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Capasso E, Cortese R, Auriemma G, Di Biase S, Di Donna G, Niola M. Vehicular homicide or cardiovascular event? The importance of the autopsy findings. Leg Med (Tokyo) 2024; 67:102386. [PMID: 38157675 DOI: 10.1016/j.legalmed.2023.102386] [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: 11/24/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
We present the case of a 61 years old woman who was hit by a car, resulting in fractures of the pubic bone, left ischium-pubis ramus and right femur, with need of hip replacement surgery. In the next days she was affected by two episodes of acute coronary syndrome, treated with coronary angioplasty surgery. After undergoing total hip replacement surgery an episode of asystole caused her death. A full autopsy showed coronary stenosis and chronic ischemic heart disease associated with a recent myocardial infarction. The pre-existing condition of T.L. could not be ignored but the initial traumatic event and the subsequent fractures played a further co-occurrent causal role. The initial trauma represented the first step of the phenomenological chain that led to a series of adverse cardiological events and to an irreversible asystole, so that the car driver should be partly considered accountable for the death of the woman.
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Affiliation(s)
- Emanuele Capasso
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Roberto Cortese
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Gianluca Auriemma
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Sabrina Di Biase
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Gaetano Di Donna
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Massimo Niola
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
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Chen Q, Chen Q, Wang Q, Xu R, Liu T, Liu Y, Ding Z, Sun H. Particulate matter and ozone might trigger deaths from chronic ischemic heart disease. Ecotoxicol Environ Saf 2022; 242:113931. [PMID: 35914398 DOI: 10.1016/j.ecoenv.2022.113931] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
AIMS To study the association between short-term exposure to air pollutants and mortality of Chronic Ischemic Heart Disease (CIHD). METHODS Using a case-crossover design, we investigated 148,443 CIHD deaths from 2015 to 2020 in Jiangsu Province, China. Exposure to six ambient pollutants, including PM10, PM2.5, NO2, CO, SO2, and O3, was assessed by extracting daily concentrations from validated 10 km × 10 km pollutant grids at each subject's residential address. A conditional logistic regression approach was used to explore the exposure-response relationship with adjustment for temperature and relative humidity. We calculated the Population Attributable Fractions (PAFs) and the attributable deaths number of CIHD. RESULTS An increase of 10 μg/m3 in PM10 and PM2.5 exposure was associated with a 1.16% (95% CI: 0.85-1.48%) and 1.80% (1.36-2.24%) increase in CIHD mortality, respectively. A threshold value of 123 µg/m3 was identified for the association between O3 exposure and CIHD mortality. Controlling for PM2.5, each increase of 10 µg/m3 in O3 (>threshold) was statistically significantly associated with a 0.94% (0.19-1.71%) increase in CIHD mortality, however there was no association between NO2, SO2, CO exposure and CIHD mortality. Reducing PM2.5, PM10 and O3 to the WHO air quality guidelines would prevent 6.16% (95% CI: 4.70-7.58%), 4.30% (3.18-5.43%) and 1.29% (0.48-4.20%) of CIHD deaths, respectively. During the warm season, mortality and PAFs of CIHD associated with PM2.5, PM10, and O3 were significantly higher. CONCLUSIONS Short-term exposure to ambient PM2.5, PM10, and O3 might trigger deaths from CIHD. These findings indicate that the premature deaths of CIHD patients can be alleviated by reducing exposure to polluted air.
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Affiliation(s)
- Qing Chen
- Department of Planning and Finance, First People's Hospital of Lianyungang City 6, Zhenhua East Road, Lianyungang, Jiangsu, 222000, China
| | - Qi Chen
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Qingqing Wang
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Zhen Ding
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China.
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Qayyum AA, Mathiasen AB, Helqvist S, Jørgensen E, Haack-Sørensen M, Ekblond A, Kastrup J. Autologous adipose-derived stromal cell treatment for patients with refractory angina (MyStromalCell Trial): 3-years follow-up results. J Transl Med 2019; 17:360. [PMID: 31711513 PMCID: PMC6849216 DOI: 10.1186/s12967-019-2110-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 06/10/2019] [Accepted: 10/26/2019] [Indexed: 12/15/2022] Open
Abstract
Background Stem cell therapy is investigated as a treatment option for patients with ischemic heart disease. In this study, long-term safety and efficacy of autologous intra-myocardial injections of adipose-derived stromal cells (ASCs) was studied in patients with refractory angina. Methods Sixty patients with coronary artery stenosis and preserved left ventricular ejection fraction were 2:1 randomised to intramyocardial injections of ASCs or saline and followed for 3 years. Results For patients in the ASC group, the bicycle exercise time and the exercise performance in watt were un-changed (383 ± 30 s to 370 ± 44 s, P = 0.052 and 81 ± 6 to 78 ± 10, P = 0.123, respectively), but the performance in METs was reduced significantly (4.2 ± 0.3 to 4.0 ± 0.4, P = 0.027) during the follow-up period. However, in the same period, there was in the placebo group a significant decline in bicycle exercise time (437 ± 53 s to 383 ± 58 s, P = 0.001), the exercise performance measured in watt (87 ± 12 W to 80 ± 12 W, P = 0.019) and in METs (4.5 ± 0.4 to 4.1 ± 0.4, P = 0.002). Moreover, angina measured as CCS class was significantly reduced in the ASC group but not in the placebo group (2.5 ± 0.9 to 1.8 ± 1.2, P = 0.002 and 2.5 ± 0.8 to 2.1 ± 1.3, P = 0.186, respectively). However, no significant change was observed between the two groups. Conclusions Patients receiving ASCs had improved cardiac symptoms and unchanged exercise capacity, in opposition to deterioration in the placebo group. Trial registration ClinicalTrials.gov Identifier: NCT01449032. Registered 7 October 2011—Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT01449032?term=jens+kastrup&rank=7
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Affiliation(s)
- Abbas Ali Qayyum
- Department of Cardiology & Cardiac Catheterization Laboratory 2014, Rigshospitalet University of Copenhagen, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark.
| | - Anders Bruun Mathiasen
- Department of Cardiology & Cardiac Catheterization Laboratory 2014, Rigshospitalet University of Copenhagen, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark
| | - Steffen Helqvist
- Department of Cardiology & Cardiac Catheterization Laboratory 2014, Rigshospitalet University of Copenhagen, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark
| | - Erik Jørgensen
- Department of Cardiology, Gentofte University of Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Mandana Haack-Sørensen
- Cardiology Stem Cell Centre 9302, Rigshospitalet University of Copenhagen, Henrik Harpestrengsvej 4C, 2100, Copenhagen, Denmark
| | - Annette Ekblond
- Cardiology Stem Cell Centre 9302, Rigshospitalet University of Copenhagen, Henrik Harpestrengsvej 4C, 2100, Copenhagen, Denmark
| | - Jens Kastrup
- Department of Cardiology & Cardiac Catheterization Laboratory 2014, Rigshospitalet University of Copenhagen, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark.,Cardiology Stem Cell Centre 9302, Rigshospitalet University of Copenhagen, Henrik Harpestrengsvej 4C, 2100, Copenhagen, Denmark
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You M, Fang W, Wang X, Yang T. Modelling of the ICF core sets for chronic ischemic heart disease using the LASSO model in Chinese patients. Health Qual Life Outcomes 2018; 16:139. [PMID: 29996874 PMCID: PMC6042460 DOI: 10.1186/s12955-018-0957-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 07/11/2017] [Accepted: 06/13/2018] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to examine the associations among the International Classification of Functioning, Disability, and Health (ICF) core sets relevant to chronic ischemic heart disease (CIHD) using the least absolute shrinkage and selection operator (LASSO) model based on the ICF core sets scale in Chinese patients. Methods This was a prospective study of 120 patients with CIHD selected from January 2013 to June 2014 at the Fada Institute of Forensic Medicine & Science (Beijing, China). Functioning was qualified using the ICF core sets checklist for CIHD (Chinese version). The variables of core set categories of the ICF assessment scale for CIHD were entered into the LASSO model for mining dependencies among those variables. Graphical modeling was applied using LASSO generalized linear models. Results “Muscle endurance functions”, “sensations associated with cardiovascular and respiratory functions”, “blood vessel functions”, and “heart functions” were the most injured in CIHD status. “Recreation and leisure” and “intimate relationships” were the most affected in CIHD status. “General social support services, systems, and policies” and “acquaintances, peers, colleagues, neighbors, and community members” were important for the outcome of functional status of the CIHD patient. “Economic self-sufficiency” and “family relationships” of the CIHD patient were not undermined in most cases. Conclusions Graphical modeling can be used to describe associations between different areas of functioning in CIHD patients. The results suggest that these associations could be used as basis to improve rehabilitation and provide a deeper understanding of functioning in Chinese CIHD patients. Electronic supplementary material The online version of this article (10.1186/s12955-018-0957-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meng You
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China
| | - Wen Fang
- Beijing Jiaotong University, Beijing, China
| | - Xu Wang
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China
| | - Tiantong Yang
- Collaborative Innovation Center of Judicial Civilization, Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, 25 Xitucheng Road, Beijing, 100040, China.
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Dong P, Hu H, Guan X, Ung COL, Shi L, Han S, Yu S. Cost-consequence analysis of salvianolate injection for the treatment of coronary heart disease. Chin Med 2018; 13:28. [PMID: 29946348 PMCID: PMC6000959 DOI: 10.1186/s13020-018-0185-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 05/20/2018] [Accepted: 05/27/2018] [Indexed: 01/07/2023] Open
Abstract
Background Complicated with the impact of aging population and urbanization, coronary heart disease (CHD) incurs more and more disease burdens in China. Salvianolate injection is a Chinese patent drug widely used for treating CHD in China. A series of studies have verified the efficacy of salvianolate injection
, but the high drug cost has raised concerns. It is, therefore, important to conduct cost-consequence analysis to demonstrate whether salvianolate injection is associated with outcome improvement and cost containment. The aim of this study was to retrospectively evaluate the cost-consequence of salvianolate injection for the treatment of coronary heart disease by combining salvianolate injection with conventional treatment from a societal perspective. Methods We retrospectively studied hospitalized patients with CHD from August 2011 to December 2015 by using electronic medical record database. Patients who received salvianolate injection combined with conventional treatment were selected as exposed group, while those who received conventional treatment alone were selected as unexposed group. Propensity score matching (PSM) analysis was used to balance the characteristics of patients. After PSM, we evaluated hospital stay, total nitrates dosage, total medical costs, and subcategories costs. Patients with chronic ischemic heart disease were analyzed as a highly selected subcohort. Results For the overall group, hospital stay was significantly decreased by 2.9 days (P < 0.05) and total nitrates dosage was significantly decreased by 172.4 mg (P < 0.05) in exposed group; cost savings of pharmacy cost, examination cost, laboratory cost, operation cost and treatment was observed as significant (at P < 0.05); and the additional expenditure of Chinese patent drug (1174.9 CNY) was less than the saving of total medical costs (2636.4 CNY). For chronic ischemic heart disease subcohort, compared with unexposed group, significant decreases were also found in hospital stay and total nitrates dosage (P < 0.05); cost savings were significant (P < 0.05) for exposed group in terms of total medical costs (4339.5 CNY) and subcategories costs (including pharmacy cost, examination cost, operation cost and treatment cost); and the additional expenditure of Chinese patent drug (1189.3 CNY) was less than the saving of total medical costs. Conclusion Compared with conventional treatment for the treatment of CHD, combination of salvianolate injection and conventional treatment was associated with a reduction in hospital stay and total nitrates dosage. The acquisition cost of Chinese patent drug (including salvianolate injection) was offset by a higher reduction in total medical costs, especially for chronic ischemic heart disease. Electronic supplementary material The online version of this article (10.1186/s13020-018-0185-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pengxin Dong
- 1School of Pharmaceutical Sciences, Shandong University, Jinan, Shandong China.,2International Research Center of Medical Administration, Peking University, Beijing, China
| | - Hao Hu
- 3State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Xiaodong Guan
- 4School of Pharmaceutical Science, Peking University Health Science Center, Beijing, China
| | - Carolina Oi Lam Ung
- 3State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Luwen Shi
- 2International Research Center of Medical Administration, Peking University, Beijing, China.,4School of Pharmaceutical Science, Peking University Health Science Center, Beijing, China
| | - Sheng Han
- 2International Research Center of Medical Administration, Peking University, Beijing, China
| | - Shuwen Yu
- 1School of Pharmaceutical Sciences, Shandong University, Jinan, Shandong China.,5Shandong University Affiliated Jinan Central Hospital, Jinan, Shandong China
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Baritussio A, Scatteia A, Bucciarelli-Ducci C. Role of cardiovascular magnetic resonance in acute and chronic ischemic heart disease. Int J Cardiovasc Imaging 2018; 34:67-80. [PMID: 28315985 DOI: 10.1007/s10554-017-1116-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
Abstract
Cardiovascular magnetic resonance (CMR) is a multi-parametric, multi-planar, non-invasive imaging technique, which allows accurate determination of biventricular function and precise myocardial tissue characterization in a one-stop-shop technique, free from the use of ionizing radiations. Though CMR has been increasingly applied over the last two decades in every-day clinical practice, its widest application has been in the assessment of ischemic cardiomyopathy.
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Lotfi AS, Eftekhari H, Atreya AR, Kashikar A, Sivalingam SK, Giannoni M, Visintainer P, Engelman D. Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery. World J Cardiol 2016; 8:615-622. [PMID: 27847563 PMCID: PMC5088368 DOI: 10.4330/wjc.v8.i10.615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 07/26/2016] [Accepted: 08/29/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF).
METHODS This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC (control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke.
RESULTS POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group (P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups.
CONCLUSION This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.
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Koenig S, Arya A, Hindricks G, Dinov B. Catheter ablation of ventricular tachycardia in the setting of electrical storm after revascularization of a chronic total occlusion of the right coronary artery: An uncommon presentation of reperfusion arrhythmia. HeartRhythm Case Rep 2016; 2:462-464. [PMID: 28491737 PMCID: PMC5419978 DOI: 10.1016/j.hrcr.2016.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sebastian Koenig
- Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany
| | - Arash Arya
- Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany
| | - Gerhard Hindricks
- Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany
| | - Borislav Dinov
- Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany
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Cordero A, Galve E, Bertomeu-Martínez V, Bueno H, Fácila L, Alegría E, Cequier Á, Ruiz E, González-Juanatey JR. Trends in Risk Factors and Treatments in Patients With Stable Ischemic Heart Disease Seen at Cardiology Clinics Between 2006 and 2014. ACTA ACUST UNITED AC 2015; 69:401-7. [PMID: 26631917 DOI: 10.1016/j.rec.2015.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 05/22/2015] [Accepted: 08/06/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES Chronic ischemic heart disease is the most prevalent of all cardiovascular diseases. Patients are at high risk of complications. In recent decades, changes may have occurred in the clinical characteristics of the disease, its treatment and control of risk factors. METHODS A direct comparison of 2 national registries of patients with chronic ischemic heart disease carried out in 2006 (n=1583) and 2014 (n=1110). RESULTS We observed statistically significant differences between the 2 registries, with a higher percentage of men and smokers in the 2014 registry, but a lower prevalence of diabetes mellitus and hypertension. Heart failure and stroke were more prevalent in the 2006 registry. Patients in the 2014 registry had better results for lipid profile, blood glucose, creatinine, and glomerular filtration rate. We observed higher use of recommended drugs for secondary prevention and an increased percentage of patients receiving optimal medical therapy, from 32.5% to 49.5% (P<.01). Use of high-intensity statin doses also increased from 10.5% to 42.8% (P<.01). We found better control of some risk factors (improved dyslipidemia, heart rate, and blood glucose in patients with diabetes) but worse blood pressure control. CONCLUSIONS The clinical profile of patients with chronic ischemic heart disease is similar in the 2 registries. There has been an improvement in patients' medical therapy and dyslipidemia control, blood glucose, and heart rate, but there is still much room for improvement in the control of other cardiovascular risk factors.
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Affiliation(s)
- Alberto Cordero
- Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain.
| | - Enrique Galve
- Departamento de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain
| | - Vicente Bertomeu-Martínez
- Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - Héctor Bueno
- Departamento de Cardiología, Hospital 12 de Octubre, Madrid, Spain
| | - Lorenzo Fácila
- Departamento de Cardiología, Hospital General de Valencia, Valencia, Spain
| | - Eduardo Alegría
- Departamento de Cardiología, Policlínica Gipuzkoa, San Sebastián, Guipúzcoa, Spain
| | - Ángel Cequier
- Departamento de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Emilio Ruiz
- Departamento Médico, Laboratorios Ferrer, Barcelona, Spain
| | - José Ramón González-Juanatey
- Departamento de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Farin E, Schmidt E, Gramm L. Patient communication competence: development of a German questionnaire and correlates of competent patient behavior. Patient Educ Couns 2014; 94:342-350. [PMID: 24332119 DOI: 10.1016/j.pec.2013.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 10/25/2013] [Accepted: 11/19/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of our study was to design and psychometrically test a patient questionnaire to capture patient communication competence in the context of patient-provider interaction (CoCo questionnaire). We also aimed to determine patient characteristics associated with competent patient behavior. METHODS To assure content validity, we initially conducted 17 focus groups (n=97) made up of patients and providers. In the main study n=1.264 patients with chronic back pain, chronic-ischemic heart disease or breast cancer who underwent inpatient rehabilitation were surveyed at the end of rehabilitation. RESULTS The CoCo questionnaire contains four scales (patient adherence in communication, critical and participative communication, communication about personal circumstances, active disease-related communication) and 28 items addressing competent patient behavior. We provide evidence of unidimensionality, local independence, reliability, a Rasch-Model fit, the absence of differential item functioning, and signs of construct validity. The most important correlates of communication competence are health literacy and communication self-efficacy. CONCLUSION The CoCo questionnaire has good psychometric properties in German. Future research should examine CoCo's responsiveness and analyze criterion validity by means of observation data. PRACTICE IMPLICATIONS The CoCo questionnaire can be recommended for use in evaluating patient communication training programs.
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Affiliation(s)
- Erik Farin
- Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany.
| | - Erika Schmidt
- Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany
| | - Lukas Gramm
- Department of Quality Management and Social Medicine, University Freiburg - Medical Center, Freiburg, Germany
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