospitalized patients with atrial fibrillation across body mass index categories: design and rationale for a retrospective cohort study. Ther Adv Drug Saf 2024; 15:20420986241227014. [PMID: 38300763 PMCID: PMC10823844 DOI: 10.1177/20420986241227014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
Background Atrial fibrillation (AF) and obesity are common conditions globally; yet, there remains suboptimal pharmacological management contributing to high rates of hospitalization in patients with AF. The altered pathophysiology of both obese and underweight individuals may influence the pharmacology of medications, including those used to manage AF. This, in turn, increases the risk of adverse events and impacts patient risk for stroke and rehospitalization. Despite the well-established complications of obesity, research investigating the relationship between obesity and AF is scant. Objectives The primary aim of this study is to describe cardiovascular-related hospitalization in AF patients according to BMI categories. A secondary aim is to describe anticoagulant and antiarrhythmic prescribing practice patterns in patients with AF, according to the BMI category. Design A retrospective, exploratory descriptive observational cohort study, using routinely collected electronic medical record data from five public hospitals within a single health district, with a population dominantly that is culturally and linguistically diverse, and has a low socioeconomic status. Methods and analysis Data extraction will include a 24-month period (January 2017 to December 2018) with a 12-month follow-up. All adult (⩾18 years) patients at discharge diagnosed with AF, prescribed any oral anticoagulant and/or oral rate/rhythm control agent, will be eligible for inclusion. Ethics and dissemination Ethics approval from the health district and the University of Wollongong has been granted. Findings will seek to demonstrate associations between management strategies and patient outcomes, as well as describe patterns of acute care management from prescribers. These data will be used to inform and generate hypotheses for large-scale studies examining the impact of body weight on anticoagulation prescribing at national and global scales.
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Affiliation(s)
- Fahad Shaikh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Rochelle Wynne
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
- The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Ronald L. Castelino
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Pharmacy Department, Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Sally C. Inglis
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Sydney, NSW, Australia
| | | | - Caleb Ferguson
- Centre for Chronic & Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Peeler A, Nelson K, Agrawalla V, Badawi S, Moore R, Li D, Street L, Hager DN, Dennison Himmelfarb C, Davidson PM, Koirala B. Living with multimorbidity: A qualitative exploration of shared experiences of patients, family caregivers, and healthcare professionals in managing symptoms in the United States. J Adv Nurs 2024. [PMID: 38197539 DOI: 10.1111/jan.15998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 01/11/2024]
Abstract
AIMS To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. DESIGN Experience-based co-design. METHODS Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. RESULTS Twenty-three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient-provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow-up care. CONCLUSION Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE AND IMPACT This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. REPORTING METHOD We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. PATIENT OR PUBLIC CONTRIBUTION This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience-based co-design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co-design events, to support symptom management for people with multimorbidity.
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Affiliation(s)
- Anna Peeler
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, London, England
| | - Katie Nelson
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | | | - Sarah Badawi
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Robyn Moore
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - David Li
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Lara Street
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - David N Hager
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Binu Koirala
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
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Chen Y, Turkson-Ocran RA, Koirala B, Davidson PM, Commodore-Mensah Y, Himmelfarb CD. Association Between the Composite Cardiovascular Risk and mHealth Use Among Adults in the 2017-2020 Health Information National Trends Survey: Cross-Sectional Study. J Med Internet Res 2024; 26:e46277. [PMID: 38175685 PMCID: PMC10797506 DOI: 10.2196/46277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 09/24/2023] [Accepted: 10/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Numerous studies have suggested that the relationship between cardiovascular disease (CVD) risk and the usage of mobile health (mHealth) technology may vary depending on the total number of CVD risk factors present. However, whether higher CVD risk is associated with a greater likelihood of engaging in specific mHealth use among US adults is currently unknown. OBJECTIVE We aim to assess the associations between the composite CVD risk and each component of mHealth use among US adults regardless of whether they have a history of CVD or not. METHODS This study used cross-sectional data from the 2017 to 2020 Health Information National Trends Survey. The exposure was CVD risk (diabetes, hypertension, smoking, physical inactivity, and overweight or obesity). We defined low, moderate, and high CVD risk as having 0-1, 2-3, and 4-5 CVD risk factors, respectively. The outcome variables of interest were each component of mHealth use, including using mHealth to make health decisions, track health progress, share health information, and discuss health decisions with health providers. We used multivariable logistic regression models to examine the association between CVD risk and mHealth use adjusted for demographic factors. RESULTS We included 10,531 adults, with a mean age of 54 (SD 16.2) years. Among the included participants, 50.2% were men, 65.4% were non-Hispanic White, 41.9% used mHealth to make health decisions, 50.8% used mHealth to track health progress toward a health-related goal, 18.3% used mHealth to share health information with health providers, and 37.7% used mHealth to discuss health decisions with health providers (all are weighted percentages). Adults with moderate CVD risk were more likely to use mHealth to share health information with health providers (adjusted odds ratio 1.49, 95% CI 1.24-1.80) and discuss health decisions with health providers (1.22, 95% CI 1.04-1.44) compared to those with low CVD risk. Similarly, having high CVD risk was associated with higher odds of using mHealth to share health information with health providers (2.61, 95% CI 1.93-3.54) and discuss health decisions with health providers (1.56, 95% CI 1.17-2.10) compared to those with low CVD risk. Upon stratifying by age and gender, we observed age and gender disparities in the relationship between CVD risk and the usage of mHealth to discuss health decisions with health providers. CONCLUSIONS Adults with a greater number of CVD risk factors were more likely to use mHealth to share health information with health providers and discuss health decisions with health providers. These findings suggest a promising avenue for enhancing health care communication and advancing both primary and secondary prevention efforts related to managing CVD risk factors through the effective usage of mHealth technology.
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Affiliation(s)
- Yuling Chen
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | | | - Binu Koirala
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
- University of Wollongong, New South Wales, Australia
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Cheryl Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Piasecki RJ, Hunt EA, Perrin N, Spaulding EM, Winters B, Samuel L, Davidson PM, Chandra Strobos N, Churpek M, Himmelfarb CR. Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients. Resuscitation 2024; 194:110041. [PMID: 37952578 PMCID: PMC10842078 DOI: 10.1016/j.resuscitation.2023.110041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which multiple RRS triggers occur together to activate RRS events are unknown. The purpose of this study was to identify these patterns (RRS trigger clusters) and determine their association with outcomes among hospitalized adult patients. METHODS RRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry's MET module were examined (n = 134,406). Cluster analysis methods were performed to identify RRS trigger clusters. Pearson's chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regressions were used to examine the associations between RRS trigger clusters and outcomes. RESULTS Six RRS trigger clusters were identified. Predominant RRS triggers for each cluster were: tachypnea, new onset difficulty in breathing, decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, mental status changes (Cluster 3); tachycardia, staff concern (Cluster 4); mental status changes (Cluster 5); hypotension, staff concern (Cluster 6). Significant differences in patient characteristics were observed across clusters. Patients in Clusters 3 and 6 had an increased likelihood of in-hospital cardiac arrest (p < 0.01). All clusters had an increased risk of mortality (p < 0.01). CONCLUSIONS We discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and aiding in clinician decision-making during RRS events.
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Affiliation(s)
- Rebecca J Piasecki
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
| | - Elizabeth A Hunt
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
| | - Nancy Perrin
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
| | - Erin M Spaulding
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
| | - Bradford Winters
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
| | - Laura Samuel
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
| | - Patricia M Davidson
- University of Wollongong Australia, Northfields Ave., Wollongong, NSW 2522, Australia
| | | | - Matthew Churpek
- University of Wisconsin-Madison, Union South, 1308 W. Dayton St., Madison, WI 53715, United States
| | - Cheryl R Himmelfarb
- Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States
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Li Q, Zeng J, Zhao B, Perrin N, Wenzel J, Liu F, Pang D, Liu H, Hu X, Li X, Wang Y, Davidson PM, Shi L, Campbell JC. Nurses' preparedness, opinions, barriers, and facilitators in responding to intimate partner violence: A mixed-methods study. J Nurs Scholarsh 2024; 56:174-190. [PMID: 37565409 DOI: 10.1111/jnu.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low- and middle-income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. DESIGN An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. METHODS The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In-depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. RESULTS The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV-related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti-domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first-line support requirements even without formal education or training on IPV) were identified. CONCLUSIONS Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. CLINICAL RELEVANCE The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector.
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Affiliation(s)
- Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Bing Zhao
- School of Nursing, Shenyang Medical College, Shenyang, China
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuqin Liu
- College of Nursing, Texas Woman's University, Dallas, Texas, USA
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
| | - Huaping Liu
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanyan Wang
- Nursing Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, and Science and Technology Department, West China Hospital, Sichuan University, Chengdu, China
| | | | - Leiyu Shi
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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De Raeve P, Davidson PM, Bergs J, Patch M, Jack SM, Castro-Ayala A, Xyrichis A, Preston W. Advanced practice nursing in Europe-Results from a pan-European survey of 35 countries. J Adv Nurs 2024; 80:377-386. [PMID: 37458267 DOI: 10.1111/jan.15775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/25/2023] [Accepted: 06/24/2023] [Indexed: 12/18/2023]
Abstract
AIM To report the results of a mapping exercise by the European Federation of Nurses on current advanced practice nursing frameworks and developments across Europe. DESIGN Online, cross-sectional, questionnaire study. METHODS An online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. The questionnaire solicited input on 60 items concerning key features of advanced practice nursing, intending to map existing developments and better understand the current state of advanced practice nursing in Europe. Data analysis used descriptive statistics, including counts and percentages, tabulation; open-text responses were handled with thematic synthesis techniques. RESULTS The definition, sense-making and operationalization of advanced practice nursing vary across Europe. Important variations were noted in the definition and requirements of advanced practice nursing, resulting in different views on the competencies and scope of practice associated with this role. Importantly, the level of education and training required to qualify and practice as an advanced practice nurse varies across European countries. Furthermore, only 11 countries reported the existence of a national legislation establishing minimum educational requirements. CONCLUSION Significant variation exists in how countries define advanced practice nursing and how it is regulated at academic and practice levels. More research is needed to clarify whether this variation results from designing models of advanced practice nursing that work in different contexts; and what impact a standardized regulatory framework could have to grow the volume of advanced practice nurses across Europe. IMPACT The current paper exposes the lack of clarity on the development and implementation of advanced practice nursing across Europe. We found significant variation in the definition, recognition, regulation and education of advanced practice nurses. Our data are essential to policymakers, professional associations and employers to ensure a coordinated and systematic effort in the consistency and ongoing development of advanced practice nurses across Europe. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution applied; the participants were national nurses' associations.
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Affiliation(s)
| | - Patricia M Davidson
- University of Wollongong, Wollongong, New South Wales, Australia
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Jochen Bergs
- Research Group of Healthcare and Ethics, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Michelle Patch
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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11
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Middleton R, Metusela C, Marriott‐Statham K, Ferguson C, Davidson PM. The engagement of older people living with chronic lung disease in a peer support community-based exercise programme: A qualitative study. Health Expect 2023; 26:2409-2417. [PMID: 37571972 PMCID: PMC10632631 DOI: 10.1111/hex.13847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/26/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Chronic lung disease is a common and complex condition. Pulmonary rehabilitation programmes-either hospital-based or in the community are recommended in evidence-based clinical practice guidelines. AIM To explore the experience of older people with chronic lung disease involved in a peer support community-based exercise maintenance programme. DESIGN AND METHOD Participants were a part of the Lungs in Action programme run in a local community leisure centre through Lung Foundation Australia. All the programme participants (n = 25) were invited by an independent person through email and/or letter to participate in the study and provided with a participant information and consent form. Participants who returned consent forms were scheduled for group interviews. Participants were recruited over a 2-week period between 30 August and 13 September 2022. We conducted qualitative group interviews using a semi-structured interview guide to explore the experiences of older people living with chronic lung disease. Data were analysed using reflexive thematic analysis. RESULTS A total of 14 participants (eight female and six male) aged between 64 and 86 years were interviewed. Three themes emerged from the data: motivation, authentic social engagement, and sustainable achievement. Motivation stemmed from the participants' perceived health benefits, and from the trainers' motivation and encouragement. Participants discussed how sharing experiences created an environment of trust and understanding, fun and friendship. Social engagement and creating authentic relationships were key aspects raised by participants. Feeling more confident in themselves and being able to accomplish physical tasks, making activities of daily living more manageable featured highly in participants' responses. DISCUSSION AND CONCLUSION Community-based peer support exercise groups enable environments for people with chronic lung disease to maintain physical fitness, and to connect with others to form friendships and have fun.
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Affiliation(s)
- Rebekkah Middleton
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
| | - Christine Metusela
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
| | | | - Caleb Ferguson
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
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12
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Saylor MA, Pavlovic N, DeGroot L, Peeler A, Nelson KE, Perrin N, Gilotra NA, Wolff JL, Davidson PM, Szanton SL. Feasibility of a Multi-Component Strengths-Building Intervention for Caregivers of Persons With Heart Failure. J Appl Gerontol 2023; 42:2371-2382. [PMID: 37707361 PMCID: PMC10840901 DOI: 10.1177/07334648231191595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Caregivers of persons with heart failure (HF) navigate complex care plans, yet support strategies often focus solely on meeting the needs of patients. We conducted a randomized waitlist control trial (N = 38) to test the feasibility and gauge initial effect size of the Caregiver Support intervention on quality of life, caregiver burden, and self-efficacy among HF caregivers. The intervention includes up to five remote, nurse-facilitated sessions. Components address: holistic caregiver assessment, life purpose, action planning, resources, and future planning. Caregivers were 93.3% female, 60% White, and 63.3% spouses. Average age was 59.4. Participants who completed the intervention reported high satisfaction and acceptability of activities. Between-group effect sizes at 16 and 32 weeks suggest improvement in quality of life (mental health) (.88; 1.08), caregiver burden (.31; .37), and self-efficacy (.63; .74). Caregivers found Caregiver Support acceptable and feasible. Findings contribute evidence that this intervention can enhance caregiver outcomes. Clinicaltrials.gov Identifier NCT04090749.
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Affiliation(s)
| | - Noelle Pavlovic
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Lyndsay DeGroot
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Anna Peeler
- King’s College London, Cicely Saunders Institute, London, United Kingdom
| | - Katie E. Nelson
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Nisha A. Gilotra
- Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Jennifer L. Wolff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | | | - Sarah L. Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
- King’s College London, Cicely Saunders Institute, London, United Kingdom
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13
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Peeler A, Davidson PM, Gleason KT, Stephens RS, Ferrell B, Kim BS, Cho SM. Palliative Care Utilization in Patients Requiring Extracorporeal Membrane Oxygenation: An Observational Study. ASAIO J 2023; 69:1009-1015. [PMID: 37549652 PMCID: PMC10615693 DOI: 10.1097/mat.0000000000002021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Palliative care (PC) is a model of care centered around improving the quality of life for individuals with life-limiting illnesses. Few studies have examined its impact in patients on extracorporeal membrane oxygenation (ECMO). We aimed to describe demographics, clinical characteristics, and complications associated with PC consultation in adult patients requiring ECMO support. We analyzed data from an ECMO registry, including patients aged 18 years and older who have received either venoarterial (VA)- or venovenous (VV)-ECMO support between July 2016 and September 2021. We used analysis of variance and Fisher exact tests to identify factors associated with PC consultation. Of 256, 177 patients (69.1%) received VA-ECMO support and 79 (30.9%) received VV-ECMO support. Overall, 115 patients (44.9%) received PC consultation while on ECMO. Patients receiving PC consultation were more likely to be non-white (47% vs. 53%, p = 0.016), have an attending physician from a medical versus surgical specialty (65.3% vs. 39.6%), have VV-ECMO (77.2% vs. 30.5%, p < 0.001), and have longer ECMO duration (6.2 vs. 23.0, p < 0.001). Patients were seen by the PC team on an average of 7.6 times (range, 1-35), with those who died having significantly more visits (11.2 vs. 5.6, p < 0.001) despite the shorter hospital stay. The average time from cannulation to the first PC visit was 5.3 ± 5 days. Congestive heart failure in VA-ECMO, coronavirus disease 2019 infection in VV-ECMO, and non-white race and longer ECMO duration for all patients were associated with PC consultation. We found that despite the benefits of PC, it is underused in this population.
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Affiliation(s)
- Anna Peeler
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King’s College London, London, United Kingdom
| | | | | | - R. Scott Stephens
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | | | - Bo Soo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Sung-Min Cho
- Division of Neuroscience Critical Care, Departments of Neurology and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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Abstract
We report the results of a mapping exercise by the European Federation of Nurses (EFN) on challenges and solutions related to violence against nurses. This is an issue of growing international concern, with the problem accentuated during and following the COVID-19 pandemic. Following a cross-sectional observational design, an online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. Face validity was achieved through an expert panel. Descriptive statistics were used for data analysis, including counts, percentages, and tabulation. Qualitative data analysis followed thematic synthesis techniques. Three main findings are noted. First, violent incidents against nurses are under-reported due to fear of victimization, employer discouragement, and the perception that reporting will not make any difference. Second, perpetrators of violent acts extend beyond patients and families to include health professionals of different ranks. Third, violent incidences have a significant adverse effect on nurses' health and retention, leading to nurses reducing their working hours or opting for part-time work. Violence against nurses is an expression of a broader problem that is rooted in the failure to recognize and manage violence at the level of the healthcare organization, and the absence of appropriate legislation to maintain minimum standards of safe working environments. This is partly the result of inadequate European Union-wide legislation targeting workplace violence in the health professions. Nurses need more institutional support through dedicated funding aimed at targeted interventions, more legislative commitment to ratify policies against discrimination, and an opportunity to voice the needs to the appropriate policymakers with the ability to bring significant change to existing conditions. Given the severity of the situation, inaction could lead to irreplaceable damage to the nursing workforce, compounding pressures resulting from the COVID-19 pandemic. Ultimately, this situation can further drive existing nurses out of the profession, weakening health systems worldwide.
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Affiliation(s)
- Paul de Raeve
- European Federation of Nurses Associations, Ixelles, Brussels, Belgium
| | - Andreas Xyrichis
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Francesco Bolzonella
- School of Business and Economics, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Jochen Bergs
- Faculty of Medicine and Life Sciences, Healthcare & Ethics Research Group, UHasselt – Hasselt University, Hasselt, Limburg, Belgium
| | - Patricia M. Davidson
- University of Wollongong, Dean Emerita Johns Hopkins University (US), Wollongong, New South Wales, Australia
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15
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McNabb KC, Bergman AJ, Smith-Wright R, Seltzer J, Slone SE, Tomiwa T, Alharthi A, Davidson PM, Commodore-Mensah Y, Ogungbe O. "It was almost like it's set up for people to fail" A qualitative analysis of experiences and unmet supportive needs of people with Long COVID. BMC Public Health 2023; 23:2131. [PMID: 37904110 PMCID: PMC10617090 DOI: 10.1186/s12889-023-17033-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Almost twenty percent of adults with COVID-19 develop Long COVID, leading to prolonged symptoms and disability. Understanding the supportive needs of people with Long COVID is vital to enacting effective models of care and policies. DESIGN/METHODS This qualitative sub-study explored the experiences of people with Long COVID and their unmet needs. Participants enrolled in a larger study to evaluate the post-acute cardiovascular impacts of COVID-19 were invited to participate in subsequent in-depth interviews. Participants were enrolled purposively until saturation at 24 participants. Data were analyzed using thematic content analysis. RESULTS Participants focused on adaptations to life with Long COVID and their unmet needs in different life spheres. Three domains, 1) occupational and financial; 2) healthcare-related; and 3) social and emotional support, emerged as areas affecting quality of life. Although participants were motivated to return to work for financial and personal reasons, Long COVID symptoms often resulted in the inability to perform tasks required by their existing jobs, and unemployment. Those who maintained employment through employer accommodations still needed additional support. Participants encountered diagnostic challenges, challenges in accessing specialty appointments, insurance loopholes, high healthcare costs, and medical skepticism. Existing social networks provided support for completing daily tasks; however, those with Long COVID typically turned to others with similar lived experiences for emotional support. Participants found government support programs inadequate and difficult to access in all three domains. DISCUSSION We propose a five-pronged policy approach to support persons with Long COVID. These overarching recommendations are (1) improve public awareness of Long COVID; (2) improve clinical care quality and access; (3) implement additional school and workplace accommodations; (4) strengthen socioeconomic benefits and social services; and (5) improve research on Long COVID.
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Affiliation(s)
- Katherine C McNabb
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Alanna J Bergman
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205, USA
| | | | - Jaime Seltzer
- Stanford University, Stanford School of Medicine, Palo Alto, USA
- The Myalgic Encephalomyelitis Action Network, Santa Monica, USA
| | - Sarah E Slone
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
| | - Tosin Tomiwa
- Johns Hopkins University, Johns Hopkins Institute for Clinical and Translational Research, Baltimore, USA
| | - Abeer Alharthi
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
| | | | - Yvonne Commodore-Mensah
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, USA
| | - Oluwabunmi Ogungbe
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
- Johns Hopkins University, Johns Hopkins School of Medicine, Baltimore, USA
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Li J, Fong DYT, Lok KYW, Wong JYH, Ho MM, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Key lifestyles and interim health outcomes for effective interventions in general populations: A network analysis of a large international observational study. J Glob Health 2023; 13:04125. [PMID: 37861130 PMCID: PMC10588292 DOI: 10.7189/jogh.13.04125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences. Methods An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic. Results Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction). Conclusions Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azher University, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Egypt
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Dennison Himmelfarb CR, Beckie TM, Allen LA, Commodore-Mensah Y, Davidson PM, Lin G, Lutz B, Spatz ES. Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation 2023; 148:912-931. [PMID: 37577791 DOI: 10.1161/cir.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Shared decision-making is increasingly embraced in health care and recommended in cardiovascular guidelines. Patient involvement in health care decisions, patient-clinician communication, and models of patient-centered care are critical to improve health outcomes and to promote equity, but formal models and evaluation in cardiovascular care are nascent. Shared decision-making promotes equity by involving clinicians and patients, sharing the best available evidence, and recognizing the needs, values, and experiences of individuals and their families when faced with the task of making decisions. Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues. Strategies effective in promoting shared decision-making include educating clinicians on communication techniques, engaging multidisciplinary medical teams, incorporating trained decision coaches, and using tools (ie, patient decision aids) at appropriate literacy and numeracy levels to support patients in their cardiovascular decisions. This scientific statement shines a light on the limited but growing body of evidence of the impact of shared decision-making on cardiovascular outcomes and the potential of shared decision-making as a driver of health equity so that everyone has just opportunities. Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.
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Tankumpuan T, Kruahong S, Benjasirisan C, Davidson PM. 'Snapshot' cohort study design across multi-site research settings: challenges, strategies, and solutions. Eur J Cardiovasc Nurs 2023; 22:664-668. [PMID: 37306298 DOI: 10.1093/eurjcn/zvad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/13/2023]
Abstract
Multi-site research studies redefine cohort studies by simultaneously providing a cross-sectional snapshot of patients and monitoring them over time, to evaluate outcomes. However, careful design is crucial to minimize potential biases, such as seasonal variations, that may arise during the study period. Addressing snapshot study challenges requires strategic solutions: implementing multi-stage sampling for representativeness, providing rigorous data collection training, using translation techniques and content validation for cultural and linguistic appropriateness, streamlining ethical approval processes, and applying comprehensive data management for follow-up and missing data. These strategies can optimize the efficacy and ethicality of snapshot studies.
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Affiliation(s)
- Thitipong Tankumpuan
- Mahidol University, Faculty of Nursing, 2 Wang Lang Road, Siriraj, Bangkoknoi, Bangkok 10700Thailand
| | - Suratsawadee Kruahong
- Mahidol University, Faculty of Nursing, 2 Wang Lang Road, Siriraj, Bangkoknoi, Bangkok 10700Thailand
| | - Chitchanok Benjasirisan
- Mahidol University, Faculty of Nursing, 2 Wang Lang Road, Siriraj, Bangkoknoi, Bangkok 10700Thailand
| | - Patricia M Davidson
- University of Wollongong, The Vice-Chancellor's Unit Building 36, University of Wollongong, NSW, 2522, Wollongong, Australia
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Singh GK, Bowers AP, Ferguson C, Ivynian SE, Chambers S, Davidson PM, Hickman LD. Hospital-service use in the last year of life by patients aged ⩾60 years who died of heart failure or cardiomyopathy: A retrospective linked data study. Palliat Med 2023; 37:1232-1240. [PMID: 37306096 PMCID: PMC10503248 DOI: 10.1177/02692163231180912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Understanding patterns of health care use in the last year of life is critical in health services planning. AIM To describe hospital-based service and palliative care use in hospital in the year preceding death for patients who died of heart failure or cardiomyopathy in Queensland from 2008 to 2018 and had at least one hospitalisation in the year preceding death. DESIGN A retrospective data linkage study was conducted using administrative health data relating to hospitalisations, emergency department visits and deaths. PARTICIPANTS AND SETTING Participants included were those aged ⩾60 years, had a hospitalisation in their last year of life and died of heart failure or cardiomyopathy in Queensland, Australia. RESULTS Of the 4697 participants, there were 25,583 hospital admissions. Three quarters (n = 3420, 73%) of participants were aged ⩾80 years and over half died in hospital (n = 2886, 61%). The median number of hospital admissions in the last year of life was 3 (interquartile range [IQR] 2-5). The care type was recorded as 'acute' for 89% (n = 22,729) of hospital admissions, and few (n = 853, 3%) hospital admissions had a care type recorded as 'palliative.' Of the 4697 participants, 3458 had emergency department visit(s), presenting 10,330 times collectively. CONCLUSION In this study, patients who died of heart failure or cardiomyopathy were predominantly aged ⩾80 years and over half died in hospital. These patients experienced repeat acute hospitalisations in the year preceding death. Improving timely access to palliative care services in the outpatient or community setting is needed for patients with heart failure.
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Affiliation(s)
- Gursharan K Singh
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Alison P Bowers
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | | | - Serra E Ivynian
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia
| | - Shirley Chambers
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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Li J, Fong DYT, Lok KYW, Wong JYH, Man Ho M, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Global impacts of COVID-19 on lifestyles and health and preparation preferences: An international survey of 30 countries. J Glob Health 2023; 13:06031. [PMID: 37565394 PMCID: PMC10416140 DOI: 10.7189/jogh.13.06031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Background The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. Methods We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels. Results 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. Conclusions Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azher University, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL) – Londrina, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Egypt
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Astell-Burt T, Pritchard T, Francois M, Ivers R, Olcoń K, Davidson PM, Feng X. Nature prescriptions should address motivations and barriers to be effective, equitable, and sustainable. Lancet Planet Health 2023; 7:e542-e543. [PMID: 37437995 DOI: 10.1016/s2542-5196(23)00108-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 07/14/2023]
Affiliation(s)
- Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia; Population Wellbeing and Environment Research Lab, Sydney, NSW, Australia.
| | - Tanya Pritchard
- Population Wellbeing and Environment Research Lab, Sydney, NSW, Australia; School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Monique Francois
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Rowena Ivers
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Katarzyna Olcoń
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Patricia M Davidson
- Vice Chancellor's Unit, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia; The George Institute of Global Health, Sydney, NSW, Australia.
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Shaikh F, Wynne R, Castelino RL, Inglis SC, Davidson PM, Ferguson C. Practices, beliefs, and attitudes of clinicians in prescribing direct oral anticoagulants for obese adults with atrial fibrillation: a qualitative study. Int J Clin Pharm 2023:10.1007/s11096-023-01583-z. [PMID: 37253952 PMCID: PMC10228882 DOI: 10.1007/s11096-023-01583-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/24/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) and obesity affect over 60 and 650 million people, respectively. AIM This study aimed to explore clinician practices, beliefs, and attitudes towards the use of direct oral anticoagulants (DOACs) in obese adults (BMI ≥ 30 kg/m2) with AF. METHOD Semi-structured interviews via video conference were conducted with multidisciplinary clinicians from across Australia, with expertise in DOAC use in adults with AF. Clinicians were invited to participate using purposive and snowball sampling techniques. Data were analysed in NVIVO using thematic analysis. RESULTS Fifteen clinicians including cardiologists (n = 5), hospital and academic pharmacists (n = 5), general practitioners (n = 2), a haematologist, a neurologist and a clinical pharmacologist participated. Interviews were on average 31 ± 9 min. Key themes identified were: Health system factors in decision-making Disparities between rural and metropolitan geographic areas, availability of health services, and time limitations for in-patient decision-making, were described; Condition-related factors in decision-making Clinicians questioned the significance of obesity as part of decision-making due to the practical limitations of dose modification, and the rarity of the extremely obese cohort; Decision-making in the context of uncertainty Clinicians reported limited availability, reliability and awareness of primary evidence including limited guidance from clinical guidelines for DOAC use in obesity. CONCLUSION This study highlights the complexity of decision-making for clinicians, due to the limited availability, reliability and awareness of evidence, the intrinsic complexity of the obese cohort and limited guidance from clinical guidelines. This highlights the urgent need for contemporary research to improve the quality of evidence to guide informed shared decision-making.
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Affiliation(s)
- Fahad Shaikh
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.
| | - Rochelle Wynne
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
- The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Ronald L Castelino
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Pharmacy Department, Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia
| | - Sally C Inglis
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Sydney, NSW, Australia
| | | | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
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Abshire Saylor M, DeGroot L, Pavlovic N, McIlvennan CK, Taylor J, Gilotra NA, Gallo JJ, Davidson PM, Wolff JL, Szanton SL. The Context of Caregiving in Heart Failure: A Dyadic, Mixed Methods Analysis. J Cardiovasc Nurs 2023; 38:00005082-990000000-00079. [PMID: 37068019 PMCID: PMC10567991 DOI: 10.1097/jcn.0000000000000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND Caregiving for persons with heart failure (HF) varies based on the individual, family, and home contexts of the dyad, yet the dyadic context of HF caregiving is poorly understood. OBJECTIVE The aim of this study was to explore dyadic perspectives on the context of caregiving for persons with HF. METHODS Family caregivers and persons with HF completed surveys and semistructured interviews. Investigators also photographed caregiving areas to complement home environment data. Descriptive qualitative analysis resulted in 7 contextual domains, and each domain was rated as strength, need, or neutral. We grouped dyads by number of challenging domains of context, categorizing dyads as high (≥3 domains), moderate (1-2 domains), or minimal (0 domains) needs. Quantitative instruments included the 36-item Short Form Health Survey, ENRICHD Social Support, HF Symptom Severity, and Zarit Burden Interview. We applied the average score of each quantitative measure to the groups derived from the qualitative analysis to integrate data in a joint display. RESULTS The most common strength was the dyadic relationship, and the most challenging domain was caregiving intensity. Every dyad had at least 2 domains of strengths. Of 12 dyads, high-needs dyads (n = 3) had the worst average score for 7 of 10 instruments including caregiver and patient factors. The moderate-needs dyads (n = 6) experienced the lowest caregiver social support and mental health, and the highest burden. CONCLUSION Strengths and needs were evident in all patient-caregiver dyads with important distinctions in levels of need based on assessment of multiple contextual domains. Comprehensive dyadic and home assessments may improve understanding of unmet needs and improve intervention tailoring.
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McDonagh J, Ferguson C, Frost SA, Davidson PM. Frailty in Heart Failure: It's Time to Intervene. Heart Lung Circ 2023; 32:438-440. [PMID: 37080638 DOI: 10.1016/j.hlc.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Affiliation(s)
- Julee McDonagh
- The University of Wollongong, School of Nursing, Faculty of Science, Medicine, and Health, Wollongong, NSW, Australia; The Centre for Chronic and Complex Care, Blacktown Hospital, Sydney, NSW, Australia.
| | - Caleb Ferguson
- The University of Wollongong, School of Nursing, Faculty of Science, Medicine, and Health, Wollongong, NSW, Australia; The Centre for Chronic and Complex Care, Blacktown Hospital, Sydney, NSW, Australia
| | - Steven A Frost
- The University of Wollongong, School of Nursing, Faculty of Science, Medicine, and Health, Wollongong, NSW, Australia
| | - Patricia M Davidson
- The Centre for Chronic and Complex Care, Blacktown Hospital, Sydney, NSW, Australia; The Vice Chancellor's Unit, The University of Wollongong, Wollongong, NSW, Australia
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Kruahong S, Tankumpuan T, Kelly K, Davidson PM, Kuntajak P. Community empowerment: A concept analysis. J Adv Nurs 2023. [PMID: 36912456 DOI: 10.1111/jan.15613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 03/14/2023]
Abstract
AIM To report an analysis of the concept of community empowerment. DESIGN Concept analysis. DATA SOURCES Literature published in the CINAHL, PubMed, Scopus and Medline electronic databases from 2016 to 2022 were systematically searched from 30 July to 1 October 2022. METHOD The amended guideline from Walker and Avant's approach (2011) to concept analysis was performed in nine stages: choosing a concept, determining the purpose of analysis, identifying definitions of the concept, defining attributes, identifying a model case, identifying antecedents, identifying consequences, defining empirical referents and applying the concept to nursing practice. RESULTS Community empowerment is a fundamental idea in health promotion that may assist communities in defining priorities, making choices, developing strategies and executing them to improve health and minimize inequalities in health. Community empowerment is an effective tool that advanced practice nurses (APNs) may employ to eliminate health inequities and promote community health. CONCLUSION This concept analysis is one step towards broadening nurses' understanding of one of the ideas of health promotion. Additionally, the concept of community empowerment represents an opportunity for additional research in nursing that is applicable to communities. IMPACT Community empowerment has served as a guiding paradigm for both theory and practice in health promotion. Also, it is recognized that social, economic and environmental elements have a direct effect on health status. However, community empowerment research in advanced nursing practices is limited. This paper will guide future nursing research on community empowerment that goes beyond involvement and engagement, for this is an effective strategy APNs can use to address health disparities and improve community health.
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Affiliation(s)
- Suratsawadee Kruahong
- Faculty of Nursing, Department of Surgical Nursing, Mahidol University, Bangkok, Thailand
| | - Thitipong Tankumpuan
- Faculty of Nursing, Department of Surgical Nursing, Mahidol University, Bangkok, Thailand
| | - Kathleen Kelly
- School of Health Sciences, Russell Sage College, Troy, New York, USA
| | | | - Premgamon Kuntajak
- Faculty of Nursing, Department of Surgical Nursing, Mahidol University, Bangkok, Thailand
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McCaffrey N, Cheah SL, Luckett T, Phillips JL, Agar M, Davidson PM, Boyle F, Shaw T, Currow DC, Lovell M. Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial. PLoS One 2023; 18:e0282465. [PMID: 36854021 PMCID: PMC9974128 DOI: 10.1371/journal.pone.0282465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND About 70% of patients with advanced cancer experience pain. Few studies have investigated the use of healthcare in this population and the relationship between pain intensity and costs. METHODS Adults with advanced cancer and scored worst pain ≥ 2/10 on a numeric rating scale (NRS) were recruited from 6 Australian oncology/palliative care outpatient services to the Stop Cancer PAIN trial (08/15-06/19). Out-of-hospital, publicly funded services, prescriptions and costs were estimated for the three months before pain screening. Descriptive statistics summarize the clinico-demographic variables, health services and costs, treatments and pain scores. Relationships with costs were explored using Spearman correlations, Mann-Whitney U and Kruskal-Wallis tests, and a gamma log-link generalized linear model. RESULTS Overall, 212 participants had median worst pain scores of five (inter-quartile range 4). The most frequently prescribed medications were opioids (60.1%) and peptic ulcer/gastro-oesophageal reflux disease (GORD) drugs (51.6%). The total average healthcare cost in the three months before the census date was A$6,742 (95% CI $5,637, $7,847), approximately $27,000 annually. Men had higher mean healthcare costs than women, adjusting for age, cancer type and pain levels (men $7,872, women $4,493, p<0.01) and higher expenditure on prescriptions (men $5,559, women $2,034, p<0.01). CONCLUSIONS In this population with pain and cancer, there was no clear relationship between healthcare costs and pain severity. These treatment patterns requiring further exploration including the prevalence of peptic ulcer/GORD drugs, and lipid lowering agents and the higher healthcare costs for men. TRIAL REGISTRATION ACTRN12615000064505. World Health Organisation unique trial number U1111-1164-4649. Registered 23 January 2015.
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Affiliation(s)
- Nikki McCaffrey
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood Campus, Burwood, VIC, Australia
- * E-mail:
| | - Seong Leang Cheah
- Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation Sydney), University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Tim Luckett
- Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation Sydney), University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Jane L. Phillips
- Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation Sydney), University of Technology Sydney (UTS), Sydney, NSW, Australia
- Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove Brisbane, Queensland
| | - Meera Agar
- Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation Sydney), University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Patricia M. Davidson
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Frances Boyle
- Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital North Sydney, and University of Sydney, Sydney, NSW, Australia
| | - Tim Shaw
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - David C. Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Melanie Lovell
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
- Northern Clinical School, University of Sydney, Sydney, NSW, Australia
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Piasecki RJ, Hunt EA, Perrin N, Spaulding EM, Winters B, Samuel L, Davidson PM, Strobos NC, Churpek M, Himmelfarb CR. Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients. medRxiv 2023:2023.02.06.23285560. [PMID: 36798369 PMCID: PMC9934794 DOI: 10.1101/2023.02.06.23285560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which RRS triggers co-occur to activate the medical emergency team (MET) to respond to RRS events is unknown. The purpose of this study was to identify and describe the patterns (RRS trigger clusters) in which RRS triggers co-occur when used to activate the MET and determine the association of these clusters with outcomes using a sample of hospitalized adult patients. Methods RRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry's MET module were examined (n=134,406). A combination of cluster analyses methods was performed to group patients into RRS trigger clusters based on the triggers used to activate their RRS events. Pearson's chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regression was used to examine the associations between RRS trigger clusters and outcomes following RRS events. Results Six RRS trigger clusters were identified in the study sample. The RRS triggers that predominantly identified each cluster were as follows: tachypnea, new onset difficulty in breathing, and decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, and staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, and mental status changes (Cluster 3); tachycardia and staff concern (Cluster 4); mental status changes (Cluster 5); hypotension and staff concern (Cluster 6). Significant differences in patient characteristics were observed across RRS trigger clusters. Patients in Clusters 3 and 6 were associated with an increased likelihood of in-hospital cardiac arrest (IHCA [p<0.01]), while Cluster 4 was associated with a decreased likelihood of IHCA (p<0.01). All clusters were associated with an increased risk of mortality (p<0.01). Conclusions We discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes following RRS events. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and may aid in clinician decision-making during RRS events.
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Koirala B, Peeler A, Dennison Himmelfarb C, Davidson PM. Living with multiple chronic conditions: How we achieve holistic care and optimize health outcomes. J Adv Nurs 2023; 79:e7-e9. [PMID: 36062872 PMCID: PMC9877113 DOI: 10.1111/jan.15433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 01/28/2023]
Abstract
Editorials are opinion pieces. This piece has not been subject to peer review and the opinions expressed are those of the authors. None of the authors have relevant political or other affiliations to declare.
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Affiliation(s)
- Binu Koirala
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Anna Peeler
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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29
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DeGroot L, Pavlovic N, Perrin N, Gilotra NA, Dy SM, Davidson PM, Szanton SL, Saylor MA. Palliative Care Needs of Physically Frail Community-Dwelling Older Adults With Heart Failure. J Pain Symptom Manage 2023; 65:500-509. [PMID: 36736499 DOI: 10.1016/j.jpainsymman.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/29/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
CONTEXT Physical frailty is emerging as a potential "trigger" for palliative care (PC) consultation, but the PC needs of physically frail persons with heart failure (HF) in the outpatient setting have not been well described. OBJECTIVES This study describes the PC needs of community dwelling, physically frail persons with HF. METHODS We included persons with HF ≥50 years old who experienced ≥1 hospitalization in the prior year and excluded those with moderate/severe cognitive impairment, hospice patients, or non-English speaking persons. Measures included the FRAIL scale (0-5: 0 = robust, 1-2 = prefrail, 3-5 = frail) and the Integrated Palliative Outcome Scale (IPOS) (17 items, score 0-68; higher score = higher PC needs). Multiple linear regression tested the association between frailty group and palliative care needs. RESULTS Participants (N = 286) had a mean age of 68 (range 50-92) were majority male (63%) and White (68%) and averaged two hospitalizations annually. Most were physically frail (44%) or prefrail (41%). Mean PC needs (IPOS) score was 19.7 (range 0-58). On average, participants reported 5.86 (SD 4.28) PC needs affecting them moderately, severely, or overwhelmingly in the last week. Patient-perceived family/friend anxiety (58%) weakness/lack of energy (58%), and shortness of breath (47%) were the most prevalent needs. Frail participants had higher mean PC needs score (26) than prefrail (16, P < 0.001) or robust participants (11, P < 0.001). Frail participants experienced an average of 8.32 (SD 3.72) moderate/severe/overwhelming needs compared to prefrail (4.56, SD 3.77) and robust (2.39, SD 2.91) participants (P < 0.001). Frail participants reported higher prevalence of weakness/lack of energy (83%), shortness of breath (66%), and family/friend anxiety (69%) than prefrail (48%, 39%, 54%) or robust (13%, 14%, 35%) participants (P < 0.001). CONCLUSION Physically frail people with HF have higher unmet PC needs than those who are nonfrail. Implementing PC needs and frailty assessments may help identify vulnerable patients with unmet needs requiring further assessment and follow-up.
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Affiliation(s)
- Lyndsay DeGroot
- Johns Hopkins University School of Nursing (L.D., N.P., N.P., S.L.S., M.A.S.), Baltimore, Maryland, USA.
| | - Noelle Pavlovic
- Johns Hopkins University School of Nursing (L.D., N.P., N.P., S.L.S., M.A.S.), Baltimore, Maryland, USA
| | - Nancy Perrin
- Johns Hopkins University School of Nursing (L.D., N.P., N.P., S.L.S., M.A.S.), Baltimore, Maryland, USA
| | - Nisha A Gilotra
- Johns Hopkins University School of Medicine (N.A.G), Baltimore, Maryland, USA
| | - Sydney M Dy
- Johns Hopkins University School of Public Health (S.M.D), Baltimore, Maryland, USA
| | | | - Sarah L Szanton
- Johns Hopkins University School of Nursing (L.D., N.P., N.P., S.L.S., M.A.S.), Baltimore, Maryland, USA
| | - Martha Abshire Saylor
- Johns Hopkins University School of Nursing (L.D., N.P., N.P., S.L.S., M.A.S.), Baltimore, Maryland, USA
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Wongsa D, Soivong P, Chaiard J, Davidson PM. Patterns of Health-Related Quality of Life among Stroke Survivors: A Longitudinal Study. West J Nurs Res 2023; 45:511-519. [PMID: 36715267 DOI: 10.1177/01939459231151385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Six months poststroke is critical for optimizing stroke survivors' recovery and improving their health-related quality of life (HRQoL). Understanding HRQoL profiles in specific domains can provide a more typical plan for stroke survivors. This pilot study aimed to explore the HRQoL patterns among 39 stroke survivors within 6 months following diagnosis. The results revealed that there were four patterns based on HRQoL domains. Pattern 1: energy, family role, mobility, self-care, social role, and work/productivity domains likely to improve; Pattern 2: language and vision domains likely to improve and be stable; Pattern 3: thinking and upper extremity function domains likely to worsen and improve later; and Pattern 4: mood and personality domains likely to worsen and be constant. Health care providers can apply these results by continuing to assess and provide care to stroke survivors focusing on functional status, cognitive status, and depression over time. Further study should explore the factors predicting HRQoL.
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Affiliation(s)
- Danil Wongsa
- Faculty of Nursing, Chiang Mai University, Muang Chiang Mai, Thailand
| | - Pratum Soivong
- Faculty of Nursing, Chiang Mai University, Muang Chiang Mai, Thailand
| | - Jindarat Chaiard
- Faculty of Nursing, Chiang Mai University, Muang Chiang Mai, Thailand
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31
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Ogungbe O, Slone S, Alharthi A, Tomiwa T, Kumbe B, Bergman A, McNabb K, Smith Wright R, Farley JE, Dennison Himmelfarb CR, Cooper LA, Post WS, Davidson PM, Commodore-Mensah Y. "Living like an empty gas tank with a leak": Mixed methods study on post-acute sequelae of COVID-19. PLoS One 2022; 17:e0279684. [PMID: 36584125 PMCID: PMC9803174 DOI: 10.1371/journal.pone.0279684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The burden and presentation of post-acute sequela of SARS-CoV-2 infection (PASC) are a developing major public health concern. OBJECTIVES To characterize the burden of PASC in community-dwelling individuals and understand the experiences of people living with PASC. METHODS This mixed-methods study of COVID-19 positive community-dwelling persons involved surveys and in-depth interviews. Main outcome was self-report of possible PASC symptoms 3 weeks or longer after positive COVID-19 test. In-depth interviews were guided by a semi-structured interview guide with open-ended questions and probes based on emerging literature on PASC and the impact of COVID-19. RESULTS With a survey response rate of 70%, 442 participants were included in this analysis, mean (SD) age 45.4 (16.2) years, 71% female, 12% Black/African American. Compared to those with no PASC symptoms, persons who reported PASC symptoms were more likely to be older (mean age: 46.5 vs. 42; p = 0.013), female (74.3% vs. 61.2%; p = 0.010), to have pre-existing conditions (49.6% vs. 34%; p = 0.005), and to have been hospitalized for COVID-19 (14.2% vs. 2.9%; p = 0.002). About 30% of the participants experienced severe fatigue; the proportion of persons reporting severe fatigue was 7-fold greater in those with PASC symptoms (Adjusted Prevalence Ratio [aPR] 6.73, 95%CI: 2.80-16.18). Persons with PASC symptoms were more likely to report poor quality of life (16% vs. 5%, p<0.001) and worse mental health functioning (Mean difference: -1.87 95%CI: -2.38, -1.37, p<0.001). Themes from in-depth interviews revealed PASC was experienced as debilitating. CONCLUSIONS In this study, the prevalence of PASC among community-dwelling adults was substantial. Participants reported considerable coping difficulties, restrictions in everyday activities, invisibility of symptoms and experiences, and impediments to getting and receiving PASC care.
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Affiliation(s)
- Oluwabunmi Ogungbe
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Sarah Slone
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Abeer Alharthi
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Tosin Tomiwa
- Texas Tech University, Lubbock, Texas, United States of America
| | - Baridosia Kumbe
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Alanna Bergman
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Katherine McNabb
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Rhonda Smith Wright
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jason E. Farley
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Cheryl R. Dennison Himmelfarb
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Lisa A. Cooper
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Wendy S. Post
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Patricia M. Davidson
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- University of Wollongong, Wollongong, Australia
| | - Yvonne Commodore-Mensah
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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32
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Han HR, Lee JW, Saylor MA, Parisi JM, Hornstein E, Agarwalla V, Jajodia A, Li Q, Weikert M, Davidson PM, Szanton SL. Methods and operational aspects of human-centred design into research processes for individuals with multiple chronic conditions: A survey study. Nurs Open 2022; 10:3075-3083. [PMID: 36515006 PMCID: PMC10077392 DOI: 10.1002/nop2.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/22/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
AIM To examine ways in which human-centred design was integrated into a nursing school's research processes involving individuals with multiple chronic conditions. DESIGN Cross-sectional survey study. METHODS Three surveys were sent out, with surveys 1 and 2 involving faculty who had worked closely with design strategists and survey 3 as a school-wide survey eliciting experience with human-centred design, respectively. RESULTS Survey respondents (n = 7 for surveys 1 and 2 and n = 36 for survey 3) had no or minimal experience with human-centred design. Faculty respondents indicated it helped engaging various stakeholders, particularly in intervention development. Key lessons learned included: (1) the importance of designer involvement from study conception, (2) distinguishing a design strategist's skillset from strictly visual design, (3) challenges during the ethical review processes, and (4) sustainability of resources. The dynamic approach of human-centred design has benefited our efforts to advance the science of caring for individuals with multiple chronic conditions.
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Affiliation(s)
- Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins School of Public Health, Baltimore, Maryland, USA.,Center for Community Programs, Innovation and Scholarship, Baltimore, Maryland, USA
| | - Ji Won Lee
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | | | | | | | | | - Anushka Jajodia
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Center for Community Programs, Innovation and Scholarship, Baltimore, Maryland, USA
| | - Qiwei Li
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Mike Weikert
- Center for Social Design & Master of Arts in Social Design, MICA, Baltimore, Maryland, USA
| | | | - Sarah L Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Abshire Saylor M, Denhaerynck K, Mielke J, Davidson PM, Dobbels F, Russell CL, De Geest S. Multi-level correlates of received social support among heart transplant recipients in the international BRIGHT Study: a secondary analysis. Eur J Cardiovasc Nurs 2022; 21:857-867. [PMID: 35670232 DOI: 10.1093/eurjcn/zvac041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/29/2022]
Abstract
AIMS Social support is critical in follow-up of patients after heart transplant (HTx) and positively influences well-being and clinical outcomes such as medication adherence. The purpose of this study was to (i) explore received social support variation (emotional and practical) in HTx recipients at country and centre level and (ii) to assess multi-level correlates. METHODS AND RESULTS Secondary data analysis of the multi-level cross-sectional BRIGHT study was conducted in 36 HTx centres in 11 countries. Received social support related to medication adherence was measured with emotional and practical sub-scales. The Conceptual Model of Social Networks and Health guided selection of patient, micro (interpersonal and psychosocial), meso (HTx centre) and macro-level (country health system) factors. Descriptive statistics, intraclass correlations, and sequential multiple ordinal mixed logistic regression analysis were used. A total of 1379 adult HTx recipients were included. Patient level correlates (female sex, living alone, and fewer depressive symptoms) and micro-level correlates (higher level of chronic disease management and trust in the healthcare team) were associated with better emotional social support. Similarly, patient level (living alone, younger age, and male sex), micro-level and meso-level (patient and clinician-rated higher level of chronic disease management) were associated with better practical social support. Social support varied at country and centre levels for emotional and practical dimensions. CONCLUSIONS Social support in HTx recipients varies by country, centre, and was associated with multi-level correlates. Qualitative and longitudinal studies are needed to understand influencing factors of social support for intervention development, improvement of social support, and clinical outcomes.
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Affiliation(s)
- Martha Abshire Saylor
- Johns Hopkins University School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205USA
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Juliane Mielke
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Patricia M Davidson
- University of Wollongong, NSW, Australia.,Johns Hopkins University School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205USA
| | - Fabienne Dobbels
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU, Leuven, Belgium
| | - Cynthia L Russell
- School of Nursing Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
| | - Sabina De Geest
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.,School of Nursing Nursing and Health Studies, University of Missouri-Kansas City, Missouri, USA
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34
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Bahouth MN, Negoita S, Tenberg A, Zink EK, Abshire MA, Davidson PM, Suarez JI, Szanton SL, Gottesman RF. Noninvasive cardiac output monitor to quantify hydration status in ischemic stroke patients: A feasibility study. J Neurol Sci 2022; 442:120413. [PMID: 36215798 DOI: 10.1016/j.jns.2022.120413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/25/2022] [Accepted: 09/04/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Individuals who are dehydrated, volume contracted or both at the time of hospitalization for acute ischemic stroke have worse clinical outcomes than do individuals with optimal volume status. Currently, there is no gold standard method for measuring hydration status, except indirect markers of a volume contracted state (VCS) including elevated blood urea nitrogen (BUN)/creatinine ratio. We sought to test the feasibility and acceptability of a non-invasive cardiac output monitor (NICOM) for the measurement of hydration status in a group of hospitalized ischemic stroke patients, and explore the relationship with a common indirect laboratory-based measure of VCS. METHODS We performed a prospective observational feasibility study of hospitalized acute ischemic stroke patients. We collected hemodynamic parameters using the NICOM device before and after fluid auto-bolus via passive leg raise and BUN/creatinine ratio. Successful acquisition of relevant hemodynamic data was the primary objective of this study. We explored agreement between the NICOM results and BUN/creatinine ratio using Cohen's kappa statistic. RESULTS Thirty patients hospitalized with acute ischemic stroke were enrolled. We found that 29/30 patients tolerated assessment with NICOM. Hemodynamic data were collected in all 30 patients. Data capture took an average of 10 min(SD ± 112 s). Agreement between NICOM and BUN/creatinine ratio was 70%; (expected agreement 51%; kappa 0.38). Agreement was stronger in the cohort without history of diabetes (81% agreement, kappa 0.61). CONCLUSIONS NICOM assessment was feasible in hospitalized stroke patients. The identification of an objective, real-time measure of hydration status would be clinically useful, and could allow precise, goal-directed care.
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Affiliation(s)
- M N Bahouth
- Department of Neurology, Johns Hopkins School of Medicine, United States of America.
| | - S Negoita
- Department of Neurology, Johns Hopkins School of Medicine, United States of America
| | - A Tenberg
- Johns Hopkins Hospital, United States of America
| | - E K Zink
- Johns Hopkins Hospital, United States of America
| | - M A Abshire
- Johns Hopkins School of Nursing, United States of America
| | - P M Davidson
- Johns Hopkins School of Nursing, United States of America
| | - J I Suarez
- Department of Neurology, Johns Hopkins School of Medicine, United States of America
| | - S L Szanton
- Johns Hopkins School of Nursing, United States of America
| | - R F Gottesman
- Department of Neurology, Johns Hopkins School of Medicine, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States of America
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35
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Frazer K, Davidson PM. Sustainable Development Goals-A clarion call for leadership in nursing and midwifery. J Nurs Manag 2022; 30:3888-3890. [PMID: 36219540 DOI: 10.1111/jonm.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Kate Frazer
- School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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36
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Hampton R, Outten CE, Street L, Miranda S, Koirala B, Davidson PM, Hager DN. Expedited upskilling of intermediate care nurses to provide critical care during the COVID-19 pandemic. Nurs Open 2022; 10:1767-1775. [PMID: 36314890 PMCID: PMC9875122 DOI: 10.1002/nop2.1433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/26/2022] [Accepted: 10/10/2022] [Indexed: 01/27/2023] Open
Abstract
AIM Describe the strategy, efficacy and preferred mechanisms of training used to rapidly upskill intermediate care nursing staff to provide critical care during the COVID-19 pandemic. DESIGN Descriptive study. METHODS The strategy used from March through December 2020 to upskill nurses in an intermediate care unit to administer critical care upon rapid conversion of the intermediate care unit to an intensive care unit for coronavirus disease 2019 is described. Training and education included paired staffing models, interdisciplinary education, skills days and self-directed learning. Nurses engaged in this upskilling process were surveyed to evaluate their confidence in new critical care competencies and educational preferences. RESULTS Of 38 intermediate care nurses, 35 completed training and began independent intensive care practice. Nursing confidence in critical care competencies increased steadily. Nurses demonstrated the greatest preference for peer education models, particularly those incorporating the hospital's pre-existing medical intensive care nurses. PATIENT AND PUBLIC CONTRIBUTIONS No patient or public contributions were made to this manuscript.
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Affiliation(s)
- Rachel Hampton
- Medical Nursing, Department of MedicineJohns Hopkins HospitalBaltimoreMarylandUSA
| | - Carrie E. Outten
- Medical Nursing, Department of MedicineJohns Hopkins HospitalBaltimoreMarylandUSA
| | - Lara Street
- Medical Nursing, Department of MedicineJohns Hopkins HospitalBaltimoreMarylandUSA
| | - Sheila Miranda
- Medical Nursing, Department of MedicineJohns Hopkins HospitalBaltimoreMarylandUSA
| | - Binu Koirala
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
| | - Patricia M. Davidson
- Johns Hopkins University School of NursingBaltimoreMarylandUSA,Present address:
University of WollongongWollongongNew South WalesAustralia
| | - David N. Hager
- Division of Pulmonary and Critical Care Medicine, Department of MedicineJohns Hopkins UniversityBaltimoreMarylandUSA
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McDonagh J, Ferguson C, Prichard R, Chang S, Philips JL, Davidson PM, Newton PJ, Macdonald PS. Comparison of six frailty instruments in adults with heart failure: a prospective cohort pilot study. Eur J Cardiovasc Nurs 2022; 22:345-354. [DOI: 10.1093/eurjcn/zvac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To compare the frailty prevalence and predictive performance of six frailty instruments in adults with heart failure and determine feasibility of study methods.
Methods and Results
Prospective cohort pilot study. Adults aged 18 years or older with a confirmed diagnosis of heart failure in Sydney, New South Wales, Australia. The Frailty Phenotype; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI); St Vincent’s Frailty instrument; St Vincent’s Frailty instrument plus cognition and mood; The Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale; and the Deficit Accumulation Index were compared. Multiple logistic regression was used to develop six frailty instrument models to evaluate the association between each frailty instrument and composite all-cause rehospitalisation and mortality at 12 months
One hundred and thirty-one patients were included with a mean age of 54 (± 14[SD]). Frailty prevalence ranged from 33-81%. All instruments except one (the FRAIL scale) appeared to signal an increased odds of rehospitalisation and/or mortality, yet these results were non-significant. The six frailty instrument models displayed sensitivity between 88-92% and C-statistic values of 0.71-0.73, suggesting satisfactory discrimination.
Conclusions
The prevalence of frailty varied across six frailty instruments yet was in the higher range despite a ‘younger’ heart failure cohort. Further research is required to confirm the psychometric properties of these instruments for routine clinical use in an adequately powered and more diverse heart failure cohort.
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Affiliation(s)
- Julee McDonagh
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle , Gosford, New South Wales , Australia
| | - Caleb Ferguson
- The School of Nursing, University of Wollongong , Wollongong, New South Wales , Australia
| | - Roslyn Prichard
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast , Sippy Downs, Queensland , Australia
| | - Sungwon Chang
- School of Public Health, The University of Technology Sydney , Ultimo, New South Wales , Australia
| | - Jane L Philips
- School of Nursing, Faculty of Health, Queensland University of Technology , Brisbane, Queensland , Australia
| | - Patricia M Davidson
- The Vice-Chancellor’s Unit, University of Wollongong , Wollongong, New South Wales , Australia
| | - Phillip J Newton
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle , Gosford, New South Wales , Australia
| | - Peter S Macdonald
- St Vincent’s Hospital Heart and Lung Clinic, St Vincent’s Hospital Sydney , Darlinghurst, New South Wales , Australia
- Victor Chang Cardiac Research Institute , Darlinghurst, New South Wales , Australia
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Ogungbe O, Gilotra NA, Davidson PM, Farley JE, Dennison Himmelfarb CR, Post WS, Commodore-Mensah Y. Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study. Open Heart 2022. [PMCID: PMC9445235 DOI: 10.1136/openhrt-2022-002084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection. Methods We performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive test, COVID-19 hospitalisation, age, sex, education, income) and cardiac-related PASC. Results In a sample of 442 persons, mean (SD) age was 45.4 (16.2) years, 71% were women, 13% were black, 46% had pre-existing conditions, 23% had cardiovascular (CV) risk factors and 4% had CVD. Prevalence of cardiac PASC was 43% and newly diagnosed cardiac conditions were 27%. The odds for cardiac-related PASC were higher among persons with underlying pre-existing conditions (adjusted OR (aOR): 2.00, 95% CI: 1.28 to 3.10) and among those who were hospitalised (aOR: 3.03, 95% CI: 1.58 to 5.83). Conclusions More than a third of persons with COVID-19 reported cardiac-related PASC symptoms. Underlying CVD, pre-existing diseases, age and COVID-19 hospitalisation are possible risk factors for cardiac-related PASC symptoms. COVID-19 may exacerbate CV risk factors and increase risk of complications.
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Affiliation(s)
| | - Nisha A Gilotra
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Jason E Farley
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- The Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wendy S Post
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bell ES, Shah P, Zuela-Sopilniak N, Kim D, Varlet AA, Morival JL, McGregor AL, Isermann P, Davidson PM, Elacqua JJ, Lakins JN, Vahdat L, Weaver VM, Smolka MB, Span PN, Lammerding J. Low lamin A levels enhance confined cell migration and metastatic capacity in breast cancer. Oncogene 2022; 41:4211-4230. [PMID: 35896617 PMCID: PMC9925375 DOI: 10.1038/s41388-022-02420-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/07/2023]
Abstract
Aberrations in nuclear size and shape are commonly used to identify cancerous tissue. However, it remains unclear whether the disturbed nuclear structure directly contributes to the cancer pathology or is merely a consequence of other events occurring during tumorigenesis. Here, we show that highly invasive and proliferative breast cancer cells frequently exhibit Akt-driven lower expression of the nuclear envelope proteins lamin A/C, leading to increased nuclear deformability that permits enhanced cell migration through confined environments that mimic interstitial spaces encountered during metastasis. Importantly, increasing lamin A/C expression in highly invasive breast cancer cells reflected gene expression changes characteristic of human breast tumors with higher LMNA expression, and specifically affected pathways related to cell-ECM interactions, cell metabolism, and PI3K/Akt signaling. Further supporting an important role of lamins in breast cancer metastasis, analysis of lamin levels in human breast tumors revealed a significant association between lower lamin A levels, Akt signaling, and decreased disease-free survival. These findings suggest that downregulation of lamin A/C in breast cancer cells may influence both cellular physical properties and biochemical signaling to promote metastatic progression.
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Affiliation(s)
- Emily S. Bell
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY,Current address: Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA
| | - Pragya Shah
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | | | - Dongsung Kim
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | - Alice-Anais Varlet
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | - Julien L.P. Morival
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | - Alexandra L. McGregor
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY,Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY
| | - Philipp Isermann
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | | | - Joshua J. Elacqua
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | - Jonathan N. Lakins
- Center for Bioengineering and Tissue Regeneration, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Linda Vahdat
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Valerie M. Weaver
- Center for Bioengineering and Tissue Regeneration, Department of Surgery, University of California, San Francisco, San Francisco, CA,Helen Diller Cancer Center, Department of Bioengineering and Therapeutic Sciences, and Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Marcus B. Smolka
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY
| | - Paul N. Span
- Department of Radiation Oncology, Radiotherapy & OncoImmunology laboratory, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Jan Lammerding
- Weill Institute for Cell and Molecular Biology, Cornell University, Ithaca, NY, USA. .,Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
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40
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Nelson KE, Saylor MA, Anderson A, Buck H, Davidson PM, DeGroot L, Fisher M, Gilotra NA, Pavlovic N, Szanton SL. "We're all we got is each other": Mixed-methods analysis of patient-caregiver dyads' management of heart failure. Heart Lung 2022; 55:24-28. [PMID: 35436655 DOI: 10.1016/j.hrtlng.2022.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/21/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals living with heart failure often require informal caregiving assistance for optimal self-care maintenance. The influence of caregiver burden and resilience on dyadic congruence is not well understood. OBJECTIVE To compare how dyadic congruence is influenced by level of burden and resilience expressed by caregivers of patients with heart failure. METHODS Mixed-methods analysis of individuals with heart failure and their caregivers, focusing on measures of caregiver burden (Zarit Burden Interview) and resilience (Brief Resilience Scale). Data were integrated using the Heart Failure Care Dyadic Typology. RESULTS Twelve dyads (n=24 participants) were classified as Type II (n=7) and Type III (n=5) dyads. Among Type II dyads, average caregiver burden was 19.43 (± 13.89) and resilience was 3.16 (± 1.04). For Type III dyads, average caregiver burden was 3.80 (± 4.27) and resilience 4.07 (± 1.36), respectively. Two key themes were derived: 1) caregivers' tendency to take the lead, and 2) the usefulness of cognitive reframing. Data integration elucidated that theme 1 was more common among Type II dyads and those with higher burden, and theme 2 was more prevalent among Type III dyads and those with higher resilience. CONCLUSION Findings highlight important variances in how dyads collectively manage heart failure. Future inquiry should involve tailored intervention development to bolster informal caregivers' quality of life and ability to better support patients throughout their heart failure trajectory.
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Affiliation(s)
- Katie E Nelson
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA.
| | | | - Annabel Anderson
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
| | - Harleah Buck
- University of Iowa College of Nursing, Iowa City, IA, USA
| | | | - Lyndsay DeGroot
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
| | - Marlena Fisher
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
| | - Nisha A Gilotra
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Noelle Pavlovic
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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41
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Ogungbe O, Commodore-Mensah Y, Dennison Himmelfarb CR, Ferguson C, Martin K, Davidson PM. COVID-19: Lessons Learned and a Need for Data Driven Decision Making. Heart Lung Circ 2022; 31:905-909. [PMID: 35752453 PMCID: PMC9221316 DOI: 10.1016/j.hlc.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC, VA, USA
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; University of Wollongong, Wollongong, NSW, Australia; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Abstract
BACKGROUND Heart failure is a troublesome condition with high healthcare utilization and cost. Most individuals with heart failure experience multiple symptoms including breathlessness, pain, depression, and anxiety. PURPOSE The aim of this study was to review the literature describing the use of the Edmonton Symptom Assessment Scale to assess the burden of symptoms and the impact of symptoms on heart failure outcomes including quality of life and functional outcomes. METHODS The search engines PubMed, Scopus, CINAHL, and Web of Science were searched from January 2001 to March 2020. A review of literature was undertaken using key terms "heart failure," "CHF," "cardiac failure," "heart decompensation," "myocardial failure," "Edmonton Symptom Assessment Scale". Hand searching of articles was also undertaken. RESULTS The search resulted in 33 relevant articles, which were imported into Rayyan, a Web-based systematic review software program. We present synthesis of results of studies (1) using the Edmonton Symptom Assessment Scale as an assessment of symptom burden and (2) evaluating the impact of symptom burden on quality of life and functional status. CONCLUSION This review highlighted the Edmonton Symptom Assessment Scale as a predictive instrument to identify symptom burden, symptom clusters, and symptom changes for patients living with heart failure. The clinical use of the Edmonton Symptom Assessment Scale may identify treatment priorities, promote self-management, inform the treatment plan, and advance effective therapeutic adjustments. The symptom burden in heart failure is high, and improving the symptom experience is an important focus of future healthcare interventions. The Edmonton Symptom Assessment Scale has utility in heart failure management due to psychometric properties and ease of administration. CLINICAL IMPLICATIONS The Edmonton Symptom Assessment Scale may be useful in measuring patient-reported symptom burden in patients with heart failure in the clinical setting because it correlates well with other heart failure measures on quality of life and functional outcomes and provides useful information on symptom burden.
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43
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De Raeve P, Bolzonella F, Davidson PM. A Theoretically Derived Approach to Impact: Implementing Policy Influence Strategies. Policy Polit Nurs Pract 2022; 23:150-161. [PMID: 35656783 DOI: 10.1177/15271544221100164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Advocacy is an intentional act of influencing government and an important precondition for successful policy change in society. Drawing from an existing framework on policy influence, we propose an approach to quantifying the impact of policy influence efforts, specifically within the context of European Public Health (EPH) advocacy. The analysis hinges on the article "Moving from tokenism" which provides a starting point to conceptualize strategies to quantify impact. An exploratory case study approach allowed to integrate literature on advocacy evaluation in parallel with the internal documentation of a EPH advocacy organization We provide recommendations to advocacy organizations that aim to create an infrastructure towards quantifying the impact of their efforts. The framework is mostly tailored to the needs of EPH advocacy, but it can also have resonance beyond the scope of a specific sector.
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Affiliation(s)
- Paul De Raeve
- Secretary General European Federation of Nurses Associations, Brussels, Belgium
| | - Francesco Bolzonella
- 120669Maastricht University, School of Business and Economics, Maastricht, Netherlands
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44
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Abshire Saylor M, Pavlovic NV, DeGroot L, Jajodia A, de Hladek MC, Perrin N, Wolff J, Davidson PM, Szanton S. Strengths-building through life purpose, self-care goal setting and social support: Study protocol for Caregiver Support. Contemp Clin Trials Commun 2022; 28:100917. [PMID: 35602009 PMCID: PMC9118505 DOI: 10.1016/j.conctc.2022.100917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/15/2022] [Accepted: 04/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background For caregivers of people with heart failure, addressing a range of care recipient needs at home can potentially be burdensome, but caregivers may also gain meaning from caregiving. The Caregiver Support Program, a multicomponent strengths-based intervention, is designed to improve outcomes of heart failure caregivers. Objectives 1) Test the feasibility and gauge an initial effect size of the Caregiver Support Program to improve caregiver quality of life (primary outcome), and fatigue and burden (secondary outcomes) from baseline to 16 weeks, 2) test whether fatigue and caregiver burden are associated with objective measures of resilience (sweat inflammatory cytokines (Il-6 and IL-10) and self-reported resilience, 3) evaluate changes in heart rate variability, IL-6 and IL-10, pre- and post-intervention. Methods This is a single-blind, two group, waitlist control trial. Eligible caregivers are 1) ≥ 18 years, 2) English speaking, 3) live with the person with heart failure or visit them at least 3 days per week to provide care, 4) provide support for at least 1 instrumental activity of daily living (IADL), 5) live within a 1 h driving radius of the Johns Hopkins Hospital, and 6) the care-recipient has been hospitalized within the last 6 months. Trial participants are randomized into the immediate intervention (n = 24) or waitlist control group (n = 24). Data collection is at baseline, 16 weeks, and 32 weeks. Conclusion The Caregiver Support program has the potential to increase quality of life and decrease fatigue and caregiver burden for caregivers of people with heart failure and multiple co-morbidities.
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45
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McDonagh J, Prichard R, Ferguson C, Phillips JL, Davidson PM, Macdonald PS, Newton PJ. Clinician Estimates of Frailty Compared to Formal Frailty Assessment in Adults With Heart Failure: A Cross-Sectional Analysis. Heart Lung Circ 2022; 31:1241-1246. [PMID: 35501244 DOI: 10.1016/j.hlc.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 11/02/2021] [Accepted: 04/06/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frailty assessment is recommended for patients with heart failure. Despite the availability of instruments to assess frailty, there are no clear recommendations regarding the optimal instrument to use in a heart failure context. This ambiguity combined with a lack of education and resources, often leads clinicians to rely on subjective estimates of frailty, such as 'the end-of-the-bed' or 'eyeball' test. AIM To examine the association between clinician-estimated frailty and formal frailty assessment in adults with heart failure. METHODS Cross-sectional analysis of the FRAilty MEasurement in Heart Failure (FRAME-HF) study. PARTICIPANTS (1) Adults aged ≥18 years in the outpatient heart failure clinic and cardiology ward; (2) and cardiovascular clinicians (nurses, physicians, and allied-health professionals). Following participant recruitment, cardiovascular clinicians were asked to rate the participant's frailty status based on their routine clinical assessment as either: frail, pre-frail, or non-frail, which was then compared to a formal frailty assessment using a modified version of the Frailty Phenotype. The association between clinician-estimated frailty and formal frailty assessment were examined using a weighted Kappa statistic and Spearman's correlation coefficient. RESULTS A total of 75 patients and 39 clinicians were recruited, producing 194 paired frailty assessments. Mean age of the patients was 54 (±13) years. Correlation of pooled clinician-estimated frailty to formal frailty was fair (0.52, p=0.00). Correlation was highest between allied-health estimated frailty and formal frailty (0.70, p=0.00). Agreement between pooled clinician-estimated frailty and formal frailty was fair (0.33) and was highest between allied health-estimated frailty and formal frailty (0.45). CONCLUSION Subjective clinician-estimated frailty is not a reliable replacement for formal frailty assessment in adults with heart failure, underscoring the need for assessment using a valid and reliable instrument.
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Affiliation(s)
- Julee McDonagh
- College of Health, Medicine and Wellbeing/School of Nursing and Midwifery, The University of Newcastle, Gosford, NSW, Australia.
| | - Roslyn Prichard
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Brisbane, Qld, Australia
| | - Caleb Ferguson
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia; Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Jane L Phillips
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia
| | | | - Peter S Macdonald
- St Vincent's Hospital Heart and Lung Clinic, St Vincent's Hospital Sydney, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
| | - Phillip J Newton
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
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Jeamjitvibool T, Tankumpuan T, Lukkahatai N, Davidson PM. Noncommunicable diseases and social determinants of health in Buddhist monks: An integrative review. Res Nurs Health 2022; 45:249-260. [DOI: 10.1002/nur.22215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 01/01/2022] [Accepted: 01/22/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Thanakrit Jeamjitvibool
- Department of Adult and Geriatric Nursing, Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science Chulabhorn Royal Academy Bangkok Thailand
| | - Thitipong Tankumpuan
- Department of Surgical Nursing, Faculty of Nursing Mahidol University Bangkok Thailand
| | - Nada Lukkahatai
- The Johns Hopkins University School of Nursing Baltimore Maryland USA
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47
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Lv X, Cao Y, Li Y, Liu Y, Li R, Guan X, Li L, Li J, Si S, Xue F, Ji X, Zhao J, Soh KL, Davidson PM. The TARGET Nurses' health cohort study protocol: Towards a revolution in getting nurses' health ticked. J Adv Nurs 2022; 78:1815-1823. [PMID: 35352386 DOI: 10.1111/jan.15204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/23/2022] [Accepted: 02/13/2022] [Indexed: 01/01/2023]
Abstract
AIM To evaluate the health status of nurses in China and explore the impact of work-related stress, work environment and lifestyle factors on their health outcomes. DESIGN The Chinese Nurses' Health Study is a multicentred, prospective cohort study. METHODS We plan to recruit approximately 80,000 registered nurses aged between 18 and 65 years. Eligible nurses will be introduced to complete a series of web-based questionnaires after obtaining their informed consent. Follow-up questionnaires will be completed at 2-year interval to continuously track subsequent exposures. Health-related indicators will be obtained through self-reporting by nurses and the provincial and national registry platforms such as National Central Cancer Registry. The funding was approved in July 2020 and Research Ethics Committee approval was granted in February 2021. DISCUSSION The study is the first multicentred prospective cohort study that aims to assess the impact of work-related stress, work environment and lifestyle factors on the health of Chinese nurses. The results of the Chinese Nurses' Health Cohort Study will potentially draw a picture of the current situation of general health and well-being among nurses in China and their health risks. This will be critical in recommending locally tailored strategic preventive measures and policies to reduce health and well-being threats for nurses and potentially general public, thereby promoting the quality of healthcare in China and globally. IMPACT This study will help to understand the health status and working environment characteristics of Chinese nurses, and provide valuable epidemiological evidence for improving working environment and promoting well-being. The results of this study are potentially of great significance for formulating targeted nursing strategies to promote the nurses' health, nursing quality and patient safety in China and even around the world. CLINICAL TRIAL REGISTRATION NUMBER AND NAME OF TRIAL REGISTER ChiCTR.org (ID:ChiCTR2100043202), The Nurses' Health Cohort Study of Shandong.
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Affiliation(s)
- Xiaoyan Lv
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China.,School of Nursing & Rehabilitation, Shandong University, Jinan, P. R. China
| | - Yuxin Li
- School of Nursing & Rehabilitation, Shandong University, Jinan, P. R. China
| | - Yunhong Liu
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Rong Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Xiangyun Guan
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Li Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Junli Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.,Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, P. R. China
| | - Shucheng Si
- School of Public Health, Shandong University, Jinan, P. R. China.,Data Science Institute, Shandong University, Jinan, P. R. China
| | - Fuzhong Xue
- School of Public Health, Shandong University, Jinan, P. R. China.,Data Science Institute, Shandong University, Jinan, P. R. China
| | - Xiaokang Ji
- School of Public Health, Shandong University, Jinan, P. R. China.,Data Science Institute, Shandong University, Jinan, P. R. China
| | - Junqiang Zhao
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Kim Lam Soh
- Department of Nursing, Universiti Putra Malaysia, Serdang, Malaysia
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48
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Dino MJS, Davidson PM, Dion KW, Szanton SL, Ong IL. Nursing and Human-Computer Interaction in Healthcare Robots for Older People: An Integrative Review. International Journal of Nursing Studies Advances 2022. [DOI: 10.1016/j.ijnsa.2022.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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49
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Zhao S, Cao Y, Cao H, Liu K, Lv X, Zhang J, Li Y, Davidson PM. Chinese Version of the mHealth App Usability Questionnaire: Cross-Cultural Adaptation and Validation. Front Psychol 2022; 13:813309. [PMID: 35185732 PMCID: PMC8848504 DOI: 10.3389/fpsyg.2022.813309] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Mobile health (mHealth) apps have shown the advantages of improving medication compliance, saving time required for diagnosis and treatment, reducing medical expenses, etc. The World Health Organization (WHO) has recommended that mHealth apps should be evaluated prior to their implementation to ensure their accuracy in data analysis. Objective This study aimed to translate the patient version of the interactive mHealth app usability questionnaire (MAUQ) into Chinese, and to conduct cross-cultural adaptation and reliability and validity tests. Methods The Brislin’s translation model was used in this study. The cross-cultural adaptation was performed according to experts’ comments and the results of prediction test. The convenience sampling method was utilized to investigate 346 patients who used the “Good Doctor” (“Good Doctor” is the most popular mHealth app in China), and the reliability and validity of the questionnaire were evaluated as well. Results After translation and cross-cultural adaptation, there were a total of 21 items and 3 dimensions: usability and satisfaction (8 items), system information arrangement (6 items), and efficiency (7 items). The content validity index was determined to be 0.952, indicating that the 21 items used to evaluate the usability of the Chinese version of the MAUQ were well correlated. The Cronbach’s α coefficient of the total questionnaire was 0.912, which revealed that the questionnaire had a high internal consistency. The values of test-retest reliability and split-half reliability of the Chinese version of the MAUQ were 0.869 and 0.701, respectively, representing that the questionnaire had a good stability. Conclusion The translated questionnaire has good reliability and validity in the context of Chinese culture, and it could be used as a usability testing tool for the patient version of interactive mHealth apps.
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Affiliation(s)
- Shuqing Zhao
- Department of Nursing, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,School of Nursing and Rehabilitation, Shandong University, Jinan, China.,Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, China
| | - Heng Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China.,Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Kao Liu
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, China
| | - Xiaoyan Lv
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, China
| | - Jinxin Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yuxin Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Patricia M Davidson
- The Vice-Chancellor's Unit, University of Wollongong, Wollongong, NSW, Australia
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Aghili MS, Darvishpoor Kakhki A, Gachkar L, Davidson PM. Predictors of contracting COVID-19 in nursing homes: Implications for clinical practice. J Adv Nurs 2022; 78:2799-2806. [PMID: 35170066 DOI: 10.1111/jan.15188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/23/2021] [Accepted: 01/15/2022] [Indexed: 11/30/2022]
Abstract
AIMS The aim of the study was to identify the predictors of contracting COVID-19 among older people in nursing homes in Iran. DESIGN A case-control study. METHODS Four-hundred-nine nursing home residents aged 60 years and above, with a 1:2 ratio of those infected with SARS-CoV-2 to those not infected, from six nursing homes in Tehran between 25 March and 12 July 2021 were recruited. Participants completed a questionnaire comprising demographic and underlying disease questions, practice about prevention principles of SARS-CoV-2 infection, probably predisposing factors of the infection, and environmental and staff characteristic of nursing homes. Logistic regression was used to determine risk factors associated with contracting COVID-19. RESULTS The mean age was 77.37 (±9.20) years; 54% were female. A logistic regression model showed that the most important predictors of becoming infected by SARS-CoV-2 included not using mask outside the room (odds ratio [OR]: 3.37, 95% CI: 1.74-6.53), longer staff shifts (OR: 3.02, 95% CI: 1.68-5.43), using cloth mask or not wearing a mask (OR: 2.47, 95% CI: 1.13-5.42) and not having glass barrier in visitors space (OR: 1.95, 95% CI: 1.11-3.50). CONCLUSION The results indicate that an increase in older people becoming infected by SARS-CoV-2 in nursing homes is probably because of not wearing a mask in common places, use of a cloth mask, longer staff shift durations and not having a glass shield when interacting with visitors from outside of nursing homes. IMPACT The predictors identified in this study can assist in reducing SARS-CoV-2 infections in older people institutionalized in nursing homes. These data items can also inform the development of interventions to improve principles of infection prevention and control.
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Affiliation(s)
- Mohammad Sadegh Aghili
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Latif Gachkar
- Department of Infectious Diseases, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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