ORCID Profile
0000-0001-8518-6307
Current Organisation
Queen's University Belfast
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Publisher: Elsevier BV
Date: 06-2002
Publisher: Elsevier BV
Date: 02-2006
Publisher: Elsevier BV
Date: 06-2002
DOI: 10.1016/S0167-5273(02)00064-5
Abstract: Nurses are increasingly being involved in initiatives to improve the co-ordination, delivery and eventual outcomes of health care. Key components of these initiatives include application of evidence-based treatments, ensuring in idualised follow-up and the provision of "seamless" care overall. There is evidence in key areas that nurse-led interventions for patients with heart disease are effective, and that they are likely to work in other areas if properly supported and appropriate structures and systems are put in place to promote such practice. Given the promising results to date, it would be disappointing if these issues remain unresolved and the potential value of this type of interventions unfulfilled.
Publisher: Oxford University Press (OUP)
Date: 06-06-2018
Publisher: Springer Science and Business Media LLC
Date: 13-09-2006
DOI: 10.1007/S11136-006-0065-1
Abstract: To evaluate the validity, reliability, and cultural relevance of the Chinese Mandarin version of Myocardial Infarction Dimensional Assessment Scale (MIDAS) as a disease-specific quality of life measure. The cultural relevance and content validity of the Chinese Mandarin version of the MIDAS (CM-MIDAS) was evaluated by an expert panel. Measurement performance was tested on 180 randomly selected Chinese MI patents. Thirty participants from the primary group completed the CM-MIDAS for test-retest reliability after 2 weeks. Reliability, validity and discriminatory power of the CM-MIDAS were calculated. Two items were modified as suggested by the expert panel. The overall CM-MIDAS had acceptable internal consistency with Cronbach's alpha coefficient 0.93 for the scale and 0.71-0.94 for the seven domains. Test-retest reliability by intraclass correlations was 0.85 for the overall scale and 0.74-0.94 for the seven domains. There was acceptable concurrent validity with significant (p < 0.05) correlations between the CM-MDAS and the Chinese Version of the Short Form 36. The principal components analysis extracted seven factors that explained 67.18% of the variance with high factor loading indicating good construct validity. Empirical data support CM-MIDAS as a valid and reliable disease-specific quality of life measure for Chinese Mandarin speaking patients with myocardial infarction.
Publisher: Informa UK Limited
Date: 13-11-2014
Publisher: Massachusetts Medical Society
Date: 16-02-2012
DOI: 10.1056/NEJMC1114006
Publisher: Springer Singapore
Date: 2016
Publisher: Mark Allen Group
Date: 04-2007
DOI: 10.12968/BJCA.2007.2.4.23456
Abstract: Aim: This study aimed to evaluate the effect of cardiac rehabilitation on changing patients’ exercise intensity and physiological outcomes. Methods: The study used a pre- and post-inter vention test design to evaluate an 8-week cardiac rehabilitation programme. The focus of this programme was supervised exercise and the content includeddiet, physical activity, stress management and risk factor management. Patients attended three 2-hour sessions every week and these were supervised by a nurse specialist. Results: After 8 weeks of cardiac rehabilitation, the patients’ exercise intensity, systolic and diastolic blood pressure, body mass index, total cholesterol, high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol, and triglycerides were all improved. However, except for the high density lipoprotein cholesterol levels, the improvements were not sustained at 3 months. Among behaviour changes, only the improved behaviour in smoking and exercise were maintained at 3 months. Conclusions: The results of this study indicate that cardiac rehabilitation is effective in improving cardiac patient outcomes in the short term but that other approaches, such as motivational interviewing and counselling, and strategies such as unsupervised exercise programmes in community settings, may be needed to maintain the physiological improvements.
Publisher: Wiley
Date: 05-03-2008
Publisher: Oxford University Press (OUP)
Date: 07-06-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2008
DOI: 10.1111/J.1744-1609.2008.00111.X
Abstract: Background Cardiac catheterisation plays a vital role in the diagnosis and evaluation of cardiac conditions. The goal of management of patients after cardiac catheterisation is to reduce the risk of development of any local or prolonged vascular complications, in particular bleeding and haematoma formation at the puncture site. Bed rest and immobilisation of the affected leg are recommended practices to ensure adequate haemostasis at the femoral arterial puncture site and prevent complications. Objectives The objective of this review was to present the best available evidence for the optimal length of bed rest after trans-femoral diagnostic cardiac catheterisation. The main outcome of interest was the incidence of bleeding and haematoma formation following varying periods of bed rest. Search strategy We searched the following databases: CINAHL, Medline, Cochrane Library, Current Contents, EBSCO, Web of Science, Embase, British Nursing Index, Controlled clinical trials database, Google Scholar. Reference lists of relevant articles and conference proceedings were searched. We also contacted key organisations and researchers in the field. Selection criteria All randomised and quasi-randomised controlled trials that compared the effects of different lengths of bed rest following trans-femoral diagnostic cardiac catheterisation on patient outcomes were considered for inclusion in the review. Data collection and analysis Eligibility of the trials for inclusion in the review, details of eligible trials and the methodological quality of the trials were assessed independently by two reviewers. Odds ratios (OR) for dichotomous data and a weighted mean difference for continuous data were calculated with 95% confidence intervals (CI). Where synthesis was inappropriate, trials were considered separately. Main results Eighteen trials involving a total of 4294 participants were included in the review. One trial included three treatment groups. In seven trials among 747 people there was no significant difference in the incidence of bleeding following six or less than 6 h of bed rest (OR 1.47 95% CI 0.60, 3.64). Likewise, there was no significant difference in the incidence of bleeding following bed rest at other time periods. In eight trials involving 2272 patients there was no significant difference in the incidence of haematoma formation following 6 or less than 6 h of bed rest (OR 0.82 95% CI 0.59, 1.16). Significantly fewer patients randomised to less than 6 h of bed rest complained of back pain. The odds of developing back pain at 4 (OR 24.60 95% CI 1.29, 469) and 24 h (OR 2.47 95% CI 1.16, 5.23) following coronary catheterisation was significantly higher among patients randomised to 6 compared with 3 h of bed rest. Authors' conclusions There is evidence of no benefit relating to bleeding and haematoma formation in patients who have more than 3 h of bed rest following trans-femoral diagnostic cardiac catheterisation. However, there is evidence of benefit relating to decreased incidence and severity of back pain and cost-effectiveness following 3 h of bed rest. There is suggestive but inconclusive evidence of a benefit from bed rest for 2 h following trans-femoral cardiac catheterisation. Clinicians should consider a balance between avoiding increased risk of haematoma formation following 2-2.5 h of bed rest and circumventing back pain following more than 4 h of bed rest.
Publisher: Elsevier BV
Date: 02-2004
Publisher: Oxford University Press (OUP)
Date: 29-07-2016
Abstract: There is increasing evidence supporting the relationship between family support and patient outcomes. Therefore, involving families in the care of cardiovascular patients is expected to be beneficial for patients. The quality of the encounter with families highly depends on the attitudes of nurses towards the importance of families in patient care. The aim of this study was to describe the attitudes of nurses towards family involvement in patient care and to investigate the in idual contributions of demographic, professional and regional background characteristics. A survey was distributed among cardiovascular nurses attending an international conference in Norway and a national conference in Belgium. Nurses were asked to complete a questionnaire, including the Families' Importance in Nursing Care - Nurses' Attitudes scale. The study population consisted of respondents from Belgium ( n = 348) and from Scandinavian countries (Norway, Sweden and Denmark n = 77). In general, nurses viewed the family as important in care. However, attitudes towards actively inviting families to take part in patient care were less positive. Higher educational level and a main practice role in research, education or management were significantly associated with more positive attitudes. Furthermore, the attitudes of respondents living in Scandinavia were more positive as compared to the attitudes of respondents living in Belgium. Education on the importance of families and active family involvement in patient care seems to be necessary in basic, undergraduate education, but also in clinical practice. More research is necessary in order to explore the cultural and regional differences in the attitudes of nurses towards the involvement of families in patient care.
Publisher: Oxford University Press (OUP)
Date: 02-2002
Publisher: Frontiers Media SA
Date: 13-06-2017
Publisher: Oxford University Press (OUP)
Date: 09-01-2013
Publisher: Hindawi Limited
Date: 2022
DOI: 10.1111/JONM.13391
Publisher: BMJ
Date: 25-09-2011
Publisher: Mark Allen Group
Date: 02-07-2018
DOI: 10.12968/BJCA.2018.13.7.330
Abstract: Despite the 60-year history of attempting to understand the relationship between personality and cardiovascular disease (CVD), in idual dispositions that affect the manner in which people think, feel and act are not typically considered in cardiac clinical settings. To identify how persistent negative emotional states and behavioural traits impacted cardiovascular health, early studies focused on the Type A personality (competitive, aggressive) and, later on, the Type D personality (‘distressed’). Recent evidence on other personality types or behaviours, such as borderline personality disorder, alexithymia and neuroticism, suggest that it may be the core elements of these, alongside hostility and proneness to anger, that lead to atherosclerosis, endothelial dysfunction, coronary artery calcification, and inflammation. The current paper, and part 2 of the Psychology in Cardiology series, explores the evidence supporting different interventions for people with health-compromising personality factors, to assist in planning lifestyle modification.
Publisher: Oxford University Press (OUP)
Date: 10-2002
DOI: 10.1016/S1474-5151(02)00036-1
Abstract: The working Group on Cardiovascular Nursing is actively involved in international research though the UNITE (Undertaking Nursing Research Throughout Europe) research program, a new initiative for the WGCN. A group of cardiovascular nursing researchers from a number of different European countries committed themselves to a research group that is designed to promulgate international research in the field of cardiac nursing. The first study was a survey on coronary risk factors in a cohort of cardiac nurses from Europe. At this moment four additional studies are planned aimed at the development of the nursing profession in Europe and improvement of care for patients with chronic cardiac disease. If, as hoped, these studies prove to be successful, it will provide the seed for other international collaborations of this type.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Cambridge University Press (CUP)
Date: 28-09-2009
DOI: 10.1017/S1041610209990950
Abstract: Background: Depression is a common psychological problem among older people. Health-related quality of life (HRQoL) is now recognized by healthcare providers as an important treatment goal for people with depression. This study aimed to identify predictors of change in HRQoL among older people with depression. Methods: In a longitudinal study, data were collected when participants were newly diagnosed with a depressive disorder at a regional outpatient department in Hong Kong and 12 months later. Seventy-seven Chinese participants aged 65 years or older completed the study. Measures included the Physical Health Condition Checklist (PHCC), Geriatric Depression Scale (GDS), Modified Barthel Index (MBI), Instrumental Activities of Daily Living (IADL) scale, Social Support Questionnaire (SSQ), and World Health Organization Quality of Life Scale-Brief Version (WHOQOL). Results: Significant improvements between the first and second assessments were noted in the total WHOQOL scores, GDS scores, and the number of the social support. The results of linear regression models showed that the increases in the IADL scores and decreases in the PHCC and GDS scores were significantly associated with higher final WHOQOL scores. Discussion: Treatment for depression was effective in improving the participants’ overall condition and their perceived HRQoL. The results suggest that interventions to alleviate older people's level of depression, manage their physical ill health and enhance their instrumental activities of daily living ability could help improve their perceived HRQoL.
Publisher: Wiley
Date: 09-1986
DOI: 10.1111/J.1365-2648.1986.TB01291.X
Abstract: The attitudes of 67 student nurses towards the nursing process were studied by means of a questionnaire. Attitudes became more favourable over the 8-week study period. The results indicate that a positive environment is influential in changing the attitudes of student nurses towards the nursing process. These findings lend further support to our original work.
Publisher: Oxford University Press (OUP)
Date: 09-07-2017
Abstract: Depression is common among patients with coronary heart disease (CHD) and has a major impact on their quality of life, morbidity and mortality. The aim of this study was to map the 12-month psychosocial outcomes of patients with CHD who were screened positive for depression in an acute cardiac ward. A prospective cohort study was conducted of the psychosocial trajectory (depression, anxiety, wellbeing, social support, mental health service access) of 212 patients with CHD who were screened for depression after being admitted to acute cardiac wards of a major metropolitan hospital. Outcomes were assessed before hospital discharge and at one, three, six and 12 months post-discharge. Linear mixed models identified that those patients screened at 'moderate to high' risk of depression at baseline had higher levels of depression ( F(1,173)=53.93, p<0.0001) and anxiety ( F(1,180)=67.01, p<0.001), and lower levels of wellbeing ( F(1,186)=42.47, p<0.001) and social support ( F(1,177)=25.40, p<0.0001), compared to those at 'no to low' risk of depression. Levels of depression and wellbeing remained fairly constant over the 12-month trajectory. Surgical and medical treatment groups were of similar psychological composition over the 12-month period. These findings attest to the effectiveness and predictive validity of a simple nurse-administered screening tool designed to identify depression in hospital patients with CHD and also indicate that a screening and referral tool alone is not sufficient to achieve optimal disease management. A collaborative care model involving family members and integrated pathways to primary care is recommended.
Publisher: Wiley
Date: 14-11-2011
DOI: 10.1111/J.1468-3083.2011.04327.X
Abstract: In Hong Kong, at the time of the study, compression treatment was not considered usual care for venous leg ulcer patients. This randomized controlled trial compared quality of life (QOL) aspects in venous leg ulcer patients of over 55-years of age, of short-stretch compression (SSB), four-layer compression bandaging (4LB) and usual care (UC) (moist wound healing dressing, no compression). Study period was 24-weeks, the primary outcome was the patient functional status, disease-specific and generic health-related QOL measures and ulcer healing rates, comparing week 1 vs. week 24 (end) results. Assessments included photogrammetry, Brief Pain Inventory, SF-12 Health Survey, Charing Cross Venous Ulcer Questionnaire and Frenchay Activity Index. Data analysis was performed using, where appropriate Kaplan Meier and log rank chi-square and the repeated measures analysis of variance test. A total of 321 patients participated in the study, 45 (14%) withdrew for various reasons. Compression bandaging in both groups significantly reduced pain (P < 0.0001) and improved functional status and QOL. Healing rate at 24 weeks for both compression groups was significant (P < 0.001) for SSB this was 72.0% (77/107) vs. 67.3% in the 4LB group (72/107) and 29.0% (31/107) with usual care. The reduction in ulcer area from weeks 12 to 24 was significant only for SSB (P < 0.047). Compression was shown to be feasible for elderly community care patients in Hong Kong and is currently implemented as part of standard venous leg ulcer treatment.
Publisher: Wiley
Date: 15-09-2010
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.IJCARD.2014.11.152
Abstract: This work aims to test the hypothesis that the funniest comedians are most at risk of a premature death and reduced longevity compared to their relatively less funny counterparts. A retrospective longitudinal cohort study with a nested case-control analysis of longevity of 53 male British comedians born between 1900 and 1954 was conducted. All comedians were given a subjective score from 1 (relatively funny) to 10 (hilariously funny) by the study investigators. The survival profile of all comedians was then examined adjusting for decade of birth, whether they worked in a comedy team and their comedy score. A nested case-control analysis examined the longevity of those comedians working in teams according to their pre-specified status within the team (straight/less funny versus funny team member). On an adjusted basis, there was no correlation between the decade of birth (HR 0.94, 95% 0.65 to 1.38 per incremental decade p=0.763) and comedy team status (HR 1.13, 95% 0.51 to 2.48 versus independent comedian p=0.761) with longevity. However, an increasingly funny comedy score was associated with increased mortality (HR 1.24, 95% CI 1.06 to 1.44 per unit funny score p=0.006). Of the 23 comedians adjudged to be very funny (score 8-10), 18 (78%) had died versus 12 (40%) of the rest mean age at death 63.3±12.2 versus 72.3±14.7 (p=0.079). Within comedy teams, those identified as the funnier member(s) of the partnership were, on an adjusted basis, more than three times more likely to die prematurely when compared to their more serious comedy partners (HR 3.52, 95% CI 1.22, 10.1 p=0.020). These data suggest that elite comedians are at increased risk of premature death compared to their less funny counterparts. Mental health issues and personality characteristics that help shape their comedic talent and success may well explain their reduced longevity and raises serious issues for identifying and mitigating their risk of a premature death.
Publisher: Research Square Platform LLC
Date: 07-07-2023
DOI: 10.21203/RS.3.RS-3143853/V1
Abstract: Background Cardiac distress may be viewed as a persistent negative emotional state that spans multiple psychosocial domains and challenges a patient’s capacity to cope with living with their heart condition. The Cardiac Distress Inventory (CDI) is a disease-specific clinical assessment tool that captures the complexity of this distress. In busy settings such as primary care, cardiac rehabilitation, and counselling services, however, there is a need to administer briefer tools to aid in identification and screening. The aim of the present study was to develop a short, valid screening version of the CDI. Methods A total of 405 participants reporting an acute coronary event in the previous 12 months was recruited from three hospitals, through social media and by direct enrolment on the study website. Participants completed an online survey which included the full version of the CDI and general distress measures including the Kessler K6, Patient Health Questionnaire-4, and Emotion Thermometers. Relationship of the CDI with these instruments, Rasch analysis model fit and clinical expertise were all used to select items for the short form (CDI-SF). Construct validity and receiver operating characteristics in relation to the Kessler K6 were examined. Results The final 12 item CDI-SF exhibited excellent internal consistency indicative of unidimensionality and good convergent and discriminant validity in comparison to clinical status measures, all indicative of good construct validity. Using the K6 validated cutoff of ≥18 as the reference variable, the CDI-SF had a very high Area Under the Curve (AUC) (AUC = 0.913 (95% CI: 0.88 to 0.94). A CDI-SF score of ≥ 13 was found to indicate general cardiac distress which may warrant further investigation using the original CDI. Conclusion The psychometric findings detailed here indicate that CDI-SF provides a brief psychometrically sound screening measure indicative of general cardiac distress, that can be used in both clinical and research settings.
Publisher: Elsevier BV
Date: 08-2010
Publisher: FapUNIFESP (SciELO)
Date: 2023
Publisher: Wiley
Date: 03-1993
Publisher: FapUNIFESP (SciELO)
Date: 2023
Publisher: Wiley
Date: 06-2008
Publisher: Hindawi Limited
Date: 10-2020
DOI: 10.1111/JONM.13021
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.JNS.2019.116476
Abstract: Older stroke survivors are at risk of long-term cognitive impairment, which is associated with a number of modifiable and non-modifiable factors. We aimed to assess the association between the modifiable risk factors, serum cholesterol, low density lipoprotein, high density lipoprotein, serum triglycerides, body mass index (BMI) and smoking status on cognitive function, while controlling for the non-modifiable factors, acute functional impairment, diabetes status and age. A cross-sectional study from a metropolitan university hospital in Sweden involving older adults (n = 149). Assessments occurred at 20 months post-stroke, using the Mini Mental State Examination and serum blood levels of cholesterol, low density lipoprotein, high density lipoprotein and serum triglycerides. Hierarchical linear regression showed that only acute functional impairment significantly contributed to long-term cognitive impairment in stroke survivors. Only 12% of the s le showed healthy cholesterol levels while the remaining patients showed borderline or high cholesterol levels. In terms of BMI, only 2% of the s le were underweight, 38% were within healthy range and 26% were overweight/obese. Only eight women and four men were smokers, therefore our s le of smokers was likely too small to detect any differences between smokers and non-smokers in regard to cognitive outcomes. Serum cholesterol, low density lipoprotein, high density lipoprotein, serum triglycerides, BMI or smoking status did not influence cognitive outcomes in older stroke surviving in iduals. These findings suggest that modification of these factors may not influence cognitive outcomes in stroke-surviving in iduals however should be interpreted as preliminary given limitations in the current study.
Publisher: Wiley
Date: 10-07-2012
Publisher: Royal College of Psychiatrists
Date: 07-2014
DOI: 10.1192/BJP.BP.113.134635
Abstract: Psychoeducation programmes for people with schizophrenia are shown to reduce relapses but few studies have indicated significant improvements in patients' illness awareness and insight, functioning, symptom severity or rates of readmission to hospital. To examine the effects of a mindfulness-based psychoeducation programme for Chinese people with schizophrenia. A multisite randomised controlled trial was conducted with 107 out-patients with schizophrenia: 36 and 35 received a 6-month mindfulness-based psychoeducation and a conventional psychoeducation programme, respectively, and 35 received routine care alone. Patient outcome measures were psychiatric symptom severity, psychosocial functioning, social support, insight into illness/treatment, and frequency and duration of readmissions to hospital (ClinicalTrials.gov: trial registration NCT01667601). The mindfulness-based psychoeducation group reported significantly greater improvements in psychiatric symptoms, psychosocial functioning, insight into illness/treatment and duration of readmissions to hospital over 24 months when compared with the other two groups. Mindfulness-based psychoeducation appears to be a promising approach to treatment for Chinese patients with schizophrenia.
Publisher: Wiley
Date: 12-11-2001
DOI: 10.1046/J.1365-2648.2001.01985.X
Abstract: To examine those sources of information which nurses find useful for reducing the uncertainty associated with their clinical decisions. Nursing research has concentrated almost exclusively on the concept of research implementation. Few, if any, papers examine the use of research knowledge in the context of clinical decision-making. There is a need to establish how useful nurses perceive information sources are, for reducing the uncertainties they face when making clinical decisions. Cross-case analysis involving qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England, United Kingdom. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 hours and 122 nurses were involved in the Q modelling exercise. Text-based and electronic sources of research-based information yielded only small amounts of utility for practising clinicians. Despite isolating four significantly different perspectives on what sources were useful for clinical decision-making, it was human sources of information for practice that were overwhelmingly perceived as the most useful in reducing the clinical uncertainties of nurse decision-makers. It is not research knowledge per se that carries little weight in the clinical decisions of nurses, but rather the medium through which it is delivered. Specifically, text-based and electronic resources are not viewed as useful by nurses engaged in making decisions in real time, in real practice, but those in iduals who represent a trusted and clinically credible source are. More research needs to be carried out on the qualities of people regarded as clinically important information agents (specifically, those in clinical nurse specialist and associated roles) whose messages for practice appear so useful for clinicians.
Publisher: Wiley
Date: 19-08-2016
DOI: 10.1111/JAN.12751
Publisher: SAGE Publications
Date: 28-04-2009
Abstract: Abstract Cardiac rehabilitation is an integral component of comprehensive cardiac care and is effective in reducing morbidity and mortality and improving quality of life. However, despite a 50-year-history and extensive evidence base attesting to its clinical and cost-effectiveness, including adding years to life and life to years, and exhortations that its implementation should be a key priority, the majority of cardiac patients do not receive rehabilitation. There is a comparative dearth of funding and wide variation in service provision, with a health care system that often fails to address issues such as sub-optimal referral, enrolment and completion, particularly amongst certain potential user groups that could benefit. This paper reviews these issues and suggests ways of overcoming the obstacles identified. It also highlights some of the knowledge gaps and areas that warrant further research.
Publisher: Wiley
Date: 14-10-2018
DOI: 10.1111/JAN.13841
Publisher: BMJ
Date: 08-2019
DOI: 10.1136/BMJOPEN-2018-025525
Abstract: To identify differences in psychosocial, behavioural and clinical outcomes between patients with heart failure (HF) with and without stroke. A secondary analysis of 1023 patients with heart failure enrolled in the Coordinating study evaluating Outcomes of Advising and Counselling in Heart failure. Seventeen hospitals located across the Netherlands. Depressive symptoms (Centre for Epidemiological Studies Depression Scale), quality of life (Minnesota Living with Heart Failure Questionnaire, Ladder of Life Scale), self-care (European Heart Failure Self-Care Behaviour Scale), adherence to HF management (modified version of the Heart Failure Compliance Questionnaire) and readmission for HF, cardiovascular-cause and all-cause hospitalisations at 18 months, and all-cause mortality at 18 months and 3 years. Compared with those without stroke, patients with HF with a stroke (10.3% n=105) had twice the likelihood of severe depressive symptoms (OR 2.83, 95% CI 1.27 to 6.28, p=0.011 OR 2.24, 95% CI 1.03 to 4.88, p=0.043) at 12 and 18 months, poorer disease-specific and generic quality of life (OR 2.80, 95% CI 1.61 to 4.84, p .001 OR 2.00, 95% CI 1.09 to 3.50, p=0.019) at 12 months, poorer self-care (OR 1.80, 95% CI 1.05 to 3.11, p=0.034 OR 2.87, 95% CI 1.61 to 5.11, p .0011) and HF management adherence (OR 0.39, 95% CI 0.18 to 0.81, p=0.012 OR 0.35, 95% CI 0.17 to 0.72, p=0.004) at 12 and 18 months, higher rates of hospitalisations and mortality at 18 months and higher all-cause mortality (HR 1.43, 95% CI 1.07 to 1.91, p=0.016) at 3 years. Patients with HF and stroke have worse psychosocial, behavioural and clinical outcomes, notably from 12 months, than those without stroke. To ameliorate these poor outcomes long-term, integrated disease management pathways are warranted.
Publisher: BMJ
Date: 06-2019
Publisher: Public Library of Science (PLoS)
Date: 13-10-2023
Publisher: Elsevier BV
Date: 05-2019
Publisher: Wiley
Date: 16-01-2004
Publisher: American Medical Association (AMA)
Date: 27-03-2006
DOI: 10.1001/ARCHINTE.166.6.645
Abstract: Data on the long-term benefits of nonspecific disease management programs are limited. We performed a long-term follow-up of a previously published randomized trial. We compared all-cause mortality and recurrent hospitalization during median follow-up of 7.5 years in a heterogeneous cohort of patients with chronic illness initially exposed to a multidisciplinary, home-based intervention (HBI) (n = 260) or to usual postdischarge care (n = 268). During follow-up, HBI had no impact on all-cause mortality (relative risk, 1.04 95% confidence interval, 0.80-1.35) or event-free survival from death or unplanned hospitalization (relative risk, 1.03 95% confidence interval, 0.86-1.24). Initial analysis suggested that HBI had only a marginal impact in reducing unplanned hospitalization, with 677 readmissions vs 824 for the usual care group (mean +/- SD rate, 0.72 +/- 0.96 vs 0.84 +/- 1.20 readmissions atient per year P = .08). When accounting for increased hospital activity in HBI patients with chronic obstructive pulmonary disease during follow-up for 2 years, post hoc analyses showed that HBI reduced readmissions by 14% within 2 years in patients without this condition (mean +/- SD rate, 0.54 +/- 0.72 vs 0.63 +/- 0.88 readmission atient per year P = .04) and by 21% in all surviving patients within 3 to 8 years (mean +/- SD rate, 0.64 +/- 1.26 vs 0.81 +/- 1.61 readmissions atient per year P = .03). Overall, recurrent hospital costs were significantly lower (14%) in the HBI group (mean +/- SD, 823 dollars +/- 1642 dollars vs 960 dollars +/- 1376 dollars per patient per year P = .045). This unique study suggests that a nonspecific HBI provides long-term cost benefits in a range of chronic illnesses, except for chronic obstructive pulmonary disease.
Publisher: Oxford University Press (OUP)
Date: 16-10-2016
Abstract: Depression is common in patients with coronary heart disease, and together these conditions significantly affect health outcomes. Impaired social support is also considered an important predictor of coronary heart disease prognosis and, as there is a complex interplay between social isolation and depression, interventions to address both may be required. This review aimed to assess the effectiveness of psychosocial interventions addressing both depression and social support for people with coronary heart disease and depression. PRISMA guidelines were used to search major health databases to identify randomised controlled trials that evaluated psychosocial interventions compared with usual care in patients with coronary heart disease and depression the primary outcome was depressive symptoms and secondary outcomes were mortality (all-cause and cardiac), myocardial infarction, revascularisation, anxiety, social support and quality of life. Data, when suitable, were pooled using a random-effects meta-analysis model. Five studies (n=1358 participants) were eligible and included. The psychosocial intervention group had significantly lower levels of depressive symptoms (standardised mean difference (SMD) -0.15, 95% confidence interval (CI) -0.27 to -0.03 P=0.02) and higher levels of social support (SMD 0.17 95% CI 0.04 to 0.30 P=0.01) but no differences were found for mortality (all-cause and cardiac), myocardial infarction, revascularisation, anxiety or quality of life. Psychosocial interventions for patients with coronary heart disease and depression result in modest reductions in depressive symptoms and improvements in social support. However, caution is warranted in view of the small number of studies included in the review and potential heterogeneity in outcomes and in differences in treatment.
Publisher: Wiley
Date: 28-04-2017
Publisher: Elsevier BV
Date: 1985
DOI: 10.1016/0266-612X(85)90002-1
Abstract: Management of renal cell carcinoma (RCC) with tumor thrombus extending to the renal vein and inferior vena cava (IVC) is challenging. The aim of this study was to evaluate the benefit of surgical management in such patients. From February 1995 to February 2013, 520 patients were treated for RCC at Hirosaki University Hospital, Hirosaki, Japan. The RCC patients with tumor thrombus extending to the renal vein (n = 42) and IVC (n = 43) were included in this study. The records of these 85 patients were retrospectively reviewed to assess the relevant clinical and pathological variables and survival. Prognostic factors were identified by multivariate analysis. The benefit of surgical management was evaluated using propensity score matching to compare overall survival between patients who received surgical management and those who did not. RCC was confirmed by pathological examination of surgical or biopsy specimens in 74 of the 85 patients (87%). Sixty-five patients (76%) received surgical management (radical nephrectomy with thrombectomy). Distant metastasis was identified in 45 patients (53%). The proportion of patients with tumor thrombus level 0 (renal vein only), I, II, III, and IV was 49%, 13%, 18%, 14%, and 5%, respectively. The estimated 5-year overall survival rate was 70% in patients with thrombus extending to the renal vein and 23% in patients with thrombus extending to the IVC. Multivariate analysis identified thrombus extending to the IVC, presence of distant metastasis, surgical management, serum albumin concentration, serum choline esterase concentration, neutrophil-lymphocyte ratio, and Carlson comorbidity index as independent prognostic factors. In propensity score-matched patients, overall survival was significantly longer in those who received surgical management than those who did not. Surgical management may improve the prognosis of RCC patients with thrombus extending to the renal vein and IVC.
Publisher: Elsevier BV
Date: 05-2004
Publisher: Oxford University Press (OUP)
Date: 03-2009
Publisher: Springer Science and Business Media LLC
Date: 2003
Publisher: Oxford University Press (OUP)
Date: 02-2002
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.LUNGCAN.2008.05.003
Abstract: This study assessed first-line chemotherapy treatment patterns over time and identified predictors of chemotherapy use and treatment selection among elderly patients with newly diagnosed Stage IIIB/IV non-small cell lung cancer (NSCLC) in the United States. Patients aged 65 years and older newly diagnosed with Stage IIIB/IV NSCLC between 1997 and 2002 were identified and followed through 2003 using the Surveillance, Epidemiology and End Results (SEER)-Medicare database to evaluate temporal trends in chemotherapy treatment. Multivariate logistic regression models were estimated to identify predictors of chemotherapy treatment and factors associated with use of cisplatin/carboplatin (platinum) and either a taxane or gemcitabine versus other treatments. Chemotherapy use increased from approximately 28% of Stage IIIB/IV NSCLC patients diagnosed in 1997 to 36% of patients diagnosed in 2002. Doublet therapy was most commonly used as first-line therapy, received by 74% of chemotherapy-treated patients across all study years. Use of doublet therapy with platinum and either a taxane or gemcitabine also increased over time (with the largest increase for gemcitabine combinations from 0.3% in 1997 to 11.8% in 2002). Males were more likely than females to be treated with chemotherapy (odds ratios [95% CI]: 1.14 [1.06-1.22]), as were patients in the Northeast and South relative to patients in the West (1.24 [1.13-1.36] and 1.33 [1.20-1.47], respectively). Use of first-line chemotherapy treatment among elderly Stage IIIB/IV NSCLC patients is low, but appears to be increasing, with potential regional and gender differences in treatment. These findings are likely to be of interest to clinicians and policymakers.
Publisher: Elsevier BV
Date: 05-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2011
Publisher: Elsevier BV
Date: 09-2021
Publisher: Wiley
Date: 25-08-2005
DOI: 10.1111/J.1365-2648.2005.03545.X
Abstract: This paper reports a study to examine the effectiveness of a 12-session mutual support group for Chinese families caring for a relative with schizophrenia compared with a psycho-educational group and routine family support services in Hong Kong. Schizophrenia is a disruptive and distressing illness for patients and their families. With the current trend of community care for mental illness, there is evidence that family intervention reduces patient relapse and re-hospitalization, satisfies the health needs of families and enhances their coping capabilities. A randomized controlled trial was conducted from May 2002 to June 2003 with 96 Chinese families of a relative with schizophrenia selected from two psychiatric outpatient clinics in Hong Kong. Families were randomly assigned to receive mutual support (n = 32), psycho-education (n = 33) or standard care only (n = 31). The interventions were delivered at outpatient clinics over a 6-month period. Pre- and post- (1 week and 6 months) testing took place and families' functioning, mental health service utilization, patients' level of functioning and duration of re-hospitalization were measured. At both post-test periods, family caregivers and patients in the mutual support group reported statistically significant improvements on family and patients' level of functioning, when compared with their counterparts in the psycho-education and standard care groups. The findings support the use of mutual support groups as an effective modality of family intervention in a Chinese population caring for a family member with schizophrenia to improve both family and patient functioning.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2006
DOI: 10.1111/J.1479-6988.2006.00036.X
Abstract: Aim Despite increasing efforts to promote the utilisation of research in daily nursing practice it is apparent that there are a number of obstacles to address. This paper reports a study to examine the barriers to, and facilitators of, research utilisation among registered nurses in Hong Kong. Methods A survey design and a random s ling method was used. The final s le consisted of 1487 registered nurses working in private and public health-care sectors in Hong Kong. A bilingual version of the Research Utilisation Questionnaire, comprising a 31-item barriers scale, and an 8-item facilitators scale was used. The instrument was mailed to participants who were asked to return the completed questionnaire by mail. Results The highest ranking barriers to research utilisation reported by respondents were related mainly to organisational factors with regards to inadequate facilities, no authority to change procedures, and time constraints. Hong Kong nurses, however, did not appear to see any problem with regards to items related to characteristics of research, such as conclusions drawn from research being justified, research articles not being published fast enough, and literature reporting conflicting results. This indicates that nurses are aware of research developments in nursing and can critically analyse research reports. With regards to facilitators of research utilisation, respondents agreed that managerial and peer support are the greatest facilitators. Conclusions The results indicate that factors influencing research utilisation are multidimensional and should be taken into account by all involved in the research enterprise: researchers, practitioners, educators, managers and policy-makers. The results of this study provide directions on how to assist nurses in Hong Kong in their efforts to utilise research.
Publisher: Springer Science and Business Media LLC
Date: 08-05-2021
DOI: 10.1186/S12902-021-00760-3
Abstract: Mental health problems are highly prevalent in people with type 1 diabetes mellitus (T1DM), which adversely impact physical health and quality of life. This study aimed to explore the experiences of people with T1DM who had completed the Mental health IN DiabeteS Optimal Health Program (MINDS OHP), a novel intervention developed to bridge the gap between physical and mental health care. Participants with T1DM were invited to take part in a focus group or semi-structured interviews. Participants were recruited from outpatient and community settings. The focus group and interviews were audio-recorded and transcribed verbatim. Thematic content analysis was used and identified themes were cross-validated by researchers and member-checked by participants. Ten people with T1DM were included. Two key themes emerged: ‘MINDS OHP experiences’ and ‘lived experiences of diabetes’. MINDS OHP experiences included five sub-themes: program benefits, follow-up and timing, suggested improvements, collaborative partners, and materials suitability. Lived experiences also included five sub-themes: bridging the gap between mental and physical health, support networks, stigma and shame, management intrusiveness, and adolescence and critical life points. The MINDS OHP for people with T1DM was generally well received, though study findings suggest a number of improvements could be made to the program, such as including family members, and consideration being given to its routine early inclusion in diabetes management, ideally in primary care.
Publisher: Elsevier BV
Date: 11-2008
DOI: 10.1016/J.ORALONCOLOGY.2008.01.003
Abstract: Oral mucositis (OM) is the most frequent and severe complication of chemotherapy for children with cancer, yet little is known about its risk factors. The aim of this study was to determine the risk factors associated with chemotherapy-induced OM in children. A matched case-control design was used. The matching criteria were age, type of cancer and chemotherapy regimen. Patient-and treatment-related data were collected via chart review. Conditional logistic regression analyses were performed to estimate odds ratios (OR) and adjusted odds ratios (AOR) for the development of OM. Fifty-one cases and 51 controls were identified. The mean+/-SD age of the children was 7.6+/-5.2 years, with 65 (63.73%) boys. Eighty-two percent of the children had been diagnosed with haematological malignancies (n=84). The most common chemotherapy regimen was a combination of plant alkaloids and antitumor antibiotics (n=42, 41.18%). In the multivariable model, lower body weight (AOR=0.91 95% CI=0.84-0.98 p=0.013), lower value of log nadir neutrophil count (AOR=0.33 95% CI=0.16-0.68 p=0.0025), and higher value of peak creatinine (AOR=1.06 95% CI=1.01-1.12 p=0.025) were significantly associated with a greater risk of OM. Our findings suggest that children who are neutropenic, those with serum creatinine elevation, and those with a low body weight prior to chemotherapy are at greater risk of developing OM.
Publisher: Elsevier BV
Date: 02-1996
DOI: 10.1016/S0002-8223(96)00040-5
Abstract: Conspicuous egg-shaped, white, and smooth structures were observed at a hydrothermal vent site in the Guaymas Basin, Gulf of California. The gelatinous structures decomposed within hours after s ling. Scanning electron microscopy (SEM) and light microscopy showed that the structure consisted of filaments of less than 0.1 μm thickness, similar to those observed for "
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2020
Publisher: Wiley
Date: 2006
Publisher: Oxford University Press (OUP)
Date: 03-2005
Publisher: Elsevier BV
Date: 2003
DOI: 10.1016/S0020-7489(02)00039-1
Abstract: The study identified barriers to research implementation experienced by nurses, midwives and health visitors in five trusts and one health authority in Yorkshire, UK. Funk et al. (Appl. Nurs. Res. 4(1) (1991a) 39, Appl. Nurs. Res. 4(2) (1999b) 90) developed the BARRIERS to research utilisation questionnaire over 10 years ago, but no replication, in size (n = 1989) and extent, of that study appeared to have occurred. The staff population (n = 4501) were sent the BARRIERS questionnaire. 44.6% (n = 2009) were returned. Findings suggested nurses need time to read and apply research authority to change practice critical appraisal skills, an understanding of statistics and support of managers and peers (particularly doctors) to achieve successful practice change.
Publisher: Wiley
Date: 10-08-2006
Publisher: Elsevier BV
Date: 04-2021
Publisher: Springer Science and Business Media LLC
Date: 07-1992
DOI: 10.2165/00019053-199202010-00005
Abstract: In this article we review published studies of the cost-effectiveness of drug therapy for hypercholesterolaemia to take stock of the principal findings that have been reported to date. We identified 9 studies that met all criteria for inclusion in our review, including 3 of bile-acid sequestrants (cholestyramine, colestipol), 2 of HMG-CoA reductase inhibitor (lovastatin), and 4 that considered both an HMG-CoA reductase inhibitor (simvastatin) and a bile-acid sequestrant (cholestyramine). While these studies were largely consistent in methodological approach, some differences were noted in the costs attributed to drug therapy. The cost-effectiveness of therapy with bile-acid sequestrants was found to range from $100 000 to $209 000 per year of life saved (1991 $US) for middle-aged men (42 to 55 years of age) with moderately high cholesterol levels (280 to 290 mg/dl) and otherwise average coronary risk characteristics. Corresponding cost-effectiveness ratios that have been reported for lovastatin range from $64 000 to $82 000, while those for simvastatin range from $45 000 to $65 000. Studies to date therefore suggest that therapy with HMG-CoA reductase inhibitors (i.e. lovastatin and simvastatin) is substantially more cost-effective than treatment with bile-acid sequestrants.
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.NEDT.2009.03.007
Abstract: This paper contends that nursing, particularly in the UK, is at risk of losing its place in the academy. The paper aims to review the role of universities and the place of nursing within them to highlight the tensions facing nursing and nurses in the universities and to suggest some ways of overcoming these tensions.
Publisher: Wiley
Date: 02-03-2018
DOI: 10.1111/INR.12450
Abstract: Most studies have reported that higher levels (baccalaureate degree) of educational attainment by nurses are associated with lower levels of patient mortality. Researchers working in developed economies (e.g. North America and Europe) have almost exclusively conducted these studies. The value of baccalaureate nurse education has not been tested in countries with a developing economy. A retrospective observational study conducted in seven hospitals. Patient mortality was the main outcome of interest. Anonymized data were extracted from nurses and patients from two different administrative sources and linked using the staff identification number that exists in both systems. We used bivariate logistic regression models to test the association between mortality and the educational attainment of the admitting nurse (responsible for assessment and care planning). Data were extracted for 11 918 (12, 830 admissions) patients and 7415 nurses over the first 6 months of 2015. The majority of nurses were educated in South Asia and just over half were educated to at least bachelor degree level. After adjusting for confounding and clustering, nurse education was not found to be associated with mortality. Our observations may suggest that in a developing economy, the academic level of nurses' education is not associated with a reduction in patient mortality. Findings should be interpreted with considerable caution but do challenge widely held assumptions about the value of baccalaureate-prepared nurses. Further research focused on nursing education in developing economies is required to inform health policy and planning.
Publisher: Elsevier BV
Date: 02-2015
Publisher: SAGE Publications
Date: 12-1992
DOI: 10.1177/106002809202601201
Abstract: To determine whether choice of a first- versus third-generation cephalosporin as initial therapy for lower respiratory tract infections in hospitalized adults affects the course and duration of care, both of which may influence antimicrobial treatment cost. Retrospective analysis of discharge abstracts and hospital pharmacy records. Forty-eight US acute-care hospitals. One thousand ninety-two hospitalized adults (aged y) with principal diagnoses of lower respiratory tract infections (DRGs 79–80, 89–90). Cefazolin or ceftriaxone, given as sole antimicrobial therapy for at least one day. (1) The number of patients who received another parenteral antibiotic anytime prior to hospital discharge (2) the number of days during which patients received any parenteral antibiotic while in the hospital and (3) the number of days patients remained hospitalized following the start of antibiotic therapy. Patients treated with cefazolin (n=763) were more likely to receive another parenteral antibiotic while in the hospital (30.3 vs. 20.7 percent p .001) and received more total days of therapy (7.2 vs. 6.7 d p .05) than those treated with ceftriaxone (n=329). Although the time to hospital discharge did not differ in the full s le (9.2 d for both groups), it was greater among those receiving cefazolin (8.6 vs. 8.0 d p .05) when patients with lengths of stay exceeding 24 days were excluded from both groups. In addition to acquisition cost, differences in course and duration of care should be considered when determining the most cost-effective choice for antimicrobial therapy.
Publisher: Wiley
Date: 08-06-2011
DOI: 10.1111/J.1365-2702.2011.03724.X
Abstract: To establish the psychometric properties of the Chinese version of the State Self-Esteem Scale in stroke patients. Self-esteem is seen to enhance peoples' ability to cope with disease: low self-esteem may inhibit participation in rehabilitation and thus result in poor health and social outcomes. Although the Chinese version of the State Self-Esteem Scale has been used as an outcome measure for stroke rehabilitation, no study has examined its factor structure in this patient group. A cross-sectional design. A convenience s le of 265 Chinese stroke patients (mean age 71·4, SD 10·3 years), with a minimum score of 18 out of a possible 30 for the Mini Mental State Exam recruited from two regional rehabilitation hospitals in Hong Kong. An exploratory factor analysis and an internal consistency analysis of the State Self-Esteem Scale were conducted. Pearson's correlation coefficients were calculated between the State Self-Esteem Scale and the Geriatric Depression Scale to determine convergent validity. The final factor solution comprised a three-factor model with correlated constructs and accounted for 49·5% of the total variance. Significant negative correlations were found between the Geriatric Depression Scale and the State Self-Esteem Scale subscale scores (r-0·31 to -0·55, p < 0·01), indicating that the State Self-Esteem Scale had acceptable convergent validity. The new three-factor structure had higher Cronbach's alphas when compared with the original three-factor structure. The State Self-Esteem Scale appears to be a useful measure for assessing state self-esteem in stroke patients. To establish the concurrent, discriminative and construct validities, the factor structure of the SSES could be further developed and tested.
Publisher: Wiley
Date: 14-08-2018
DOI: 10.1111/JAN.13705
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-04-2021
Publisher: Oxford University Press (OUP)
Date: 17-10-2005
Publisher: Wiley
Date: 17-11-2014
DOI: 10.1111/JAN.12573
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.JPSYCHORES.2005.03.010
Abstract: The aim of this study was to examine the extent to which illness perceptions predict attendance at cardiac rehabilitation and quality of life following myocardial infarction (MI). The illness perceptions of 194 MI patients were assessed whilst the patients were still in hospital following an MI. The mean age was 63.3 years (S.D. = 10.6), and 142 of the patients were men. Cardiac rehabilitation attendance and quality of life were assessed via a postal questionnaire 6 months later. In contrast to previous work reported in this area, illness perceptions were not significantly associated with attendance at cardiac rehabilitation. Illness perceptions measured within 24 h of an acute MI were predictive of quality of life 6 months later. Previous reports may have overestimated the extent to which illness perceptions predict attendance at cardiac rehabilitation. The relationship between illness perceptions and quality of life at 6 months suggests that interventions to alter illness perceptions, especially perceptions of consequences, may be useful in improving health-related quality of life (HRQoL) following an MI.
Publisher: Wiley
Date: 25-03-2018
DOI: 10.1111/JAN.13544
Abstract: The aim of this study was to psychometrically evaluate the Heart Failure Screening Tool (Heart-FaST) via: (1) examination of internal construct validity (2) testing of scale function in accordance with design and (3) recommendation for change/s, if items are not well adjusted, to improve psychometric credential. Self-care is vital to the management of heart failure. The Heart-FaST may provide a prospective assessment of risk, regarding the likelihood that patients with heart failure will engage in self-care. Psychometric validation of the Heart-FaST using Rasch analysis. The Heart-FaST was administered to 135 patients (median age = 68, IQR = 59-78 years 105 males) enrolled in a multidisciplinary heart failure management program. The Heart-FaST is a nurse-administered tool for screening patients with HF at risk of poor self-care. A Rasch analysis of responses was conducted which tested data against Rasch model expectations, including whether items serve as unbiased, non-redundant indicators of risk and measure a single construct and that rating scales operate as intended. The results showed that data met Rasch model expectations after rescoring or deleting items due to poor discrimination, disordered thresholds, differential item functioning, or response dependence. There was no evidence of multidimensionality which supports the use of total scores from Heart-FaST as indicators of risk. Aggregate scores from this modified screening tool rank heart failure patients according to their "risk of poor self-care" demonstrating that the Heart-FaST items constitute a meaningful scale to identify heart failure patients at risk of poor engagement in heart failure self-care.
Publisher: Wiley
Date: 03-06-2008
DOI: 10.1002/NUR.20289
Abstract: A survey of 1,487 nurses was conducted to examine barriers to and facilitators of research utilization. Characteristics of the organization were the greatest barriers to research utilization the highest ranked of these were inadequate facilities, lack of authority to change practice, lack of time, and lack of cooperation from physicians. The three highest ranked organizational facilitators were managerial support, colleague support, and education to increase nursing knowledge. Age and years of working experience were not significantly correlated with any of the subscales. To integrate the use of research evidence into the culture of various clinical settings, and with the aim of extending evidence-based practice into the private and primary health care sectors in Hong Kong, local organizational barriers and facilitators need to be addressed.
Publisher: Elsevier BV
Date: 05-2002
Publisher: Oxford University Press (OUP)
Date: 02-01-2023
DOI: 10.1093/EURHEARTJ/EHAC747
Abstract: Coronary heart disease is the most common reason for referral to exercise-based cardiac rehabilitation (CR) globally. However, the generalizability of previous meta-analyses of randomized controlled trials (RCTs) is questioned. Therefore, a contemporary updated meta-analysis was undertaken. Database and trial registry searches were conducted to September 2020, seeking RCTs of exercise-based interventions with ≥6-month follow-up, compared with no-exercise control for adults with myocardial infarction, angina pectoris, or following coronary artery bypass graft, or percutaneous coronary intervention. The outcomes of mortality, recurrent clinical events, and health-related quality of life (HRQoL) were pooled using random-effects meta-analysis, and cost-effectiveness data were narratively synthesized. Meta-regression was used to examine effect modification. Study quality was assessed using the Cochrane risk of bias tool. A total of 85 RCTs involving 23 430 participants with a median 12-month follow-up were included. Overall, exercise-based CR was associated with significant risk reductions in cardiovascular mortality [risk ratio (RR): 0.74, 95% confidence interval (CI): 0.64–0.86, number needed to treat (NNT): 37], hospitalizations (RR: 0.77, 95% CI: 0.67–0.89, NNT: 37), and myocardial infarction (RR: 0.82, 95% CI: 0.70–0.96, NNT: 100). There was some evidence of significantly improved HRQoL with CR participation, and CR is cost-effective. There was no significant impact on overall mortality (RR: 0.96, 95% CI: 0.89–1.04), coronary artery bypass graft (RR: 0.96, 95% CI: 0.80–1.15), or percutaneous coronary intervention (RR: 0.84, 95% CI: 0.69–1.02). No significant difference in effects was found across different patient groups, CR delivery models, doses, follow-up, or risk of bias. This review confirms that participation in exercise-based CR by patients with coronary heart disease receiving contemporary medical management reduces cardiovascular mortality, recurrent cardiac events, and hospitalizations and provides additional evidence supporting the improvement in HRQoL and the cost-effectiveness of CR.
Publisher: Oxford University Press (OUP)
Date: 12-2002
Publisher: Wiley
Date: 02-02-2021
DOI: 10.1111/NEP.13850
Publisher: Oxford University Press (OUP)
Date: 11-11-2021
Publisher: Elsevier BV
Date: 11-2011
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.HRTLNG.2005.05.002
Abstract: The use of elective percutaneous transluminal coronary angioplasty (PTCA) as a treatment for coronary heart disease is increasing. Despite this, little is known about the prevalence and patterns of anxiety and depression experienced by patients undergoing and recovering from this procedure. Anxiety and depression are factors known to negatively influence recovery after a cardiac event. The purpose of this study was to (1) describe the levels of anxiety and depression reported by patients pre- and postelective PTCA, and (2) determine associations evident between anxiety and depression and the sociodemographic and clinical variables of gender, marital status, history of acute myocardial infarction, and attendance at cardiac rehabilitation. In this descriptive, repeated-measures investigation, patients (n = 140) were requested to complete the Spielberger State Trait Anxiety Inventory and Cardiac Depression Scale (CDS) at three time points: 0(1) before admission for elective PTCA (T(1)) (2) 6 to 8 weeks (T(2)) after PTCA and (3) 6 to 8 months (T(3)) after PTCA. A typical participant was male (75%), of European ethnicity (90%), aged 62 years (standard deviation = 10.7) with single or double vessel disease, and had attended cardiac rehabilitation in the past. At T(1), 16% of men and 24% of women had state anxiety scores comparable to those experienced by neuropsychiatric patients. Trait anxiety scores remained relatively constant over time higher scores at T(1) were associated with past acute myocardial infarction. CDS scores at T(2) and T(3) were significantly lower than those at T(1). However, an unexpected increase in CDS scores occurred at T(3), compared with T(2). At T(3), 14% of men and 10% of women were depressed, relative to T(1). The findings lend support for the closer surveillance of emotional status in this population. Specialist nurses have the potential to play a greater role in identifying those at risk of developing anxiety and depression. However, this unmet need will remain unmet until specialist nurses who spend the most face-to-face time with patients are equipped with the skills and resources to systematically identify those "at risk."
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-1999
DOI: 10.1097/00006454-199903000-00006
Abstract: Otitis media is one of the most common office diagnoses among children in the US and the leading reason for the use of antimicrobials in pediatric practice. We undertook this study to characterize medical and surgical management of otitis media. Using claims data from a large New England health insurer, we identified all children <10 years of age who had one or more episodes of acute otitis media between July, 1995, and June, 1996, and examined patterns of treatment for this condition. Study subjects (n = 22,004) averaged 2.9 physician office visits for management of otitis media among children <2 years of age, one-fourth had 6 or more such visits. Amoxicillin was prescribed as initial therapy in more than one-half (56.6%) of all episodes of acute otitis media, followed by cephalosporins (18.3%), trimethoprim-sulfamethoxazole (12.3%), macrolides (6.4%) and amoxicillin-clavulanate (6.0%). Over multiple episodes, however, use of amoxicillin declined by about 50%. Antimicrobial prophylaxis was received by 7.3% of all study subjects for a mean of 61.3 days the incidence of breakthrough episodes of acute otitis media during prophylaxis varied according to the antimicrobial used (13.9, 12.3 and 19.5% for amoxicillin, trimethoprim-sulfamethoxazole and sulfisoxazole, respectively). Surgical procedures related to otitis media were performed on 3.8% of all study subjects, including 4.6% of children <2 years of age. The health care burden of otitis media is large, particularly in the first 2 years of life.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.HLC.2012.07.050
Abstract: Heart failure self-care is vital to achieving clinical stability and improved health outcomes. Yet despite the attention it has been given, in both research and clinical practice, effective self-care remains elusive. It is recognised that there are many patient factors that impact on attaining effective self-care skills. Systematic research is warranted to resolve the knowledge gap of how patients process information and develop the necessary self-care skills. In addition, sound screening tools are needed to assess factors that hinder the development of effective heart failure self-care skills. In this manner, education and support strategies can be applied on an in idualised needs basis to enhance health outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2016
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JPSYCHIRES.2017.08.004
Abstract: Meditation is a popular form of stress management, argued to mediate stress reactivity. However, many studies in this field commonly fail to include an active control group. Given the frequency with which people are selecting meditation as a form of self-management, it is important to validate if the practice is effective in mediating stress-reactivity using well-controlled studies. Thus, we aimed to conduct a meta-analysis investigating the neurobiological effects of meditation, including focused attention, open monitoring and automatic self-transcending subtypes, compared to an active control, on markers of stress. In the current meta-analysis and systematic review, we included randomised controlled trials comparing meditation interventions compared to an active control on physiological markers of stress. Studied outcomes include cortisol, blood pressure, heart-rate, lipids and peripheral cytokine expression. Forty-five studies were included. All meditation subtypes reduced systolic blood pressure. Focused attention meditations also reduced cortisol and open monitoring meditations also reduced heart rate. When all meditation forms were analysed together, meditation reduced cortisol, C - reactive protein, blood pressure, heart rate, triglycerides and tumour necrosis factor-alpha. Overall, meditation practice leads to decreased physiological markers of stress in a range of populations.
Publisher: Oxford University Press (OUP)
Date: 11-09-2016
Abstract: There is clear evidence across the globe that the clinical complexity of patients presenting to hospital with the syndrome of heart failure is increasing - not only in terms of the presence of concurrent disease states, but with additional socio-demographic risk factors that complicate treatment. Management strategies that treat heart failure as the main determinant of health outcomes ignores the multiple and complex issues that will inevitably erode the efficacy and efficiency of current heart failure management programmes. This complex problem (or conundrum) requires a different way of thinking around the complex interactions that underpin poor outcomes in heart failure. In this context, we present the COordinated NUrse-led inteNsified Disease management for continuity of caRe for mUltiMorbidity in Heart Failure (CONUNDRUM-HF) matrix that may well inform future research and models of care to achieve better health outcomes in this rapidly increasing patient population.
Publisher: Elsevier BV
Date: 1990
DOI: 10.1016/0022-3999(90)90080-N
Abstract: Self-ratings of anxiety and depression were studied over six months in 60 male patients, under 66 yr of age, who were admitted to a coronary care unit with a first time acute myocardial infarction. Patients were randomly assigned to either a treatment group, where they received a simple programme of in-hospital counselling in addition to routine care, or to a control group, where they received routine care only. All patients completed the Hospital Anxiety and Depression scale and a battery of visual analogue scales measuring anxiety on a range of topics related to recovery from a myocardial infarction. Patients who received in-hospital counselling reported statistically significantly less anxiety and depression than those who received routine care alone. This effect was sustained for six months after leaving hospital. It is concluded that a simple programme of in-hospital counselling, provided by a coronary care nurse, is efficacious and should be routinely offered to first myocardial infarction patients in hospital.
Publisher: Wiley
Date: 28-01-2014
DOI: 10.1111/JAN.12327
Publisher: Springer Science and Business Media LLC
Date: 2002
Abstract: The purpose of this study was to develop and validate a disease-specific health status measure for in iduals with myocardial infarction (MI). The development of the myocardial infarction dimensional assessment scale (MIDAS) followed three main stages. Stage 1 consisted of in-depth, semi-structured, exploratory interviews conducted on a s le of 31 patients to identify areas of salience and concern to patients with MI. These interviews generated 48 candidate questions. In stage 2 the 48-item questionnaire was used in a postal survey to identify appropriate rephrasing/shortening, to determine acceptability and to help identify sub-scales of the instrument addressing different dimensions of MI. Finally, in stage 3 the construct validity of MIDAS subscales was examined in relation to clinical and other health outcomes. A single centre (district general hospital) in England was used for stages 1 and 3 and a national postal survey was conducted for stage 2. A total of 410 patients were recruited for the national survey (stage 2). Full data were available on 348 (85%) patients. One hundred and fifty-five patients were recruited to test construct validity (stage 3). The MIDAS contains 35 questions measuring seven areas of health status: physical activity, insecurity, emotional reaction, dependency, diet, concerns over medication and side effects. The measure has high face, internal and construct validity and is likely to prove useful in the evaluation of treatment regimes for MI.
Publisher: Elsevier BV
Date: 04-2011
Publisher: Wiley
Date: 10-2001
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.IJCARD.2014.10.154
Abstract: Cardiac rehabilitation (CR) is the sum of interventions required to ensure the best physical, psychological and social conditions so that patients with cardiac disease may assume their place in society and slow the progression of the disease. Exercise testing (ET) early after MI has been shown to result in earlier return to work than the non-performance of ET. Research quality CR has resulted in lower cardiovascular mortality and lower recurrent hospitalisation and has been shown to be cost-effective. However, the content of cardiac rehabilitation programmes varies considerably. The only randomised trial of CR as usually performed in the 'real world' showed that CR had no impact on cardiac death rates or any other outcome. Only 20-50% of eligible patients attend CR programmes and attendance at CR has not improved in the last 20 years despite major attempts to increase participation in CR. Alternative methods for provision of CR have been sought. These include home-based CR, case management approaches, and nurse coordinated prevention programmes. Telephone based programmes, such as The COACH Program, have been introduced to coach patients and improve behavioural and biomedical risk factors. These have been shown to improve risk factors better than usual patient care and to reduce recurrences of cardiac events after discharge from hospital due to MI. Expansion of novel approaches such as The COACH Program may help to counteract the non-attendance at CR.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.IJCARD.2014.04.164
Abstract: We compared the longer-term impact of the two most commonly applied forms of post-discharge management designed to minimize recurrent hospitalization and prolong survival in typically older patients with chronic heart failure (CHF). We followed a multi-center randomized controlled trial cohort of Australian patients hospitalized with CHF and initially allocated to home-based or specialized CHF clinic-based intervention for 1368 ± 216 days. Blinded endpoints included event-free survival from all-cause emergency hospitalization or death, all-cause mortality and rate of all-cause hospitalization and stay. 280 patients (73% male, aged 71 ± 14 years and 73% left ventricular systolic dysfunction) were initially randomized to home-based (n=143) or clinic-based (n=137) intervention. During extended follow-up (complete for 274 patients), 1139 all-cause hospitalizations (7477 days of hospital stay) and 121 (43.2%) deaths occurred. There was no difference in the primary endpoint 20 (14.0%) home-based versus 13 (7.4%) clinic-based patients remained event-free (adjusted HR 0.89, 95% CI 0.70 to 1.15 p=0.378). Significantly fewer home-based (51/143, 35.7%) than clinic-based intervention (71/137, 51.8%) patients died (adjusted HR 0.62, 95% CI 0.42 to 0.90: p=0.012). Home-based versus clinic-based intervention patients accumulated 592 and 547 all-cause hospitalizations (p=0.087) associated with 3067 (median 4.0, IQR 2.0 to 6.8) versus 4410 (6.0, IQR 3.0 to 12.0) days of hospital stay (p<0.01 for rate and duration of hospital stay). Relative to clinic-based intervention, home-based intervention was not associated with prolonged event-free survival. Home-based intervention was, however, associated with significantly fewer all-cause deaths and significantly fewer days of hospital stay in the longer-term. Australian New Zealand Clinical Trials Registry number 12607000069459 (www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=81803).
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1016/J.IJCARD.2006.07.218
Abstract: Home-based cardiac rehabilitation offers an alternative to traditional, hospital-based cardiac rehabilitation. To compare the cost effectiveness of home-based cardiac rehabilitation and hospital-based cardiac rehabilitation. 104 patients with an uncomplicated acute myocardial infarction and without major comorbidity were randomized to receive home-based rehabilitation (n=60) i.e. nurse facilitated, self-help package of 6 weeks' duration (the Heart Manual) or hospital-based rehabilitation for 8-10 weeks (n=44). Complete economic data were available in 80 patients (48 who received home-based rehabilitation and 32 who received hospital-based rehabilitation). Healthcare costs, patient costs, and quality of life (EQ-5D4.13) were assessed over the 9 months of the study. The cost of running the home-based rehabilitation programme was slightly lower than that of the hospital-based programme (mean (95% confidence interval) difference - 30 pounds sterling (- 45 pounds sterling to - 12 pounds sterling) [-44 euro, -67 euro to -18 euro] per patient. The cost difference was largely the result of reduced personnel costs. Over the 9 months of the study, no significant difference was seen between the two groups in overall healthcare costs (78 pounds sterling, - 1102 pounds sterling to 1191 pounds sterling [-115 euro, -1631 euro to -1763 euro] per patient) or quality adjusted life-years (-0.06 (-0.15 to 0.02)). The lack of significant difference between home-based rehabilitation and hospital-based rehabilitation did not alter when different costs and different methods of analysis were used. The health gain and total healthcare costs of the present hospital-based and home-based cardiac rehabilitation programmes for patients after myocardial infarction appear to be similar. These initial results require affirmation by further economic evaluations of cardiac rehabilitation in different settings.
Publisher: Informa UK Limited
Date: 19-03-2020
Publisher: Oxford University Press (OUP)
Date: 03-2006
DOI: 10.1016/J.EJCNURSE.2005.10.010
Abstract: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the care for adults with congenital cardiac anomalies in Europe. The Euro Heart Survey on Adult Congenital Heart Disease has previously showed that 20 out of 48 specialist centres (42%) have nurse specialists affiliated with their programme. Fifteen of these 20 centres (75%) validly completed a web-based survey tool. Specialist centres had a median number of 2 nurse specialists on staff, corresponding with 1 full-time equivalent. In most centres, the nurse specialists were also affiliated with other cardiac care programmes, in addition to congenital heart disease. The involvement of nurse specialists was not related to the caseload of inpatients and outpatient visits. Physical examination was the most prevalent activity undertaken by nurse specialists (93.3%), followed by telephone accessibility (86.7%), patient education (86.7%), co-ordination of care (73.3%), and follow-up after discharge (73.3%). Patient education covered mainly prevention and prophylaxis of endocarditis (100%), cardiovascular risk factors (92.3%), sport activities (92.3%), the type and characteristics of the heart defect (92.3%), the definition and aetiology of endocarditis (84.6%), cardiac risk in case of pregnancy (84.6%), and heredity (84.6%). Two third of the nurse specialists were involved in research. This survey revealed gaps in the provision of care for these patients in Europe and demonstrated that there is room for improvement in order to provide adequate chronic disease management. The results of this study can be used by in idual hospitals for benchmarking.
Publisher: Elsevier BV
Date: 08-2014
Publisher: Wiley
Date: 12-03-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-05-2016
DOI: 10.1161/CIRCULATIONAHA.116.020730
Abstract: We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failure, as well, were recruited. Overall, 612 and 614 patients, respectively, were allocated to a home visit 7 to 14 days postdischarge by a cardiac nurse with follow-up and multidisciplinary support according to clinical need or standard management. The primary outcome of days-alive and out-of-hospital was examined on an intention-to-treat basis. During 1371 days (interquartile range, 1112–1605) of follow-up, 218 patients died and 17 917 days of hospital stay were recorded. In comparison with standard management, HBI patients achieved significantly prolonged event-free survival (90.1% [95% confidence interval, 88.2–92.0] versus 87.2% [95% confidence interval, 85.1–89.3] days-alive and out-of-hospital P =0.020). This reflected less all-cause mortality (adjusted hazard ratio, 0.67 95% confidence interval, 0.50–0.88 P =0.005) and unplanned hospital stay (median, 0.22 [interquartile range, 0–1.3] versus 0.36 [0–2.1] days/100 days follow-up P =0.011). Analyses of the differential impact of HBI on all-cause mortality showed significant interactions (characterized by U-shaped relationships) with age ( P =0.005) and comorbidity ( P =0.041) HBI was most effective for those aged 60 to 82 years (59%–65% of in idual trial cohorts) and with a Charlson Comorbidity Index Score of 5 to 8 (36%–61%). These data provide further support for the application of postdischarge HBI across the full spectrum of patients being hospitalized for chronic forms of heart disease. URL: www.anzctr.org.au . Unique identifiers: 12610000221055, 12608000022369, 12607000069459.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2016
Publisher: Wiley
Date: 22-11-2020
DOI: 10.1111/JPM.12703
Abstract: The quality of life (QoL) of people with severe mental illness (SMI) is a growing international concern. Many earlier studies report the determinants and correlates of QoL and functioning in people with SMI in Western countries. The QoL and functioning of Asian inpatients with SMI are largely unknown, particularly at the point where they have been assessed as being ready for hospital discharge. Physical health, social functioning and community living skills, and negative symptoms are important areas of concern immediately pre‐discharge. Social relationship related QoL, overall symptoms, unemployment, education level, living situation, physical illness and treatment duration predict functioning levels. Mental health nurses should consider interventions beyond the traditional focus on psychopathology to improve functioning outcomes in people with SMI recently discharged from hospital. Inpatient services should utilise the opportunity to monitor and address physical health problems before discharge from inpatient care. There is a lack of evidence on quality of life (QoL) and functioning in Asian people with severe mental illness (SMI) immediately prior to hospital discharge. This information could have major implications for treatment. To profile perceived quality of life, symptom severity and level of functioning among people with SMI. A cross‐sectional study involving 347 adult inpatients with SMI. QoL (WHO Quality of Life ‐ Brief Form), symptom severity (Positive and Negative Syndrome Scale) and level of functioning (Specific Level of Functioning) were measured immediately pre‐discharge. Participants reported low social relationship‐related QOL. Weak correlations were found between functioning, QoL and symptoms. Regression analysis identified the social relationship QoL domain, employment status, education level, living situation, physical illnesses, overall symptoms and the duration of receiving psychiatric services were statistically significant predictors of functioning levels. The findings may highlight a need for interventions beyond the traditional emphasis on psychiatric symptoms in order to improve functioning following an inpatient admission. Interventions to improve functioning in recently discharged people with SMI may need to be specifically designed to improve patients’ social relationships, support return to employment and minimise the risk of physical illness.
Publisher: Wiley
Date: 03-1988
DOI: 10.1111/J.1365-2648.1988.TB01411.X
Abstract: Seventy-six wives of patients suffering a first myocardial infarction were studied by questionnaire 6 weeks after their husbands went home. Despite the routine provision of support and information to spouses during their husband's stay in hospital, a high proportion reported physical and emotional symptoms of stress. The majority of wives felt they were poorly informed about myocardial infarction, had not had enough opportunity to ask the experts questions, and had received most support from relatives. The reasons for these findings are discussed and suggestions for early and systematic nursing intervention are made in an attempt to reduce stress and prevent the development of unhealthy patterns of behaviour.
Publisher: Oxford University Press (OUP)
Date: 18-03-2011
Publisher: Oxford University Press (OUP)
Date: 26-07-2023
Abstract: Engaging in self-care is an important aspect of the prevention and management of coronary heart disease (CHD), the leading cause of premature death in Thailand. As no validated tool exists to measure self-care in Thai people with CHD, we translated and examined the psychometric properties of the Self-Care of Coronary Heart Disease Inventory Version 3 (SC-CHDI-V3) in a Thai population. The SC-CHDI-V3 was translated into Thai using the standard forward and backward translation procedure for self-care instruments. A cross-sectional design was used to examine the psychometric properties of the Thai version of the SC-CHDI-V3 in 250 patients with confirmed CHD in a tertiary hospital in southern Thailand. Cronbach’s alpha and McDonald’s omega coefficients were used to assess internal consistency, and confirmatory factor analysis was performed to assess construct validity. The Thai version of the SC-CHDI-V3 demonstrated acceptable internal consistency (Cronbach’s alpha and McDonald’s omega coefficients of each scale ranged from 0.821 to 0.910). Reliability estimates were adequate for each scale (range 0.863–0.906). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.996–1.000 root mean square error of approximation = & .001–0.040). The Thai version of the SC-CHDI-V3 appears to be a valid and reliable instrument for measuring engagement in self-care maintenance, self-care monitoring, and self-care management among Thai people with CHD.
Publisher: Wiley
Date: 15-06-2007
DOI: 10.1002/CNCR.22730
Abstract: Oropharyngeal mucositis (OM) causes profound impairment of patients' health-related quality of life (HQoL). The aim of the article is to describe the development and preliminary validation of an HQoL instrument, OMQoL, specifically for patients with OM. First, a qualitative phase was conducted to generate items (n = 23). Face validity was assessed by focus group interviews (n = 13). Expert content review (n = 7) was used to ensure content validity. The second step was a quantitative validation phase comprised a multicenter study (n = 210) to help identify subscales of the instrument addressing different dimensions of OM and to measure reliability. The qualitative interview generated 171 items. Using focus group discussion and expert content review, items were reduced to 41 items. Factor and scaling analyses of these 41 items resulted in 4 subscales, contributed by 31 items, depicting problems with symptoms, diet, social function, and swallowing. The floor effect was modest. The factorial structure was satisfactory with loading >0.40 on each subscale for all items. All corrected item-total corrections were higher than 0.40 (r = 0.457-0.874). The internal consistency reliability of each subscale was high, with Cronbach alpha coefficients ranging from 0.906 to 0.934. The test-retest reliability of the in idual items using weighted kappa was good (kappa values 0.610-0.895). The intraclass correlation results for the subscale totals were all in excess of 0.70 (0.864-0.934). An initial psychometric analysis of the OMQoL was encouraging. The OMQoL could provide a valuable tool for the assessment of HQoL of patients with OM.
Publisher: Cambridge University Press (CUP)
Date: 22-03-2006
DOI: 10.1017/S1047951106000102
Abstract: The purpose of the study was to develop a questionnaire measuring health-related R1 quality of life for children and adolescents with congenital heart disease, the ConQol, that would have both clinical and research applications. We describe here the process of construction of a questionnaire, the piloting and the development of a weighted scoring system, and data on the psychometric performance of the measure in a s le of 640 children and young people recruited via 6 regional centres for paediatric cardiology from across the United Kingdom. The ConQol has two versions, one designed for children aged from 8 to 11 years, and the other for young people aged from 12 to 16 years. Initial findings suggest that it is a valid and reliable instrument, is acceptable to respondents, and is simple to administer in both a research and clinical context.
Publisher: Elsevier BV
Date: 08-2010
Publisher: SAGE Publications
Date: 05-1993
Publisher: Wiley
Date: 12-2010
Publisher: AMPCo
Date: 08-2013
DOI: 10.5694/MJA13.10440
Abstract: In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute in idual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an in idual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.
Publisher: MDPI AG
Date: 07-07-2022
Abstract: Research quality is a term often bandied around but rarely clearly defined or measured [...]
Publisher: Oxford University Press (OUP)
Date: 27-05-2013
Abstract: Successful management of warfarin, new anti-thrombotic agents and self-monitoring devices requires that health care professionals effectively counsel and educate patients. Previous studies indicate that health care professionals do not always have the knowledge to provide patients with the correct information. The purpose of this study was to investigate European cardiovascular nurses' knowledge on the overall management of anticoagulation therapy and examine if this knowledge was influenced by level of education and years in clinical practice. A questionnaire including 47 items on practice patterns and knowledge on warfarin, new anticoagulants, warfarin-drug and warfarin-food interactions, and self-management of International Normalized Ratio (INR) was distributed to the attendants at a European conference in 2012. The response rate was 32% (n=206), of whom 84% reported having direct patient contact. Warfarin was the most common used oral anticoagulation in daily practice. One third offered their patients both patient self-testing and patient self-management of INR. The mean total score on the knowledge questions was 28±6 (maximum possible score 53). Nurses in direct patient care had a higher mean score (p=0.011). Knowledge on warfarin and medication-interactions were low, but knowledge on warfarin-diet interactions and how to advise patients on warfarin as somewhat better. European cardiac nurses need to improve their knowledge and practice patterns on oral anticoagulation therapy. This area of knowledge is important in order to deliver optimal care to cardiac patients and to minimise adverse effects of the treatment.
Publisher: Oxford University Press (OUP)
Date: 19-12-2019
Abstract: The aim of this study was to synthesise and evaluate the effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease. Relevant randomised controlled trials evaluating mobile phone-based self-management interventions for medication adherence and/or change in blood pressure in coronary heart disease patients were identified by searching six electronic databases (PubMed, Cochrane, CINAHL, ProQuest, Scopus and EMBASE) from January 2008 to January 2019. The trials were screened, data were extracted and quality was assessed by two independent reviewers. Meta-analyses were performed for different outcomes while narrative syntheses were conducted for studies that could not be pooled or when there was the presence of high heterogeneity. Fifteen trials were included in this review, of which 11 of these trials were meta-analysed. Mobile phone-based self-management interventions were associated with a statistically significant reduction in diastolic blood pressure (combined mean difference of −1.99 (95% confidence interval (CI) –3.20 to −0.78 P=0.0001)). However, the combined effect on medication adherence (medium size effect of d=0.72 (95% CI −0.32 to 1.75 P=0.17)) and change in systolic blood pressure (combined mean difference of −1.08 (95% CI −5.51 to 3.35 P=0.63)) was not statistically significant. There was significant heterogeneity among the trials reviewed. Mobile phone-based self-management interventions have the potential to improve self-management and adherence in patients with coronary heart disease but better designed, conducted and reported trials are needed to demonstrate this.
Publisher: Elsevier BV
Date: 1990
DOI: 10.1016/0022-3999(90)90081-E
Abstract: Self-ratings of anxiety and depression were studied over six months in 60 wives of first time myocardial infarction patients. Couples were randomly assigned to either a treatment group, where they received a simple programme of education and psychological support in addition to routine care, or to a control group, where they received routine care only. All wives completed the Hospital Anxiety and Depression scale and a battery of visual analogue scales measuring anxiety on a range of topics related to recovery from a heart attack. Wives in the treatment group reported statistically significantly less anxiety than controls. This effect was sustained for six months after the counselling. It is concluded that a simple programme of in hospital counselling is efficacious and should be routinely offered to the wives of coronary patients.
Publisher: Wiley
Date: 07-11-2012
DOI: 10.1111/NIN.12008
Publisher: Hindawi Limited
Date: 24-02-2015
DOI: 10.1111/IJCP.12569
Publisher: Wiley
Date: 21-05-2021
DOI: 10.1002/NOP2.944
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.IJCARD.2013.10.082
Abstract: Cardiovascular disease (CVD) mortality rates have declined steadily over the past few decades but gender, socioeconomic and ethnic/racial disparities have not. These disparities impede cardiovascular health care reaching all those in need. The origins of disparities in CVD are numerous and wide-ranging, having largely evolved from inequalities in society. Similarly, disparities in CVD, interventions and outcomes will also vary depending on the minority or disadvantaged group. For this reason, strategies aimed at reducing such disparities must be stratified according to the target group, while keeping in mind that these groups are not mutually exclusive. There is a pressing need to move beyond what can be inferred from traditional cardiovascular risk factor profiling toward implementation of interventions designed to address the needs of these populations that will eventuate in a reduction of disparities in morbidity and mortality from CVD. This will require targeted and sustainable actions. Only by ensuring timely and equitable access to care for all through increased awareness and active participation can we start to close the gap and deliver appropriate, acceptable and just care to all, regardless of gender, socioeconomic status or ethnicity/race.
Publisher: Wiley
Date: 15-04-2011
DOI: 10.1111/J.1365-2702.2010.03586.X
Abstract: Aim. To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong. Background. Hospital‐acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low. Design. An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit. Methods. Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed. Results. The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74·7% and with glove use 72·4%. In approximately two‐third of episodes, participants washed their hands after each patient contact though, 78·5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28·6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non‐intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤5, 6–10, years. Relevance to clinical practice. Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed.
Publisher: Wiley
Date: 23-01-2012
DOI: 10.1111/J.1365-2702.2011.03934.X
Abstract: Aim. The aim of this paper is to describe the implementation of a depression screening and referral tool in two cardiac wards of a major metropolitan public hospital. The tool consisted of two sections: (1) screening for depression risk (Cardiac Depression Scale‐5) and (2) consequential referral actions. Background. Prior research has shown that depression in patients with heart disease is associated with significantly impaired quality of life, decreased medication adherence, increased morbidity and increased use of healthcare services. Design. A prospective in‐patient study design. Method. A consecutive s le of 202 patients admitted to either the cardiac medical ( n = 145) or surgical ( n = 57) wards of a major Melbourne metropolitan hospital were recruited into the study over an 18‐week period. Results. Just over half (54%) of the patients were identified as ‘at risk’ of depression. Of these, 19% were assessed as moderate risk and 35% high risk. Of those patients, 91% had the risk score documented in their medical history, 90% had engaged in discussions with clinicians regarding their risk score, 85% had their risk score communicated formally to the medical team and 25% were formally referred for appropriate follow‐up – significantly more than prior to implementation of the screening and referral tool. Conclusions. By providing a formalised mechanism for detecting depression, documented screening and referral rates improved for those with comorbid depression and heart disease affording an opportunity for early intervention. These findings support a move towards integrated approaches to screening of depression to become standard practice in the acute cardiac setting. Relevance to clinical practice. Such mechanisms also have the potential to initiate the development of new models of care that acknowledge the complexity of comorbid depression and heart disease and provide pathways from speciality to primary care which integrate the physical and psychosocial domains inclusive of screening, referral, systematic monitoring and streamlined behavioural and physical care.
Publisher: Wiley
Date: 06-09-2012
Publisher: Wiley
Date: 14-08-2013
Publisher: Public Library of Science (PLoS)
Date: 05-09-2013
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.PSYM.2011.04.003
Abstract: To evaluate the validity and reliability of the Chinese version of the Short-Form Cardiac Depression Scale (CDS) as a screening tool. Measurement performance was tested on 239 Chinese cardiac patients who were asked to complete the Chinese versions of the Short-Form CDS, the CDS, the Beck Depression Inventory, and an overall measure (single item) of mood status. The Chinese Short-Form CDS demonstrated acceptable internal consistency (Cronbach's α 0. 76). The high correlation coefficients (r = 0.63-0.74, P < 0.01) between the five items and the total scale provide further evidence of internal consistency. There was acceptable concurrent validity with significantly high correlations between the Chinese versions of the Short- Form CDS and the CDS (r = 0.80, P< 0.0001) and the Beck Depression Inventory (r = 0.64, P < 0.0001). Principal components analysis revealed a single dimension extracted from the data set, which resembles that reported by the authors of the original scale. The Chinese Short-Form CDS appears to be a valid and reliable user-friendly measure for monitoring depressed mood in Chinese-speaking patients with cardiac disease.
Publisher: Wiley
Date: 28-05-2005
DOI: 10.1016/J.EJHEART.2004.06.006
Abstract: The modern management of chronic heart failure has led to improved life expectancy, functioning and health-related quality of life (HRQL). HRQL measures the effects of an illness or a treatment from the patient's perspective. It is now recognised that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. Although there are a number of quality-of-life measures, which can be separated into two types-generic and disease specific-many have been developed, with little or no account being taken of the patient's perspective. Because most of the widely used measures are not patient centred, they may lack sensitivity and specificity in determining those aspects of HRQL important to in idual patients. This paper reviews the use of quality-of-life assessment tools in the evaluation of patients with heart failure.
Publisher: Wiley
Date: 06-2003
Publisher: Oxford University Press (OUP)
Date: 15-01-2012
DOI: 10.2146/AJHP110149
Abstract: The results of a pharmacoeconomic study of the cost-effectiveness of posaconazole versus fluconazole in preventing invasive fungal infections (IFIs) in patients with graft-versus-host disease (GVHD) are reported. The results of a randomized clinical trial suggested that posaconazole may be as effective as fluconazole for the prevention of IFIs in recipients of allogeneic cell transplants who develop severe GVHD and that posaconazole may be superior to fluconazole in reducing IFI-related deaths. Using published data from that trial and data from secondary sources, an economic model was developed to estimate the costs, IFIs avoided, and life-years saved with posaconazole versus fluconazole therapy. The results of the modeled 112-day treatment simulation were extrapolated to a lifetime horizon. In the modeled simulation, posaconazole therapy was associated with a lower probability of IFI development (0.05 versus 0.09), increased discounted life-years (7.87 life-years versus 7.66 life-years), and higher discounted costs per patient ($8,860 versus $5,710 in 2006 U.S. dollars) relative to fluconazole therapy. The estimated incremental cost-effectiveness of posaconazole versus fluconazole for IFI prophylaxis was $85,300 per IFI avoided and $15,300 per life-year saved. A sensitivity analysis indicated a 90% probability that the use of posaconazole for this purpose would be cost-effective at a threshold of $50,000 per life-year saved. Posaconazole is in the range of currently accepted criteria for cost- effectiveness relative to fluconazole for the prevention of IFIs among patients with GVHD.
Publisher: Informa UK Limited
Date: 2014
DOI: 10.2147/IJGM.S54230
Publisher: Elsevier BV
Date: 08-2012
Publisher: JMIR Publications Inc.
Date: 12-05-2022
DOI: 10.2196/36673
Abstract: Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, which continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far is the adoption of holistic management approaches. The Optimal Health Program (OHP) is a brief 5-session, plus booster, psychosocial program designed to support mental and physical well-being that has been used effectively for a range of chronic conditions. This study examines the feasibility and acceptability of employing an especially customized version of OHP (long COVID OHP [LC-OHP]) to improve psychological and physical health of people with long COVID. This is a feasibility randomized controlled trial that will be running from November 2021 to February 2023. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. A total of 60 participants will be randomized into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the program (primary) and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy, and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the program. Quantitative data will be analyzed using SPSS, and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analyzed to identify common emerging themes. This is an ongoing study, which began in November 2021. Long COVID has a significant impact on an in idual’s mental and physical functioning. The LC-OHP has a potential to provide people living with long COVID with additional support and to improve self-efficacy. The findings of this study would identify the feasibility of delivering this program to this population and will provide an indication for the program’s effectiveness. ISRCTN Registry ISRCTN38746119 www.isrctn.com/ISRCTN38746119 DERR1-10.2196/36673
Publisher: Wiley
Date: 12-01-2010
Publisher: Elsevier BV
Date: 06-2003
DOI: 10.1016/S0738-3991(02)00126-X
Abstract: We systematically reviewed studies examining information needs of post-myocardial infarction patients and their families. Electronic databases and bibliographies of relevant papers were searched and experts in the field contacted to find relevant studies. A standardised data form was used to extract data on study populations, instruments and results. Of 14 published studies, 6 used the same instrument. Information about risk factors ranked as the most important category overall, followed by information on cardiac anatomy and physiology, medications, and physical activity. Information about miscellaneous items, diet, psychological factors, and the CCU, although ranked lower, were still rated important. Some variation between settings was evident. Patients preferred physicians over nurses as information givers. Differences were found between patient and nurse ratings of information categories. Differences were found in the self-perceived information needs of patients responding to different instruments, indicating a priming effect. Changes in ranking of information categories between CCU, PCCU and PD are congruent with decreasing levels of patient dependency. The information needs of women and other post-MI subgroups, including the elderly, minority ethnic groups, patients with severe coronary disease, and deprived patients, have not been assessed. Patients have not been involved in the design of information needs assessment instruments.
Publisher: Elsevier BV
Date: 06-1994
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.JVAL.2011.03.005
Abstract: We evaluated the cost-effectiveness of universal mass vaccination (UMV) against influenza compared with a targeted vaccine program (TVP) for selected age and risk groups in the United States. We modeled costs and outcomes of seasonal influenza with UMV and TVP, taking a societal perspective. The US population was stratified to model age-specific (< 5, 5-17, 18-49, 50-64, and 65+ years) vaccine coverage and efficacy. Probability of influenza-related illness (ILI) and complications, health-care utilization, costs, and survival were estimated. For a season's intervention, ILI cases in that year, lifetime costs (2008 US$), and quality-adjusted life years (QALYs) lost (both discounted at 3% per annum) were calculated for each policy and used to derive incremental cost-effectiveness ratios. A range of sensitivity and alternative-scenario analyses were conducted. In base-case analyses, TVP resulted in 63 million ILI cases, 859,000 QALYs lost, and $114.5 billion in direct and indirect costs corresponding estimates for UMV were 61 million cases, 825,000 QALYs lost, and $111.4 billion. UMV was therefore estimated to dominate TVP, saving $3.1 billion and 34,000 QALYs. In probabilistic sensitivity analyses, UMV was dominant in 82% and dominated in 0% of iterations. In alternative-scenario analyses, UMV dominated TVP when lower estimates of vaccine coverage were used. Lower estimates of ILI risk among unvaccinated, vaccine effectiveness, and risk of complications resulted in ICERs of $2800, $8100, and $15,900 per QALY gained, respectively, for UMV compared with TVP. UMV against seasonal influenza is cost saving in the United States under reasonable assumptions for coverage, cost, and efficacy.
Publisher: Wiley
Date: 08-06-2006
DOI: 10.1111/J.1365-2648.2006.03915.X
Abstract: This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing. Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable. Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study. One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used. Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.
Publisher: Informa UK Limited
Date: 06-2022
DOI: 10.1080/09638288.2021.1933220
Abstract: To examine the psychometric properties of a Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES) among stroke survivors. The PS-SES was translated into Chinese. A cross-sectional descriptive study was conducted with 336 stroke survivors recruited from the neurology departments of five hospitals in China. Reliability, concurrent validity, and construct validity of the scale were determined. The Chinese version of the PS-SES (PS-SES-C) showed good internal consistency and test-retest reliability, with a Cronbach's α of 0.98 and an intraclass correlation coefficient of 0.79. There was a moderate to strong positive correlation between the PS-SES-C and Chinese version of the General Self-Efficacy Scale ( The PS-SES-C is a reliable and valid instrument for assessing self-efficacy in managing the participation of Chinese stroke survivors.Implications for rehabilitationSelf-efficacy significantly predicts activity and participation in stroke survivors and is a major outcome measure in many stroke rehabilitation programmes.The translated Chinese version of the Participation Strategies Self-efficacy Scale is a valid and reliable tool to evaluate stroke survivors' self-efficacy in managing participation.The Chinese version of the Participation Strategies Self-efficacy Scale can be used to assess stroke recovery among the Chinese population in clinical and research settings.
Publisher: Elsevier BV
Date: 1992
DOI: 10.1016/0002-9149(92)91318-X
Abstract: To evaluate in detail the extent to which step sectioning and immunohistochemical examination of sentinel lymph nodes (SNs) in patients with breast cancer reveal additional node positive patients, to arrive at a sensitive yet workable protocol for histopathological SN examination. This study comprised 86 women with one or more positive SN after a successful SN procedure for clinical stage T1-T2 invasive breast cancer. SNs were lamellated into pieces of approximately 0.5 cm in size. One initial haematoxylin and eosin (H&E) stained central cross section was made for each block. When negative, four step ribbons were cut at intervals of 250 microm. One section from each ribbon was stained with H&E, and one was used for immunohistochemistry (IHC). When taking the cumulative total of detected metastases at level 5 as 100%, the percentage of SN positive patients increased from 80%, 83%, 85%, 87% to 88% in the H&E sections through levels 1 to 5, and with IHC these values were 86%, 90%, 94%, 98%, and 100%. Three of nine patients in whom metastases were detected at levels 3-5 only had metastases in the subsequent axillary lymph node dissection. Multiple level sectioning of SNs (five levels at 250 microm intervals) and the use of IHC detects additional metastases up to the last level. Although more levels of sectioning might increase the yield even further, this protocol ensures a reasonable workload for the pathologist with an acceptable sensitivity when compared with the published literature.
Publisher: Springer Science and Business Media LLC
Date: 10-03-2021
DOI: 10.1186/S12955-021-01730-Y
Abstract: The Trunk Impairment Scale (TIS) has been translated into Chinese, but the psychometric properties of the Chinese version of the TIS (TIS-C) have not yet been established. We aimed to examine the reliability and validity of the TIS-C for assessing sitting balance among Chinese people with a stroke. A descriptive, cross-sectional design was used. We recruited a convenience s le of 170 subacute stroke patients aged 18 years or over from the neurology departments of four traditional Chinese medicine hospitals in China. Patients completed the TIS-C, the Berg Balance Scale and the Modified Barthel Index. The psychometric properties of the TIS-C were examined to establish test–retest reliability, internal consistency, equivalence, and content, criterion, and construct validity. Intraclass correlation coefficients for inter-rater and intra-rater reliability ranged from 0.75 to 0.89 and from 0.90 to 0.97, respectively. The TIS-C Cronbach α was 0.86. The strong correlation between the total score of the TIS-C and the Berg Balance Scale ( r s = 0.81, p 0.001) or Modified Barthel Index ( r s = 0.84, p 0.001) suggested good concurrent and convergent validity, respectively. Known-group validity was supported by the significant difference ( p 0.001) in TIS-C scores between participants with mild and moderate stroke. The TIS-C is a valid and reliable tool for assessing static and dynamic sitting balance as well as coordination of trunk movement among stroke survivors with mild and moderate stroke.
Publisher: Wiley
Date: 15-02-2016
DOI: 10.1111/JAN.12924
Publisher: Wiley
Date: 07-1981
DOI: 10.1111/J.1365-2648.1981.TB03224.X
Abstract: This paper reviews the proper technique which should be adopted by the nurse in order to obtain accurate blood pressure measurements. Although this is difficult using conventional instruments, statistics uniformly confirm the harmful significance of an elevated blood pressure. Any nurse delivery high quality care must be able to carry out nursing procedures skillfully and accurately. The methodology of blood pressure recording is discussed, analysed and evaluated. It is well-documented that there are many potential sources of error in recording blood pressure, including poor technique and observer bias. The paper deals with these and highlights some of the dilemmas that this technique presents to the nurse. A claim is made that many nurses are often inadequately trained in blood pressure measurement, and with increasing reliance on the nurse for records, much more attention need to be focused on this area.
Publisher: Wiley
Date: 10-11-2009
DOI: 10.1111/J.1365-2702.2009.02876.X
Abstract: To explore Chinese health care professionals' perceptions of cardiac rehabilitation for patients with coronary heart disease in mainland China. Coronary heart disease is a rapidly growing major health problem in mainland China and little is known about the current provision of rehabilitation for this population. A qualitative study. Face-to-face interviews were conducted with 18 Chinese health care professionals. The interviews were tape-recorded, transcribed and content analysis was used to identify categories. Content analysis of the data revealed three major categories: underdeveloped cardiac rehabilitation services, multiple obstacles to the establishment of a cardiac rehabilitation programme and a perceived need for professional guidance to patients. The current situation of cardiac rehabilitation in hospitals of China is poor with multiple obstacles prohibiting the development of cardiac rehabilitation services in the country and this has resulted in high rates of recurrence of heart attacks, coronary risk factors going undetected and/or untreated and psychological distress being observed among Chinese coronary heart disease patients. Relevance to clinical practice. The findings provide useful pointers for Chinese health professionals to explore ways of providing an effective, safe, convenient and culturally sensitive rehabilitation programme for Chinese patients with coronary heart disease.
Publisher: Frontiers Media SA
Date: 31-01-2018
Publisher: Public Library of Science (PLoS)
Date: 26-04-2018
Publisher: Informa Healthcare
Date: 08-02-2010
DOI: 10.3111/13696991003604108
Abstract: Ventilator-associated pneumonia (VAP), the most common nosocomial infection in critically ill patients, is associated with significantly longer duration of mechanical ventilation, and increased mortality, hospital days, and health-care costs. A previously published prospective, randomized study established the noninferiority of intravenous (IV) doripenem versus IV imipenem/cilastatin ('imipenem') for VAP. This study compares the economic outcomes of IV therapy with doripenem versus imipenem as first-line treatment for VAP. A decision-analytic model of inpatient care and outcomes for VAP was used to estimate costs associated with VAP treatment. The model calculates total hospital costs, comprising costs of initial and concomitant therapy, and costs associated with mechanical ventilation, intensive care unit stays, and total days in hospital. Total treatment costs for doripenem were $10,630 lower than for imipenem ($71,259 vs. 81,889), driven primarily by differences in costs of mechanical ventilation ($45,224 for doripenem, $57,348 for imipenem). Probabilistic sensitivity analyses found doripenem consistently cost saving versus imipenem in 1,000 simulations. Study limitations include use of a simple model to represent a complex disease process and reliance on trial data that may not reflect real-world care and outcomes. Doripenem is a cost saving first-line treatment for VAP versus imipenem while providing an equivalent rate of cure.
Publisher: Elsevier BV
Date: 1983
DOI: 10.1016/0020-7489(83)90016-0
Abstract: This paper reviews the debate concerning the relationship between dietary fats and heart disease. The paper also addresses the questions "should nurses persuade patients with heart disease to follow a low-fat, low-cholesterol diet?", "If so, will patients be less liable to a heart attack?" and "are such recommendations based on valid scientific evidence?". The author examines the recent evidence which is critical of such dietary regimens, and claims that much of the dietary advice given by nurses to these patients is biased, misleading and scientifically unfounded.
Publisher: Springer Science and Business Media LLC
Date: 08-2017
DOI: 10.1007/S11136-017-1666-6
Abstract: Multi-attribute utility instruments (MAUIs) are widely used to measure utility weights. This study sought to compare utility weights of two popular MAUIs, the EQ-5D-3L and the SF-6D, and inform researchers in the selection of generic MAUI for use with cardiovascular (CVD) patients. Data were collected in the Young@Heart study, a randomised controlled trial of a nurse-led multidisciplinary home-based intervention compared to standard usual care. Participants (n = 598) completed the EQ-5D-3L and the SF-12v2, from which the SF-6D can be constructed, at baseline and at 24-month follow-up. This study examined discrimination, responsiveness, correlation and differences across the two instruments. Both MAUIs were able to discriminate between the NYHA severity classes and recorded similar changes between the two time points although only SF-6D differences were significant. Correlations between the dimensions of the two MAUIs were low. There were significant differences between the two instruments in mild conditions but they were similar in severe conditions. Substantial ceiling and floor effects were observed. Our findings indicate that the EQ-5D and the SF-6D cover different spaces in health due to their classification systems. Both measures were capable of discriminating between severity groups and responsive to quality of life changes in the follow-up. It is recommended to use the EQ-5D-3L in severe and the SF-6D in mild CVD conditions.
Publisher: Springer Science and Business Media LLC
Date: 22-02-2015
Publisher: Elsevier BV
Date: 05-2007
Publisher: Oxford University Press (OUP)
Date: 03-2011
DOI: 10.1016/J.EJCNURSE.2010.10.004
Abstract: Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice. To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions. A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience s le of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management. Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence. Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.
Publisher: Oxford University Press (OUP)
Date: 06-2006
DOI: 10.1016/J.EJCNURSE.2006.01.003
Abstract: It has been recognized that a clinically significant portion of patients with coronary artery disease (CAD) continue to experience anginal and other related symptoms that are refractory to the combination of medical therapy and revascularization. The Euro Heart Survey on Revascularization (EHSCR) provided an opportunity to assess pharmacological treatment and outcome in patients with proven CAD who were ineligible for revascularization. We performed a secondary analysis of EHS-CR data. After excluding patients with ST-elevation myocardial infarction and those in whom revascularization was not indicated, 4409 patients remained in the analyses. We selected two groups: (1) patients in whom revascularization was the preferred treatment option (n = 3777, 86%), and (2) patients who were considered ineligible for revascularization (n = 632, 14%). Patient ineligible for revascularization had a worse risk profile, more often had a total occlusion (59% vs. 37%, p < 0.001), were treated more often with ACE-inhibitors (65% vs. 55%, p < 0.001) but less likely with aspirin (83% vs. 88%, p < 0.001). Overall, they had higher case-fatality at 1-year (7.0% vs. 3.7%, p < 0.001). Regarding self-perceived health status, measured via the EuroQol 5D (EQ-5D) questionnaire, these same patients reported more problems on all dimensions of the EQ-5D. Furthermore, in the revascularization group we observed an increase between discharge and 1-year follow up (utility score from 0.85 to 1.00) whereas patients ineligible for revascularization did not improve over time (utility score remained 0.80) In this large cohort of European patients with CAD, those considered ineligible for revascularization had more co-morbidities and risk factors, and scored worse on self-perceived health status as compared to revascularized patients in the revascularization group. With the exception of ACE-inhibitors and aspirin, there were no major differences regarding drug treatment between the two groups. Given these clinically significant observations, there appears to be a role for nurse-led, multidisciplinary, rehabilitation teams that target clinically vulnerable patients whose symptoms remain refractory to standard medical care.
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1016/J.IJCARD.2006.11.018
Abstract: Participation in cardiac rehabilitation after acute myocardial infarction is sub-optimal. Offering home-based rehabilitation may improve uptake. We report the first randomized study of cardiac rehabilitation to include patient preference. To compare the clinical effectiveness of a home-based rehabilitation with hospital-based rehabilitation after myocardial infarction and to determine whether patient choice affects clinical outcomes. Pragmatic randomized controlled trial with patient preference arms. Rural South West England. Patients admitted with uncomplicated myocardial infarction were offered hospital-based rehabilitation classes over 8-10 weeks or a self-help package of six weeks' duration (the Heart Manual) supported by a nurse. Primary outcomes at 9 months were mean depression and anxiety scores on the Hospital Anxiety Depression scale, quality of life after myocardial infarction (MacNew) score and serum total cholesterol. Of the 230 patients who agreed to participate, 104 (45%) consented to randomization and 126 (55%) chose their rehabilitation programme. Nine month follow-up data were available for 84/104 (81%) randomized and 100/126 (79%) preference patients. At follow-up no difference was seen in the change in mean depression scores between the randomized home and hospital-based groups (mean difference: 0 95% confidence interval, -1.12 to 1.12) nor mean anxiety score (-0.07 -1.42 to 1.28), mean global MacNew score (0.14 -0.35 to 0.62) and mean total cholesterol levels (-0.18 -0.62 to 0.27). Neither were there any significant differences in outcomes between the preference groups. Home-based cardiac rehabilitation with the Heart Manual was as effective as hospital-based rehabilitation for patients after myocardial infarction. Choosing a rehabilitation programme did not significantly affect clinical outcomes.
Publisher: Wiley
Date: 07-1986
DOI: 10.1111/J.1365-2648.1986.TB01272.X
Abstract: Although sleep has been identified as an activity generally considered necessary for normal functioning, the nursing literature on the subject is relatively scanty. This paper is an attempt to review sleep and its relationship to nursing practice. A discussion of nursing interventions that are likely to ensure that adequate sleep is maintained is included.
Publisher: Wiley
Date: 26-09-2015
DOI: 10.1111/JOCN.12703
Abstract: The aim of this study was to evaluate nurses' perceptions of an education programme and screening and referral tool designed for cardiac nurses to facilitate depression screening and referral procedures for patients with coronary heart disease. There is a high prevalence of depression in patients with coronary heart disease that is often undetected. It is important therefore that nurses working with cardiac patients are equipped with the knowledge and skills to recognise the signs and symptoms of depression and refer appropriately. A qualitative approach with purposive s ling and semi-structural interviews was implemented within the Donabedian 'Structure-Process-Outcome' evaluation framework. Semi-structured interviews were conducted with 14 cardiac nurses working in a major metropolitan hospital six weeks post-attending an education programme on depression and coronary heart disease. Thematic data analysis was implemented, specifically adhering to Halcomb and Davidson's (2006) pragmatic data analysis, to examine nurse knowledge and experience of depression assessment and referral in an acute cardiac ward. The key findings of this study were that the education programme: (1) increased the knowledge base of nurses working with cardiac patients on comorbid depression and coronary heart disease, and (2) assisted in the identification of depression and the referral of 'at risk' patients. Emphasis was placed on the translational significance of educating cardiac nurses about depression via the introduction of a depression screening and referral instrument designed specifically for use in the cardiac ward. As a result, participants found they were better equipped to identify depressive symptoms and, guided by the screening instrument, to confidently instigate referral procedures. Much complexity lies in caring for cardiac patients with depression, including issues such as misdiagnosis. Targeted education, including use of appropriate instruments, has the potential to facilitate early recognition of the signs and symptoms of depression in the acute cardiac setting.
Publisher: Wiley
Date: 15-02-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
Publisher: Springer Science and Business Media LLC
Date: 02-08-2008
DOI: 10.1007/S00520-008-0485-2
Abstract: An oropharyngeal mucositis (OM)-specific health-related quality of life measure (OMQoL) has been developed to assess the impact of OM from the perspective of patients. The current paper describes the convergent, concurrent, and known-group validities and responsiveness in relation to clinical and health outcomes. A multicenter approach was used, and 137 patients treated with different cancer therapies completed the OMQoL and the European Organization for Research and Treatment of Cancer Quality of Life questionnaire [EORTC QLQ-C30 (Ch)] twice over a 4-week period or weekly over a 7-week period, along with concurrent measures of OM and its related symptoms. The OM-related symptom scores correlated highly with the OMQoL, confirming its convergent validity (r = -0.724--0.971, p < 0.01). Moderate correlations between the subscales of the OMQoL and EORTC QLQ-C30 (Ch) were indicative of good concurrent validity (r = 0.450-0.724, p < 0.01). The OMQoL was able to distinguish between patients with different severities of OM (p < 0.01) and types of cancer therapy (p < 0.01), providing evidence of good known-group validity. The changes in effects sizes corresponding to changes in OM curves indicate that the OMQoL is responsive to changes in OM status. These findings suggest that the OMQoL has very good psychometric properties and can be used as a health-related quality of life assessment for cancer patients with OM. Much work is still needed in strengthening the psychometric qualities and interpretability of the OMQoL by demonstrating its ability to detect outcome changes over time.
Publisher: Oxford University Press (OUP)
Date: 10-2009
Publisher: Elsevier BV
Date: 11-2013
Publisher: Informa UK Limited
Date: 11-1999
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.IJNURSTU.2011.02.021
Abstract: The study aims were to (a) describe the experiences of Chinese Australians with heart disease following discharge from hospital for an acute cardiac event (b) identify patterns and cultural differences of Chinese Australians following discharge from hospital and (c) illustrate the illness/health seeking behaviors and health beliefs of Chinese Australians. Qualitative study. Interview data were obtained from the following sources: (a) focus groups of Chinese community participants without heart disease (b) interviews with patients recently discharged from hospital following an admission for an acute cardiac event and (c) interviews with Chinese-born health professionals working in Australia. Qualitative thematic analysis was undertaken. Study themes generated from the data were: (1) linking traditional values and beliefs with Western medicine (2) reverence for health professionals and family and (3) juxtaposing traditional beliefs and self-management. Considering the influence of cultural values in developing health care plans and clinical decision making is important.
Publisher: BMJ
Date: 02-01-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-01-2018
DOI: 10.1161/STR.49.SUPPL_1.TP152
Abstract: Hemiplegic shoulder pain (HSP) limits stroke survivors’ physical function, which in turn impairs their capabilities in participating in activities and compromises their quality of life (QoL). Systematic reviews report acupuncture is potentially beneficial in reducing HSP and improving physical function. A study was conducted to investigate the feasibility and acceptance of a 6-week acupuncture treatment among community-dwelling survivors. It was hypothesized that there would be no significant problems in recruiting participants, conducting the true and sham treatment, and measuring clinical outcomes. Fifteen survivors with HSP were recruited and assigned randomly to a true acupuncture, sham acupuncture, or control group in a 1:1:1 ratio. Participants in the true acupuncture group received an acupuncture treatment regimen developed by a panel of experts in Chinese and Western medicine. Acupuncture devices with needles that retract into the handle were used in the sham group. Participants in the control group received usual rehabilitative care. Outcomes including HSP, upper extremity function, depressive symptoms, social participation, and QoL were collected at baseline and 1 week after completion of the treatment for the true and sham groups: participants were asked to comment on the acceptability and satisfaction of the treatment within 1 week after the 6-week treatment. Data were collected at baseline and at 7 weeks for the control group. The participants’ mean age was 62.67 years. The mean duration post-stroke was 6.33 years. Eighty percent had an ischemic stroke and 66.7% a left-sided weakness. A total of 7-15 acupoints were used for the true and sham groups. Overall, participants found the traditional Chinese Medicine practitioners helpful and attentive to their health concerns. No adverse events were reported throughout the study. More participants in the true acupuncture group reported reduced HSP after the treatment. They expressed that they were willing to participate in the treatment again. In conclusion, the high level of user satisfaction indicated the feasibility of conducting a large-scale randomized controlled trial to evaluate the effects of the proposed acupuncture treatment on survivors’ post-stroke HSP and health outcomes.
Publisher: Wiley
Date: 27-06-2008
DOI: 10.1007/S10464-008-9178-8
Abstract: Family interventions in schizophrenia have shown positive effects on patients but little attention has been paid to their effects on family members, particularly those in non-Western countries. This randomized controlled trial evaluated the effectiveness of a bi-weekly, 12-session, family-led mutual support group for Chinese caregivers of schizophrenia sufferers over 6 months compared with standard psychiatric care. It was conducted with 76 families of outpatients with schizophrenia in Hong Kong of whom 38 were assigned randomly to either a mutual support group or standard care. Families' psychosocial health status and patients' symptom severity and length of re-hospitalizations at recruitment, one-week and 12-month post-intervention were compared between groups. Results of repeated-measures mixed model indicated that the mutual support group experienced significantly greater improvements in families' burden, functioning and number of support persons and length of patients' re-hospitalizations at two post-tests. The findings provide evidence that mutual support groups can be an effective family-initiated, community-based intervention for Chinese schizophrenia sufferers.
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.IJCARD.2011.12.088
Abstract: Depression is the third leading cause of disease burden worldwide and is predicted to be the leading cause by 2030. Importantly, depression has been identified as an independent risk factor for coronary heart disease (CHD) and both share significant physiological overlap. Identification of depression is complex. Consequently, accurate diagnosis of comorbid depression and CHD is challenging and requires a move toward an interdisciplinary engagement of knowledge transfer. A concerted effort is required utilising translational research to better identify depression in the CHD population. This approach is not meant to categorise patients, rather it is aimed at progressing toward an improved prognosis. Further, this approach should provide health professionals with the confidence to apply the term depression and define its meaning in a more precise and consistent manner.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2016
Publisher: Elsevier BV
Date: 06-1994
DOI: 10.1016/0964-3397(94)90002-7
Abstract: In 100 patients admitted to a coronary care unit with a history of chest pain thought to be due to myocardial infarction, the intensity of pain was independently rated by the patient and the primary nurse caring for the patient soon after admission. Pain intensity was assessed using a visual analogue scale designed to yield a score of 0-100. 10 experienced coronary care nurses who had participated in a short programme of pain assessment and management were included in the study. A strong positive correlation between the patients' and nurses' ratings was found. Possible explanations for these findings are discussed.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2011
Abstract: Despite favourable results from past meta-analyses, some recent large trials have not found Heart Failure (HF) disease management programs to be beneficial. To explore reasons for this, we evaluated evidence from existing meta-analyses. Systematic review incorporating meta-review was used. We selected meta-analyses of randomized controlled trials published after 1995 in English that examined the effects of HF disease management programs on key outcomes. Databases searched: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR), DARE, NHS EED, NHS HTA, Ageline, AMED, Scopus, Web of Science and CINAHL cited references, experts and existing reviews were also searched. 15 meta-analyses were identified containing a mean of 18.5 randomized trials of HF interventions +/- 10.1 (range: 6 to 36). Overall quality of the meta-analyses was very mixed (Mean AMSTAR Score = 6.4 +/- 1.9 range 2-9). Reporting inadequacies were widespread around populations, intervention components, settings and characteristics, comparison, and comparator groups. Heterogeneity (statistical, clinical, and methodological) was not taken into account sufficiently when drawing conclusions from pooled analyses. Meta-analyses of heart failure disease management programs have promising findings but often fail to report key characteristics of populations, interventions, and comparisons. Existing reviews are of mixed quality and do not adequately take account of program complexity and heterogeneity.
Publisher: Wiley
Date: 2007
DOI: 10.1002/NUR.20189
Abstract: Health-related quality of life is an important outcome indicator of mental health. We assessed the perception of health-related quality of life of persons with schizophrenia in Hong Kong and Taipei. In-person survey interviews were conducted using the Chinese World Health Organization Quality of Life Scale--Brief Version. A convenience s le was recruited from psychiatric outpatient departments: 176 from Hong Kong and 80 from Taipei. We found that both groups were significantly less satisfied with their psychological and social relationship domains compared to other domains. Poor mental health predicted poor perception of health-related quality of life. Schizophrenia has an impact on many aspects of a person's functioning. A rehabilitation model that takes into account symptoms, financial situation, family support, and social functioning is required.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.HRTLNG.2011.05.005
Abstract: This study evaluated the effects of a home-based rehabilitation program for Chinese patients with myocardial infarction in terms of health-related quality of life and psychological status. This was a randomized, controlled trial with data collected at 2 university-affiliated public general hospitals in Xian (Shaanxi Province, People's Republic of China). One hundred and sixty patients with a myocardial infarction were randomly assigned to either the interventional group (a home-based cardiac rehabilitation program using a self-help manual) or the control group (usual care). Health-related quality of life (generic, Chinese Short Form 36-Item Health Survey disease-specific, Chinese Myocardial Infarction Dimensional Assessment Scale) and psychological status (the Chinese Hospital Anxiety and Depression Scale) were measured at baseline, program completion (6 weeks), and 3 and 6 months after hospital discharge. Significant differences were evident in the main outcomes when the home-based group was compared with the usual care group at 6 weeks, 3 months, and 6 months. The home-based group had significantly higher scores on 4 of the 8 domains of the Chinese Short Form 36-Item Health Survey and on 3 of the 7 dimensions of the Chinese Myocardial Infarction Dimensional Assessment Scale, with significantly lower scores on the anxiety, but not the depression, subscale of the Chinese Hospital Anxiety and Depression Scale. A simple, home-based cardiac rehabilitation program for patients with acute myocardial infarction, using a self-help manual, improves health-related quality of life and reduces anxiety. It appears feasible and acceptable, and does not produce inferior outcomes compared with usualcare in China.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.HLC.2016.01.011
Abstract: This paper, based on the 2015 CSANZ Cardiovascular Nursing Lecture, takes its title from the invitation to give this lecture in Melbourne being received when the author was visiting Florence, after whom Florence Nightingale, the founder of modern nursing, is named. Her work has indirectly shaped and influenced cardiovascular nursing, which has developed over the past 50 years. Despite its relatively short history, cardiovascular nursing has made a major contribution to improving the cardiovascular health and well-being of patients and families through health promotion, risk reduction and disease prevention. Ex les include cardiac rehabilitation and secondary prevention and chronic heart failure disease management. Challenges, however, remain, including nurses practising to the full extent of their education and training, working as full partners with physicians and other health professionals in redesigning healthcare, ensuring better data collection and being more active in advocacy and policy initiatives. Cardiovascular nursing has a strong record of innovation but should always remember that it is there to serve the public and, bearing in mind the risk of potential harm versus benefit, be mindful of Florence Nightingale's wise counsel, "First, do no harm".
Publisher: BMJ
Date: 10-2005
DOI: 10.1136/EBN.8.4.108
Publisher: Elsevier BV
Date: 03-2005
Publisher: BMJ
Date: 07-2004
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2005
DOI: 10.1161/01.STR.0000185743.41231.85
Abstract: Background and Purpose— Teaching effective problem-solving skills to family caregivers of patients with chronic disease has been shown to be useful for promoting physical and psychosocial well-being. However, the use and effectiveness of problem solving for supporting caregivers in stroke care has not been reviewed. This article aims to identify and review studies that have examined the effectiveness of teaching problem solving skills to caregivers in stroke care, highlight gaps in the evidence base, and recommend avenues for additional research. Methods— A structured review of literature identified from nursing, medicine, and psychology databases from 1970 to 2004 was conducted. Eleven articles reporting the development or evaluation of effective problem-solving interventions for caregivers of patients with stroke were critically appraised using recognized quality criteria. Results— The results of this review show that the strength of evidence for problem-solving interventions for caregivers of stroke patients is limited. Because some studies used small s les and varied methods and interventions, making a comparison was difficult. Caregivers’ problem-solving abilities were rarely measured, and the theoretical concepts and framework underpinning most studies were unclear. Conclusions— Evidence from the review suggests a need to additionally study the link between theoretical concepts of effective problem solving and outcomes using standardized measures and to examine also the processes involved in implementing the intervention using multimethod designs, including both quantitative and qualitative approaches.
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-046160
Abstract: Heart failure is a growing challenge to healthcare systems worldwide. Technological solutions have the potential to improve the health of patients and help to reduce costs. Acceptability is a prerequisite for the use and a successful implementation of new disruptive technologies. This qualitative study aimed to explore determinants that influence the acceptance of patients and their informal caregivers regarding a patient-oriented digital decision-making solution—a doctor-at-home system. We applied a semistructured design using an interview guide that was based on a theoretical framework influenced by established acceptance theories. The interviews were analysed using a content analysis. A multicentred study in four European countries. We interviewed 49 patients and 33 of their informal caregivers. Most of the patients were male (76%) and aged between 60 and 69 years (43%). Informal caregivers were mostly female (85%). The majority of patients (55%) suffered from heart failure with mild symptoms. Four main categories emerged from the data: needs and expectations, preferences regarding the care process, perceived risk and trust . Participants expressed clear wishes and expectations regarding a doctor-at-home , especially the need for reassurance and support in the management of heart failure. They were receptive to changes to the current healthcare processes. However, trust was identified as an important basis for acceptance and use. Finally, perceived risk for decision-making errors is a crucial topic in need of attention. Patients and informal caregivers see clear benefits of digitalisation in healthcare. They perceive that an interactive decision-making system for patients could empower and enable effective self-care. Our results provide important insights for development processes of patient-centred decision-making systems by identifying facilitators and barriers for acceptance. Further research is needed, especially regarding the influence and mitigation of patients and informal caregivers’ perceived risks.
Publisher: Wiley
Date: 16-02-2010
DOI: 10.1111/J.1365-2702.2009.03106.X
Abstract: Aims. This study sought to measure the rates and trajectory of depression over six months following admission for an acute cardiac event and describe the relationship between depression and life satisfaction. Background. Co‐morbid depression has an impact on cardiac mortality and is associated with the significant impairment of quality of life and well‐being, impairments in psychosocial function, decreased medication adherence and increased morbidity. Design. This was a descriptive, correlational study. Method. The study was undertaken at a large public hospital in Melbourne. Participants were asked to complete a survey containing the cardiac depression scale (CDS) and the Personal Well‐being Index. Results. This study mapped the course of depression over six months of a cohort of patients admitted for an acute cardiac event. Significant levels of depressive symptoms were found, at a level consistent with the literature. A significant correlation between depressive symptoms as measured by the CDS and the Personal Well‐being Index was found. Conclusions. Depression remains a significant problem following admission for an acute coronary event. The Personal Well‐being Index may be a simple, effective and non‐confrontational initial screening tool for those at risk of depressive symptoms in this population. Relevance to clinical practice. Despite the known impact of depression on coronary heart disease (CHD), there is limited research describing its trajectory. This study makes a compelling case for the systematic screening for depression in patients with CHD and the importance of the nursing role in identifying at risk in iduals.
Publisher: Radcliffe Media Media Ltd
Date: 23-09-2022
DOI: 10.15420/CFR.2022.16
Abstract: Many people with heart failure do not receive cardiac rehabilitation despite a strong evidence base attesting to its effectiveness, and national and international guideline recommendations. A more holistic approach to heart failure rehabilitation is proposed as an alternative to the predominant focus on exercise, emphasising the important role of education and psychosocial support, and acknowledging that this depends on patient need, choice and preference. An in idualised, needs-led approach, exploiting the latest digital technologies when appropriate, may help fill existing gaps, improve access, uptake and completion, and ensure optimal health and wellbeing for people with heart failure and their families. Exercise, education, lifestyle change and psychosocial support should, as core elements, unless contraindicated due to medical reasons, be offered routinely to people with heart failure, but tailored to in idual circumstances, such as with regard to age and frailty, and possibly for recipients of cardiac implantable electronic devices or left ventricular assist devices.
Publisher: Informa UK Limited
Date: 27-04-2009
DOI: 10.1080/07399330902785232
Abstract: Epidemiological evidence suggests that psychosocial stress may be a contributing factor in the development of coronary heart disease. This article uses data from a study of 29 women resident in the Southeast of the United Kingdom. The women took part in semistructured interviews and completed the Short Form-36 item (SF-36) Health Survey. The women recorded low sores on the role functioning (emotional) scale of the SF-36. Interview data suggested that some women found aspects of their domestic life stressful and attributed this stress as a causal factor. Education and advice for women about coronary risk may need to acknowledge the home as a potential cause of psychosocial stress.
Publisher: Mark Allen Group
Date: 02-06-2018
DOI: 10.12968/BJCA.2018.13.6.286
Abstract: After cardiac events, rates of depression and anxiety of 20–30% have been reported, along with elevated rates of post-traumatic stress disorder and higher rates of suicide. As unresolved negative affect is associated with greater morbidity and mortality, attempts have been made to understand the complexity of emotional and psychological responses to cardiac events. Although many studies purport to measure ‘cardiac distress’, they are often limited by adopting a definition of distress as depression plus anxiety. Following the lead of the oncology and diabetes fields in the development of condition-specific distress measures, this article argues for a multidimensional approach to cardiac distress and its measurement it builds on the concept of the ‘cardiac blues’, to show the importance of understanding and measuring how this transient phenomenon of adjustment can become a persistent negative state which challenges the ability to cope with living after a cardiac event.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2009
DOI: 10.1007/S00520-009-0771-7
Abstract: This study determined the incidence of severe oral mucositis (OM), patients' self-reported moderate and severe oral symptoms, and change of quality of life (QoL), as well as examined whether OM severity and pain scores predicted the impairment of oral function and QoL. A multicenter approach was used and 137 patients treated with stomatotoxic chemotherapy (45%), high-dose myeloablative chemotherapy with or without concomitant total body irradiation (12%), head and neck irradiation with or without concomitant chemotherapy (44%) completed the OM-specific QoL measure (OMQoL) once or twice weekly over a 4- or 10-week period, along with concurrent measures of OM using WHO Mucositis Grading System and oral symptoms using 10 cm visual analog scale. The incidence of severe OM was 50% (n = 68). About 77-80% of patients with severe OM reported moderate or severe mouth or throat pain, and 66-78% reported moderate or severe oral functional problems. The oral symptoms peak and area-under-the-curve (AUC) scores of patients with severe OM (peak 5.6 to 6.8 AUC 3.8 to 5.2) were significantly higher than those without OM and those with mild OM (p < 0.01). The OMQoL subscales peak and AUC scores of patients with severe OM (peak 47.9 to 62.1 AUC -40.1 to -25.8) were significantly lower than those without OM and those with mild OM (p < 0.01). Of those with severe OM, 88-94% had a drop in the OMQoL subscale scores to at least 10 points from the baseline. Pain resulting from OM, in particular throat pain, is most predictive of oral functional impairment (standardized β = 0.53-0.83). Severe OM can cause profound pain and oral functional incapability and clinical significant impairment of QoL.
Publisher: Wiley
Date: 25-07-2002
DOI: 10.1046/J.1365-2648.2002.02301.X
Abstract: The burden of illness associated with Coronary Heart Disease (CHD) has determined this as a key focus for research at a basic science, in idual and population level. Although considerable research has been conducted on specific aspects of the experience of CHD, such as anxiety or depression, there is a lack of research investigating the global aspects of the illness experience from the in idual's perspective. Furthermore, there is a paucity of research examining the cross-cultural experiences of patients from Non-English Speaking Backgrounds (NESB). Given the multicultural nature of Australian society, and that health and illness are culturally constructed experiences (Manderson 1990), it is important to include the perspectives of people from minority cultures in health related research in order to provide culturally sensitive and appropriate health care and information during an illness. Further, the potential to prevent and modulate the course of CHD, by strategies such as smoking cessation and lipid management, mandate a health promotion agenda based on equity and access for all members of society. This article discusses cultural aspects of CHD in relation to nursing and allied health care during the recovery phase of an acute cardiac event. It reviews the research that has been conducted in this area, focusing on the Chinese-Australian population. The CINAHL, MEDLINE, FAMILY (Australian Family and Society Abstracts Database), PsychINFO, and Multicultural Australian and immigration Studies (MAIS) databases were searched, identifying literature published from 1982. Keywords used were Chin* (Chinese, China), Asia* (Asia, Asian), experience, adjustment, psychological, heart, coronary, cardiac, health and services. Reports not written in English were excluded. Australian Government reports were also searched, as well as hand searching of nursing and medical textbooks. These searches resulted in over 1000 articles. However, only around 50 were relevant for this review. Chinese-Australians are one of the fastest growing populations in Australia, and are at increased risk of CHD upon settling to Australia. Recommendations for future research and for the practice of nursing are provided.
Publisher: AMPCo
Date: 05-2013
DOI: 10.5694/MJA13.10153
Abstract: In 2003, the National Heart Foundation of Australia position statement on "stress" and heart disease found that depression was an important risk factor for coronary heart disease (CHD). This 2013 statement updates the evidence on depression (mild, moderate and severe) in patients with CHD, and provides guidance for health professionals on screening and treatment for depression in patients with CHD. The prevalence of depression is high in patients with CHD and it has a significant impact on the patient's quality of life and adherence to therapy, and an independent effect on prognosis. Rates of major depressive disorder of around 15% have been reported in patients after myocardial infarction or coronary artery bypass grafting. To provide the best possible care, it is important to recognise depression in patients with CHD. Routine screening for depression in all patients with CHD is indicated at first presentation, and again at the next follow-up appointment. A follow-up screen should occur 2-3 months after a CHD event. Screening should then be considered on a yearly basis, as for any other major risk factor for CHD. A simple tool for initial screening, such as the Patient Health Questionnaire-2 (PHQ-2) or the short-form Cardiac Depression Scale (CDS), can be incorporated into usual clinical practice with minimum interference, and may increase uptake of screening. Patients with positive screening results may need further evaluation. Appropriate treatment should be commenced, and the patient monitored. If screening is followed by comprehensive care, depression outcomes are likely to be improved. Patients with CHD and depression respond to cognitive behaviour therapy, collaborative care, exercise and some drug therapies in a similar way to the general population. However, tricyclic antidepressant drugs may worsen CHD outcomes and should be avoided. Coordination of care between health care providers is essential for optimal outcomes for patients. The benefits of treating depression include improved quality of life, improved adherence to other therapies and, potentially, improved CHD outcomes.
Publisher: Wiley
Date: 05-03-2008
Publisher: Wiley
Date: 10-2001
Publisher: Springer Science and Business Media LLC
Date: 28-08-2013
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-034946
Abstract: Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers review of generic and condition-specific distress measures focus group testing with cardiac rehabilitation professionals feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI’s psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. Approved by the Monash Health Human Research Ethics Committee (approval number—RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups academic and medical communities via publications and presentations in the training of cardiac secondary prevention professionals and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals.
Publisher: Oxford University Press (OUP)
Date: 24-05-2017
Publisher: Elsevier BV
Date: 2013
Publisher: Wiley
Date: 05-06-2009
DOI: 10.1111/J.1365-2702.2008.02736.X
Abstract: To evaluate further the psychometric properties of the Chinese version of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for anxiety and depression in Chinese patients with coronary heart disease (CHD) in Xian, China. There is considerable evidence that anxiety and depression are common in patients with CHD and are associated with increased morbidity and mortality. A valid, reliable and sensitive screening tool that can be used readily on this group of patients would be useful for assessment, intervention and outcome evaluation. A single group, cross-sectional study. Measurement performance was tested on 314 Chinese patients with CHD and repeated on 173 of them two weeks later. The Chinese version of HADS (C-HADS) had acceptable internal consistency and test-retest reliability, with a Cronbach's alpha of 0.85 and intraclass correlation coefficient of 0.90, respectively. There was acceptable concurrent validity with significant (p < 0.05) correlations between the anxiety and depression subscales of the C-HADS and CHD patients' perceived health status as measured by the Chinese-Mandarin version of the Short Form-36 health survey (CM:SF-36). Principal components analysis revealed a three-factor solution accounting for 53% of the total variance. The three underlying sub-scale dimensions are depression, psychic anxiety and psychomotor anxiety. The responsiveness of the C-HADS was also satisfactory with significant correlation between the changes in the C-HADS score and the changes in the mental health domain of the CM:SF-36 (p < 0.01). Finally, over one-third of the patients demonstrated psychological distress. Empirical data support the C-HADS as a reliable and valid screening instrument for the assessment of anxiety and depression in Chinese-speaking patients with CHD. A tri-dimensional scoring approach should be considered as potentially clinically useful for this group of patients. The C-HADS can guide and evaluate the delivery of psychological care for Chinese patients with CHD.
Publisher: Hindawi Limited
Date: 11-2022
DOI: 10.1111/JONM.13888
Abstract: The aim of the study is to discuss the changing role of patients, nurses and doctors in an era of digital health and heart failure care. With a growing demand for heart failure care and a shortage of health care professionals to meet it, digital technologies offer a potential solution to overcoming these challenges. In reviewing pertinent research evidence and drawing on our collective clinical and research experiences, including the co-design and development of an autonomous remote system, DoctorME, we offer some reflections and propose some practical suggestions for nurturing truly collaborative heart failure care. Digital health offers real opportunities to deliver heart failure care, but patients and health care professionals will require digital skills training and appropriate health services technological infrastructure. Heart failure care is being transformed by digital technologies, and innovations such as DoctorME have profound implications for patients, nurses and doctors. These include major cultural change and health service transformation. Nurse managers should create inclusive and supportive working environments where collaborative working and digital technologies in heart failure care are embraced. Nurse managers need to recognize, value and communicate the importance of digital health in heart failure care, ensuring that staff have appropriate digital skills training.
Publisher: Wiley
Date: 19-10-2010
DOI: 10.1111/J.1365-2702.2010.03349.X
Abstract: Aim. To examine the perceptions of the code of professional conduct among practising registered nurses in Hong Kong. Background. A code of professional conduct is intended to guide nurses in their practice and to ensure congruence with nursing goals and objectives. Such a code for nurses in Hong Kong has been in effect for two decades but, to date, no study has examined the perceptions of it among practising nurses. Design. A survey of 320 practising registered nurses working in a hospital cluster in Hong Kong (mean postregistration experience = 11·8 years). Methods. A questionnaire developed to assess nurses’ perceptions of the Code of Professional Conduct devised by the Nursing Council of Hong Kong. Results. Providing safe and competent care, practising in accordance with the law and maintaining agreed standards were ranked in order as the three most important aspects. Safeguarding informed decision‐making for patients who were mentally incapacitated or unable to speak for themselves, participating in continuing nursing education and raising objections to practices that compromise safe and appropriate care were considered the most challenging aspects to achieve in professional nursing practice. Conclusions. To educate nurses to become more assertive in safeguarding patients’ rights and to encourage and support lifelong learning remains a major challenge in professional nursing practice. The profession and statutory bodies need to consider how best to enable practising nurses to address these issues. Relevance to clinical practice. Examining the perceptions of practising nurses about the professional code is necessary to ensure that the profession is prepared to meet the ever‐changing demands and expectations of the public whom it claims to serve.
Publisher: Oxford University Press (OUP)
Date: 12-1995
Publisher: Elsevier BV
Date: 05-2005
DOI: 10.1016/J.NEDT.2005.01.011
Abstract: In this paper, four experienced researchers from the UK, China and Australia offer guidance in research supervision based on their experiences and the recent document, Improving standards in postgraduate research degree programmes [Higher Education Funding Council for England, 2003. Improving standards in postgraduate research degree programmes. Formal consultation. Department for Employment and Learning, Northern Ireland, Higher Education Funding Council for England, Higher Education Funding Council for Wales, Scottish Higher Education Funding Council, HEFCE, London]. Supervision is an important aspect of not only the development of the neophyte researcher, but of academic staff and research activity in general. With increased academic accountability, good supervision should be an integral component of a quality research governance framework and resourced as such. Recommendations include: adoption of these standards rigorous selection of research students and supervisors and development of projects development of departmental procedures for monitoring, feedback and intellectual property and transparency, rigour and fairness in examination procedures.
Publisher: Informa UK Limited
Date: 05-2006
DOI: 10.1080/13548500500286845
Abstract: Metabolic control is central to positive clinical outcome in patients with diabetes. Empowerment has been linked to metabolic control in this clinical group. The current study sought to determine key psychometric properties of the Chinese version of the Diabetes Empowerment Scale (C-DES) and to explore the relationship of the C-DES sub-scales to metabolic control in 189 patients with a diagnosis of diabetes. Confirmatory factor analysis established that the five sub-scales of the C-DES offered a highly satisfactory fit to the data. Furthermore, C-DES sub-scales were found to have generally acceptable internal consistency and ergent reliability. However, convergent reliability of C-DES sub-scales could not be established against metabolic control. It is concluded that future research needs to address ambiguities in the relationship between empowerment and metabolic control in order to afford patients an evidenced-based treatment package to assure optimal metabolic control.
Publisher: Wiley
Date: 02-2015
DOI: 10.5694/MJA14.00575
Abstract: To measure changes in cardiovascular risk factors among patients with coronary heart disease (CHD) and/or type 2 diabetes enrolled in a centralised statewide coaching program delivered by telephone and mail-out in the public health sector in Queensland. A population-based audit of cardiovascular risk factor data collected prospectively as part of The COACH (Coaching Patients On Achieving Cardiovascular Health) Program (TCP) delivered through Queensland Health's Health Contact Centre. 1962 patients with CHD and 707 patients with type 2 diabetes who completed TCP from 20 February 2009 to 20 June 2013, of whom 145 were Indigenous Australians. Changes in fasting lipids, fasting glucose, glycosylated haemoglobin levels, blood pressure, body weight, body mass index, smoking, alcohol consumption and physical activity, as measured at entry to and completion of the program. Statistically significant improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, improvements in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous Queenslanders. A centralised statewide coaching program delivered by telephone and mail-out overcomes obstacles of distance and limited access to health services and facilitates a guideline-concordant decrease in cardiovascular risk.
Publisher: Oxford University Press (OUP)
Date: 09-2003
Publisher: Wiley
Date: 2006
DOI: 10.1002/NUR.20171
Abstract: The purpose of this study was to identify, through in-depth interview, factors that influenced 27 Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction (AMI). The median delay time from the onset of symptoms to arrival at the hospital was 15.6 hours for men and 53.7 hours for women. Three major categories emerged from the data: (a) becoming aware of the threat, (b) maintaining a sense of normality, and (c) struggling to mobilize resources. A variety of decisions were made by patients from the onset of chest pain to seeking help. These decisions were heavily influenced by healthcare factors (access to emergency medical service (EMS) and treatment), personal factors (cognitive interpretations of symptoms), sociocultural factors (family situation, cultural beliefs, and practices), and coping strategies.
Publisher: Wiley
Date: 2009
DOI: 10.1002/GPS.2068
Abstract: To identify predictors of change in Health Related Quality of Life (HRQoL) among community dwelling Chinese older people with depression. A community based prospective, longitudinal study was conducted in a regional psychiatric outpatient department. A convenience s le of 31 older people who were newly diagnosed with depression was recruited. Assessments were conducted at the first session of psychiatric consultation and again after 12 months. Measures included subjective perception of HRQoL, level of depression, number of medical conditions, activities of daily living, functional abilities, and social support. The majority of participants had significant improvement in their HRQoL, level of depression, and general health conditions at 12-month follow-up. The ability of instrumental activity of daily living skills was a predictor of baseline HRQoL and changes in 12-month follow-up. Level of depression was also a predictor of changes in HRQoL over the 12-months period. Treatment and interventions of depression were effective in improvement participants' mental condition and their perceived HRQoL. Interventions to promote older people's level of depression and their instrumental activity of daily living abilities could help to improve their perceived HRQoL. This study provides insight for healthcare professionals in planning innovative services to meet their health needs.
Publisher: Wiley
Date: 03-1983
DOI: 10.1111/J.1365-2648.1983.TB00302.X
Abstract: The attitudes of qualified nursing staff towards the nursing process were studied. Three distinct nursing units received varying degrees of planning and education regarding the principles and practice of the nursing process. The attitudes of the nursing staff of these units were assessed by means of a 20-item questionnaire. Statistically significant differences (P less than 0.001) between the mean attitude scores for the three units were found, but comparison of the overall mean attitude scores for the three grades of nurses within each unit did not result in statistical significance (P greater than 0.35). Further analysis indicated that a structured educational programme was beneficial in creating a positive attitude towards the nursing process whereas a less structured approach had the opposite effect.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2016
Publisher: Wiley
Date: 23-12-2014
DOI: 10.1111/JAN.12610
Publisher: Elsevier BV
Date: 02-2000
Publisher: Informa UK Limited
Date: 09-2014
DOI: 10.1310/TSR2105-421
Abstract: Health care provider experiences of the carer have been researched, but little is written about how these can inform development of support programs. This study aimed to (1) explore health care provider perceptions of stroke carer roles and support needs and (2) examine carer needs across the stroke care trajectory to assist with development of an Optimal Health Program (OHP) to support carers. This study is part of a staged program of research that will evaluate and refine the OHP. Four dual-moderated semi-structured focus groups of stroke health care providers across acute, subacute, and community rehabilitation services were conducted. Facilitators used a semi-structured focus group schedule to guide discussion. Sessions were recorded, transcribed, and analyzed using thematic and content analysis. Three key themes emerged: transition, information, and impact of stroke. A number of subthemes highlighted the distinct roles of health care providers and carers. Specific elements of the OHP were identified as having the potential to advance support for carers across the stroke care trajectory. Findings support the integration of an OHP for carers within existing stroke care services in Australian public hospital and community settings. This study suggests how health care provider experiences could inform a self-management OHP to assist carers in navigating stroke services and to address their health-related concerns.
Publisher: Informa UK Limited
Date: 1982
Publisher: Elsevier BV
Date: 08-2004
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.IJNURSTU.2009.08.004
Abstract: There is a growing use of multisensory therapy in enhancing sense of well-being and reducing challenging or stereotypic self-stimulating behaviour in people with a developmental disability. This review aimed to present the best available evidence on the effect of multisensory therapy in adult clients with developmental disabilities on the frequency of challenging behavior, stereotypic self-stimulating behavior, and positive behaviour and changes of physiological measures. Systematic review. A search of electronic databases of published research studies (January 1985-December 2008) was conducted, using appropriate search terms. The reference lists and bibliographies of retrieved articles were reviewed to identify research not located through other search strategies. Studies that investigated the effects of multisensory environment in relation to outcomes were examined. Data were extracted independently by two reviewers. Methodological quality was also assessed by two reviewers against key quality criteria. One hundred and thirty-two studies were identified from database search of which 17 met the inclusion criteria for review. The evidence supports that participants' had displayed more positive behaviour after multisensory therapy sessions. There is no strong evidence supporting that multisensory therapy could help in reducing challenging behaviour or stereotypic self-stimulating behaviour. This systematic review demonstrates a beneficial effect of multisensory therapy in promoting participants' positive emotions. While the reviewers acknowledge the difficulty in carrying out randomized controlled trial in people with developmental disabilities and challenging behavior, the lack of trial-derived evidence makes it difficult to arrive at a conclusion of the effectiveness of the multisensory therapy. Future study should use well-designed randomised controlled trials to evaluate the short and long term effectiveness of multisensory therapy. There is also a need for qualitative studies which allow the clients to tell the stories of their experiences.
Publisher: Oxford University Press (OUP)
Date: 02-2002
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.IJCARD.2016.06.284
Abstract: This study aimed to confirm, in a large, erse cohort of elite Stand-up Comedians and other entertainers, that there is an inverse association between comedic ability and longevity. This retrospective cohort study included 200 Stand-up Comedians (13% women), 113 Comedy Actors (17.5% women), and 184 Dramatic Actors (29.3% women) listed in the top 200 in each category in a popular online ranking website. Longevity within each group was examined adjusting for life expectancy by year of birth and within-group ranking score. Stand-up Comedians were younger than Comedy Actors (median birth year 1962 versus 1947: p<0.001) and Dramatic Actors (1962 versus 1946: p<0.001). Overall, 36/200 (18.0%), 33/114 (29.0%) and 56/184 (30.9%) of Stand-up Comedians, Comedy Actors and Dramatic Actors, respectively, had died (p=0.011). There was a significant gradient (p=0.011) in the age of death, with Stand-up Comedians dying at a younger age (67.1±21.3years) than their Comedy Actor (68.9±15.4years) and Dramatic Actor (70.7±16.6years) counterparts. Stand-up Comedians (38.9% versus 19.6%) were more likely to die prematurely compared to Dramatic Actors p=0.043, OR 1.98 95% CI 1.01 to 3.87). Independent of year of birth, for Stand-up Comedians alone, higher comedy rank was associated with shorter longevity (hazard ratio 0.938, 95% CI 0.880 to 0.999 for a 10-rank difference p=0.045). These data reaffirm an adverse relationship between comedic ability and longevity, with elite Stand-up Comedians more highly rated by the public more likely to die prematurely.
Publisher: Oxford University Press (OUP)
Date: 22-08-2014
Abstract: Screening for self-care capacity is advocated before applying educational strategies. No screening tool has been specifically developed to assess barriers that impede engagement in self-care in people with heart failure. Earlier conceptual work (InCOGNITO) identified NYHA class, mild cognitive impairment and depressive symptoms as barriers that impede engagement in HF self-care. Study aims were: 1) to develop the Heart Failure Screening Tool (Heart-FaST) as a means of assessing three critical barriers to self-care 2) to assess the content validity of the Heart-FaST and 3) to test the feasibility of implementing the Heart-FaST in clinical practice. The Heart-FaST was developed from barriers identified in previous research (InCOGNITO) and from expert panel consensus. Content validity was assessed by examining the proportion of experts who scored each item as relevant. The InCOGNITO study indicated that four cognitive tasks, seven emotional questions and NYHA functional class were significantly correlated with the self-care scales: maintenance, management and confidence. These factors were used to create the Heart-FaST items. Consensus on wording and items to be included in the Heart-FaST was reached after two rounds of panel discussion. All items had an item-level content validity index ≥ 0.78. High scores on each barrier (physical, cognitive and emotional functioning) suggest poor self-care and the need for more intensive disease management efforts. The Heart-FaST measures three critical barriers that impede engagement in self-care. In clinical practice this tool may assist in in idually tailoring educational and support strategies to promote effective heart failure self-care.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 09-2008
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: SAGE Publications
Date: 06-05-2022
DOI: 10.1177/17571774221092558
Abstract: The emergence of COVID-19 has been an ordeal for nurses worldwide. It is crucial to understand their experiences at the frontline, attempt to allay their concerns, and help inform future pandemic response capabilities. To explore nurses’ lived experiences at the frontline in order to identify and address their concerns and help enhance future responses to infectious disease outbreaks. A qualitative study was carried out. Semi-structured interviews were conducted with 60 registered nurses who came to Hubei from different parts of China to care for patients with COVID-19. Interviews were audio-recorded and transcribed verbatim for thematic analysis. Six major themes emerged: emotional turmoil due to personal and professional concerns, quality issues with personal protective equipment and associated physical discomfort, witnessing and managing patient distress, readiness of emergency response mechanisms in the health system, collective community awareness and preparedness, and heightened professional pride and confidence in future epidemic control. Nurses were placed in challenging and unfamiliar situations to deal with unexpected and unpredictable events which caused considerable psychological and physical distress. Support in the form of government edicts, hospital management policies, community generosity and collegiality was highly welcomed by the nurses. Policy makers and managers should ensure that nurses are provided with the support and resources necessary for dealing with large-scale infectious disease outbreaks. Priority should be given to risk assessment, infection prevention and control, and patient and staff health and safety.
Publisher: Hindawi Limited
Date: 13-05-2019
DOI: 10.1111/JONM.12781
Publisher: Wiley
Date: 02-2001
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1111/J.1524-4733.2007.00226.X
Abstract: A variety of pharmacologic therapies are available or in development for the prevention of breast cancer recurrence. Assessing the value of these treatments is compromised by a paucity of data on the impact of recurrence on economic costs and survival. The purpose of this study was to shed light on these issues. We conducted a retrospective analysis of linked SEER-Medicare data. All patients in the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) registry who were diagnosed with nonmetastatic breast cancer during 1991-1993 were identified, and their subsequent Medicare claims were scanned for evidence of further breast cancer events (local or distant recurrence, contralateral breast cancer). Medicare claims were then scanned from the time of the event through 2002 to assess patterns of survival and costs. We identified 10,798 patients in SEER who were diagnosed with nonmetastatic breast cancer during 1991-1993, including 1833 who subsequently had another breast cancer event (local recurrence, 958 distant recurrence, 622 contralateral breast cancer, 253). Median survival was 37 months and 8 months among patients with local and distant recurrence, respectively 53% of patients with contralateral breast cancer remained alive after all the data were censored at 97 months. Expected 10-year costs (2004 US$, discounted 3%) attributable to distant recurrence, local recurrence, and contralateral breast cancer were $11,450 (SE 2056), $19,596 (SE 1754), and $19,183 (SE 4131), respectively. Breast cancer recurrence and contralateral breast cancer lead to substantial increases in costs, amounting to approximately $11,000-19,000 over 10 years depending on type. The impact of these events on survival also varies considerably by type.
Publisher: Wiley
Date: 19-08-2004
Publisher: Oxford University Press (OUP)
Date: 12-2006
Publisher: Wiley
Date: 19-02-2008
DOI: 10.1111/J.1365-2702.2007.02036.X
Abstract: To adapt, cross-culturally, an established quality of life (QoL) scale for Hong Kong Chinese patients with diabetes to measure their QoL and to identify the predictors of QoL in this population. Healthcare providers are called on to assess and enhance the QoL of patients with diabetes. However, there is a lack of empirical QoL data pertaining to such in iduals in China. The diabetes-specific QoL scale (DQoL) developed by Jacobson and the Diabetes Control and Complications Trial research group was cross-culturally adapted for use in a s le of 206 Hong Kong Chinese patients recruited from a diabetes specialist outpatient clinic. Demographic and clinical data were also collected. The cross-cultural adaptation process produced a Hong Kong Chinese version of the DQoL scale with 37 items (HKC-DQoL-37) that demonstrated good internal consistency (alpha = 0.87) and acceptable test-retest validity (ICC 0.70, 95% CI 0.36-0.87). Discriminant validity was confirmed by comparing QoL scores between patients with and without insulin treatment. The QoL status of this s le (Mean = 2.2, SD = 0.5) is similar to that of Chinese immigrants and Caucasians in North America. Multiple regression analyses identified four predictors of poor QoL: (i) younger age, (ii) with diabetes complications, (iii) with admission due to hypoglycaemia, (iv) on insulin treatment. Findings provide preliminary evidence on the validity and reliability of the HKC-DQoL-37. The four predictors of poor DQoL in Hong Kong Chinese patients are consistent with those identified in the West. Understanding these predictors of poor QoL could help nurses and others to design and deliver appropriate interventions to these patients.
Publisher: BMJ
Date: 12-07-2012
Publisher: BMJ
Date: 18-02-2014
DOI: 10.1136/HEARTJNL-2013-304852
Abstract: Disease management interventions for heart failure (HF) are inconsistent and very seldom incorporate the views and needs of patients and their caregivers into intervention design. To improve intervention effectiveness and consistency, a systematic review identified 49 studies which examined the views and needs of patients with HF and their caregivers about the nature and determinants of effective HF self-care. The findings identify key drivers of effective self-care, such as the capacity of patients to successfully integrate self-care practices with their preferred normal daily life patterns and recognise and respond to HF symptoms in a timely manner. Future interventions for HF self-care must involve family members throughout the intervention and harness patients' normal daily routines.
Publisher: American Medical Association (AMA)
Date: 11-10-1999
DOI: 10.1001/ARCHINTE.159.18.2177
Abstract: Obesity is an established risk factor for several chronic diseases. The lifetime health and economic consequences of obesity for in idual patients have not been documented. To estimate the lifetime health and economic consequences of obesity. We developed a dynamic model of the relationship between body mass index and the risks and associated costs of 5 obesity-related diseases: hypertension, hypercholesterolemia, type 2 diabetes mellitus, coronary heart disease, and stroke. The model was estimated using data from the Third National Health and Nutrition Examination Survey, the Framingham Heart Study, and other secondary sources. We used this model to estimate (1) risks of hypertension, hypercholesterolemia, and type 2 diabetes mellitus at future ages (2) lifetime risks of coronary heart disease and stroke (3) life expectancy and (4) expected lifetime medical care costs of these 5 diseases for men and women aged 35 to 64 years with body mass indexes of 22.5, 27.5, 32.5, and 37.5 kg/m2 (nonobese and mildly, moderately, and severely obese, respectively). Disease risks and costs increase substantially with increased body mass index. The risk of hypertension for moderately obese 45- to 54-year-old men, for ex le, is roughly 2-fold higher than for their nonobese peers (38.1% vs 17.7%), whereas the risk of type 2 diabetes mellitus is almost 3-fold higher (8.1% vs 3.0%). Lifetime risks of coronary heart disease and stroke are similarly elevated (41.8% vs 34.9% and 16.2% vs 13.9%, respectively), whereas life expectancy is reduced by 1 year (26.5 vs 27.5 years). Total discounted lifetime medical care costs for the treatment of these 5 diseases are estimated to differ by $10,000 ($29,600 vs $19,600). Similar results were obtained for women. The lifetime health and economic consequences of obesity are substantial and suggest that efforts to prevent or reduce this problem might yield significant benefits.
Publisher: Oxford University Press (OUP)
Date: 19-11-2015
Abstract: Fatigue is a common symptom in patients with heart failure that is easy to ignore. In addition, fatigue may affect patients' physical function and psychosocial conditions that can impair their quality of life. An effective nursing care programme is required to alleviate patients' fatigue and improve their quality of life. To investigate the effects of a supportive educational nursing care programme on fatigue and quality of life in patients with heart failure. A randomised controlled trial design was used. Ninety-two patients with heart failure were randomly assigned to an intervention group (n=47) or a control group (n=45). The patients in the intervention group participated in 12 weeks of a supportive educational nursing care programme including fatigue assessment, education, coaching self-care and evaluation. The intervention was conducted by a cardiac nurse during four face-to-face interviews and three follow-up telephone interviews. Fatigue and quality of life were assessed at the baseline and 4 weeks, 8 weeks and 12 weeks after enrollment in both groups. The participants in the intervention group exhibited a significant decrease in the level of fatigue after 12 weeks, whereas those in the control group exhibited no significant changes. Compared with the control group, the intervention group exhibited a significantly greater decrease in the level of fatigue and significantly greater improvement in quality of life after 12 weeks of intervention. The supportive educational nursing care programme was recommended to alleviate fatigue and improve quality of life in patients with heart failure.
Publisher: Springer Science and Business Media LLC
Date: 12-1999
DOI: 10.1007/S11920-999-0021-1
Abstract: In this paper, we present a systematic review of the literature on current issues in the economics of depression management, focusing on studies within three distinct areas of interest: 1) the clinical and economic outcomes of alternative patterns of antidepressant use 2) the impact of depression and antidepressant therapy on the costs of general medical-care services and 3) the effects of depression and associated benefits of antidepressant therapy on worker productivity. Our review suggests that 1) patterns of antidepressant use are important predictors of symptom improvement, relapse/recurrence, and costs of care, and that use patterns vary according to the antidepressant received as initial therapy 2) patients with depression have higher costs of general medical-care services compared with their nondepressed peers, and that treatment of depression may reduce these costs and 3) depression can result in productivity losses via increased rates of absenteeism and short-term disability as well as via impaired on-the-job performance.
Publisher: Oxford University Press (OUP)
Date: 12-2009
DOI: 10.1016/J.EJCNURSE.2009.05.003
Abstract: Heart failure management programs which include education are the gold standard for management of patients with heart failure. Identifying the learning styles and learning needs of heart failure patients is an essential step in developing effective education strategies within these programs. To investigate the learning style and learning needs of heart failure patients. Patients diagnosed with heart failure at a large tertiary referral hospital completed a Heart Failure Learning Style and Needs Inventory. From the total of 55 patients who completed the questionnaire 64% reported a preference for multimodal learning style, 18% preferred read/write, 11% preferred auditory, and 7% preferred kinesthetic. In relation to educational topics, signs and symptoms was ranked as the most important topic to learn about followed by prognosis. This study provides a poignant snap-shot into the world of chronic disease. In essence, the patients' educational needs for living with heart failure can be summed up as "Never better, getting worse, unpredictable". The results indicate that these groups of patients need to know (Need2Know) about information regarding their signs and symptoms as well as wanting to elicit the significance of their disease and whether it can be cured.
Publisher: Oxford University Press (OUP)
Date: 10-2009
DOI: 10.1016/J.EJCNURSE.2009.05.002
Abstract: We investigated the level of knowledge of hematological management of patients with Eisenmenger syndrome among general cardiovascular nurses and nurses who specialize in congenital heart disease (CHD). We conducted a survey at two international conferences attended by cardiovascular nurses. Nurses were asked to complete a questionnaire comprising two questions and three clinical case scenarios. Overall, 89 nurses participated (response rate 90.8%), 43 of whom specialized in CHD. The level of knowledge displayed among cardiovascular nurses is poor. About one-third of nurses not specialized in CHD recognized the definition of Eisenmenger syndrome and knew what normal hematocrit levels are. With respect to the cases presented, less than 10% of the nurses could give a correct answer. The level of knowledge of specialized nurses was significantly higher, but also here, important gaps in the level of knowledge could be observed. Less than two-thirds knew the reference values of hematocrit and knew the appropriate management in two cases. Less than half of the specialized nurses knew about the procedure of isovolumic phlebotomy. The level of knowledge displayed by cardiovascular nurses regarding the hematological management of patients with Eisenmenger syndrome is poor. Also the knowledge of nurses specialized in CHD could be improved.
Publisher: Elsevier BV
Date: 1986
DOI: 10.1016/0266-612X(86)90070-2
Abstract: Women, during pregnancy and lactation, should eat foods that contain adequate amounts of choline. A mother delivers large amounts of choline across the placenta to the fetus, and after birth she delivers large amounts of choline in milk to the infant this greatly increases the demand on the choline stores of the mother. Adequate intake of dietary choline may be important for optimal fetal outcome (birth defects, brain development) and for maternal liver and placental function. Diets in many low income countries and in approximately one-fourth of women in high income countries, like the United States, may be too low in choline content. Prenatal vitamin supplements do not contain an adequate source of choline. For women who do not eat foods containing milk, meat, eggs, or other choline-rich foods, a diet supplement should be considered.
Publisher: Wiley
Date: 03-04-2006
DOI: 10.1111/J.1365-2702.2006.01373.X
Abstract: This paper reviews placebo and placebo effects and their measurement and application to nursing. Ethical and methodological issues are also discussed. Implications for nursing and recommendations for future study are offered. Placebos have been used for decades in clinical trials but discussion about conceptual, methodological and ethical issues has been comparatively scarce. It is concluded that true placebo effects are difficult to measure and control and the use of credible placebo is sometimes impractical in clinical nursing research. This leads to the increased use of usual care as a control by researchers. However, more information should be reported in studies that use this approach, including the specification of usual care, its monitoring and patient adherence. Where its use is considered ethical, safe and feasible, a placebo arm should be included in studies of efficacy to distinguish between active and inactive treatment.
Publisher: Wiley
Date: 20-07-2017
DOI: 10.1111/JOCN.13836
Abstract: To examine whether chronic heart failure patient-carer dyads who disagree about the ision of illness management tasks (incongruent) experience poorer psychosocial health and self-care, than those who agree (congruent). Informal carers often assist patients with chronic heart failure in the complex management of their illness, but little is known about how relationship dynamics may affect psychosocial health. A prospective cross-sectional study was adopted with a purposeful s le of 25 chronic heart failure patient-carer dyads residing in Australia. Data were collected via mail-out questionnaires. Dyads were classified as congruent or incongruent using the Heart Failure Care Assessment Scale. Depression, anxiety, stress and quality of life were assessed in patients and carers. Additionally, self-care and relationship quality were assessed in patients and burden and esteem were assessed in carers. Differences in congruent and incongruent patient and carer outcomes were examined. Dyads were predominantly spousal and around a third demonstrated incongruence. No significant differences were found between congruent (n = 16) and incongruent (n = 9) dyads, although patients in incongruent dyads tended to have been diagnosed more recently. In chronic heart failure patient-carer dyads incongruence exists even for patients with relatively mild chronic heart failure symptoms. These findings indicate that dyadic incongruence in illness management might not affect high-functioning chronic heart failure heart failure patients or their carers. Given the prevalence of dyadic incongruence and the possibility of further negative outcomes with disease progression, it is important to examine factors such as length of time since diagnosis or type of carer relationship. By implementing self-care education and management strategies that focus on the dyad, rather than the in idual, nurses have the potential to improve both patient and carer outcomes.
Publisher: Wiley
Date: 05-06-2009
DOI: 10.1111/J.1365-2702.2008.02716.X
Abstract: To investigate the learning style and preferences for information delivery of heart failure patients for the purpose of informing the design of educational resources. Patient education is a vital component of heart failure management programmes however the content and delivery of education varies in each programme. Traditionally education programmes for patients have focussed on educational needs as identified by health care providers however research has shown there are discrepancies between patients' and nurses' perceptions of the learning needs of heart failure patients. There is no evidence that educational programmes for heart failure patients are based on identification of patients learning needs or their preferred learning style. Qualitative. A purposive s le of 12 participants, diagnosed with heart failure and enrolled in a heart failure management programme, participated in semi-structured interviews. Four themes emerged: knowledge quest (L-loading), barriers to learning (L-inhibitors), facilitators for learning (L-agonists), and meeting educational needs (L-titration). Integral to these themes was the participant's relationship with health care professionals. This study provides unique information regarding the preferred learning modality of heart failure patients and, as such, serves to inform the development of appropriate education resources specifically tailored for this population. The development of effective modes of education is likely to further enhance heart failure management programmes service organisation and delivery and improve health outcomes for heart failure patients.
Publisher: Oxford University Press (OUP)
Date: 04-2004
Publisher: Wiley
Date: 18-05-2011
DOI: 10.1111/J.1365-2702.2010.03687.X
Abstract: Aim. The aim of this study was to develop a potential scoring algorithm for interventions in a chronic heart failure management programme – the Heart Failure Intervention Score – to facilitate quality improvement and programme auditing. Background. The overall efficacy of chronic heart failure management programmes has been demonstrated in several meta‐analyses. However, meta‐analyses did not determine in idual interventions in a programme that resulted in beneficial patient outcomes. Design. A prospective cross‐sectional survey design. Method. All chronic heart failure management programmes in Australia ( n = 62), identified by a national register, were surveyed to determine programme characteristics and interventions. Results. Of the 62 national chronic heart failure management programmes, 48 (77%) completed the survey and 27 in idual interventions were identified. Variability in the use of the key interventions was common among the programmes. Each intervention was given an arbitrary weighted score according to the level of supportive evidence available and a total score calculated. Programmes were then categorised into low or high complexity based on several interventions implemented and their weighted score. A total score of ≥190 (median = 178, interquartile range 176–195) was used to ide programmes into two groups. Nine programmes were categorised into high Heart Failure Intervention Score group and majority of these were based in the acute hospital setting (78%). In the low Heart Failure Intervention Score group, there were 39 programmes of which there were a higher proportion of community‐based programmes (38%) and programmes in small community hospitals (10%). Conclusion. The Heart Failure Intervention Score provides a potential evidence‐based quality improvement tool through which a set of minimum standards can be developed. Implementation of the Heart Failure Intervention Score provides guidance to programme coordinators to enable monitoring of standards of heart failure programmes, which may potentially result in better patient outcomes. Relevance to clinical practice. The Heart Failure Intervention Score is an evidence‐based tool that can be easily used by heart failure programme coordinators to ensure that their programme is evidence‐based, which will improve the quality of their programme and potentially programme outcomes.
Publisher: Oxford University Press (OUP)
Date: 05-2008
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.HRTLNG.2013.08.003
Abstract: Psychosocial factors and physical health are associated with increased psychological distress post-heart transplant. Integrating findings from qualitative studies could highlight mechanisms for how these factors contribute to psychological well-being, thus aiding the development of interventions. To integrate qualitative findings regarding adult heart transplant recipients experiences, such as their emotions, perceptions and attitudes. A systematic review and meta-summary were conducted. Data from seven studies were categorized into 16 abstracted findings. The most prominent finding across the studies related to recipients' perceptions of the importance of social support. Other prominent findings related to factors that promoted psychological well-being, such as faith, optimism and sense of control. Psychological well-being may be improved by enhancing perceived control over health and daily life, promoting an optimistic outlook by facilitating access to social support from other heart transplant recipients and ensuring post-transplant recipient-caregiver partnerships adequately support the transition back to independence.
Publisher: Elsevier BV
Date: 03-2017
Publisher: Wiley
Date: 04-2009
DOI: 10.1002/GPS.2129
Abstract: This study aimed to measure and compare the perceptions of HRQoL amongst Chinese older people with depression between Hong Kong and Shanghai and to explore the association of HRQoL with clinical factors, level of functioning and social support in the two sites. A cross-sectional study was conducted with a convenience s le of 80 older people from Hong Kong and 71 from Shanghai with a diagnosis of depression. The results showed that both the Hong Kong and Shanghai groups had a poor perception of their HRQoL when compared with Caucasian populations. The Shanghai group had a significantly higher HRQoL perception than did the Hong Kong group. Physical health problems that affected functional abilities also influenced older people's satisfaction with life. The severity of depression, number of medical conditions, functional abilities and satisfaction towards social support were predictors of HRQoL. The high rate of depression in Hong Kong and Shanghai deserves attention. Older people with depression have both psychological and physical health care needs. This study provides insights for healthcare professionals to plan innovative and co-ordinated services that meet the various health care needs of older people with depression.
Publisher: Elsevier BV
Date: 06-1998
DOI: 10.1016/S0041-1345(98)00187-0
Abstract: Long noncoding RNAs (lncRNAs) play important roles in the regulation of immunological and apoptotic function. This study aimed to explore the critical immune- and apoptosis-related lncRNAs in the occurrence and development of Henoch-Schönlein purpura nephritis (HSPN) in children. Differential analysis was employed to identify the differentially expressed lncRNAs, as well as the immune- and apoptosis-related mRNAs in children with HSPN. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were used to validate the immunological and apoptotic roles of the differentially expressed immune- and apoptosis-related lncRNAs and mRNAs. Spearman's correlation analysis was performed to analyze the differentially expressed lncRNAs and immune- and apoptosis-related messenger RNAs (mRNAs). Based on the competing endogenous RNA (ceRNA) mechanism, the immune- and apoptosis-related lncRNA-microRNA (miRNA)-mRNA regulatory network was then constructed in children with HSPN. The expression levels of the lncRNAs in the lncRNA-miRNA-mRNA regulatory network were further confirmed by quantitative real-time polymerase chain in the peripheral blood s les of children with HSPN. By intersecting the differentially expressed immune-related and apoptosis-related genes through GO and KEGG analyses, a total of 43 genes were identified in children with HSPN, and 100 lncRNAs highly correlated with the above genes were identified by correlation analysis. The immune- and apoptosis-related lncRNA-miRNA-mRNA regulatory network was then established based on ceRNA mechanism. Dysregulation of a total of 11 lncRNAs were discovered, including upregulated SNHG3, LINC00152, TUG1, GAS5, FGD5-AS1, DLEU2, and SCARNA9 and downregulated SNHG1, NEAT1, DISC1-IT1, and PVT1. The validation conducted in the clinical s les also suggested that the above lncRNAs in the specific regulatory network may act as potential biomarkers with prognosis in children with HSPN. LncRNAs may play essential regulatory roles in the occurrence and development of HSPN in children, and the immune- and apoptosis-related lncRNA-miRNA-mRNA regulatory network might be the underlying molecular mechanism that dissects the disease pathogenesis. In addition, the dysregulated lncRNAs in the regulatory network may be novel biomarkers for the diagnosis and therapy of HSPN in children.
Publisher: Wiley
Date: 17-06-2020
DOI: 10.1002/EHF2.12813
Publisher: Oxford University Press (OUP)
Date: 06-2008
Publisher: SAGE Publications
Date: 07-2006
Publisher: AMPCo
Date: 2015
DOI: 10.5694/MJA14.00238
Abstract: To estimate the current and future prevalence of atrial fibrillation (AF) in the Australian adult population according to age and sex. Application of international AF prevalence statistics to Australian adult population data (for people ≥ 55 years) to estimate population prevalence use of population projections to estimate potential future prevalence of AF. Estimated prevalence of AF in 2014 and future prevalence projected to 2034. We estimated that at 30 June 2014 there would be 328,562 cases of AF among people aged ≥ 55 years (a prevalence of 5.35% 95% CI, 3.79%-7.53%), comprising 174,986 men (prevalence, 5.97% 95% CI, 4.11%-8.54%) and 153,576 women (prevalence, 4.79% 95% CI, 3.50%-6.60%). Without significant changes to the natural history of AF, by 2034 this figure is projected to rise to over 600,000 (prevalence, 6.39% 95% CI, 4.56%-8.90%), with a prevalence of 7.22% among men (95% CI, 4.99%-10.28%) and 5.64% (95% CI, 4.18%-7.64%) among women. The greatest projected regional increase in prevalence between 2014 and 2034 is expected in Queensland, with a likely twofold increase (from 61,613 cases to 123,142 cases), although New South Wales cases will remain predominant, with a 1.7-fold increase (from 110 892 to 191 578). We also predicted that between 2014 and 2034 the number of AF cases would double among older age groups (from 200 638 to 414 377 in iduals aged ≥ 75 years) and would increase 2.5-fold among men aged ≥ 85 years (from 29 370 to 71 582). These data are indicative of a largely underappreciated AF prevalence in Australia. They mandate a more systematic effort to both understand and respond to an evolving AF burden.
Publisher: Elsevier BV
Date: 09-1985
Publisher: Elsevier BV
Date: 11-1999
DOI: 10.1016/S0964-3397(99)80043-3
Abstract: The first coronary care units (CCUs) were opened in the 1960s in an attempt to reduce mortality from acute myocardial infarction (AMI). Nurses were closely involved in the development and success of these early units. This paper will provide an overview of the history and development of the CCU, including nurses' crucial involvement in pioneering the first CCUs in the 1960s through to the emerging role of nurses in the care of cardiac patients in the late 1990's.
Publisher: Springer Science and Business Media LLC
Date: 05-01-2012
Abstract: Hierarchical scales are very useful in clinical practice due to their ability to discriminate precisely between in iduals, and the original English version of the Myocardial Infarction Dimensional Assessment Scale has been shown to contain a hierarchy of items. The purpose of this study was to analyse a Mandarin Chinese translation of the Myocardial Infarction Dimensional Assessment Scale for a hierarchy of items according to the criteria of Mokken scaling. Data from 180 Chinese participants who completed the Chinese translation of the Myocardial Infarction Dimensional Assessment Scale were analysed using the Mokken Scaling Procedure and the 'R' statistical programme using the diagnostics available in these programmes. Correlation between Mandarin Chinese items and a Chinese translation of the Short Form (36) Health Survey was also analysed. Fifteen items from the Mandarin Chinese Myocardial Infarction Dimensional Assessment Scale were retained in a strong and reliable Mokken scale invariant item ordering was not evident and the Mokken scaled items of the Chinese Myocardial Infarction Dimensional Assessment Scale correlated with the Short Form (36) Health Survey. Items from the Mandarin Chinese Myocardial Infarction Dimensional Assessment Scale form a Mokken scale and this offers further insight into how the items of the Myocardial Infarction Dimensional Assessment Scale relate to the measurement of health-related quality of life people with a myocardial infarction.
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: SAGE Publications
Date: 04-07-2013
Abstract: To investigate the long-term effects of motivational interviewing on clinical outcomes, psychological outcomes, health-related quality of life among cardiac rehabilitation patients with poor motivation. A randomized controlled trial with blind data collectors. Cardiac rehabilitation centre. A total of 146 cardiac rehabilitation patients with poor motivation. All participants received usual care, including exercise and education, while those in the experimental group also received 10 sessions of motivational interviewing, each lasting 30–45 minutes. Clinical and psychological outcomes and health-related quality of life were assessed at baseline and at six, nine and 12 months for both groups. There was no significant difference between the two groups at baseline on demographic and clinical outcomes except for monthly family income ( p = 0.034). Patients in the experimental group had higher increases in health-related quality of life (SF-36) scores in bodily pain (88.7 SD 16.7 vs. 87.6 SD 18.7 at month 12, p = 0.044) and role limitation owing to emotional problems (86.9 SD 19.2 vs. 78.6 SD 21.8 at month 9, p = 0.019 85.8 SD 18.9 vs. 76.9 SD 23.9 at month 12, p = 0.022). No statistically significant group difference was found among other outcomes. The long-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in studied patients is limited.
Publisher: Wiley
Date: 09-1990
DOI: 10.1111/J.1365-2648.1990.TB01987.X
Abstract: Self-ratings of satisfaction were studied over 6 months in 60 male first-time myocardial infarction patients and their wives. Couples were randomly assigned to either a treatment group, where they received a simple programme of education and psychological support in addition to routine care, or to a control group, where they received routine care only. All patients completed visual analogue scales measuring satisfaction regarding their general health, life in general, care and information received. All wives completed visual analogue scales measuring satisfaction regarding information received and care the patient received. Patients and wives in the treatment group reported statistically significantly more satisfaction than those in the control group. This effect was sustained for 6 months after counselling.
Publisher: Elsevier BV
Date: 03-2005
DOI: 10.1016/J.RIDD.2004.02.002
Abstract: Many clients in Hong Kong with developmental disabilities stay in mental hospitals because of mental disorders and behavioural problems. There is a need to identify strategies that promote psychological well-being and reduce problem behaviours in this group of clients. This study evaluates the impact of multisensory therapy on participants' emotional state, level of relaxation, challenging behaviour, stereotypic self-stimulating behaviour (SSB) and adaptive behaviour (AB). Using an experimental design, 89 participants were recruited from a developmental disability unit in a hospital in Hong Kong and randomly assigned to either an experimental (n = 48) or a control group (n = 41). Multisensory therapy sessions (n = 36) were conducted with experimental group and activity sessions (n = 36) were conducted with controls for 12 weeks. Multisensory therapy promoted participants' positive emotions and relaxation. However, there was no evidence that multisensory therapy was superior to activity therapy in reducing aggressive behaviour and stereotypic self-stimulating behaviour or promoting adaptive behaviour. The key variables that influence clients' behaviours in the multisensory therapy may be related to the relationship with the carer, constant environment, relaxation and freedom from demands rather than sensory input. Multisensory therapy could be used to provide leisure and promote psychological well-being, rather than for reducing problem behaviour.
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.IJNURSTU.2007.11.003
Abstract: Stress in nursing students may be related to attrition from nursing programmes and lead to a shortage of nurses entering clinical careers. In addition, stress leads to psychological morbidity which may have profound adverse consequences for in idual nursing students. To follow a cohort of nursing students from entry to their programme to the end of the first year and to study the interrelationship between a range of psychological variables including personality, stress, coping and burnout. Prospective, repeated measures survey using self-administered questionnaires. A university school of nursing in Hong Kong. Students were selected on the basis of entry to their nursing programme in 2004 158 students entered the study and 147 completed 37 were male and 121 were female at entry. The mean age of the cohort at entry was 19.1 (S.D. 0.85) ages ranged from 18 to 26. The questionnaires administered at wave 1 were: the NEO Five Factor Inventory, the Coping in Stressful Situations questionnaire, the 12-item General Health Questionnaire, the Maslach Burnout Inventory and the Stress in Nursing Students questionnaire. At wave 2 the 12-item General Health Questionnaire, the Maslach Burnout Inventory and the Stress in Nursing Students questionnaire were administered. Students suffered greater levels of psychological morbidity and burnout at the second time wave and this was largely explained by the personality trait of neuroticism. Stress also increased and this was largely explained by emotion-oriented coping. Undertaking a nursing programme leads to increased level of stress, burnout and psychological morbidity and this is largely related to in idual personality and coping traits.
Publisher: Oxford University Press (OUP)
Date: 18-03-2011
Publisher: Oxford University Press (OUP)
Date: 03-2010
DOI: 10.1016/J.EJCNURSE.2009.10.001
Abstract: To investigate cardiovascular nurses' experiences of and attitudes towards the presence of family members during resuscitation of adult patients. A 36-item questionnaire exploring the experiences of and attitudes towards family members being present in the resuscitation room was distributed to a convenience s le of nurses attending three national and one international cardiovascular nursing conferences held in Europe during 2007. Of 820 questionnaires distributed, 411(50%) completed ones were returned. Of these 411 respondents, 178 (44%) had experienced at least one situation of families being present. Positive (23%) and negative (21%) experiences of family presence were equally distributed. Only 28 (7%) respondents stated that their unit had a protocol covering family presence. Nurses in Ireland (n=30 59%) and the UK (n=18 55%) were most likely to have experienced family presence and protocols relating to this were most commonly found in the UK (n=4 14%). Less than half of the included European cardiovascular nurses had experienced a situation of families being present during resuscitation and protocols pertaining to this were rare. There was no clear attitude towards family presence, though experience in nursing made nurses more favourable towards it.
Publisher: Hindawi Limited
Date: 10-04-2019
DOI: 10.1111/JONM.12767
Publisher: Springer Science and Business Media LLC
Date: 27-10-2020
DOI: 10.1186/S12909-020-02273-4
Abstract: Interprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these issues from the perspective of different healthcare professionals and how this might inform interprofessional education curricula. Sixteen different healthcare professionals working in a variety of aged care (acute, rehabilitative and community) settings were invited to participate in in idual semi-structured in-depth interviews designed to: (i) explore the meaning of IPCP (ii) explore the facilitators of and barriers to IPCP and (iii) examine the opportunities and challenges in interprofessional gerontological education. All interviews were tape-recorded and transcribed verbatim with thematic analysis conducted by two independent researchers. Three major themes emerged from the interviews: the need for IPCP role preparedness, scope and liability and strategies for interprofessional education. Respondents shared a common belief that IPCP improves the quality of life of older adults in both hospital and community settings by improving person-centred coordinated care and decision making in care planning. However, respondents perceived major barriers to IPCP to be lack of knowledge about healthcare professionals’ scope of practice, lack of training in interprofessional collaboration, professional culture and stereotypes, and liability issues. Suggested approaches to overcome these barriers included innovative teaching and learning approaches, engaging students early on in the curriculum of health professional degree programmes, and enhancing collaborative effective communication in health and social care settings. It is anticipated that these findings will be used to inform the development of a new interprofessional gerontological education curriculum that aims to enhance students’ competence in IPCP.
Publisher: Elsevier BV
Date: 07-2008
Publisher: American Public Health Association
Date: 10-1999
Abstract: OBJECTIVES: This study estimated the lifetime health and economic benefits of sustained modest weight loss among obese persons. METHODS: We developed a dynamic model of the relationship between body mass index (BMI) and the risks and costs of 5 obesity-related diseases: hypertension, hypercholesterolemia, type 2 diabetes, coronary heart disease (CHD), and stroke. We then calculated the lifetime health and economic benefits of a sustained 10% reduction in body weight for men and women aged 35 to 64 years with mild, moderate, and severe obesity. RESULTS: Depending on age, gender, and initial BMI, a sustained 10% weight loss would (1) reduce the expected number of years of life with hypertension, hypercholesterolemia, and type 2 diabetes by 1.2 to 2.9, 0.3 to 0.8, and 0.5 to 1.7, respectively (2) reduce the expected lifetime incidence of CHD and stroke by 12 to 38 cases per 1000 and 1 to 13 cases per 1000, respectively (3) increase life expectancy by 2 to 7 months and (4) reduce expected lifetime medical care costs of these 5 diseases by $2200 to $5300. CONCLUSIONS: Sustained modest weight loss among obese persons would yield substantial health and economic benefits.
Publisher: Elsevier BV
Date: 05-1998
Publisher: Wiley
Date: 11-1992
Publisher: Wiley
Date: 09-09-2005
Publisher: Elsevier BV
Date: 12-1994
DOI: 10.1016/0964-3397(94)90039-6
Abstract: I visited four centres of clinical cardiac care and rehabilitation to examine, compare and discuss the development of nursing research and practice and the application of this knowledge to patients and their families after a heart attack or cardiac surgery. The key areas examined were the organisation of services, specific interventions, and outcome and evaluation criteria. American care and rehabilitation services generally appear to be more directed towards the family and involve a wide range of health professionals from different disciplines. The systems, when compared to their British counterparts, are more structured in terms of organisation, coordination and evaluation, and are more geared towards cost-containment, effectiveness and efficiency. However, although British systems are increasingly emulating the American ones, they are in many respects more innovative, flexible and tailored to in idual needs.
Publisher: Hogrefe Publishing Group
Date: 11-2002
Publisher: Elsevier BV
Date: 11-2007
Publisher: MDPI AG
Date: 12-04-2023
Abstract: The scientific method assumes that researchers use evidence generated from observational research to make predictions (hypotheses) that can be tested experimentally [...]
Publisher: Wiley
Date: 08-2001
Publisher: Wiley
Date: 07-02-2006
Publisher: Springer Science and Business Media LLC
Date: 23-11-2012
Abstract: There is a high prevalence of depression in patients with heart failure (HF) that is associated with worsening prognosis. The value of using a reliable and valid instrument to measure depression in this population is therefore essential. We validated the Cardiac Depression Scale (CDS) in heart failure patients using a model of ordinal unidimensional measurement known as Mokken scaling. We administered in face-to-face interviews the CDS to 603 patients with HF. Data were analysed using Mokken scale analysis. Items of the CDS formed a statistically significant unidimensional Mokken scale of low strength (H .40) and high reliability (Rho .8). The CDS has a hierarchy of items which can be interpreted in terms of the increasingly serious effects of depression occurring as a result of HF. Identifying an appropriate instrument to measure depression in patients with HF allows for early identification and better medical management.
Publisher: Oxford University Press (OUP)
Date: 06-2009
Publisher: Wiley
Date: 04-2021
DOI: 10.1111/NIN.12412
Abstract: Nursing and nursing education face a paradox whereby the world's most trusted profession seems not to trust its own students and practitioners. Much of nursing education has adopted what has been memorably described as the ‘cop shit’ approach. This is the panoply of surveillance, anti‐plagiarism and proctoring technologies that appear to be used more for policing and punishment of an inherently dishonest student body than to develop ethical and scholarly writing among future peers and colleagues. Nurses in practice may experience similar levels of distrust as they face growing micromanagement and control of both their appearance and nursing practice. We propose that these practices of distrust emerge, not from malice, but rather from the omnipresent neoliberalism and managerialism that engulf almost every aspect of health and university life. Neoliberalism's success has been to reformat academia and practice to the point where such ingrained mistrust has become merely a neutral recognition of ‘the real world’. Dismantling nursing and education's ‘cop shit’ culture and replacing it with the trust and respect that the world's most trusted profession is accorded by wider society will not be easy, but it is vital for the future of nursing.
Publisher: Wiley
Date: 08-03-2011
Publisher: Informa UK Limited
Date: 23-04-2022
DOI: 10.1080/08870446.2022.2060507
Abstract: This study aimed to evaluate if a new Mental health IN DiabeteS Optimal Health Program (MINDS OHP) compared with usual care in adults with Type 1 and Type 2 diabetes would improve psychosocial outcomes including self-efficacy and quality of life.D There were 51 participants in the control group (mean age = 52) and 55 in the intervention group (mean age = 55). There were significant main effects of time in general self-efficacy, diabetes distress, diabetes self-efficacy, and illness perceptions, however no significant between-group differences in primary or secondary outcomes. Post-hoc analyses revealed MINDS OHP improved diabetes self-efficacy for participants with mild to severe depression and anxiety, with a small effect. Initial evaluation found MINDS OHP was associated with improved diabetes self-efficacy for adults with diabetes, for people with mild to severe levels of distress, with small effect. Further research is required to explore whether this disease-specific, collaborative care-focused intervention benefits the mental health of people with diabetes.
Publisher: Oxford University Press (OUP)
Date: 12-2012
Abstract: Motivational interviewing (MI) is effective in promoting behavioural changes in patients with substance abuse and smoking. However, its effectiveness on health outcomes in cardiac rehabilitation patients is unclear. A randomized controlled trial. A total of 146 patients assessed as having poor motivation attended a cardiac rehabilitation programme from February 2008 to June 2010. Patients (n = 73) in the control group received usual care while those in the experimental group (n = 73) received usual care plus four sessions of MI, each lasting 30–45 min. Clinical and psychological outcomes and health-related quality of life were measured at baseline and 3 months after entering the programme. Descriptive statistics, independent t-test, Pearson Chi-squared test, and generalized estimating equations models were used to analyse the data. There was no significant difference between the two groups on clinical outcomes (all p-values & .05). Patients in the experimental group had higher increases in health-related quality of life (SF-36) scores in the aspects of general health (4.74, 95% CI 0.04–9.44 p = 0.048) and role limitation due to emotional problems (8.80, 95% CI 1.16–16.43 p = 0.024). However, they reported significantly higher increases in anxiety levels (Hospital Anxiety and Depression Scale) than those in the control group (0.96, 95% CI 0.09–1.83 p = 0.030). The short-term effectiveness of MI on clinical outcomes and health-related quality of life in poorly motivated cardiac rehabilitation patients is limited. MI, however, was shown to increase anxiety levels of patients during the study period (3 months). More evidence is needed to better understand this phenomenon in the future studies.
Publisher: Wiley
Date: 17-02-2005
DOI: 10.1016/J.EJHEART.2004.08.004
Abstract: Despite abundant evidence attesting to poor physical, psychological and social functioning of congestive heart failure (CHF) patients, little is known about the impact of the disease itself on health-related quality of life (HRQL). Most previous work has focused on general quality of life issues rather than specifically on the impact of CHF on HRQL. To identify the significant demographic, clinical and psychosocial factors associated with HRQL in patients with CHF. A total of 227 CHF patients were recruited from the medical unit of a general hospital in Hong Kong. Cross-sectional data on HRQL, functional status, psychological state, social support and health perception were obtained from each patient and clinical data were obtained from hospital records. In hierarchical regression analysis, psychological distress, poor health perception, higher NYHA grading and lower education level were identified as the significant factors associated with poorer HRQL. These correlates in total explained 52% of the variance for the HRQL scores. Among these correlates, psychological distress and NYHA grading demonstrated the greatest effect on HRQL scores. The findings highlight the significance of addressing the psychological and functional health of CHF patients. Assisting these patients to cultivate a positive attitude towards their own health status is also an important treatment goal.
Publisher: Oxford University Press (OUP)
Date: 03-2012
Abstract: Cardiac nurses and allied professionals often take care of patients who also have anaemia or iron deficiency. To deliver optimal care, professionals should be knowledgeable about the prevalence, diagnosis, pathophysiology, and therapeutic management of these conditions. We therefore set out a survey to get a first impression on the current knowledge of nurses and allied professionals on anaemia and iron deficiency. A questionnaire was designed for this study by the Undertaking Nursing Interventions Throughout Europe (UNITE) Study Group. Data were collected from 125 cardiovascular nurses and allied professionals visiting the 11th Annual Spring Meeting of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology. Most respondents had general knowledge on the definition of anaemia and iron deficiency and 54% of the respondents rated anaemia and iron deficiency as important when evaluating a cardiac patient. Specific knowledge regarding anaemia and more prominently of iron deficiency was not optimal. Although cardiac nurses and allied professionals have basic knowledge of anaemia and iron deficiency, they would benefit from additional knowledge and skills to optimally deliver patient care.
Publisher: Elsevier BV
Date: 05-2011
Publisher: Wiley
Date: 11-1994
DOI: 10.1111/J.1365-2702.1994.TB00414.X
Abstract: The telephone is an effective means of communication and its use is growing as a means of offering members of the public access to health-care agencies for advice and support. Acute hospital beds are at a premium and as lengths of stay in hospital continue to fall there is an increasing need for effective discharge planning and post-discharge support. Eighty-five patients (58 men and 27 women) were interviewed over the telephone 1 week after discharge from a medical ward. Over half of the patients reported health problems and one-fifth reported social problems. Almost half of the patients sought advice. Telephone follow-up would appear to be a useful means of monitoring a patient's progress and providing an opportunity for patients seeking, or nurses offering, advice and support.
Publisher: Wiley
Date: 20-12-2005
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.CARDFAIL.2015.08.343
Abstract: Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients. The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen. In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA <26). Scores on the NINDS-CSN screen ranged from 3-11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88 P < .01 95% CI 0.83-0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity. The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols.
Publisher: Elsevier BV
Date: 08-2013
Publisher: Elsevier BV
Date: 03-2011
DOI: 10.1016/J.ORALONCOLOGY.2010.11.019
Abstract: There is a dearth of studies with respect to oral mucositis (OM) in the paediatric and adolescent populations. The purpose of this prospective cohort study was to examine the incidence and risk factors associated with OM in paediatric and adolescent patients receiving chemotherapy. OM assessments were made daily until 14days after chemotherapy using the self-report Mouth and Throat Soreness-Related Questions of the Oral Mucositis Daily Questionnaire (OMDQ MTS). Potential risk factors included age, gender, prior OM, anxiety level, cancer diagnosis, nausea/vomiting, use of growth factor, neutrophil count, liver enzymes, and creatinine value. Multiple logistic, Cox proportional hazards, and ordinal regression analyses were used to determine risk factors for the incidence and time to onset of MTS scores of ⩾2, and MTS scores across 14days by AUC categories, respectively, after adjusting for chemotherapy. A total of 140 patients who were 6-18years of age were evaluated. Forty-one percent (95% CI, 32.6-48.8%) developed OM of these, 23% and 18% reported a maximum MTS score of 2 and 3-4 as the worst OM, respectively. The mean time to onset of OM was 4.7±2.7days with a mean duration of 6.3±4days. Prior OM (RR 1.90-3.94), a higher level of anxiety (RR 1.27-1.46), WHO grade 1-2 (RR 1.86-4.59) and 3-4 (RR 3.08-9.19) neutropenia were significantly associated with a higher probability of the incidence, earlier onset, and greater severity of OM, after controlling for chemotherapy (p<0.01). OM was associated with indirect cytotoxicity, prior OM, and anxiety level after controlling for chemotherapy where neutropenia was found to be the most important factor.
Publisher: Informa UK Limited
Date: 02-12-2020
DOI: 10.1080/13548506.2019.1695865
Abstract: Diabetes has a significant negative impact on mental health and quality of life (QoL). Underpinned by the Common Sense Model (CSM) the mediating role of coping patterns, self-efficacy, anxiety and depression symptoms on the relationship between illness perceptions and QoL in patients diagnosed with diabetes was evaluated. A total of 115 participants with diabetes (56, Type 1 59, Type 2), 51% female and an average age of 52.69 (SD = 15.89) in Australia completed self-report measures of illness perceptions and psychological wellbeing. Baseline measures included illness perceptions, coping styles, psychological distress (anxiety and depression symptoms), self-efficacy, and quality of life. Mediating relationships were measured using structural equation modelling. A model of good fit was identified explaining 51% of the variation in QoL. Illness perceptions directly influenced QoL, maladaptive coping, self-efficacy, and anxiety symptoms. The relationship between illness perceptions and QoL was partially mediated by anxiety illness perceptions and depression was fully mediated by maladaptive coping and self-efficacy and self-efficacy and QoL was partially mediated by depressive symptoms. Findings provide validation of the CSM in a diabetes cohort. Psychological interventions likely to have the most benefit on psychological distress and QoL are those targeting mediating psychological processes, including maladaptive coping and self-efficacy.
Publisher: SAGE Publications
Date: 26-04-2016
Publisher: Bentham Science Publishers Ltd.
Date: 05-2006
Publisher: Oxford University Press (OUP)
Date: 1992
Abstract: This study reports the time of onset of chest pain in 792 consecutive elderly patients admitted to a coronary care unit with myocardial infarction during a 10-year period. Statistical analysis demonstrated a bimodal frequency distribution with peaks in the time of onset of chest pain between 23 h 30 and 00 h 30 and between 06 h 30 and 08 h 30.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2012
DOI: 10.1007/S12529-012-9282-X
Abstract: Depression and anxiety are common in cardiac patients, and psychological interventions may also be used as part of general cardiac rehabilitation programs. This study aims to estimate effects of psychological interventions on mortality and psychological symptoms in this group, updating an existing Cochrane Review. Systematic review and meta-regression analyses of randomized trials evaluating a psychological treatment delivered by trained staff to patients with a diagnosed cardiac disease, with a follow-up of at least 6 months, were used. There was no strong evidence that psychological intervention reduced total deaths, risk of revascularization, or non-fatal infarction. Psychological intervention did result in small/moderate improvements in depression and anxiety, and there was a small effect for cardiac mortality. Psychological treatments appear effective in treating patients with psychological symptoms of coronary heart disease. Uncertainty remains regarding the subgroups of patients who would benefit most from treatment and the characteristics of successful interventions.
Publisher: MDPI AG
Date: 31-07-2021
Abstract: Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is high, and ACT may offer an alternative treatment approach. This scoping review explored the use of ACT as an intervention to support adults living with CVD and/or T2DM. A systematic search of the literature resulted in the inclusion of 15 studies. Studies were reviewed using the Joanna Briggs Institute approach to conducting scoping reviews. Most studies (n = 13) related to people living with T2DM, and most (n = 10) used a pre-post design, four studies were randomised controlled trials, and one was a qualitative study. Eight studies reported an improvement in the outcome(s) assessed post-intervention, suggesting that ACT was an acceptable and valid intervention to support people living with CVD or T2DM. However, studies were underpowered and only limited studies involved people living with CVD. ACT was assessed as a valuable approach to improve a range of patient-reported outcomes for those living with CVD or T2DM, and further research involving robust study designs and larger cohorts are warranted.
Publisher: Wiley
Date: 13-12-2020
DOI: 10.1111/JAN.14273
Publisher: Elsevier BV
Date: 02-1985
DOI: 10.1016/0167-5273(85)90354-7
Abstract: We studied the time of onset of chest pain in 1099 patients admitted to a coronary care unit with myocardial infarction using a statistical model. Statistical analysis demonstrated an excess of infarcts with time of onset of chest pain at 0700 hours (14%) and at midnight (11%), with the remaining infarct population (75%) forming a background distribution over the 24 hr.
Publisher: Wiley
Date: 04-1989
DOI: 10.1111/J.1365-2648.1989.TB03416.X
Abstract: This study monitored and compared levels of anxiety and depression reported by first myocardial infarction (MI) male patients and their partners, throughout the patients' hospital stay. An independent variable of a programme of supportive-educative counselling provided by a coronary care nurse was introduced to determine whether it significantly affected reactions. Sixty couples were randomly assigned to one of two groups: (a) the treatment group (in which they received the systematic programme of nursing support in addition to routine care), or (b) the control group (in which they received routine care but no other intervention). Anxiety and depression were measured by the Hospital Anxiety and Depression (HAD) scale at 24 hours and 5 days after the patient's admission to hospital. At 5 days there were statistically significant differences between both groups with respect to the HAD scale mean scores. These findings strongly suggest that a simple programme of in-hospital couple counselling, provided by a coronary care nurse, statistically significantly reduces anxiety and depression in first MI male patients and anxiety in their partners.
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1016/J.PSYCHRES.2004.06.012
Abstract: The psychometric properties of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for patients with acute coronary syndrome (ACS) were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis (CFA) was conducted on the HADS to establish its psychometric properties in 138 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test-retest reliability values for the HADS total and HADS anxiety sub-scales were found to be acceptable. The HADS depression sub-scale lacked acceptable internal reliability. The underlying factor structure of the HADS comprised three distinct factors, though inconsistency between the best three-factor model fit was observed between observation points. The HADS was confirmed to be a useful screening instrument to assess symptoms of psychological distress in ACS patients. Further research is required to determine the most appropriate use of HADS sub-scale structures in clinical populations.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.IJCARD.2011.10.065
Abstract: Health outcomes associated with atrial fibrillation (AF) continue to be poor and standard management often does not provide clinical stability. The Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY) compares the efficacy of a post-discharge, nurse-led, multi-disciplinary programme to optimise AF management with usual care. SAFETY is a prospective, multi-centre, randomised controlled trial with blinded-endpoint adjudication. A target of 320 hospitalised patients with a chronic form of AF will be randomised (stratified by "rate" versus "rhythm" control) to usual post-discharge care or the SAFETY Intervention (SI). The SI involves home-based assessment, extensive clinical profiling and the application of optimal gold-standard pharmacology which is in idually tailored according to a "traffic light" framework based on clinical stability, risk profile and therapeutic management. The primary endpoint is event-free survival from all-cause death or unplanned readmission during 18-36 months follow-up. Secondary endpoints include rate of recurrent hospital stay, treatment success (i.e. maintenance of rhythm or rate control and/or application of anti-thrombotic therapy without a bleeding event) and cost-efficacy. With study recruitment to be completed in early 2012, the results of this study will be available in early 2014. If positive, SAFETY will represent a potentially cost-effective and readily applicable strategy to improve health outcomes in high risk in iduals discharged from hospital with chronic AF.
Publisher: Springer Science and Business Media LLC
Date: 29-10-2014
Publisher: Springer Science and Business Media LLC
Date: 23-01-2020
DOI: 10.1007/S10880-020-09700-0
Abstract: This study evaluated the mediating role of self-efficacy, coping, depression and anxiety on the relationship between illness perceptions and quality of life in stroke survivors (n = 72 32 females mean [SD] age 65.09 [14.14] years male mean [SD] age 69.83 [11.81]). Illness perceptions (Brief Illness Perceptions Questionnaire BIPQ), coping styles (Carver Brief-COPE scale B-COPE), depression/anxiety (Hospital Anxiety and Depression Scale HADS), self-efficacy (General Self-Efficacy Scale GSE) and quality of life (Assessment of quality of life AQOL-6D) were analysed. Correlation analyses showed illness perception, maladaptive coping, self-efficacy, depression and anxiety to have a significant negative relationship with quality of life. Mediation analyses showed that while maladaptive coping and self-efficacy did not mediate the relationship between illness perception and quality of life, depression and anxiety did. The final model explained 76.74% of the variance in quality of life. Although based on a relatively small s le size, these results provide evidence for the important role of psychosocial factors in quality of life in post-stroke cohorts.
Publisher: Wiley
Date: 2022
DOI: 10.1111/NICC.12700
Publisher: Wiley
Date: 11-2014
Publisher: MDPI AG
Date: 02-05-2021
Abstract: This paper describes the development of the ‘Brain-Fit’ app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the theory- and evidence-informed person-based approach, initial planning included a scoping review of qualitative evidence to identify barriers and facilitators to use of digital interventions in people with cardiovascular conditions and two focus groups exploring experiences and support needs of people (N = 32) with a history of TIA or minor stroke. The scoping review and focus group data were analysed thematically and findings were used to produce guiding principles, a behavioural analysis and explanatory logic model for the intervention. Optimisation included an additional focus group (N = 12) and in idual think-aloud interviews (N = 8) to explore perspectives on content and usability of a prototype app. Overall, thematic analysis highlighted uncertainty about increasing physical activity and concerns that fatigue might limit participation. Realistic goals and progressive increases in activity were seen as important to improving self-confidence and personal control. The app was seen as a useful and flexible resource. Participant feedback from the optimisation phase was used to make modifications to the app to maximise engagement, including simplification of the goal setting and daily data entry sections. Further studies are required to examine efficacy and cost-effectiveness of this novel digital intervention.
Publisher: Wiley
Date: 27-07-2016
DOI: 10.1111/JAN.13059
Abstract: To investigate the relationship between patient mortality and the educational preparation (graduateness) of the nurses who cared for them. There have been 18 studies over the last two decades examining the effect of nurses' educational qualifications on mortality. All but three have used mortality data aggregated at the hospital level that has been combined with surveys of nurses to estimate the level of graduateness in the population. Data collection and extraction generally has been done at different points in time. A retrospective, cross-sectional study. Routine administrative patient data were extracted (May-August 2015). The primary outcome was all-cause patient mortality at discharge. We were able to identify the in idual nurses who provided care during patients inpatient stay using an identification number. We were then able to calculate the 'graduateness' of the nursing care patients received by iding the number of recorded episodes of care provided by baccalaureate prepared nurses with the total number of care episodes. After adjusting for confounding, we observed a significant association between patient mortality and nurse graduateness. Our observations suggest an optimum level of baccalaureate prepared nurses of approximately 70%. Above this level, there appears to be no additional decrease in mortality rates. This study represents an important methodological step forward over previous approaches. Our observations are generally consistent with existing literature and confirm the importance of baccalaureate nurse education.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2014
DOI: 10.1007/S11136-013-0617-0
Abstract: The symptom burden of heart failure is significant and impacts upon health-related quality of life. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is widely used in clinical practice to measure self-reported health-related quality of life, but the psychometric properties of the instrument are not fully elucidated. To address this gap, we investigated item and person fit, differential item functioning, item thresholds ordering, targeting and dimensionality of the MLHFQ. Three approaches were used, exploratory factor analysis, Mokken analysis and Rasch analysis, on a convenience s le of 109 participants with a diagnosis of HF from the UK. Participants were typically male (67 %) with a mean age of 68 years (range 41-88). Findings from the exploratory factor analysis of the MLHFQ revealed three factors (physical, emotional and social) that explained 72 % of the total variance. Mokken analysis confirmed the MLHFQ total scale, and the three subscales, as valid ordinal scales: the total MLHFQ scale [overall Loevinger coefficient (H) = 0.61], physical scale (H = 0.75), emotional scale (H = 0.79) and social scale (H = 0.552). Rasch analysis confirmed the physical scale as a unidimensional scale, but this was not consistent for the total MLHFQ scale which showed poor fit to the Rasch model (χ (2) = 162), df = 42, p < 0.0001). Six items of the total scale were misfitting (7, 8, 10, 14-16) and removing them improved the fit of the total scale. The physical subscale showed fit to the Rasch model (χ (2) = 20.24, df = 16, p = 0.21), and there was evidence of unidimensionality (t tests = 0.09, lower bound 95 % CI 0.04). There was evidence of disordered thresholds for the MLHFQ total and physical scale, and targeting was poor for both the total scale and its subscales. We confirmed the MLHFQ subscales to be valid ordinal scales supporting the use of sum scores to assess quality of life in people diagnosed with HF. Floor effects were evident indicating that the ability of the instrument to identify differences across populations with mild HF may be suboptimal. The psychometric properties of the MLHFQ total scale may be improved by excluding problematic items from the total scale. Further research is warranted to verify findings from this study.
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.ICCN.2008.01.005
Abstract: Little is known about the characteristics of patients who were admitted to the coronary care unit (CCU) in the 1990s with non-ST elevation acute coronary syndromes (ACS) compared with those admitted to medical and cardiology wards in hospitals in the United Kingdom (UK). To understand if there were systematic differences in the characteristics of patients who were admitted to UK critical care units (CCU), intermediate care environments (cardiology wards) or generalist wards (acute medical ward) in an observational study carried out in the 1990s. This paper is based on a secondary analysis of PRAIS (UK), a prospective, observational, multi-centred study which recruited 1038 patients with non-ST elevation ACS. This analysis compares the characteristics of 860 of these patients dependent on whether they were cared for in a coronary care unit, acute medical ward or cardiology ward. The results showed that patients admitted to CCU were more likely to be younger, male, have a history of diabetes or have ST depression on their ECG. There was very little difference in other risk factors or prior concomitant therapy. Interestingly there were no systematic differences in treatments or outcomes other than would be expected by chance, although there were trends to higher rates of MI and heart failure in the CCU group. Our analysis shows that the main drivers of admission to CCU in the 1990s were ST depression and MI-both indicators of high risk, but older age and female gender seemed to decrease the likelihood of admission to CCU. Criteria for admission to specific specialist and non-specialist care environments should be standardised and the use of risk scores could be an important way forward.
Publisher: SAGE Publications
Date: 04-08-2014
Abstract: This cross-sectional correlational study aimed to examine health-related quality of life (HRQoL) and its predictors among patients with myocardial infarction (MI). One hundred and twenty-eight outpatients with MI were recruited from a university hospital. The 12-item Short-Form Health Survey version 2, Myocardial Infarction Dimensional Assessment Scale (MIDAS), and Hospital Anxiety and Depression Scale (HADS) were used to measure the study variables. Compared with the findings of similar studies of patients with MI, this s le, despite having significant coronary risk factors, reported generally better HRQoL. Predictors of physical HRQoL included low monthly household income, whereas predictors of mental HRQoL included ex-smoker, alcohol use, hypertension, anxiety, and depression. Special attention may need to be given to those people with a low income level, who are ex-smokers, use alcohol, or have hypertension, anxiety, or depression.
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.JVAL.2011.01.011
Abstract: Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s). Mixed treatment comparisons, a special case of network meta-analysis, combine direct evidence and indirect evidence for particular pairwise comparisons, thereby synthesizing a greater share of the available evidence than traditional meta-analysis. This report from the International Society for Pharmacoeconomics and Outcomes Research Indirect Treatment Comparisons Good Research Practices Task Force provides guidance on technical aspects of conducting network meta-analyses (our use of this term includes most methods that involve meta-analysis in the context of a network of evidence). We start with a discussion of strategies for developing networks of evidence. Next we briefly review assumptions of network meta-analysis. Then we focus on the statistical analysis of the data: objectives, models (fixed-effects and random-effects), frequentist versus Bayesian approaches, and model validation. A checklist highlights key components of network meta-analysis, and substantial ex les illustrate indirect treatment comparisons (both frequentist and Bayesian approaches) and network meta-analysis. A further section discusses eight key areas for future research.
Publisher: SAGE Publications
Date: 11-1998
DOI: 10.4278/0890-1171-13.2.120
Abstract: To estimate the economic costs of obesity to U.S. business. Standard epidemiologic methods for risk attribution and techniques for ascertaining cost of illness were used to estimate obesity-attributable expenditures on selected employee benefits, including health, life, and disability insurance and paid sick leave by private-sector firms in the U.S. in 1994. Data were obtained from a variety of secondary sources, including the National Health Interview Survey, reports from the Bureau of Labor Statistics and other federal agencies, and the published literature. Attention was focused on employees between the ages of 25 and 64 years who were classified according to body mass index (BMI) as “nonobese” (BMI 25 kg/m 2 ), “mildly obese” (BMI = 25–28.9 kg/m 2 ), or “moderately to severely obese” (BMI ≥ 29 kg/m 2 ). The cost of obesity to U.S. business in 1994 was estimated to total $12.7 billion, including $2.6 billion as a result of mild obesity and $10.1 billion due to moderate to severe obesity. Health insurance expenditures constituted $7.7 billion of the total amount, representing 43% of all spending by U.S. business on coronary heart disease, hypertension, type 2 diabetes, hypercholesterolemia, stroke, gallbladder disease, osteoarthritis of the knee, and endometrial cancer. Obesity-attributable business expenditures on paid sick leave, life insurance, and disability insurance amounted to $2.4 billion, $1.8 billion, and $800 million, respectively. The health-related economic cost of obesity to U.S. business is substantial, representing approximately 5% of total medical care costs. Further research is needed to determine the cost-effectiveness of worksite weight management programs and of other efforts to reduce the prevalence of obesity in the U.S. workforce.
Publisher: Wiley
Date: 2005
Publisher: Oxford University Press (OUP)
Date: 12-2003
Publisher: Oxford University Press (OUP)
Date: 14-08-2016
Abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia managed in clinical practice. Maintenance of intended rate or rhythm control following hospitalisation is a key therapeutic goal. The purpose of this study was to assess post-discharge maintenance of intended AF control and classify potentially predictive heart rate (HR) phenotypes via electrocardiogram (ECG) Holter monitoring. In a sub-study of a multicentre randomised controlled trial comparing AF-specific management with usual care, 24-hour ECG Holter monitoring was undertaken in 133 patients 7-14 days post-discharge. Intended rate and rhythm control were compared to Holter data. Analysis of the frequency distribution of mean hour-to-hour differences identified those with labile HRs. Mean age was 71 ± 10 years, 67 (50%) were male and mean HR was 72 ± 14 bpm. Most (89%) had persistent AF (median time in AF=39% (IQR 0-100%)). Uncontrolled HR (>90 bpm for >10% of recording) occurred in 35 (26%) patients and 49 (37%) patients did not achieve their intended rate (n=26) or rhythm control (n=23). Patients in the upper quartile of mean hour-to-hour HR variability were identified as persistently labile (n=33). A further group (n=22) with periodically labile HRs was identified. Those with coronary artery disease (OR 0.34 95% CI 0.13-0.91, p=0.033) or renal disease/dysfunction (OR 0.24 95% CI 0.06-0.98, p=0.047) were less likely to demonstrate HR stability (n=78). Post-discharge ECG Holter monitoring of AF patients represents a valuable tool to identify deviations in intended rhythm/rate control and adjust therapeutic management accordingly. It may also identify in iduals who demonstrate labile HRs.
Publisher: Oxford University Press (OUP)
Date: 06-2012
Publisher: Hindawi Limited
Date: 2019
DOI: 10.1111/JONM.12730
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/20552076211065271
Abstract: Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to evaluate the quality of apps for supporting lifestyle change following a TIA or ‘minor’ stroke. Systematic searches of Google Play and the Apple Store were carried out to identify mobile apps released between 1 November 2019 and 1 October 2021. Keywords were used including stroke, TIA, lifestyle, prevention and recovery. Quality was assessed using the Mobile Application Rating Scale (MARS). Common components were identified with the Behaviour Change Technique (BCT) Taxonomy. Descriptive statistics were used to summarize the performance results for each app. Searches identified 2545 potential apps. Thirty remained after removing duplicates and screening titles and descriptions. Six were eligible after full review of their content. All apps included at least one BCT (range: 1–16 BCTs). The most frequent BCTs included ‘information about health consequences’ ( n = 5/6), ‘verbal or visual communication from a credible source’ ( n = 4/6) and ‘action planning’ ( n = 4/6). The mean MARS score was 2.57/5 (SD: 0.51 range: 1.78–3.36). No apps were of ‘good’ overall quality (scoring more than 4/5). This is the first review of mobile health interventions for this population. Only a small number of apps were available. None were targeted specifically at people with a TIA or ‘minor’ stroke. Overall quality was low. Further work is needed to develop and test accessible, user designed, and evidence-informed digital interventions in this population.
Publisher: Wiley
Date: 11-1997
DOI: 10.1111/J.1532-5415.1997.TB02937.X
Abstract: There is an inverse relationship between the soluble interleukin-2 receptor (sIL-2R) and serum albumin, cholesterol, transferrin, prealbumin, and hemoglobin. Inasmuch as low serum albumin and cholesterol have been associated with excess mortality, we hypothesized that elevated sIL-2R would predict mortality in older adults. To determine if elevated sIL-2R predicts mortality in patients on a geriatric rehabilitation unit. Prospective cohort. University-affiliated VA medical center. Seventy-two male patients aged greater than 60 years admitted to a geriatric rehabilitation unit. Patients with severe hepatic or renal disease were excluded. We measured serum albumin, prealbumin, cholesterol, transferrin, hemoglobin, body mass index (BMI), C-reactive protein (CRP), and sIL-2R upon admission. Subjects were followed for 1 year. Low serum albumin, prealbumin, and hemoglobin and high sIL-2R and CRP predicted 1-year mortality on univariate analysis. When these predictors were included as covariates in a Cox regression model, only sIL-2R was a significant independent predictor of mortality (P = .043). Multiple linear regression with the above covariates revealed that only sIL-2R predicted time to death at (P = .003). High sIL-2R and CRP and low albumin, prealbumin, and hemoglobin predicted mortality using univariate analysis on a rehabilitation unit. However, with multivariate analysis, sIL-2R was the sole predictor of mortality.
Publisher: Wiley
Date: 24-09-2012
Publisher: John Wiley & Sons, Ltd
Date: 06-07-2011
Publisher: BMJ Publishing Group Ltd and British Cardiovascular Society
Date: 30-09-2020
Publisher: Wiley
Date: 2005
Publisher: Wiley
Date: 11-05-2009
DOI: 10.1111/J.1365-2702.2009.02800.X
Abstract: To examine the utility and validate the use of the Cardiac Depression Scale in patients who had first-time coronary artery bypass graft surgery. The Beck Depression Inventory, though frequently used, may not be sufficiently sensitive for use in cardiac patients. The Cardiac Depression Scale has been shown to identify the range of depression in medical cardiac patients. Survey. The Beck Depression Inventory and Cardiac Depression Scale were administered to 120 men at hospital discharge, as well as six, 12 and 36 weeks postoperatively. Cronbach's alpha scores were calculated for the measures at each point. Changes in scores over time were analysed using repeated measures analysis of variance. Associations between the measures scores were calculated using Pearson product-moment correlations. Agreement between the measures' dichotomised scores (depression/no depression) was examined using Cohen's Kappa statistic. Internal consistency was similar for the Beck Depression Inventory (0.793-0.904) and Cardiac Depression Scale (0.859-0.910). Depression scores decreased over time with the Beck Depression Inventory [F(2.50, 175.29) = 22.27, p < 0.001] and Cardiac Depression Scale [F(2.68, 190.37) = 13.18, p < 0.001]. The measures had similar power [Cohen's f = 0.65 (Beck Depression Inventory) and 0.43 (Cardiac Depression Scale)] to reveal changes over time. The continuous scores were highly correlated at each point [0.737 (p < 0.001)-0.819 (p < 0.001)]. However, when dichotomised scores were compared, the chance corrected level of agreement was less impressive [0.198 (p = 0.014)-0.381 (p < 0.001)]. The Cardiac Depression Scale may have utility for use with surgical cardiac patients. However, continued examination of this measure of depression is warranted. Given the prevalence of depression and its negative impact on coronary artery disease, it is important to identify even mild depression in cardiac patients. Using a measure of depression specifically for cardiac patients, rather than a generic measure, may best accomplish this goal.
Publisher: Elsevier BV
Date: 1991
DOI: 10.1016/0020-7489(91)90007-P
Abstract: This study describes the development of a classification system for the clarification, understanding and measurement of nurses' work methods. The theoretical basis of the classification system is described. The system offered distinguishes between three common work methods: primary, team and task nursing the strength of opportunity for nurse-patient interaction in each method being determined as either 'strong', 'moderate' or 'weak', according to how effectively they are practised. Preliminary testing of the system on 32 wards in 13 hospitals is described. It is concluded that further testing and possible refinement is required for validation of the system.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Hindawi Limited
Date: 2005
DOI: 10.1111/J.1365-2524.2005.00524.X
Abstract: Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. S ling methods reflected the population groups and stage of the case study. S ling included a total population of 41 nurses from whom a secondary volunteer s le was drawn for face-to-face interviews. In each case study, a convenience s le of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic s le of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice (2) the use of skills mix (3) the perceived contribution of ANP to patient care and (4) patients' expectations of care. The level of autonomy of in idual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.
Publisher: Wiley
Date: 18-02-2008
DOI: 10.1111/J.1365-2753.2007.00850.X
Abstract: Depression and anxiety in patients with coronary heart disease (CHD) is associated with a poorer prognosis. Therefore, the screening for psychological distress is strongly recommended in cardiac care and rehabilitation. The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool that has demonstrated good sensitivity and specificity for mental disorders. The factor structure of the HADS was investigated in CHD populations across three countries (Germany, Hong Kong, United Kingdom). In total, HADS data from 1793 patients with CHD were explored using confirmatory factor analysis to establish the underlying factor structure of the instrument. Three-factor models were found to offer a superior fit to the data compared with two-factor (anxiety and depression) models in all countries. The anxiety items can be separated in a factor labelled autonomic anxiety and negative affectivity. The HADS offers good possibilities to detect distressed patients with somatic illnesses, but the construct validity of the originally proposed two factors (depression, anxiety) remains unclear. In outcome studies, more precise scales should be used to reduce measurement errors based on the scales used.
Publisher: SAGE Publications
Date: 04-2006
Abstract: This column provides a discussion of the issues and challenges facing nurses and nursing in Hong Kong. The author introduces the role of nurses in the special administrative region and focuses on workforce, educational and practice issues, as well as on leadership in nursing. He concludes that Hong Kong needs to have a strategic plan to determine sufficient numbers of properly educated nurses.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Oxford University Press (OUP)
Date: 22-03-2016
Abstract: The traditional use of physically focused outcome measures fails to capture holistic, quality of life issues of importance to patients. The relatively recent, rapidly growing interest in patient-reported outcome measures (PROMs) attests to this and clinicians are faced with difficult decisions regarding their choice and use. The purpose of this review was to identify and synthesise the literature pertaining to the concept of quality of life and the main PROMs used to measure this in the cardiovascular field. A review of the recent literature was undertaken on commonly used cardiovascular health-related quality of life (HRQoL) PROMs. Two types of HRQoL PROMs are available: disease-specific and generic. Both have limitations, and in many instances there is merit in using a combination, depending on the medical condition and treatment. In addition to psychometric considerations such as reliability, validity and responsiveness, the choice of a PROM will depend on factors such as the patient/investigator burden its use may impose, resources, costs, intellectual property and copyright issues. A new 'hybrid' HRQoL PROM for use in patients across the main cardiovascular disease presentations - angina, myocardial infarction and heart failure - appears to show promise. Cardiovascular HRQoL PROMs have a wide variety of uses and can help clinicians, researchers, managers and policy makers in decision making and provide indicators of clinical and institutional quality and outcomes. New HRQoL PROMs are emerging and their choice and use should be determined by a host of issues, including psychometric properties, acceptability, feasibility and cost.
Publisher: Wiley
Date: 15-04-2019
DOI: 10.1111/JAN.14010
Publisher: Wiley
Date: 28-08-2020
DOI: 10.1111/JAN.14493
Publisher: Wiley
Date: 13-03-2012
Publisher: Wiley
Date: 15-10-2008
DOI: 10.1111/J.1365-2702.2008.02577.X
Abstract: To review the literature on inflammatory bowel disease in older and younger people and to identify whether they included a nursing or psychosocial perspective, or were informed by theories of ageing. Inflammatory bowel disease, manifested as Crohn's disease and ulcerative colitis, affects younger and older people and is associated with a range of psychosocial factors. Nurses have an important role to play in caring for people with inflammatory bowel disease. A systematic review of literature related to inflammatory bowel disease and older people was carried out using the MEDLINE, CINAHL EMBASE and Cochrane databases between 1990-2006. Generally speaking, the clinical features of inflammatory bowel disease are similar in younger and older people, as are indications for surgery, survival and the usual wide spectrum of severity of disease. Corticosteroid treatment carries additional risk for older people. The studies used both retrospective and prospective designs, with the former using patient records, and the latter using follow-up of patients with inflammatory bowel disease. S le sizes were adequate for statistical analyses but there was no reference to reliability or validity of data collection methods. None of the studies considered psychosocial aspects, or the role of nurses in caring for people with inflammatory bowel disease. A specific gerontological perspective was lacking from the papers reviewed. While the clinical features of inflammatory bowel disease are similar in younger and older people, with the bimodal distribution of age of onset of inflammatory bowel disease, the possibility exists that quality of life and adjustment in older people depend on age of onset. This has not been investigated. Future lines of enquiry taking psychosocial aspects of inflammatory bowel disease into account in older people are explored. Nurses play an increasingly important role in the assessment and management of inflammatory bowel disease patients. Little is known about factors which could predict poorer psychosocial health and the impact non-intestinal manifestations may have on this in older people with inflammatory bowel disease.
Publisher: Oxford University Press (OUP)
Date: 06-01-2014
Abstract: Post-heart transplant psychological distress may directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviors, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important in order to improve not only patients' overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy. The purpose of this study was to appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant. A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardized data extraction tool. Included studies were assessed by two independent reviewers using standardized critical appraisal instruments. Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor. Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.
Publisher: Emerald
Date: 30-09-2014
DOI: 10.1108/TLDR-07-2014-0019
Abstract: – The purpose of this paper is to explore the gender identity of people with learning disabilities as a precursor to considerations of gender dysphoria. – Discussion supported by illustrations from the literature. – There is limited research on gender identity for people with learning disabilities. – There is an urgent need to look at how men with Klinefelter's syndrome and learning disabilities are supported in relation to common female sexual characteristics. – This is personal perspective on gender and people with learning disabilities which may support work with people who question their gender.
Publisher: Wiley
Date: 12-09-2010
DOI: 10.1111/J.1365-2753.2010.01415.X
Abstract: The purpose of this study was to examine the hierarchical and cumulative nature of the 35 items of the Myocardial Infarction Dimensional Assessment Scale (MIDAS), a disease-specific health-related quality of life measure. Data from 668 participants who completed the MIDAS were analysed using the Mokken Scaling Procedure, which is a computer program that searches polychotomous data for hierarchical and cumulative scales on the basis of a range of diagnostic criteria. Fourteen MIDAS items were retained in a Mokken scale and these items included physical activity, insecurity, emotional reaction and dependency items but excluded items related to diet, medication or side-effects. Item difficulty, in item response theory terms, ran from physical activity items (low difficulty) to insecurity, suggesting that the most severe quality of life effect of myocardial infarction is loneliness and isolation. Items from the MIDAS form a strong and reliable Mokken scale, which provides new insight into the relationship between items in the MIDAS and the measurement of quality of life after myocardial infarction.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.IJCARD.2015.08.114
Abstract: To discuss research into the mechanisms of non-pharmacological interventions for cardiac populations. Overview of past research and theory. Non-pharmacological interventions for cardiac patients (including: cardiac rehabilitation, heart failure disease management programs and psychosocial interventions) have never been so common or erse, but also have never been subject to so much scrutiny and skepticism. Better understanding of outcomes of these interventions is an urgent global priority. Mechanisms are the "underlying entities, processes, or structures which operate in particular contexts to generate outcomes of interest." Research into the mechanisms of non-pharmacological interventions offers useful and robust knowledge of how and why cardiac interventions work that can be vital to explaining outcomes from interventions and inconsistencies in results. Research into intervention mechanisms can inform the design and optimization of interventions. We recommend that future research into the mechanisms of non-pharmacological interventions for cardiac population 1) view effectiveness as 'somewhat' patterned, 2) conceptualize mechanisms adequately, 3) assume they are hidden, 4) examine how context affects mechanisms, and 6) address what works for whom, when, and why.
Publisher: Oxford University Press (OUP)
Date: 11-01-2013
Abstract: A key component of the structured approach to the management of chronic heart failure (CHF) is effective patient education. Patient education is a precursor to performing appropriate health-related behaviours that can decrease rehospitalizations. To pilot test an educational intervention and to determine the efficacy of a self-care manual combined with a DVD for patients with CHF. Outcomes of interest included heart failure-related knowledge and self-care behaviours. This pilot study enrolled a s le of 38 patients with CHF. A pre-test ost-test design was conducted to assess changes in knowledge and self-care abilities. Knowledge was assessed with the Dutch Heart Failure Knowledge Scale and self-care behaviours were assessed using the Self-Care of Heart Failure Index. Of the 38 participants 71% were male, 50% were aged between 65 and 74 years, and 31.6% had not completed Year 10 education. There was a statistically significantly difference in the pre- and post-test scores for knowledge (p < 0.0001). Self-care showed positive improvement between pre- and post-test scores maintenance (p = 0.027), management (p < 0.0001) and confidence (p = 0.051). This pilot study has indicated that a patient-centred self-care manual combined with a DVD is beneficial and is associated with an improvement in patients' knowledge and self-care abilities. Healthcare professionals should utilize multimedia educational resources specifically designed to meet the learning needs of patients with CHF.
Publisher: Elsevier BV
Date: 05-2019
Publisher: Wiley
Date: 09-01-2008
DOI: 10.1111/J.1365-2648.2007.04529.X
Abstract: This paper is a report of a study to explore Chinese patients' and partners' experiences during early convalescence from a first heart attack. There are important socio-cultural differences between Chinese and western populations and comparatively little is known about the experiences of Chinese patients and partners living with a first heart attack. A qualitative study using focus groups was conducted in 2005 with 17 Chinese patients and their partners during convalescence from a first heart attack. The interviews were tape-recorded and transcribed. Analysis was used to identify categories using established qualitative phenomenological techniques. Content analysis of the data revealed five major categories: enduring uncertainty coping with changes experiencing emotional reactions living with medications and needing professional help. The experiences of Chinese patients and partners during early convalescence from a first heart attack are different from their western counterparts and are affected by cultural traditions. Findings from this study may provide useful pointers for health professionals to deliver culturally sensitive and appropriate support and education during early convalescence.
Publisher: SAGE Publications
Date: 05-2003
DOI: 10.1177/13591053030083002
Abstract: It is known that people who have suffered a heart attack can hold misconceived or maladaptive beliefs and that these can have a deleterious effect on quality of life and functioning. It has also been noted that clinicians do not routinely elicit these maladaptive beliefs. It is probable that angina sufferers also hold such beliefs. As angina is a great burden in the western world, with over two million people with angina in the UK alone, there may be large numbers of people who suffer from these frightening and unhelpful misconceptions. We believe that there is a need for a simple questionnaire that could assist the delivery of tailored education directed at dispelling common misconceptions. This article details the development and psychometric properties of just such a brief questionnaire, designed for use both in research and in clinical practice.
Publisher: SAGE Publications
Date: 04-1979
Publisher: Wiley
Date: 08-09-2018
DOI: 10.1111/JAN.13399
Publisher: BMJ
Date: 07-2008
DOI: 10.1136/EBN.11.3.86
Publisher: American Diabetes Association
Date: 10-2003
DOI: 10.2337/DIACARE.26.10.2817
Abstract: OBJECTIVE—To translate the Diabetes Empowerment Scale (DES) into Chinese and establish its psychometric properties among Hong Kong Chinese people. RESEARCH DESIGN AND METHODS—A two-stage study design, incorporating qualitative and quantitative components, determined the cultural equivalency and content validity of the translated scale and established the psychometric properties of the Chinese DES (C-DES) in 207 patients. RESULTS—Psychometric analysis supported the reliability and validity of the 20-item Chinese DES (C-DES-20) and five subscales: overcoming barriers (α = 0.89), determining suitable methods (α = 0.79), achieving goals (α = 0.78), obtaining support (α = 0.78), and coping (α = 0.76). The test-retest reliability of the intraclass correlations was satifactory when a subs le of 20 patients was tested after a 2-week interval. There was criterion validity between the global scale and metabolic control (HbA1c) of respondents with type 2 diabetes (P = 0.03). CONCLUSIONS—The C-DES-20 is a reliable and valid outcome measure for patient education and psychosocial interventions among Hong Kong Chinese people with diabetes.
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1016/J.JPSYCHORES.2004.04.368
Abstract: High levels of psychological distress have been reported in patients with congestive heart failure (CHF), resulting in increased morbidity and mortality. Yet, little is known about its associated factors. The purpose of this study is to identify the significant demographic, clinical and psychosocial correlates of psychological distress in CHF patients. Cross-sectional data were obtained from a s le of a consecutive series of hospitalized CHF patients (n = 227) with measures of psychological distress, functional status, symptom status, social support and health perception. Objective clinical variables were obtained from the hospital records. High levels of psychological distress, in particular, depression, were found in patients with CHF. In hierarchical regression analysis, poorer perceived emotional-informational support, higher levels of fatigue, poorer health perception and not living with family were identified as the significant correlates of psychological distress. These correlates, in total, explained 49% of the variance for the scores of psychological distress. None of the objective clinical variables demonstrated a significant contribution that accounted for psychological distress in CHF patients. The findings highlight the importance of addressing social support for CHF patients. Assisting this vulnerable patient group to cope with fatigue and to cultivate a positive health perception are also highly prioritized treatment goals.
Publisher: Wiley
Date: 08-2015
DOI: 10.1111/JGS.13533
Publisher: Wiley
Date: 11-11-2011
Publisher: Springer Science and Business Media LLC
Date: 26-07-2011
DOI: 10.1038/NRCARDIO.2011.101
Abstract: This Review examines recommendations and principles that promote good decision-making with regard to the insertion, deactivation, and potential malfunction of implantable cardioverter-defibrillators (ICDs). This guidance is important because ICDs are now used for primary and secondary prevention of arrhythmias in more than 20 erse clinical populations, which accounts for the exponential increase in insertion rates over the past decade. Current guidelines require clinicians to provide personalized, culturally appropriate, and easy to understand information to patients on the benefits and harms of proposed treatment choices however, obtaining valid informed consent for insertion and deactivation of ICDs is challenging. Initiating early conversations with patients and continuing this dialogue over time, implementation of localized care protocols, increased collaboration (particularly between cardiac and palliative care teams), and the provision of training for all health professionals involved in the care of these patients, can help to ensure that adequate informed consent is maintained throughout their care. In addition to providing information, health professionals should identify and address high levels of anxiety in patients and their next of kin and promote effective communication throughout decision making. In the future, use of standardized checklists or decision aids based on a clear understanding of the principles underlying key topics could support this process.
Publisher: Wiley
Date: 10-04-2013
DOI: 10.1111/JAN.12061
Publisher: Springer Science and Business Media LLC
Date: 20-05-2022
DOI: 10.1186/S12912-022-00907-0
Abstract: While there is a growth in the number of advanced practice nurses, there is a dearth of research examining their role transition from registered nurses. This study aimed to identify critical elements in the career path of nursing graduates who have taken up advanced practice roles and examine their perceived impact on patient care. An exploratory descriptive study was performed. In idual semi-structured interviews were conducted face-to-face with 10 nursing graduates now in advanced practice roles, and their ten respective managers. All interviews were audio-recorded and transcribed verbatim for latent and manifest content analyses. The nursing graduates, six of whom were male, had a mean age of 35 years. All possessed a master’s degree and formal post-registration education and/or training. Six had at least three years’ experience as an advanced practice nurse. The managers, all female, had a mean age of 49 years. Eight had at least one year’s experience in their current position. Six key themes emerged: prior enhancement of personal and professional knowledge and skills active participation in clinical roles and knowledge translation in preparation for advanced practice adapting to new and erse advanced practice nursing responsibilities role of advanced practice nurses in leadership personal qualities crucial for success in advanced practice and provision of evidence-based patient-centered care. Postgraduate education, management knowledge and leadership skills, and active participation in clinical roles and knowledge translation appear crucial ingredients for promotion of nursing graduates to advanced practice roles. Other ingredients include a positive outlook, flexibility and adaptability, and good interpersonal, communication and problem-solving skills.
Publisher: Elsevier BV
Date: 10-1991
Publisher: Informa UK Limited
Date: 30-06-2019
Publisher: Oxford University Press (OUP)
Date: 12-2004
Publisher: Elsevier BV
Date: 2005
DOI: 10.1111/J.1524-4733.2005.03065.X
Abstract: The objective of this article is to discuss issues surrounding the conduct of "piggyback evaluations," in which health-economic data are collected within an otherwise typical clinical trial. We review the methodologic literature on piggyback economic evaluations, as well as selected empiric studies. We summarize the challenges encountered in the conduct of these studies, alternative ways of addressing these challenges, and their future role in pharmacoeconomic research. Piggyback evaluations have certain advantages over other types of pharmacoeconomic studies. An economic evaluation can benefit from the experimental design that maximizes the trial's internal validity, and it is often more practical to collect economic data alongside a trial rather than to fund a stand-alone economic study. However, piggyback evaluations are subject to problems deriving from the competing nature of clinical versus economic study objectives, which can give rise to tension in such fundamental aspects of study design as the selection of study subjects and sites the extent of protocol-mandated health-care services and the determination of s le size, length of follow-up, and the study comparator(s). Many solutions have been put forth in the literature to address these challenges. Piggyback evaluations can be an appropriate means to measure the economic impact of medical interventions, provided that the methodologic challenges are acknowledged and addressed within the context of each in idual study. As long as a desire for patient-level data from clinical trials exists, there will be a need for piggyback economic evaluations in the future.
Publisher: Oxford University Press (OUP)
Date: 04-1989
Abstract: The role of temporary percutaneous endocardial pacing has been examined in a retrospective analysis of all paced patients admitted to one coronary care unit over a 6 year period. The majority of 162 cases (84.6%) were paced for complete heart block complicating acute myocardial infarction. These patients had a higher incidence of previous hypertension, myocardial infarction and diabetes, compared to matched controls (P less than 0.05, less than 0.02 and less than 0.001, respectively). Admission blood glucose levels were also higher (P less than 0.05). The in-hospital mortality was high (46.7%), especially for those with anterior myocardial infarction (74.5%). Twenty-five (15.4%) patients without recent myocardial infarction were paced for symptomatic brady-dysrhythmias, usually due to chronic complete heart block (Lenegre’s disease) or sick sinus syndrome. Most later required permanent pacing. Complications of temporary pacing were more frequent in those who died, the most common being dysrhythmias during pacemaker insertion. Review of our cases suggests that whilst facilities for temporary pacing were extremely valuable, many cases treated were not haemodynamically compromised and probably did not require pacing. Guidelines should be established on coronary care units to prevent the unnecessary morbidity, mortality and expense of the procedure.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.IJCARD.2013.12.022
Abstract: To compare and contrast the coronary heart disease (CHD) risk factors of lower socio-economic status public hospital patients with those of privately insured CHD patients before and after six months of telephone delivered coaching using The COACH Program. A retrospective observational study which contrasts the lifestyle and biomedical coronary risk factor status of 2256 public hospital patients with the same risk factors of 3278 patients who had private health insurance. All patients received an average of 5 coach sessions over 6 months. The public hospital patients were four years younger and had multiple measures confirming their lower socio-economic status than their private hospital counterparts. At entry to the program, the public hospital patients had worse risk factor levels than the privately insured patients for total and LDL-cholesterol, triglycerides, fasting glucose, smoking and physical activity levels (P<0.0001) but better status for systolic and diastolic blood pressures and alcohol intake. At exit from the program, many of these differences had diminished or disappeared. The public hospital patients had greater improvements in their risk factor status for total and LDL-cholesterol, fasting glucose, body weight, smoking status and physical activity level than did the privately insured patients (P<0.05). This paper demonstrates that a program of initiating contact with patients with CHD, identifying treatment gaps in their management and coaching to achieve guideline recommended risk factor targets can help reduce health inequalities in such patients and thus benefit all patients in the context of ongoing secondary prevention.
Publisher: Wiley
Date: 2005
Publisher: SAGE Publications
Date: 09-2006
Abstract: In this qualitative study, the authors explore from the participants' perspective the benefits and difficulties experienced by participants in a mutual support group for Chinese family carers of patients with schizophrenia in Hong Kong. Thirty family carers and 10 patients who had participated in a 12-session mutual support group were interviewed, and the 12 group sessions were audiotaped for content analysis. Three main themes emerged from the data: (a) positive personal changes attributed to group participation, which included enhanced self-identity and acceptance of the caregiving role, increased knowledge of the illness, and adoption of new coping skills (b) positive characteristics of the mutual support group, including the explicit group ideology and consensus, perceived social climate of the group, and informational support and empowerment and (c) major inhibitors of group development, specifically low or irregular group attendance, negative pressure from dominant members, and overexpression of intense and negative feelings. These findings contribute to our understanding of the therapeutic components and limitations of mutual support groups for family carers.
Publisher: Oxford University Press (OUP)
Date: 15-05-2000
Publisher: SAGE Publications
Date: 05-07-2017
Abstract: End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients’ last days. To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire. Participants were classified as insufficient or sufficient implantable cardioverter defibrillator knowledge and the two groups were compared. Implantable cardioverter defibrillator recipients ( n = 270, mean age 61 ± 14 years 73% male) were recruited from cardiology and implantable cardioverter defibrillator clinics attached to two tertiary hospitals in Melbourne, Australia, and two in Kentucky, the United States. Participants with insufficient implantable cardioverter defibrillator knowledge ( n = 77, 29%) were significantly older (mean age 66 vs 60 years, p = 0.001), less likely to be Caucasian (77% vs 87%, p = 0.047), less likely to have received implantable cardioverter defibrillator shocks (26% vs 40%, p = 0.031), and more likely to have indications of mild cognitive impairment (Montreal Cognitive Assessment score : 44% vs 16%, p 0.001). Insufficient implantable cardioverter defibrillator knowledge was associated with attitudes suggesting unwillingness to discuss implantable cardioverter defibrillator deactivation, even during the last days towards end of life ( p 0.05). Implantable cardioverter defibrillator recipients, especially those who are older or have mild cognitive impairment, often have limited knowledge about implantable cardioverter defibrillator deactivation. This study identified several potential teachable moments throughout the patients’ treatment trajectory. An interdisciplinary approach is required to ensure that discussions about implantable cardioverter defibrillator deactivation issues are initiated at appropriate time points, with family members ideally also included.
Publisher: Elsevier BV
Date: 02-2002
DOI: 10.1016/S0167-5273(01)00620-9
Abstract: The study was performed to examine the effects of giving patients with acute myocardial infarction an advice and relaxation audio tape within 24 h of admission to hospital. A prospective, two-group design was used with 243 subjects randomised to receive either the advice and relaxation tape or a music tape of their choice within 24 h of sustaining a myocardial infarction. Outcomes comprised anxiety, cardiac misconceptions, lifestyle change, attendance at a cardiac rehabilitation programme, and quality of life. Although the advice and relaxation tape reduced the number of cardiac misconceptions this did not lead to any improvements in outcome, whilst in hospital or at 6 months. Both tapes were equally appreciated by the patients, 98% of whom said that they would recommend them to other patients. An advice and relaxation tape reduces cardiac misconceptions but does not confer any other benefits over a music tape.
Publisher: Oxford University Press (OUP)
Date: 07-1994
Abstract: Amiodarone hydrochloride is increasingly being used in the treatment of ventricular and supraventricular arrhythmias. Although a highly effective anti-arrhythmic agent, its use is restricted by the high incidence of side effects. To elucidate the value of monitoring serum level of both the parent drug and its active metabolite in predicting the occurrence of side effects, the investigators examined 109 patients from a register of patients treated with amiodarone for the prevalence of known side effects of the drug. The register contained over 90% of patients treated with amiodarone at the Leicester General Hospital during the period of the study. The findings suggest cutaneous side effects and abnormal thyroid function tests (without overt gland dysfunction) are more likely to occur with increasing duration of treatment and cumulative dosage. However, neither the serum amiodarone level nor the serum metabolite level had any predictive power for the occurrence of side effects. In view of this finding, it is recommended that close attention be paid to the continued clinical monitoring of side effects and that there is utility in measuring the serum amiodarone level in each patient to avoid the prescription of unnecessarily high doses. This is necessary not only to lessen the occurrence of cumulative dose-related side effects, but also because the variable but very long half-life of the drug leads to difficulties in relating spot drug levels to long-term effects.
Publisher: Oxford University Press (OUP)
Date: 09-2007
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.JPSYCHORES.2008.03.010
Abstract: This study aimed to evaluate the validity, reliability, and cultural relevance of the Cardiac Depression Scale (CDS) as a disease-specific screening tool for Chinese cardiac patients. The language equivalency and content validity of the Chinese version of the CDS (C-CDS) were evaluated. Measurement performance was tested on 200 Chinese cardiac patients and repeated on 40 patients for test-retest reliability. One item pertaining to sexual activity was removed from the Chinese version due to poor cultural relevance. The C-CDS demonstrated acceptable internal consistency (Cronbach's alpha of .91 for the total scale and .53-.78 for the subscales). The high correlation (r=.64-.89) between items and the remainder of their own scale provides further evidence of internal consistency. The test-retest reliability was satisfactory with intraclass correlation coefficients of .94 for the overall scale and .73-.92 for the six subscales. The total and subscale scores that were not significantly different (P>.05) over a 2-week period further support the stability of the instrument. There was acceptable concurrent validity with moderate (r>or=.3, P<.001) correlations between the C-CDS and the Chinese version of the Hospital Anxiety and Depression Scale. Principal component analysis revealed six factors, and one dimension was extracted from the data set, which closely resembles the structure of the original instrument. Empirical data support the C-CDS as a valid and reliable disease-specific tool in assessing depressed mood in Chinese-speaking patients with cardiac disease.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.SOCSCIMED.2017.06.046
Abstract: There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health. The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community. The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used. Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied. It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a erse range of research and clinical settings.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Cambridge University Press (CUP)
Date: 10-11-2015
DOI: 10.1017/S1041610214002385
Abstract: Stroke usually occurs in the latter years of life, is sudden and all too often unexpected and unforgiving. When non-fatal, stroke, the second leading cause of disability after dementia, is nearly always disabling (World Health Organization (WHO), 2011). Due to common ensuing physical and cognitive impairments, many stroke survivors are unable to care for themselves in the following weeks, months, and possibly years (Lutz et al. , 2011). Thus, the caregiver role is instant and often long-term with no or very little time to adapt to the many, varied and immediate challenges.
Publisher: Wiley
Date: 06-10-2021
DOI: 10.1111/JOCN.15504
Publisher: Oxford University Press (OUP)
Date: 19-05-2012
Publisher: Elsevier BV
Date: 09-2005
Publisher: Wiley
Date: 11-10-2010
DOI: 10.1111/J.1365-2702.2010.03317.X
Abstract: Aim and objective. The primary aim was to examine the prevalence of poststroke depression in Chinese stroke survivors six months after discharge from a rehabilitation hospital. A second aim was to determine whether six‐month poststroke depression was associated with psychological, social and physical outcomes and demographic variables. Background. There has been increasing recognition of the influence of depression on poststroke recovery. While some previous studies report associations between depression and social, psychological, physical and clinical outcomes, few studies had sufficient s le sizes for regression analysis thereby limiting the clinical applicability of their findings. Design. A cross‐sectional design was used. Method. Data were collected from 124 male and 86 female stroke survivors (mean age 71·7, SD 10·2 years). The Geriatric Depression Scale was used to measure depression, the State Self‐esteem Scale to measure state self‐esteem, the London Handicap Scale to measure participation restriction, the Social Support Questionnaire to measure satisfaction with social support and the Modified Barthel Index to measure functional ability. Results. Forty‐two survivors (20·5%) reported mild and 33 (16·1%) reported severe depression. The presence of depression was associated with low levels of state self‐esteem, social support satisfaction and functional ability. Logistic regression analysis revealed that these variables were statistically significant in predicting the probability of having depression ( p 0·05). Conclusions. Analyses in the present study revealed distinct patterns of correlates of depression, and the results were in agreement with prior studies that depression has a consistent positive association with physical disability, living arrangements and social support and no significant association with the different types of brain lesion. Relevance to clinical practice. There is a need, routinely, to assess stroke survivors for depression and, where necessary, to intervene with the aim of enhancing psychological and social well‐being.
Publisher: Elsevier BV
Date: 04-2020
Publisher: Elsevier BV
Date: 05-1997
DOI: 10.1016/S0167-5273(97)02951-3
Abstract: We sent a short postal questionnaire to 244 centres in England and Wales that admitted patients with cardiac conditions. In total, 199 (81%) of the centres claimed to provide a cardiac rehabilitation service. Of these, 25 were randomly selected as a representative s le and visited in order to obtain detailed information concerning the provision of services. Most (18 (72%)) of the centres had commenced their rehabilitation programme within the previous 5 years, usually at the instigation of interested staff. Patient entry to cardiac rehabilitation programmes was restricted women (who represented only 15% of attenders), elderly people (excluded in 10 (40%) centres), and those with more complex problems, such as angina or heart failure, were under-represented. The central components of all programmes were education and exercise training but there was a wide range in the quantity and quality of service provision. Most (22 (88%)) programmes were hospital out-patient based, one (4%) was hospital in-patient based, one (4%) was community-based and one (4%) was home-based. The staffing and funding of programmes was variable, with 7 (28%) having no identified funding. There are wide variations in the resources currently available for the rehabilitation of patients with coronary heart disease. There is a need for clearer direction of these services, in particular to determine minimum service provision. Guidelines are necessary to give a framework for this relatively new and rapidly expanding service.
Publisher: Oxford University Press (OUP)
Date: 18-11-2005
Abstract: Disease management programmes (DMPs) have evolved as an innovative clinical practice system to enhance the discharge outcomes of older people with heart failure. Yet, clinical trials which have examined their effectiveness have reported inconsistent findings. This may be explained by variations in the design of DMPs. The aim is to identify the characteristics of DMPs which are crucial to reducing hospital readmission and/or mortality of older people with heart failure. A systematic computerized search was conducted to identify randomized controlled trials of the last 10 years, which examined the effects of DMPs on hospital readmission and mortality of older people with heart failure. The identified DMPs were classified as effective and ineffective, according to statistically significant changes in discharge outcomes. Twenty-one trials were identified, 11 (52.4%) of which reported DMPs improving the discharge outcomes of older people with heart failure. The results indicate that an effective DMP should be multi-faceted and consists of an in-hospital phase of care, intensive patient education, self-care supportive strategy, optimization of medical regimen, and ongoing surveillance and management of clinical deterioration. Cardiac nurse and cardiologist should be actively involved and a flexible approach should be adopted to deliver the follow-up care. This study defines precisely the characteristics of the care team and the organization content and delivery method of the DMP which are crucial to enhance the discharge outcomes of older people with heart failure.
Publisher: American Psychiatric Association Publishing
Date: 10-2013
DOI: 10.1176/APPI.PS.201200243
Abstract: This study was conducted to test the effects of a nine-month family-led peer support group for Chinese people with schizophrenia in Hong Kong over a three-year follow-up and to compare outcomes with those of psychoeducation and standard psychiatric outpatient care. A randomized controlled trial of 106 Chinese families of patients with schizophrenia was conducted between August 2007 and January 2011 in three psychiatric outpatient clinics. Families were randomly assigned to peer support (N=35), psychoeducation (N=35), or standard care (N=36). In addition to standard care received, peer support and psychoeducation consisted of 14 two-hour group sessions, with patients participating in six to 14 sessions. Multiple patient and family outcomes--including families' support service utilization and functioning and patients' functioning mental state and rehospitalization rate--were measured at recruitment and one week, 18 months, and 36 months after completion of the interventions. Patients and families in the peer support group reported consistently greater improvements over three years in overall functioning (family p<.005 patient p<.001) and reductions in duration and number of hospitalizations (p<.01 for both), without any increase in service utilization. Family-led peer support groups were an effective intervention for Chinese people with schizophrenia, resulting in long-term effects of improving patient and family functioning and reducing rehospitalizations.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.PEC.2015.10.009
Abstract: To systematically review evidence for the efficacy of family-based education for heart failure (HF) patients and carers. A systematic review was conducted. Databases CINAHL, MEDLINE Complete, Cochrane, PubMed, Web of Science, EMBASE, PsycINFO, and Scopus were searched between 1 January 2005 and 1 May 2015. Randomised controlled trials included HF patient and carer dyads or carers alone. The primary outcome was HF knowledge. Secondary outcomes included self-care behaviour, dietary and treatment adherence, quality of life, depression, perceived control, hospital readmissions, and carer burden. Six trials reported in nine papers were included. Wide variation in the quality of the studies was found. Two studies only examined HF knowledge a significant improvement among patients and carers was reported. Other significant findings were enhanced patient self-care, boosted dietary and treatment adherence, enriched patient quality of life, improved perceived control among patients but not carers, and reduced carer burden Modest evidence was found for family-based education among HF patients and carers. Methodological shortcomings of trials signify the need for empirically sound future research. Family-based HF education needs to include strategies that are tailored to the HF patient and carer, and sustainable in nature.
Publisher: Oxford University Press (OUP)
Date: 20-02-2011
DOI: 10.1016/J.EJCNURSE.2011.01.004
Abstract: Cardiac misconceptions are common and may have a detrimental effect on patients. Such misconceptions may be introduced or reinforced by vague and inconsistent advice from healthcare staff and can adversely affect health outcomes. To assess whether level of cardiac misconceptions significantly differs between groups of healthcare staff based on occupation. The 22-item York cardiac beliefs questionnaire (YCBQ) was administered to a convenience s le of healthcare staff (n = 263) in direct contact with cardiac patients. Data was also collected on the occupation of healthcare staff and years worked. Medical staff had the lowest mean score (17.5, CI 15.6-19.4), indicating fewest misconceptions, and unqualified healthcare workers had the highest mean score (32.1, CI 28.4-35.7). Analysis by ANOVA indicated differences between staff groups to be statistically significant (F = 17.66, p < 0.001). Length of time worked was found to be significantly associated with cardiac misconception score (Pearson's r = - 0.243, p < 0.001). Further analysis demonstrated that significant differences between mean group scores remained when years worked was defined as a covariate, F = 15.68, p < 0.001). There is significant variability in cardiac misconceptions in different groups of healthcare staff. Education to correct cardiac misconceptions should be particularly targeted at unqualified healthcare staff. The importance of maintaining appropriate ratios of qualified to unqualified healthcare staff in the care of cardiac patients is supported by this study.
Publisher: BMJ
Date: 04-2010
DOI: 10.1136/EBM1031
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.APNR.2013.11.008
Abstract: Coronary heart disease (CHD) is a major cause of death and disability and negatively impacts on patients' health-related quality of life (HRQoL). This study aimed to explore HRQoL and identify its predictors among outpatients with CHD in Singapore. A correlational study was conducted with a convenience s le of 106 outpatients with CHD recruited from a public hospital. HRQoL outcomes were measured using the Short Form-12 Health Survey (SF-12), Medical Outcomes Study Social Support Survey (MOS-SSS) and Hospital Anxiety and Depression Scale (HADS). Patients reported a generally high level of HRQoL as assessed by SF-12. Those aged over 65years reported significantly higher mental health and those who were married had higher levels of education or income reported significantly higher physical health. There were significant negative correlations between physical and mental health and anxiety and depression (p<.05). Perceived social support was negatively correlated with anxiety and depression and positively correlated with mental health. Education level and depression significantly predicted physical health, while age, anxiety and depression predicted mental health. Anxiety, depression, age and education are significant predictors of HRQoL in this patient population and should be assessed routinely and, where appropriate, addressed through in idually-tailored interventions.
Publisher: Wiley
Date: 06-12-2014
DOI: 10.1002/EJHF.12
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.IJNURSTU.2010.08.011
Abstract: Effective self-care is the cornerstone of the successful management of heart failure (HF). The European Heart Failure Self-care Behaviour Scale is a brief, reliable and valid scale to measure this important construct among patients with HF. Although the EHFScBS has been translated to different languages, no Chinese version is available. Indeed, previous findings investigating the psychometric properties of EHFScBS indicated ambiguity of the conceptual structure of this scale. The aim of this study was to translate the European Heart Failure Self-care Behaviour Scale (EHFScBS) into Chinese and to test its psychometric properties in the Chinese patients with HF. The EHFScBS (English Version) was translated to Chinese using Brislin's forward and backward translation method. Panel review was used to examine its semantic equivalence and content validity. The EHFScBS (Chinese Version) was then tested with a convenience s le of 143 Chinese HF patients who attended a specialist clinic from January to September 2007. The content validity index (CVI) of the EHFScBS (Chinese version) was satisfactory (Item CVI=0.96 Scale CVI=0.89), with Cronbach's alpha 0.82. Convergent validity was supported by a moderate relationship, statistical significant with a measure for social support (r=-0.36, p<0.001). However, the findings did not support the hypothesised three-factor structure of the EHFScBS (Chinese Version). Instead, all items except one fit well a two-factor structure to measure help-seeking and regimen-complying behaviours. The adequate psychometric properties and clear conceptual structure of EHFScBS (Chinese Version) warrant its use in Chinese patients with HF.
Publisher: Oxford University Press (OUP)
Date: 05-07-2014
Abstract: Healthcare providers are called on to assess and improve the health-related quality of life (HRQL) of patients with myocardial infarction (MI). However, there is lack of empirical data on HRQL of such in iduals in mainland China. The purpose of this study is to assess HRQL and identify associated factors in hospitalized Chinese MI patients. A single group, cross-sectional design was adopted with a s le of 192 hospitalized MI patients at two teaching hospitals in Xi'an, People's Republic of China. HRQL was assessed using the Chinese Mandarin versions of the Short Form 36 health survey (SF-36), the Myocardial Infarction Dimensional Assessment Scale (MIDAS), and the Hospital Anxiety and Depression Scale (HADS). Chinese MI patients reported poor HRQL as measured by both the generic (SF-36) and disease-specific (MIDAS) instruments. Advancing age and the presence of heart failure, anxiety, and depression were significant predictors of overall HRQL. Smoking and hypertension were significant predictors of the physical aspects of HRQL. Assessing HRQL of hospitalized Chinese MI patients and identifying associated factors may help health professionals in the design and delivery of appropriately tailored and culturally relevant interventions to this group of patients.
Publisher: Oxford University Press (OUP)
Date: 06-2011
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.JPSYCHORES.2010.01.014
Abstract: Type D personality predicts poor prognosis in coronary heart disease (CHD) but little is known about Type D in non-Western cultures. We examined the (a) validity of the Type D construct and its assessment with the DS14 scale in the Chinese culture, (b) prevalence of Type D, and (c) gender vs. Type D discrepancies in depression/anxiety, among Chinese patients with CHD. Patients with CHD (N=326) completed the Chinese version of the DS14. The NEO Five Factor Inventory (NEO-FFI), Hospital Anxiety and Depression Scale (HADS), and Stress Symptom Checklist (SSC) were administered to subs les to establish construct and discriminant validity. Administration of the DS14, HADS, and SSC was repeated at 1 month after hospital discharge in 66 patients, and stability of the DS14 was examined in another subs le of 100 patients. The theoretical structure of the Type D construct in the Chinese culture was supported (chi(2)/df=2.89, root mean square error of approximation=0.08, normal fit index=0.91, non-normal fit index=0.91, comparative fit index=0.93). The Negative Affectivity (NA) and Social Inhibition (SI) subscales of the DS14 in the entire s le were internally consistent (Cronbach's alpha=0.89/0.81), measured stable traits (3-month test-retest ICC=0.76/0.74), and correlated significantly with the neuroticism (NA/neuroticism, r=0.78, P<.001) and extraversion subscales (SI/extraversion, r=-0.64, P<.001) of the NEO-FFI, respectively. The prevalence of Type D personality was 31%. Type D was not related to transient emotional states. However, Chinese patients with a Type D personality were at increased concurrent risk of anxiety (P=.002) and depression (P=.016). Type D personality is a cross-culturally valid construct, is associated with an increased risk of anxiety and depression, and deserves prompt attention in estimating the prognostic risk of Chinese CHD patients.
Publisher: Oxford University Press (OUP)
Date: 04-02-2013
Abstract: This study aimed to explore and identify the relationship between health-related quality of life (HRQoL) and perceived social support among Chinese patients with coronary heart disease (CHD) in mainland China. A descriptive correlational study was conducted with a convenience s le of 200 Chinese patients with CHD recruited from the cardiac outpatient departments of two university-affiliated hospitals in Xi'an, China. The Chinese Mandarin versions of the Short-form 36-item health survey (CM:SF-36) and the Medical Outcomes Study Social Support Survey (CM:MOS-SSS) were administered to assess HRQoL and perceived social support. The results indicated that Chinese patients with CHD reported a poorer HRQoL and lower social support compared with their Western and Hong Kong counterparts. Multiple regression analyses identified four significant predictors of deteriorated physical health (increasing age, co-morbidity with heart failure or hypertension, and smoking status) and two significant predictors of poor mental health (co-morbidity with heart failure and perceived social support). Health status and social support in Chinese people with CHD should be routinely assessed and, where feasible, addressed through appropriate in idually tailored interventions.
Publisher: No publisher found
Date: 2009
DOI: 10.1016/J.JACC.2009.04.051
Abstract: Heart failure (HF) disease-management programs are increasingly common. However, some large and recent trials of programs have not reported positive findings. There have also been parallel recent advances in reporting standards and theory around complex nonpharmacological interventions. These developments compel reconsideration in this Viewpoint of how research into HF-management programs should be evaluated, the quality, specificity, and usefulness of this evidence, and the recommendations for future research. Addressing the main determinants of intervention effectiveness by using the PICO (Patient, Intervention, Comparison, and Outcome) approach and the recent CONSORT (Consolidated Standards of Reporting Trials) statement on nonpharmacological trials, we will argue that in both current trials and meta-analyses, interventions and comparisons are not sufficiently well described that complex programs have been excessively oversimplified and that potentially salient differences in programs, populations, and settings are not incorporated into analyses. In preference to more general meta-analyses of programs, adequate descriptions are first needed of populations, interventions, comparisons, and outcomes in past and future trials. This could be achieved via a systematic survey of study authors based on the CONSORT statement. These more detailed data on studies should be incorporated into future meta-analyses of comparable trials and used with other techniques such as patient-based outcomes data and meta-regression. Although trials and meta-analyses continue to have potential to generate useful evidence, a more specific evidence base is needed to support the development of effective programs for different populations and settings.
Publisher: Wiley
Date: 19-08-2017
DOI: 10.1111/JAN.13090
Publisher: BMJ
Date: 24-06-2009
DOI: 10.1136/EBN.12.3.83
Publisher: MDPI AG
Date: 18-11-2022
Abstract: Taxi driving, a male-dominated occupation, is associated with an increased risk of cardiovascular disease (CVD). The increased risk is linked to a high prevalence of modifiable CVD risk factors including overweight/obesity, poor nutrition, smoking, excessive alcohol consumption and physical inactivity. Behaviour change interventions may prove advantageous, yet little research has been conducted to reduce CVD risk in this population. The purpose of this study was to co-design an eHealth intervention, ‘ManGuard’, to reduce CVD risk in male taxi drivers. The IDEAS framework was utilised to guide the development of the eHealth intervention, with the Behaviour Change Wheel (BCW) incorporated throughout to ensure the intervention was underpinned by behaviour change theory. Development and refinement of ManGuard was guided by current literature, input from a multidisciplinary team, an online survey, a systematic review and meta-analysis, and focus groups (n = 3) with male taxi drivers. Physical inactivity was identified as the prime behavior to change in order to reduce CVD risk in male taxi drivers. Male taxi drivers indicated a preference for an eHealth intervention to be delivered using smartphone technology, with a simple design, providing concise, straightforward, and relatable content, and with the ability to track and monitor progress.
Publisher: Wiley
Date: 10-2001
DOI: 10.1046/J.1365-2648.2001.01938.X
Abstract: The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Three perspectives on accessibility were identified: (a) the humanist--in which human sources of information were the most accessible (b) local information for local needs--in which locally produced resources were seen as the most accessible and (c) moving towards technology--in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such as clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely to perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses on the wards had any explicit research base. These, and the remainder were out of date (mean age of textbooks 11 years), and authorship hard to ascertain. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced.
Publisher: Mark Allen Group
Date: 02-07-2021
Publisher: Wiley
Date: 15-04-2011
DOI: 10.1111/J.1365-2702.2010.03558.X
Abstract: Aim. To review and synthesise, systematically, the research findings regarding motivational interviewing and to inform education, research and practice in relation to cardiovascular health. Background. Motivational interviewing is designed to engage ambivalent or resistant clients in the process of health behaviour change, and it has been widely used in different clinical conditions such as substance abuse, dietary adherence and smoking cessation. Motivational interviewing has also been proposed as a method for improving modifiable coronary heart disease risk factors of patients. Design. Systematic review. Method. Eligible studies published in 1999–2009 were identified from the following databases: CINAHL, Medline, PsycINFO, Cochrane Library, EBSCO, Web of Science, Embase and British Nursing Index. A manual search was conducted of bibliographies of the identified studies and relevant journals. Two researchers independently reviewed the studies. Results. Four meta‐analyses, one systematic review and three literature reviews of motivational interviewing and five primary studies of motivational interviewing pertaining to cardiovascular health were identified. Despite a dearth of primary studies in cardiovascular health settings, there appears to be strong evidence that motivational interviewing is an effective approach focusing on eliciting the person’s intrinsic motivation for change of behaviour. Conclusion. Motivational interviewing is an effective approach to changing behaviour. It offers promise in improving cardiovascular health status. Relevance to clinical practice. This review indicates that motivational interviewing is a useful method to help nurses improve health behaviour in people with coronary risk factors.
Publisher: BMJ
Date: 03-08-2012
Publisher: BMJ
Date: 04-2016
Publisher: Wiley
Date: 05-06-2009
Publisher: Springer Science and Business Media LLC
Date: 18-09-2008
DOI: 10.1007/S10198-008-0126-1
Abstract: The Treating to New Targets (TNT) clinical trial found that intensive 80 mg atorvastatin (A80) treatment reduced cardiovascular events by 22% when compared to 10 mg atorvastatin (A10) treatment. We evaluated the cost-effectiveness of intensive A80 vs A10 treatment in the United Kingdom (UK), Spain, and Germany. A lifetime Markov model was developed to predict cardiovascular disease-related events, costs, survival, and quality-adjusted life-years (QALYs). Treatment-specific event probabilities were estimated from the TNT clinical trial. Post-event survival, health-related quality of life, and country-specific medical-care costs were estimated using published sources. Intensive treatment with A80 increased both the per-patient QALYs and corresponding costs of care, when compared to the A10 treatment, in all three countries. The incremental cost per QALY gained was 9,500, 21,000, and 15,000 in the UK, Spain, and Germany, respectively. Intensive A80 treatment is estimated to be cost-effective when compared to A10 treatment in secondary cardiovascular prevention.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Elsevier BV
Date: 03-2012
Publisher: Elsevier BV
Date: 05-2007
Publisher: Springer Science and Business Media LLC
Date: 20-02-2002
Abstract: What people believe about their illness may affect how they cope with it. It has been suggested that such beliefs stem from those commonly held within society. This study compared the beliefs held by people with angina, regarding causation and coping in angina, with the beliefs of their friends who do not suffer from angina. Postal survey using the York Angina Beliefs Questionnaire (version 1), which elicits stress attributions and misconceived beliefs about causation and coping. This was administered to 164 people with angina and their non-cohabiting friends matched for age and sex. 132 people with angina and 94 friends completed the questionnaire. Peers are more likely than people with angina to believe that angina is caused by a worn out heart (p < 0.01), angina is a small heart attack (p = 0.02), and that it causes permanent damage to the heart (p < 0.001). Peers were also more likely to believe that people with angina should take life easy (p < 0.01) and avoid exercise (p = 0.04) and excitement (p < 0.01). The beliefs of the peer group about causation and coping in angina run counter to professional advice. Over time this may contribute to a reduction in patient concordance with risk factor reduction, and may help to create cardiac invalids.
Publisher: BMJ
Date: 07-2006
DOI: 10.1136/EBN.9.3.76
Publisher: Oxford University Press (OUP)
Date: 12-2010
Publisher: Oxford University Press (OUP)
Date: 17-01-2008
DOI: 10.1093/IJE/DYM294
Publisher: Wiley
Date: 20-01-2019
DOI: 10.1111/JAN.14298
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.MATURITAS.2015.03.007
Abstract: There is evidence that menopausal symptoms manifested at peri-menopause occur less frequently when compared to the symptoms experienced at post-menopause. The aim of this study was to investigate this and to test the hypothesis that depressive symptomatology mediates the relationship between menopausal stage and symptom frequency. This cross-sectional study included 213 women (M age=52 years), of whom 125 were peri- and 88 post-menopausal. Measures comprised the Center for Epidemiologic Studies-Depression scale (CES-D) and the Women's Health Questionnaire (WHQ) vasomotor symptoms and somatic symptoms subscales. Multiple mediated regression analyses provided evidence that somatic symptoms and vasomotor symptoms were less frequent at post- compared to peri-menopause, and that these differences were mediated by depressive symptomatology. Multivariate effect sizes ranged from small to moderate, and univariate effect sizes were uniformly small with wide confidence intervals. The frequency of vasomotor and somatic symptoms appears to increase with depressed affect. The management of symptoms could include interventions of a psychotherapeutic nature, which may offset this effect, particularly in women for whom depressive symptoms are a feature of the climacteric syndrome. The extent to which depression and the climacteric syndrome may be causally related to one another remains unclear and longitudinal research should further examine the mechanisms of this association.
Publisher: Elsevier BV
Date: 09-1983
DOI: 10.1016/0195-6701(83)90029-4
Abstract: The efficacy of povidone-iodine ointment in the prevention of cannula thrombophlebitis was assessed in a prospective controlled study of 100 consecutive patients. Thrombophlebitis was evaluated clinically, and in addition all cannulae were cultured, semi-quantitatively and by the conventional broth technique, to detect any bacterial colonization. The incidence of thrombophlebitis was slightly higher in the test than in the control group. It is concluded that the use of povidone-iodine ointment for prophylaxis does not reduce the incidence of cannula thrombophlebitis. There was no significant association between the incidence of thrombophlebitis and cannula colonization as measured by either the semi-quantitative technique or the conventional broth technique.
Publisher: Springer Science and Business Media LLC
Date: 10-07-2021
DOI: 10.1186/S12955-021-01814-9
Abstract: Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence) self-care management (dealing with symptoms) and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald’s omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98–1.00 root-mean-square error of approximation = 0.00–0.07). The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.
Publisher: Elsevier BV
Date: 09-2011
Publisher: Elsevier BV
Date: 07-2018
Publisher: Wiley
Date: 26-09-2023
DOI: 10.1111/HEX.13879
Publisher: Oxford University Press (OUP)
Date: 06-2002
DOI: 10.1016/S1474-5151(02)00008-7
Abstract: Cardiac rehabilitation has assumed more prominence over the past decade, due largely to an increase in user demand, an improvement in the evidence base and an enhancement of its status. This paper presents a view from the United Kingdom and suggests some ways in which cardiac rehabilitation can be improved by focusing on a number of key issues: service organisation and delivery, process and outcome measurement, performance management, and education, training and continuing professional development. The paper concludes that there is a need to make cardiac rehabilitation more widely available using creative and flexible approaches to enhance access, participation and adherence.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.AHJ.2012.08.020
Abstract: Cardiac rehabilitation and secondary prevention programs can prevent heart disease in high-risk populations. However, up to half of all patients referred to these programs do not subsequently participate. Although age, sex, and social factors are common predictors of attendance, to increase attendance rates after referral, the complex range of factors and processes influencing attendance needs to be better understood. A systematic review using qualitative meta-synthesis was conducted. Ten databases were systematically searched using 100+ search terms until October 31, 2011. To be included, studies had to contain a qualitative research component and population-specific primary data pertaining to program attendance after referral for adults older than 18 years and be published as full articles in or after 1995. Ninety studies were included (2010 patients, 120 caregivers, 312 professionals). Personal and contextual barriers and facilitators were intricately linked and consistently influenced patients' decisions to attend. The main personal factors affecting attendance after referral included patients' knowledge of services, patient identity, perceptions of heart disease, and financial or occupational constraints. These were consistently derived from social as opposed to clinical sources. Contextual factors also influenced patient attendance, including family and, less commonly, health professionals. Regardless of the perceived severity of heart disease, patients could view risk as inherently uncontrollable and any attempts to manage risk as futile. Decisions to attend programs are influenced more by social factors than by health professional advice or clinical information. Interventions to increase patient attendance should involve patients and their families and harness social mechanisms.
Publisher: Elsevier BV
Date: 09-2004
Publisher: Elsevier BV
Date: 06-1988
DOI: 10.1016/0266-612X(88)90041-7
Abstract: In the title hydrated mol-ecular salt, C(6)H(16)N(2) (2+)·2Br(-)·2H(2)O, the complete 1,4-dimethyl-piperazine-1,4-diium dication is generated by crystallographic inversion symmetry and both exocyclic C-N bonds are in equatorial orientations. In the crystal, the components are linked by N-H⋯O and O-H⋯Br hydrogen bonds, generating chains propagating in [110].
Publisher: Wiley
Date: 2006
DOI: 10.1002/GPS.1461
Abstract: Depression is the most prevalent functional mental disorder of later life. It is estimated that about 5% of the elderly population of Hong Kong are suffering from depression. To investigate the self-rated quality of life of community-dwelling elderly people diagnosed with depression, and to examine the relationships between quality of life and mental, physical health, functional status and social support. A cross-sectional descriptive survey was conducted in psychiatric outpatient clinics. A convenience s le of 80 Chinese elderly people with a diagnosis of depressive disorder was recruited. Perception of quality of life was measured by the Hong Kong Chinese World Health Organization Quality of Life Scale-Brief Version. Participants' mental status, functional abilities, physical health condition, and social support status were assessed. Sixty-one (76.3%) participants were female. They were least satisfied with 'meaningfulness of life', 'life enjoyment', 'concentration and thinking', 'energy' and 'work capacity'. Functional abilities had a positive association with participants' perceived quality of life, level of depression and number of physical health conditions had a negative association. Participants had low ratings of quality of life when compared with healthy persons and persons with chronic physical problems. Findings are discussed in light of the socio-cultural environment in Hong Kong. Comprehensive treatment and better control of depression, including different modes of medical and psychosocial intervention, could help to improve participants' perception of quality of life. A longitudinal study with a larger s le with various levels of depression and socio-demographic characteristics is recommended.
Publisher: Oxford University Press (OUP)
Date: 06-2004
Publisher: Elsevier BV
Date: 05-2006
Publisher: Public Library of Science (PLoS)
Date: 03-11-2015
Publisher: Elsevier BV
Date: 10-1995
DOI: 10.1016/0965-2302(95)90006-3
Abstract: The publication of large randomised trials such as ISIS 2 (1988) and AIMS (1990), provided striking evidence as to the effectiveness of thrombolytic therapy in reducing early mortality and morbidity in patients suffering acute myocardial infarction. This article will provide an overview of the use of thrombolytic agents in modern cardiac care, with particular reference to their impact on the Accident and Emergency department.
Publisher: Informa UK Limited
Date: 03-2010
DOI: 10.1080/13607860903421078
Abstract: In this study, we briefly described a large urban Meals on Wheels program's adoption of the Patient Health Questionnaire-9 (PHQ-9) as its depression-screening tool. Then we reported the assessment outcomes with respect to the rates, severity, and correlates of depressive symptoms. The s le consisted of 736 MOW clients. Bivariate analysis, with chi(2) statistics, was performed to examine differences in the rates and severity of depressive symptoms by age group, gender, race/ethnicity, and cognitive status. Negative binomial regression analysis was used to determine the correlates of depression symptom severity. Of the s le, 17.5% had clinically significant depressive symptoms (PHQ-9 > or = 10), and 8.8% had probable major depressive disorder (MDD). A significantly higher proportion of those under age 60 years was found to have clinically significant depressive symptoms and probable MDD. The multivariate regression results show that age, gender, race/ethnicity, income, cognitive impairment, number of chronic medical conditions, and the nutritional risk score were significant predictors of the severity of depression symptoms. Implications of and recommendations for incorporating a valid depression-screening tool into social service agencies' existing assessment process are discussed.
Publisher: Wiley
Date: 30-09-2019
DOI: 10.1111/JAN.14169
Publisher: Wiley
Date: 19-12-2019
Publisher: Wiley
Date: 28-07-2017
DOI: 10.1111/JAN.13070
Publisher: Oxford University Press (OUP)
Date: 02-2020
Publisher: Wiley
Date: 30-11-2017
DOI: 10.1111/JAN.13192
Abstract: The aim of this study was to evaluate a heart failure education programme developed for patients and carers in Thailand. Heart failure is major health problem. This is the first trial of a family-based education programme for heart failure patients and carers residing in rural Thailand. Randomized controlled trial. One hundred patient-carer dyads attending cardiac clinics in southern Thailand from April 2014 - March 2015 were randomized to usual care (n = 50) or a family-based education programme (n = 50) comprising face-to-face counselling, a heart failure manual and DVD and telephone support. Assessments of heart failure knowledge, health-related quality of life, self-care behaviours and perceived control were conducted at baseline, three and six months. Linear mixed-effects model revealed that patients and carers who received the education programme had higher knowledge scores at three and six months than those who received usual care. Among those who received the education programme, when compared with those who received usual care, patients had better self-care maintenance and confidence, and health-related quality of life scores at three and six months, and better self-care management scores at six months, whereas carers had higher perceived control scores at three months. Addressing a significant service gap in rural Thailand, this family-based heart failure programme improved patient knowledge, self-care behaviours and health-related quality of life and carer knowledge and perceived control.
Publisher: Wiley
Date: 09-11-2023
DOI: 10.1111/JAN.15490
Publisher: Elsevier BV
Date: 08-2003
DOI: 10.1016/S0165-1781(03)00162-8
Abstract: The utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for coronary care patients following acute myocardial infarction (MI) was investigated. A confirmatory factor analysis was conducted on the HADS to determine its psychometric properties in 335 MI patients over three observation points (1 week, 6 weeks and 6 months). Internal and test-retest reliabilities of the HADS total and HADS sub-scale scores were generally found to be acceptable. The underlying factor structure of the HADS comprised three distinct factors. Support was found for the use of the HADS sub-scales to assess dimensions of anhedonia, psychic anxiety and psychomotor agitation. The HADS may be a useful screening instrument to assess post-MI patients for symptoms of psychological distress. Further research is required to determine the three-factor structure of the HADS in other clinical groups.
Publisher: Wiley
Date: 10-12-2012
DOI: 10.1111/JOCN.12008
Publisher: Oxford University Press (OUP)
Date: 05-03-2013
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.JACC.2015.10.044
Abstract: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). The goal of this study is to update the Cochrane systematic review and meta-analysis of exercise-based CR for CHD. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk of bias. Studies were pooled using random effects meta-analysis, and stratified analyses were undertaken to examine potential treatment effect modifiers. A total of 63 studies with 14,486 participants with median follow-up of 12 months were included. Overall, CR led to a reduction in cardiovascular mortality (relative risk: 0.74 95% confidence interval: 0.64 to 0.86) and the risk of hospital admissions (relative risk: 0.82 95% confidence interval: 0.70 to 0.96). There was no significant effect on total mortality, myocardial infarction, or revascularization. The majority of studies (14 of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects. This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions and improvements in quality of life. These benefits appear to be consistent across patients and intervention types and were independent of study quality, setting, and publication date.
Publisher: Wiley
Date: 2006
DOI: 10.1002/GPS.1578
Abstract: With an increasing life expectancy, there is a rapidly growing sector that is aging. Depression is the most prevalent functional mental disorder of older population. It is estimated that about 21% of the older population in Shanghai are suffering from depression. This study investigated the self-rated health related quality of life of community-dwelling older people diagnosed with depression in Shanghai, and to examine the relationships between this and mental and physical health, functional status and social support. A cross-sectional survey was conducted in two community centres with a convenience s le of 71 participants. Measures included subjective perception of health related quality of life, level of depression, cognitive function, number of medical conditions, activities of daily living, functional abilities, and social support. The majority of the participants were female (n=52, 73.23%), and married (n=51, 71.8%). A higher level of depression was related to a poorer health related quality of life. Participants were least satisfied with their physical health. The level of depression, activities of daily living and satisfaction with social support were predictors of health related quality of life ratings. The study identified how depression affects the bio-psychosocial status of Chinese older people. Findings are discussed in light of the socio-cultural environment in Shanghai.
Publisher: Oxford University Press (OUP)
Date: 07-12-2017
Abstract: Although psychological interventions are recommended for the management of coronary heart disease (CHD), there remains considerable uncertainty regarding their effectiveness. Systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for CHD. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and PsycINFO were searched to April 2016. Retrieved papers, systematic reviews and trial registries were hand-searched. We included RCTs with at least 6 months of follow-up, comparing the direct effects of psychological interventions to usual care for patients following myocardial infarction or revascularisation or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data and assessed risk of bias. Studies were pooled using random effects meta-analysis and meta-regression was used to explore study-level predictors. Thirty-five studies with 10,703 participants (median follow-up 12 months) were included. Psychological interventions led to a reduction in cardiovascular mortality (rfcelative risk 0.79, 95% confidence interval [CI] 0.63 to 0.98), although no effects were observed for total mortality, myocardial infarction or revascularisation. Psychological interventions improved depressive symptoms (standardised mean difference [SMD] –0.27, 95% CI –0.39 to –0.15), anxiety (SMD –0.24, 95% CI –0.38 to –0.09) and stress (SMD –0.56, 95% CI –0.88 to –0.24) compared with controls. We found that psychological intervention improved psychological symptoms and reduced cardiac mortality for people with CHD. However, there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD.
Publisher: Wiley
Date: 18-09-2007
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.IJCARD.2011.10.036
Abstract: More data, better data or improved evidence translation: what will improve cardiovascular outcomes? As countries must focus more on the value of and access to health services over effectiveness alone, we argue that data on key aspects of interventions are predominantly missing from the current evidence-base. We examine this need in relation to secondary prevention of the most burdensome disease in the world: coronary heart disease and consider the wider forms of evidence about interventions needed by professionals, systems and governments to promote effective, accessible and efficient chronic disease management.
Publisher: Elsevier BV
Date: 04-2005
Publisher: Oxford University Press (OUP)
Date: 12-2006
DOI: 10.1016/J.EJCNURSE.2006.06.007
Abstract: Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (kappa(w)). Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (> or =5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of or =5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was or =5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (kappa(w)=0.27). Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.IJNURSTU.2010.03.015
Abstract: The objective of this study was to investigate the diagnostic performance of biochemical tests used to determine placement of nasogastric (NG) tubes after insertion in adults. A systematic review of diagnostic studies was undertaken. A literature search of the bibliographic databases and the World Wide Web was performed to locate original diagnostic studies in English or Chinese on biochemical markers for detecting NG tube location. Studies in which one or more different tests were evaluated with a reference standard, and diagnostic values were reported or could be calculated were included. Two reviewers independently checked all abstracts and full text studies for inclusion criteria. Included studies were assessed for their quality using the QUADAS tool. Study features and diagnostic values were extracted from the included studies. Of the 10 studies included in this review, seven investigated the diagnostic accuracy of pH, one investigated the diagnostic accuracy of pH and bilirubin respectively, two a combination of pH and bilirubin and one a combination of pH, pepsin and trypsin levels in identifying NG tube location. All studies used X-rays as the reference standard for comparison. Pooled results demonstrated that a pH of <or=4.0 had the ability to predict only 63% of the tubes located in the stomach. However, a pH value of <or=5.5 to determine gastric placement demonstrated a sensitivity of 0.89 (95% CI 0.82-0.94) and a specificity of 0.87 (95% CI 0.81-0.93). Bilirubin coupled with pH had a high specificity (0.99) which demonstrated the ability of the test to identify misplaced tubes in intestine. However, the ability of the test to correctly identify gastric placement of feeding tubes was relatively low (sensitivity<0.90). Due to the heterogeneity of the studies and small s le sizes, conclusions about the diagnostic performance of the different tests cannot be drawn. Better designed studies exploring the accuracy of diagnostic tests are needed to improve the diagnostic policy. Until stronger evidence becomes available practice related to the diagnostic tests used within the clinical setting will continue to be dictated by local preferences and cost factors.
Publisher: Elsevier BV
Date: 09-2008
Publisher: Elsevier BV
Date: 06-2001
Publisher: Wiley
Date: 11-09-2014
DOI: 10.1111/JAN.12378
Publisher: Wiley
Date: 11-02-2005
Publisher: Wiley
Date: 23-12-2016
DOI: 10.1111/JOCN.13124
Abstract: To examine carers' views on patient self-care in chronic heart failure (CHF). Self-care, a key strategy in the long-term management of CHF, can be complex and difficult to master. Carers play a key role in supporting patients in self-care, yet their views on it are rarely sought. A qualitative approach was adopted with a purposeful s le of carers of patients with CHF residing in Australia. Carers who identified themselves as providing informal care to a person diagnosed with chronic heart failure were interviewed about their views on patient self-care. Data were collected by face-to-face interviews with a semi-structured interview guide. Qualitative content analysis of the interviews was undertaken by two nurses and one psychologist. Four key themes were identified pertaining to CHF patient self-care: hindrance to engagement roles and relationships social support and community engagement and competency. Most carers viewed patients' fatigue and inactivity, mood and coping, and memory loss as major challenges to engagement in self-care. They viewed emotional support and encouragement, independence and organised routines as important aspects of their relationship with the patient and as facilitators of self-care, but also required for themselves support from their families, communities and healthcare professionals. They also viewed patient and carer experience and knowledge as being essential to successful self-care. Carers viewed self-care as an important issue for patients with CHF and indicated that they could play an enhanced role with the provision of better support and knowledge from their families, communities and health care professionals. Carers are closely involved in supporting patients in CHF self-care, even though their views are rarely considered in the organisation and delivery of heart failure management programmes. Therefore, their important contribution should be acknowledged and supported in contemporary heart failure health services.
Publisher: BMJ
Date: 08-2007
Publisher: Informa UK Limited
Date: 15-02-2023
Publisher: Wiley
Date: 04-08-2014
DOI: 10.1111/JAN.12492
Publisher: JMIR Publications Inc.
Date: 21-01-2022
Abstract: ong COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, which continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far is the adoption of holistic management approaches. The Optimal Health Program (OHP) is a brief 5-session, plus booster, psychosocial program designed to support mental and physical well-being that has been used effectively for a range of chronic conditions. his study examines the feasibility and acceptability of employing an especially customized version of OHP (long COVID OHP [LC-OHP]) to improve psychological and physical health of people with long COVID. his is a feasibility randomized controlled trial that will be running from November 2021 to February 2023. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. A total of 60 participants will be randomized into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the program (primary) and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy, and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the program. Quantitative data will be analyzed using SPSS, and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analyzed to identify common emerging themes. his is an ongoing study, which began in November 2021. ong COVID has a significant impact on an in idual’s mental and physical functioning. The LC-OHP has a potential to provide people living with long COVID with additional support and to improve self-efficacy. The findings of this study would identify the feasibility of delivering this program to this population and will provide an indication for the program’s effectiveness. SRCTN Registry ISRCTN38746119 www.isrctn.com/ISRCTN38746119 ERR1-10.2196/36673
Publisher: Springer Science and Business Media LLC
Date: 27-03-2012
Abstract: Myocardial infarction is a major cause of death and morbidity in many countries, including China. The aim of this study was to analyse a Mandarin Chinese translation of the Cardiac Depression Scale for a hierarchy of items according to the criteria of Mokken scaling. Data from 438 Chinese participants who completed the Chinese translation of the Cardiac Depression Scale were analysed using the Mokken scaling procedure and the 'R' statistical programme using the diagnostics available in these programmes. Correlations between Mandarin Chinese items and Chinese translations of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory were also analysed. Fifteen items from the Mandarin Chinese Cardiac Depression Scale were retained in a weak but reliable Mokken scale invariant item ordering was evident but of low accuracy and the Mokken scaled items of the Chinese Cardiac Depression Scale correlated with the Hospital Anxiety and Depression Scale and the Beck Depression Inventory. Items from the Mandarin Chinese Cardiac Depression Scale form a Mokken scale and this offers further insight into how the items of the Cardiac Depression Scale relate to the measurement of depression in people with a myocardial infarction.
Publisher: Elsevier BV
Date: 10-1983
DOI: 10.1016/0167-5273(83)90107-9
Abstract: To verify the biomechanical importance with respect to the integrity of posteromedial cortex of femoral neck fracture (FNF) and demonstrate whether the modified fixation of cannulated screws (CSs) could increase the biomechanical strength. A total of 24 left artificial femurs were randomly ided into three groups. The osteotomy was made in the center of the femoral neck at a 20° angle to the shaft axial. The posteromedial cortices of femoral neck were removed in groups B and C. In group A, 8 femurs with intact posteromedial cortex were fixed with three parallel partial thread screws (PTSs), forming a standard triangle. In group B, the femurs were stabilized with the same fixation of CSs like group A. In group C, two inferior PTSs were replaced by two fully thread screws (FTSs). The lower A-P and axial stiffness and load to failure along with higher axial displacement were found in group B compared with group A (p≤0.001 for all). Between groups B and C, the modified fixation of CSs increased A-P and axial stiffness and load to failure and reduced the axial displacement (p≤0.001 for all). We verified that the comminuted posteromedial cortex affected the biomechanical strength adversely and resulted in higher displacement. The modified fixation of CSs characterized by two inferior FTSs could improve the biomechanical performance and buttress the femoral head fragment better.
Publisher: BMJ
Date: 08-10-2009
Abstract: Cardiac rehabilitation is increasingly recognised as an integral component of comprehensive cardiac care. The evidence supporting its effectiveness in reducing morbidity and mortality and improving quality of life is compelling. Yet, despite this recognition and exhortations that its implementation should be a key priority, most cardiac patients do not receive rehabilitation. Service provision varies markedly and many programmes are focused on select populations, often operate in an inflexible manner and fail to add potential value. Issues of suboptimal referral, enrolment and completion are poorly addressed and the potential for embracing novel methods and the latest technology are rarely exploited. This paper reviews the current status of cardiac rehabilitation and proposes ways to improve access and uptake and reduce inequity to ensure that those who are likely to benefit from this complex intervention do so.
Publisher: Oxford University Press (OUP)
Date: 27-02-2019
Publisher: Wiley
Date: 14-09-2017
DOI: 10.1111/DME.13439
Abstract: Residual β-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this β-cell function reduces complications. We hypothesized that exercise preserves β-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis. A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken. Participants were assigned to control (usual care) or intervention (exercise consultation every month), in a 1 : 1 ratio for 12 months. The primary outcomes were recruitment rate, drop out, exercise adherence [weeks with ≥ 150 min of self-reported moderate to vigorous physical activity (MVPA)], and exercise uptake in the control group. The secondary outcomes were differences in insulin sensitivity and rate of loss of β-cell function between intervention and control at 6 and 12 months. Of 507 in iduals who were approached, 58 (28 control, 30 intervention) entered the study and 41 completed it. Participants were largely white European males, BMI 24.8 ± 3.8 kg/m We show that it is possible to recruit and randomize people with newly diagnosed Type 1 diabetes to a trial of an exercise intervention, and increase and maintain their exercise levels for 12 months. Future trials need to incorporate measures of greater adherence to exercise training targets, and include more appropriate measures of β-cell function. (Clinical Trials Registry No ISRCTN91388505).
Publisher: Royal College of Psychiatrists
Date: 07-2006
DOI: 10.1192/BJP.BP.105.008375
Abstract: Family intervention in schizophrenia can reduce patient relapse and improve medication adherence, but few studies on this have involved a Chinese population. To examine the effects of a mutual support group for Chinese families of people with schizophrenia, compared with psychoeducation and standard care. Randomised controlled trial in Hong Kong with 96 families of out-patients with schizophrenia, of whom 32 received mutual support, 33 psychoeducation and 31 standard care. The psychoeducation group included patients in all the sessions, the mutual support group did not. Intervention was provided over 6 months, and patient- and family-related psychosocial outcomes were compared over an 18-month follow-up. Mutual support consistently produced greater improvement in patient and family functioning and caregiver burden over the intervention and follow-up periods, compared with the other two conditions. The number of readmissions did not decrease significantly, but their duration did. Mutual support for families of Chinese people with schizophrenia can substantially benefit family and patient functioning and caregiver burden.
Publisher: Wiley
Date: 05-2005
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.IJCARD.2007.10.043
Abstract: To perform a psychometric evaluation of the Myocardial Infarction Dimensional Assessment Scale (MIDAS) in Chinese patients with coronary heart disease. Patients with angina (n=162), MI (n=124) or heart failure (n=95) were recruited from a regional university-affiliated hospital. The Chinese version of the MIDAS (C-MIDAS), the Hospital Anxiety and Depression Scale (HADS) and the Short-Form 36 Health Survey (SF-36) were administered to all patients at baseline and the C-MIDAS was also administered seven day (n=92) and three months (n=363) later. The C-MIDAS conforms to the 7-factor structure as proposed in the original version. It is reliable with Cronbach's alphas from 0.73 to 0.94 and test-retest reliabilities from 0.76 to 0.92. Four of its subscales (physical activity, insecurity, emotional reaction and dependency) correlated significantly with the SF-36 and the HADS in each diagnostic group and had good discriminative properties in terms of gender, emotional disturbance and perceived health deterioration, with responsiveness supported by medium-high effect sizes (0.43-0.83) and standardize response means (0.46-0.82). The other three subscales measuring treatment-related impacts added little to the validity and responsiveness of the C-MIDAS. To render the C-MIDAS a core health-related quality of life measure for Chinese-speaking patients with coronary heart disease, further studies need to clarify the content adequacy and cultural relevancy of those subscales measuring treatment-related impact.
Publisher: Oxford University Press (OUP)
Date: 06-2012
DOI: 10.1016/J.EJCNURSE.2011.04.005
Abstract: Routine screening and assessment for depression occurs rarely in clinical practice for a variety of reasons, including the absence of systems to facilitate the process. To identify nurses' knowledge and practice regarding depression screening and referral for cardiac patients following the implementation of education workshops and a validated screening tool with referral actions. Pre and post-test design using surveys and semi-structured interviews was conducted with a purposive s le of nurses in a large Australian metropolitan tertiary referral hospital. Prior to the introduction of the screening and referral tool, nurses engaged in an interactive one hour education workshop on the topic of depression and the tool introduced to improve depression screening following an acute cardiac event. In the pre and post-survey 40 and 30 nurses, respectively, participated with 14 also engaging in semi-structured interviews. Eighty percent reported a 'good' understanding of depression post-program compared to 30% at baseline. Sixty percent reported routinely using the depression screening and referral tool. The interviews identified three main themes that supported the utility of the education and instrument: knowledge improvement perceived self-efficacy and new knowledge into practice. The vast majority of participants reported increased skill, knowledge and confidence to screen and refer for depression post an acute cardiac event. The substantial increase in the number of nurses who engaged in screening and referral actions further demonstrated the success of the program. These encouraging results provide evidence that screening for depression can be achieved through adopting formalised processes.
Publisher: Wiley
Date: 02-2008
DOI: 10.1111/J.1365-2648.2007.04553.X
Abstract: This paper is a report of a systematic review of qualitative studies of how older people live with chronic heart failure. Chronic heart failure is a global epidemic mainly affecting an ageing population. Understanding how older people live with this disease is important to help promote their adjustment to the distressing illness experience. Eligible studies published in 1997-2007 were identified from several databases (Medline, CINAHL, PsycINFO and Sociological Abstracts). A manual search was conducted of bibliographies of the identified studies and relevant journals. Two researchers independently reviewed the studies and extracted the data. Key concepts from the papers were compared for similarities and differences. The transactional model of stress was used to guide data synthesis. Fourteen qualitative studies were identified. Most described the illness experiences of older people with chronic heart failure and associated coping strategies. There was some emerging work exploring the adjustment process. The findings indicated that living with chronic heart failure was characterized by distressing symptoms, compromised physical functioning, feelings of powerlessness and hopelessness, and social and role dysfunction. There were gender differences in the way the disease was conceived. Adjustment required patients to make sense of the illness experience, accept the prognosis, and get on with living with the condition. Empowering older people to manage chronic heart failure, instilling hope and bolstering support system are means of promoting successful adjustment to the disease. Further research needs to explore the cultural differences in the adjustment process.
Publisher: Wiley
Date: 24-08-0088
Publisher: Wiley
Date: 13-09-2013
DOI: 10.1111/JAN.12125
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.HLC.2014.02.020
Abstract: The prevalence of depression is high in cardiac patients. Depression has a significant impact on quality of life, adherence to therapy, and an independent effect on prognosis. The Cardiac Depression Scale (CDS) is the only instrument designed to measure depression in cardiac patients. This study systematically reviewed the psychometric properties of the CDS for screening of depression in patients with coronary heart disease (CHD). A search of MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Web of Science was performed using the search term Cardiac Depression Scale in the title or abstract. Eligible studies were those that assessed reliability, validity or diagnostic accuracy of the CDS in patients with CHD. Methodological quality was assessed using the QUADAS-2 and STARD. Most studies assessed the reliability and validity of the CDS: three studies assessed construct validity using factor analysis six studies assessed the validity of the CDS with other measures of depression and four studies assessed its diagnostic accuracy. However, some studies reported overlapping s les, which reduces confidence in their evaluation. This review finds the CDS to be a psychometrically sound measurement instrument for identifying mild, moderate and severe depression in cardiac populations.
Publisher: Wiley
Date: 06-2001
DOI: 10.1046/J.1365-2648.2001.01809.X
Abstract: The aim of this qualitative study was to explore and gain insights into the effects of myocardial infarction on health-related quality of life. The study was undertaken as part of a larger on-going project to develop and validate a disease-specific health-related quality of life instrument suitable for use with patients after myocardial infarction. A consecutive s le of 31 patients admitted to a district general hospital in the North of England was recruited and interviewed at home. Semi-structured interviews were conducted based on a guide developed from a review of the literature pertaining to quality of life and expert opinion. Interviews were audio-tape recorded and transcribed verbatim. Transcripts were subjected to latent and manifest content analysis and inter-rater reliability was confirmed by a researcher not involved with the interview process. Analysis of the data revealed seven major categories: physical activity/symptoms insecurity emotional reactions dependency lifestyle modification concern over medication and side-effects. Breathlessness, insecurity and feelings of over-protection were major problems, as was dissatisfaction with information and support. Myocardial infarction resulted in a variety of health-related problems which affected quality of life. Systematic monitoring and evaluation of health status should be performed routinely. This is likely to be aided by the development and use of a health-related quality of life instrument for this patient group.
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.JCRC.2005.06.004
Abstract: To assess the psychometric properties of the Simplified Therapeutic Intervention Scoring System (TISS 28) scale. A prospective observational design was used. Patients were recruited from a medical-surgical intensive care unit (ICU) and 4 rehabilitation wards of 2 university-affiliated hospitals in Hong Kong. Data necessary for the calculation of the TISS 28, the Therapeutic Intervention Scoring System (TISS 76), and severity of illness scoring system (Simplified Acute Physiology Score [SAPS II]) were recorded for each patient during the first 24 hours after his/her admission to an ICU. A significant positive correlation was found between the TISS 76 and the TISS 28 scores as well as the TISS 28 and the SAPS II scores. There was a significant difference between the TISS 28 scores among ICU patients and patients in rehabilitation wards. A significant correlation was found between the TISS 28 scores of the first and second set of TISS 28 scores. Although the findings supported the validity and reliability of the TISS 28, there were limitations of the TISS 28 in measuring nursing workload in ICUs. Hence, continued amendment and validation of the TISS 28 on larger s les in different ICUs would be required so as to provide clinical nurses with a valid and reliable assessment of nursing workload.
Publisher: Oxford University Press (OUP)
Date: 25-09-2013
Abstract: Over the last two decades the UK health service has endeavoured to place patient and public involvement at the heart of its modernisation agenda. Despite these aspirations the role of patients in the development of nursing curricula remains limited. A descriptive qualitative design was used to explore the views of cardiac patients about the educational preparation of cardiac nurses. Eight participants attending an annual conference of a patient and carer support group were recruited to the study. A focus group was conducted to explore their views on how the educational preparation of cardiac nurses in the UK should develop. Tape-recorded data were transcribed and a thematic analysis was undertaken. Four themes were identified: contradictions around practice and education demonstrating compassion delivering rehabilitation expertise leadership in practice. Participants perceived that they had a valuable role in the educational development of nurses, enhancing nurses' understanding of how in iduals live and adjust to living with cardiovascular disease. Cardiac patients believe that the education of cardiac nurses should be driven by experiences in practice, nevertheless they want nurses to be equipped to deliver care that is underpinned by a strong knowledge base and skills combined with an ability to engage, educate and deliver high quality care that is both compassionate and in idualised.
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.JPAINSYMMAN.2007.12.019
Abstract: The purpose of this study was to translate the Memorial Symptom Assessment Scale (MSAS) into Chinese and evaluate the psychometric properties of this version. The original MSAS is a 32-item, patient-rated measure that was developed to assess common cancer-related physical and psychological symptoms with respect to frequency, intensity, and distress. In this study, a two-phase design was used. Phase I involved iterative forward-backward translation, testing of content validity (CVI) and a pretest. Phase II established the psychometric properties of the Chinese version MSAS (MSAS-Ch). Results showed that the MSAS-Ch achieved content relevancy CVI of 0.94 and semantic equivalence CVI of 0.94. Pretesting was performed in 10 cancer patients, and the results revealed adequate content coverage and comprehensibility of the MSAS-Ch. A convenience s le of 370 patients undergoing cancer therapy or at the early post-treatment stage was recruited for psychometric evaluation. Confirmatory factor analysis confirmed the construct validity of the MSAS-Ch, with a good fit between the factor structure of the original version and our present s le data (goodness-of-fit indices all above 0.95). The internal consistency reliability of subscales and total MSAS-Ch was moderately high, with Cronbach alpha coefficients ranging from 0.79 to 0.87. The test-retest intraclass correlation results for the subscale and total MSAS-Ch ranged from 0.68 to 0.79. The subscale scores of MSAS-Ch were moderately correlated with the scores on various validation measurements that assessed psychological distress, pain, and health-related quality of life (r = 0.46-0.65, P < 0.01), confirming that they were measurements of similar constructs. The validity of the construct validity was also supported by comparing the MSAS-Ch scores for subpopulations that varied clinically. Inpatients and patients with poorer performance status scored higher on the MSAS-Ch subscale and total scores than outpatients and patients with higher performance status (P < 0.05). Our study shows that the MSAS-Ch has adequate psychometric properties of validity and reliability, and can be used to assess symptoms during cancer therapy and at the early post-treatment stage in Chinese-speaking patients.
Publisher: Informa UK Limited
Date: 02-2006
DOI: 10.1080/13548500500093688
Abstract: Depression is common in patients following stroke and has been found to be related to the degree of functional disability, recovery and engagement in rehabilitation. Consequently, screening for depression is crucial in this group in order to facilitate the delivery of appropriate psychological support. The current study sought to determine key psychometric properties of the Chinese version of the Geriatric Depression Scale (GDS) in this group. Three versions of the GDS were evaluated, these being the 30-item original measure (GDS-30), the short-form version comprising 15 items (GDS-SF) and a recently developed innovative four-item version (GDS-4). Confirmatory factor analysis revealed the GDS-30 and GDS-SF to offer an acceptable fit to data suggesting utility of these measures for screening. However, the GDS-4 offered a poor fit to the data, suggesting this measure was an inadequate measure of depression in this clinical group. Further, though GDS-30 and GDS-SF measures revealed good internal consistency, the performance of the GDS-4 was marginal. However, all GDS-derived measures demonstrated excellent convergent and ergent validity. It is concluded that the GDS-30 is a useful and appropriate screening instrument in this group. Further, the GDS-SF shows promise in terms of development as a multidimensional measure of depression that may have predictive and outcome monitoring potential. The psychometric shortcomings of the GDS-4 strongly suggest that this measure is unsuitable for screening in this clinical group.
Publisher: Emerald
Date: 14-03-2016
DOI: 10.1108/JMHTEP-04-2015-0017
Abstract: – The purpose of this paper is to discuss the role of psychosocial treatments to support families living with cardiovascular disease (CVD) and depression. The paper highlights that depression in people with CVD is a predictor of non-adherence to both medicines and cardiovascular rehabilitation programmes. The authors believe there is a clinical need to develop a programme of care to support the whole family to adhere to cardiovascular rehabilitation programmes. – A team of expert cardiovascular nurses, mental health nurses (MHN) and cardiologist clinical opinions and experiences. These opinions and experiences were supplemented by literature using MEDLINE as the primary database for papers published between December 2000 and December 2013. – People with CVD who become depressed are more likely to stop taking their medicine and stop working with their health care worker. Most people with heart and mood problems live with their families. Health workers could have a role in supporting families living with heart and mood problems to their care and treatment. The paper has highlighted the importance of working with families living with heart and mood problems to help them to stick with care and treatment. – Most people with heart and mood problems live with their families. The paper has highlighted the importance of working with families living with heart and mood problems to help them to persevere with care and treatment. MHN may have a role, though consideration should also be given to exploring the role of other health care workers and members of the community. As the population ages, clinicians and communities will need to consider the impact of depression on adherence when working with families living with CVD and depression.
Publisher: Oxford University Press (OUP)
Date: 04-2004
Publisher: Springer Science and Business Media LLC
Date: 07-07-2006
DOI: 10.1007/S11136-006-0012-1
Abstract: To test the reliability and validity of the Chinese Mandarin version of the SF-36 health survey (CM:SF-36) in patients with myocardial infarction (MI) in mainland China. Single group, cross-sectional design to test the measurement performance on a convenience s le of 180 Chinese patients with MI, 30 of whom were retested after 2 weeks to establish reliability. Cronbach's alpha coefficients exceeded the 0.70 criterion for all subscales except General Health, indicating good internal consistency. Test-retest reliability was adequate (intraclass correlation coefficient >0.70) for all subscales. The significant differences were detected by the presence or absence of co-morbidities and the number of risk factors in most physical subscales indicating good discriminative validity. Principal components factor analysis with varimax rotation confirmed the presence of the eight factors, though the item loadings of the Vitality and Mental Health subscales were found to differ from the original ones of the SF-36. The CM:SF-36 is a psychometrically acceptable instrument for assessing the health status of Chinese patients with myocardial infarction.
Publisher: Wiley
Date: 14-09-2020
DOI: 10.1111/JAN.14540
Publisher: Mary Ann Liebert Inc
Date: 02-2010
Abstract: To establish baseline data in a population of young Chinese women from which lifestyle risk factors for cardiovascular disease (CVD) and the implications for long-term cardiovascular health can be examined. In a cross-sectional postal survey, a 125-item questionnaire (a translated version of the Minnesota Women's Health Survey) assessing lifestyle risk factors and perceptions of health was mailed to 987 Hong Kong Chinese nurses aged 26 years and returned by 617, yielding a response rate of 63%. Of the women surveyed, 7% reported they smoked, 21% consumed alcohol regularly, and 32% exercised regularly. Ten percent reported being overweight or obese, 31% were underweight, and 8% used oral contraception. The findings have important implications for the long-term cardiovascular health of this group of young women health professionals. Baseline data of lifestyle cardiovascular risk factors demonstrate that approximately two thirds of the women in this study are at risk of developing CVD when the findings are interpreted within the classification of CVD risk in women developed by the American Heart Association. Further research is necessary to assess women's awareness of risk factors and perceived personal risk.
Publisher: Informa UK Limited
Date: 31-12-2022
DOI: 10.1080/13548506.2020.1867317
Abstract: Cognitive deficits are common in patients with chronic heart failure (HF), but little attention has been given to the investigation of prospective memory (PM) - the ability to execute delayed intentions. Importantly, many aspects of PM are crucial for patient implementation of HF self-care behaviours. Here we provide a replication of our original work involving PM in patients with HF. We compared a group of 51 HF patients to 41 closely matched controls. The primary outcome measure was a laboratory test of PM, Virtual week, which closely simulates PM tasks in daily life. A series of background cognitive tests were also administered. Consistent with our previous work, the HF group had significant PM impairment compared to controls, and these difficulties were generalised across different types of PM tasks. Surprisingly, we did not find any differences in the background cognitive tasks between groups. Compared to controls, the HF group had significant and similar sized deficits on all task parameters assessed (event, time, regular, irregular) of PM function, which likely impacts engagement in HF self-care.
Publisher: No publisher found
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 20-09-2013
DOI: 10.1007/S11136-013-0530-6
Abstract: To validate the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey (MOS-SSS-CM) using a model of ordinal unidimensional measurement known as Mokken scaling. We administered in face-to-face interviews the MOS-SSS-CM to 200 patients with coronary heart disease. Data were analysed using Mokken scaling. The MOS-SSS-CM contains a set of items which meet the criteria of a reliable (Rho = 0.87) moderate Mokken scale (H = 0.40) with weak invariant item ordering (H = 0.39). The MOS-SSS-CM has a hierarchy of items which can be interpreted in terms of concerns with the physical aspects of social support through the need for companionship to items related to more personal worries.
Publisher: Elsevier BV
Date: 02-2002
DOI: 10.1016/S0022-3999(01)00300-2
Abstract: To determine the effectiveness of in idualised educational behavioural treatment delivered by cardiac nurses in hospital compared to usual care for patients following acute myocardial infarction. One hundred and fourteen consecutive patients were randomised to receive the intervention or usual care. Outcome assessment was by self-report questionnaire (the Hospital Anxiety and Depression Scale and Dartmouth COOP Health Status), interview at 1 month, and self-report at 3 and 12 months. The primary outcome was improvement in the Dartmouth COOP total score from baseline to 3 months. Four patients needed to be treated to give an additional patient with improvement in health status at 3 months (number needed to treat [NNT] 4, 95% confidence intervals [CIs] 3 to 12). The intervention group were more confident about returning to activities 1 month after discharge from hospital. Treated patients had fewer further treatment needs. An in idualised educational behavioural treatment delivered by cardiac nurses in hospital may have substantial benefits. A large-scale pragmatic RCT is needed.
Publisher: BMJ
Date: 09-1994
DOI: 10.1136/HRT.72.3.303
Abstract: States adopt minimum wages to improve workers' economic circumstances and well-being. Many studies, but not all, find evidence of health benefits from higher minimum wages. This study used a rigorous "triple difference" strategy to identify the associations between state minimum wages and adult obesity, body mass index (weight (kg)/height (m)2), hypertension, diabetes, fair or poor health, and serious psychological distress. National Health Interview Survey data (United States, 2008-2015) on adults aged 25-64 years (n = 131,430) were linked to state policies to estimate the prevalence odds ratio or mean difference in these outcomes associated with a $1 increase in current and 2-year lagged minimum wage among less-educated adults overall and by sex, race/ethnicity, and age. In contrast to prior studies, there was no association between current minimum wage and health however, 2-year lagged minimum wage was positively associated with the likelihood of obesity (prevalence odds ratio = 1.08, 95% confidence interval: 1.00, 1.16) and with elevated body mass index (mean difference = 0.27, 95% confidence interval: 0.04, 0.49). In subgroup models, current and 2-year lagged minimum wage were associated with a higher likelihood of obesity among male and non-White or Hispanic adults. The associations with hypertension also varied by sex and the timing of the exposure.
Publisher: Oxford University Press (OUP)
Date: 17-12-2015
Publisher: Wiley
Date: 20-06-2002
DOI: 10.1046/J.1365-2648.2002.02241.X
Abstract: To examine the barriers that nurses feel prevent them from using research in the decisions they make. A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour poor response rates and small, nonrandom s ling strategies. Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the in idual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These in iduals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community.
Publisher: Elsevier BV
Date: 09-1996
Publisher: Elsevier BV
Date: 02-2009
Publisher: Oxford University Press (OUP)
Date: 07-06-2023
Abstract: Research has shown that families’ participation in a cardiovascular disease (CVD) prevention programme could boost early adoption of healthy lifestyle behaviours in families. Behaviour-based, eHealth interventions are a potential means of achieving this. This study aimed to explore expectations of families—parents and children—at risk of CVD towards the design and functionality of an eHealth family-based CVD-risk reduction programme ‘Health-e-Hearts’. Three online focus groups were conducted with six families comprising at least one parent at risk of CVD and at least one child aged 5–17 years. The focus groups were video and audio recorded and transcribed. Content analysis was used to synthesize and identify key categories and subcategories regarding development of and engagement with an eHealth programme. Three categories emerged: experiences of health apps and devices eHealth application needs of family members and motivators for using an eHealth programme. Experiences included using health apps in idually and inconsistently. Needs included personalization, free and easy-to-use, time efficient, and multiple content formats. Motivators for engaging with the programme included goal setting, rewards, and competition. Families’ expectations of an eHealth family-based CVD-risk reduction programme include the incorporation of personalized, easy-to-use design features and motivators for engaging with the programme. Family involvement in the development of an eHealth programme such as ‘Health-e-Hearts’ has the potential to boost early adoption of healthy lifestyle behaviours among all family members.
Publisher: Elsevier BV
Date: 03-1988
DOI: 10.1016/0266-612X(88)90017-X
Abstract: Betaine-homocysteine S-methyltransferase (BHMT) catalyzes the synthesis of methionine from homocysteine. In our initial report, we observed a reduced body weight in Bhmt(-/-) mice. We initiated this study to investigate the potential role of BHMT in energy metabolism. Compared with the controls (Bhmt(+/+)), Bhmt(-/-) mice had less fat mass, smaller adipocytes, and better glucose and insulin sensitivities. Compared with the controls, Bhmt(-/-) mice had increased energy expenditure, with no changes in food intake, fat uptake or absorption, or in locomotor activity. The reduced adiposity in Bhmt(-/-) mice was not due to hyperthermogenesis. Bhmt(-/-) mice failed to maintain a normal body temperature upon cold exposure because of limited fuel supplies. In vivo and ex vivo tests showed that Bhmt(-/-) mice had normal lipolytic function. The rate of (14)C-labeled fatty acid incorporated into [(14)C]triacylglycerol was the same in Bhmt(+/+) and Bhmt(-/-) gonadal fat depots (GWAT), but it was 62% lower in Bhmt(-/-) inguinal fat depots (IWAT) compared with that of Bhmt(+/+) mice. The rate of (14)C-labeled fatty acid oxidation was the same in both GWAT and IWAT from Bhmt(+/+) and Bhmt(-/-) mice. At basal level, Bhmt(-/-) GWAT had the same [(14)C]glucose oxidation as did the controls. When stimulated with insulin, Bhmt(-/-) GWAT oxidized 2.4-fold more glucose than did the controls. Compared with the controls, the rate of [(14)C]glucose oxidation was 2.4- and 1.8-fold higher, respectively, in Bhmt(-/-) IWAT without or with insulin stimulus. Our results show for the first time a role for BHMT in energy homeostasis.
Publisher: Elsevier BV
Date: 06-1989
DOI: 10.1016/0266-612X(89)90025-4
Abstract: In a continuing study, we explored how the in idual rings in neo-tanshinlactone (1) influence its potent and selective in vitro antibreast cancer activity. Accordingly, we discovered a novel class of antibreast cancer agents, 2-(furan-2-yl)naphthalen-1-ol derivatives, based on an active C-ring opened model compound 5. Further optimization led to 18 and 21, which showed decreased cytotoxic potency but better selectivity than neo-tanshinlactone analogue 2. Interestingly, 20 showed broad cytotoxicity against human cancer cell lines.
Publisher: Wiley
Date: 28-01-2014
DOI: 10.1111/JAN.12350
Publisher: Elsevier BV
Date: 11-2010
Publisher: Wiley
Date: 08-03-2011
Publisher: Oxford University Press (OUP)
Date: 06-01-2023
Abstract: In a rapidly changing health and care landscape, there is acknowledgement that the organization of care should be integrated with the patient placed at the centre. In reality, care systems are often fragmented, disjointed, and focused on the condition rather than the patient. The Science Committee of the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology recognizes the need for a statement on integrated care to guide health professionals caring for people with cardiovascular disease. This statement outlines the evidence for integrated cardiovascular care, identifies challenges, and offers advice for practice, education, and research.
Publisher: Informa UK Limited
Date: 05-2014
DOI: 10.2147/IJGM.S60932
Publisher: Oxford University Press (OUP)
Date: 03-2011
Publisher: Elsevier BV
Date: 09-2002
Publisher: Oxford University Press (OUP)
Date: 17-09-2015
Publisher: Cambridge University Press (CUP)
Date: 30-06-2022
DOI: 10.1017/S0033291722002203
Abstract: Among patients diagnosed with COVID-19, a substantial proportion are experiencing ongoing symptoms for months after infection, known as ‘long COVID’. Long COVID is associated with a wide range of physical and neuropsychological symptoms, including impacts on mental health, cognition, and psychological wellbeing. However, intervention research is only beginning to emerge. This systematic review synthesizes currently registered trials examining interventions for mental health, cognition, and psychological wellbeing in patients with long COVID. Standard systematic review guidelines were followed. Trials registered in two large trial registries in 2020 to May 2022 were reviewed. Included studies were narratively synthesized by type of intervention and a risk-of-bias assessment was conducted. Forty-two registered trials were included, with a total target s le size of 5814 participants. These include 11 psychological interventions, five pharmacological and other medical interventions, and five evaluating herbal, nutritional, or natural supplement interventions. An additional nine trials are examining cognitive and neurorehabilitation interventions and 12 are examining physiotherapy or physical rehabilitation. Most trials are randomized, but many are feasibility trials trials are evaluating a wide spectrum of outcomes. While there is a newly emerging body of research testing interventions for mental health, cognition, and psychological wellbeing in long COVID, the breadth and scope of the research remains limited. It is urgently incumbent on researchers to expand upon the intervention research currently under way, in order to generate high-quality evidence on a wide range of candidate interventions for erse long COVID patient populations.
Publisher: Oxford University Press (OUP)
Date: 20-03-2018
Publisher: Wiley
Date: 07-09-2009
Publisher: SAGE Publications
Date: 24-06-2013
Abstract: Greater participation in cardiac rehabilitation improves morbidity and mortality in people with coronary heart disease, but little is understood of patients’ decisions to participate. To develop interventions aimed at increasing completion of programmes, we conducted a qualitative systematic review and meta-synthesis to explore the complex factors and processes influencing participation in cardiac rehabilitation programmes after referral and initial access. To be included in the review, studies had to contain a qualitative research component, population specific data on programme participation in adults years, and be published ≥1995 as full articles or theses. Ten databases were searched (31 October 2011) using 100+ search terms. Of 2264 citations identified, 62 studies were included involving: 1646 patients (57% female mean age 64.2), 143 caregivers, and 79 professionals. Patients’ participation was most strongly influenced by perceptions of the nature, suitability and scheduling of programmes, social comparisons made possible by programmes, and the degree to which programmes, providers, and programme users met expectations. Women’s experiences of these factors rendered them less likely to complete. Comparatively, perceptions of programme benefits had little influence on participation. Factors reducing participation in programmes are varied but amenable to intervention. Participation should be viewed as a ‘consumer behaviour’ and interventions should mobilize family support, promote ‘patient friendly’ scheduling, and actively harness the social, identity-related, and experiential aspects of participation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2011
Publisher: Springer Science and Business Media LLC
Date: 09-09-2016
Publisher: Elsevier BV
Date: 05-2007
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.IJCARD.2015.08.066
Abstract: To assess the long-term cost-effectiveness of two multidisciplinary management programs for elderly patients hospitalized with chronic heart failure (CHF) and how it is influenced by patient characteristics. A trial-based analysis was conducted alongside a randomized controlled trial of 280 elderly patients with CHF discharged to home from three Australian tertiary hospitals. Two interventions were compared: home-based intervention (HBI) that involved home visiting with community-based care versus specialized clinic-based intervention (CBI). Bootstrapped incremental cost-utility ratios were computed based on quality-adjusted life-years (QALYs) and total healthcare costs. Cost-effectiveness acceptability curves were constructed based on incremental net monetary benefit (NMB). We performed multiple linear regression to explore which patient characteristics may impact patient-level NMB. During median follow-up of 3.2 years, HBI was associated with slightly higher QALYs (+0.26 years per person p=0.078) and lower total healthcare costs (AU$ -13,100 per person p=0.025) mainly driven by significantly reduced duration of all-cause hospital stay (-10 days p=0.006). At a willingness-to-pay threshold of AU$ 50,000 per additional QALY, the probability of HBI being better-valued was 96% and the incremental NMB of HBI was AU$ 24,342 (discounted, 5%). The variables associated with increased NMB were HBI (vs. CBI), lower Charlson Comorbidity Index, no hyponatremia, fewer months of HF, fewer prior HF admissions <1 year and a higher patient's self-care confidence. HBI's net benefit further increased in those with fewer comorbidities, a lower self-care confidence or no hyponatremia. Compared with CBI, HBI is likely to be cost-effective in elderly CHF patients with significant comorbidity.
Publisher: Wiley
Date: 14-07-2011
Publisher: Wiley
Date: 13-08-2008
DOI: 10.1111/J.1365-2702.2008.02294.X
Abstract: The aim of this study was to translate from English and evaluate the validity, reliability and cultural relevance of the Cardiovascular Limitations and Symptoms Profile (CLASP) as a health-related quality-of-life (HRQL) measure in Chinese patients with coronary heart disease. Improvement in HRQL is increasingly used as a primary outcome in determining the treatment benefit using a generic instrument. However, disease-specific instruments are being cited as more responsive and sensitive in detecting even the smallest changes in health status. Therefore, valid and reliable disease-specific measures for patients with coronary heart disease are now being developed and evaluated. Questionnaire design. The translation equivalence and content validity of the Chinese version of CLASP were evaluated by an expert panel. Measurement performance was tested on a convenience s le of 369 Chinese coronary heart disease patients. The instrument demonstrated good content validity (content validity index 0.94), acceptable internal consistency (>0.70), except for two subscales of angina and tiredness and significant positive correlations among the subscales of CLASP, Hospital Anxiety Depression Scale and the Short Form 36 Health Survey. Principal components analysis revealed nine factors that together explained 69% of the variance. The results of this study support that CLASP is a valid and reliable disease-specific health status measure for Chinese patients with coronary heart disease. However, further item modifications and testings are needed when considering the cross-cultural context. The use of disease-specific HRQL measures could effectively evaluate nursing interventions in clinical practice. Further validations of CLASP among different diagnostic groups, such as patients with heart failure and those who have survived an acute myocardial infarction, would provide further empirical support for its use with all patients with heart disorders.
Publisher: Elsevier BV
Date: 1985
DOI: 10.1016/0020-7489(85)90008-2
Abstract: This study was designed as an approximate replication of a recent Canadian study on a s le of 20 nurses from the coronary care unit of a large teaching hospital in the U.K. Results from this study indicate that knowledge and experience are the two most important factors influencing rapid decision making, and nurses make many rapid decisions in emergency situations prior to seeking medical help. These results are in agreement with those of the original study.
Publisher: Wiley
Date: 13-02-2013
DOI: 10.1002/NUR.21536
Abstract: Matched case-control research designs can be useful because matching can increase power due to reduced variability between subjects. However, inappropriate statistical analysis of matched data could result in a change in the strength of association between the dependent and independent variables or a change in the significance of the findings. We sought to ascertain whether matched case-control studies published in the nursing literature utilized appropriate statistical analyses. Of 41 articles identified that met the inclusion criteria, 31 (76%) used an inappropriate statistical test for comparing data derived from case subjects and their matched controls. In response to this finding, we developed an algorithm to support decision-making regarding statistical tests for matched case-control studies.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.PSYNEUEN.2017.08.008
Abstract: Practices that include yoga asanas and mindfulness-based stress reduction for the management of stress are increasingly popular however, the neurobiological effects of these practices on stress reactivity are not well understood. Many studies investigating the effects of such practices fail to include an active control group. Given the frequency with which people are selecting such interventions as a form of self-management, it is important to determine their effectiveness. Thus, this review investigates the effects of practices that include yoga asanas, with and without mindfulness-based stress reduction, compared to an active control, on physiological markers of stress. A systematic review and meta-analysis of randomised controlled trials published in English compared practices that included yoga asanas, with and without mindfulness-based stress reduction, to an active control, on stress-related physiological measures. The review focused on studies that measured physiological parameters such as blood pressure, heart rate, cortisol and peripheral cytokine expression. MEDLINE, AMED, CINAHL, PsycINFO, SocINDEX, PubMed, and Scopus were searched in May 2016 and updated in December 2016. Randomised controlled trials were included if they assessed at least one of the following outcomes: heart rate, blood pressure, heart rate variability, mean arterial pressure, C-reactive protein, interleukins or cortisol. Risk of bias assessments included sequence generation, allocation concealment, blinding of assessors, incomplete outcome data, selective outcome reporting and other sources of bias. Meta-analysis was undertaken using Comprehensive Meta-Analysis Software Version 3. Sensitivity analyses were performed using 'one-study-removed' analysis. Subgroup analysis was conducted for different yoga and control group types, including mindfulness-based stress reduction versus non-mindfulness-based stress reduction based interventions, different populations, length of intervention, and method of data analysis. A random-effects model was used in all analyses. Forty two studies were included in the meta-analysis. Interventions that included yoga asanas were associated with reduced evening cortisol, waking cortisol, ambulatory systolic blood pressure, resting heart rate, high frequency heart rate variability, fasting blood glucose, cholesterol and low density lipoprotein, compared to active control. However, the reported interventions were heterogeneous. Practices that include yoga asanas appear to be associated with improved regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system in various populations.
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.IJNURSTU.2010.12.004
Abstract: To review the diagnostic accuracy of end-tidal carbon dioxide detection in detecting inadvertent airway intubation and verifying correct placement of nasogastric tubes. We undertook a meta-analysis of diagnostic studies. All clinical trials that evaluated the diagnostic accuracy of the colorimetric capnometry or capnography in detecting inadvertent airway intubation and differentiating between respiratory and gastrointestinal tube placement in adults were included. Electronic databases including MEDLINE, CINAHL, EMBASE, All EBM Reviews, WanFang Data, China Journal Net, Chinese Medical Current Contents, and Index to Chinese Periodical Literature were searched from inception to July 2009. DATA EXTRACTION AND QUALITY ASSESSMENT: Data were extracted using a form piloted prior to use. Two reviewers independently extracted data relating to purpose of the trial, s le, measurements used, index test results and reference standard. Methodological quality of eligible trials was assessed independently by two reviewers using a modified version of the Quality Assessment of Diagnostic Accuracy Studies for assessing studies of diagnostic accuracy. The accuracy of diagnostic tests is presented in terms of sensitivity, specificity, predictive values, and likelihood ratios. Nine clinical trials were eligible for inclusion in the meta-analysis. Eight trials were undertaken in intubated and mechanically ventilated patients and two trials also involved participants who were alert or awake. Eight involving a total of 456 nasogastric feeding tube placements investigated the diagnostic accuracy of either colorimetric capnometry or capnography to detect feeding tube placement. One trial involving 195 gastric tube insertions compared the diagnostic accuracy of simultaneous use of a colorimetric carbon dioxide detector and capnography to detect feeding tube placement. The use of colorimetric capnometry or capnography had a sensitivity ranging from 0.88 to 1.00, specificity 0.95 to 1.00, positive likelihood ratio 15.22 to 283.35, negative likelihood ratio 0.01 to 0.25. A summary receiver operator characteristics (SROC) curve was constructed and showed an area under the curve was 0.9959. Three trials reported significant cost savings using end-tidal carbon dioxide detectors. There is evidence to support the use of capnography or colorimetric capnometry for the identification of nasogastric feeding tube placement in mechanically ventilated patients.
Publisher: SAGE Publications
Date: 2021
Publisher: Wiley
Date: 08-2001
DOI: 10.1046/J.1467-789X.2001.00037.X
Abstract: Recent years have seen a dramatic rise in the prevalence of obesity in many countries, stimulating interest in the health and economic consequences of this phenomenon. In this article, we provide a systematic review of the literature on the medical-care cost burden of obesity. Relevant studies were identified using a computerized search of the medical literature for English-language articles published between 1990 and 2001. The 18 studies that met all criteria for inclusion in the review can be classified as modelling or database studies and further distinguished as cross-sectional or longitudinal in nature. The majority of studies that have been conducted are cross-sectional modelling studies, including 10 studies reporting the burden of obesity to national health systems. These suggest that obesity accounts for 5.5-7.0% of national health expenditures in the United States and 2.0-3.5% in other countries for which estimates have been reported. Other studies highlight the burden of obesity from other perspectives, including employers and health plans, as well as the impact of obesity on future disease risks and associated medical-care costs. Despite various methodological limitations, discussed herein, this body of research leads to the inescapable conclusion that obesity exacts an immense economic toll in various countries throughout the world.
Publisher: Wiley
Date: 11-10-2006
Publisher: Elsevier BV
Date: 07-2020
Publisher: SAGE Publications
Date: 20-09-2017
Abstract: Characterizing how physical and psychological symptoms interact in heart transplant recipients may lead to advances in therapeutic options. This study examined associations between pain and major depression. A cross-sectional study was conducted with adult heart transplant recipients. Pain was measured with the bodily pain domain of the Short Form-36 Health Survey and psychological distress with the Kessler Psychological Distress Scale (K-10). The Mini International Neuropsychiatric Interview, version 6.0, was used to identify participants meeting the criteria for major depression. Hierarchical linear regression was used to determine if there was an association between pain and major depression, controlling for pharmacological treatment of depression, severity of psychological distress, and clinical characteristics including immunosuppression medication which may induce pain as a side effect. Average pain score of the 48 heart transplant recipients was 43 ( SD ± 10, range 0–100, lower scores indicate worse pain), with moderate pain reported by 39% ( n = 19). Major depression was associated with worse pain ( R 2 change = 36%, β = −16, 95% confidence interval [CI] = [−30, −4], p = .012). Pharmacological treatment for depression was associated with better pain scores ( R 2 change = 1.5%, β = 13, 95% CI [4, 23], p = .006). Heart transplant recipients with major depression had worse pain after controlling for pharmacological treatment of depression, severity of psychological distress, and clinical characteristics. Thus, it is imperative that clinicians devising a treatment regimen for pain in heart transplant recipients take into account co-occurring depression and vice versa.
Publisher: Wiley
Date: 03-2001
DOI: 10.1038/OBY.2001.23
Abstract: To assess the relationship between body mass index (BMI) and future healthcare costs. We undertook a retrospective cohort study of the relationship between obesity and future healthcare costs at Kaiser Permanente Northwest Division, a large health maintenance organization in Portland, Oregon. Study subjects (n = 1286) consisted of persons who responded to a 1990 health survey that was mailed to a random s le of adult Kaiser Permanente Northwest Division members who were 35 to 64 years of age had a BMI > or = 20 kg/m(2) (based on self-reported height and weight) did not smoke cigarettes and did not have a history of coronary heart disease, stroke, human immunodeficiency virus, or cancer. Subjects were stratified according to their BMI in 1990 (20 to 24.9, 25 to 29.9, and > or = 30 kg/m(2) n = 545, 474, and 367, respectively). We then tallied their costs (in 1998 US dollars) for all inpatient care, outpatient services, and prescription drugs over a 9-year period (1990 through 1998). For persons with BMIs of 20 to 24.9 kg/m(2), mean (+/-SE) annual costs of prescription drugs, outpatient services, inpatient care, and all medical care averaged $261 (+/-18), $848 (+/-59), $532 (+/-85), and $1631 (+/-120), respectively, over the study period. Cost ratios (95% confidence intervals) for persons with BMIs of 25 to 29.9 kg/m(2) and > or = 30 kg/m(2), respectively, were 1.37 (1.12 to 1.66) and 2.05 (1.62 to 2.55) for prescription drugs, 0.96 (0.83 to 1.13) and 1.14 (0.97 to 1.37) for outpatient services, 1.20 (0.81 to 1.86) and 1.38 (0.91 to 2.14) for inpatient care, and 1.10 (0.91 to 1.35) and 1.36 (1.11 to 1.68) for all medical care. Future healthcare costs are higher for persons who are overweight, especially those with BMIs > or = 30 kg/m(2).
Publisher: Elsevier BV
Date: 04-1998
DOI: 10.1016/S0021-9150(97)00317-1
Abstract: An international survey was conducted to assess public awareness and attitudes to coronary heart disease and to establish the frequency with which certain health-related behaviours are practised in five European countries. Members of the general public (n=5013) in iduals at increased risk of coronary disease (n=2500) patients who had suffered a myocardial infarction (n=1256) and members of their families (n=1249) were interviewed in a study conducted in France, Germany, Italy, Sweden and the United Kingdom. The survey revealed a considerable degree of indifference to coronary heart disease, despite the possession of a reasonable level of knowledge of the risks involved, even among patients who had suffered a myocardial infarction. At the same time, respondents declared themselves satisfied with the quality of advice about coronary health which they obtained from the medical profession and regarded these sources of information as highly credible. In iduals in five European countries therefore possess reasonable levels of knowledge about coronary heart disease. They also have access to sources of heart health information which are perceived as highly credible. Nonetheless, such information has a very limited impact on their practice of health-related behaviours.
Publisher: Informa UK Limited
Date: 11-2006
DOI: 10.1080/13548500500407367
Abstract: The psychometric properties of the Rosenberg Self-Esteem Scale (RSES) as a clinical research instrument for acute coronary syndrome (ACS) patients were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis was conducted on the RSES to establish its psychometric properties in 128 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test-retest reliability of the RSES-TOT (all-items) and RSES-POS sub-scale (positively valenced items) were found to be acceptable. The RSES-NEG sub-scale (negatively valenced items) lacked acceptable internal reliability. The underlying factor structure of the RSES comprised two distinct but related factors, though there was inconsistency in best model fit indices at the 1-week observation point. The use of the RSES as two sub-scales (RSES-POS and RSES-NEG) may be clinically useful in evaluating the influence of this important psychological construct on the health outcomes of patients with ACS. Directions for future research are indicated.
Publisher: Springer Science and Business Media LLC
Date: 19-01-2013
DOI: 10.1007/S11136-012-0345-X
Abstract: To evaluate the psychometric properties of the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey (MOS-SSS-CM) in patients with coronary heart disease (CHD) in mainland China. Measurement performance of the MOS-SSS-CM was tested on a convenience s le of 200 Chinese patients with CHD in a University-affiliated hospital in Xi'an, P. R. China. To establish reliability of the instrument, 40 patients were retested 2 weeks later through telephone interview. The traditional Chinese version of the MOS-SSS was transformed into a simplified Chinese Mandarin version and administered to participants, together with Chinese Mandarin versions of the Short Form-36 item Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). The MOS-SSS-CM had acceptable internal consistency with Cronbach α coefficients of 0.91 for the overall scale and 0.71-0.84 for the four subscales. The high correlation (r = 0.56-0.87) between items and the remainder of the scale provides further evidence of internal consistency. The test-retest reliability was generally acceptable with intraclass correlation coefficients of 0.89 for the overall scale and 0.74-0.88 for the four subscales. There was acceptable concurrent validity with moderate significant correlations (r ≥ 0.3, p < 0.01) between the MOS-SSS-CM and the Chinese Mandarin version of the HADS. Confirmatory factor analysis supported a four-factor structure of the MOS-SSS-CM measuring the self-perceived adequacy of functional support of Chinese patients with CHD. The MOS-SSS-CM is a valid and reliable measure for Chinese Mandarin-speaking patients with CHD.
Publisher: Oxford University Press (OUP)
Date: 17-02-2021
Abstract: The management of cardiovascular patients requires increasingly competent nursing professionals. In Italy, there are no specific postgraduate courses focused on specialist cardiac skills development for nurses. To develop such courses, content incorporating appropriate competencies is required and this study was designed to meet this. To delineate a set of core competencies to develop national educational interventions to ensure cardiac nurses in Italy achieve international standards. A three-round e-Delphi study including a panel of 32 expert cardiac nurses from the UK, Canada, Australia, New Zealand, and Italy was conducted 26 respondents completed all three rounds. The first round sought a list of five competencies from each participant which they were asked to prioritize in Round 2. In Round 3, they were asked to prioritize again with the knowledge of the priorities identified in Round 2. The final list of competencies was those achieving 70% agreement among participants. We identified 14 core competencies spanning a range of areas of competence including technical, interpersonal, health promotion, use of evidence, and management. Only minor differences were evident between the Italian and the international panel regarding the priority given to some core competences, such a leadership and taking patient history. This is the first study in Italy to delineate cardiac nurses' core competencies. As such, it provides a foundation for the development of postgraduate educational programmes for cardiac nurses including competencies that are congruent with international standards.
Publisher: Emerald
Date: 05-07-2013
DOI: 10.1108/TLDR-03-2013-0020
Abstract: This commentary aims to support Carol Walker and Cally Ward's paper by directing readers to work which could guide their practice with older people with learning disabilities and ageing family carers. The paper is a selected review of initiatives to support older people with learning disabilities and their family carers over the past decade. Ex les from the author's personal contacts are used to illustrate the discussion. There are excellent materials to support practice. These include several resources to use directly with people with learning disabilities. However the policy and funding framework of services can stand in the way of people getting good support. It can also make people's lives more difficult, including increasing social isolation. The paper provides the reader with the means to access practical tools, including free web‐based resources.
Publisher: Oxford University Press (OUP)
Date: 27-11-2017
Abstract: Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to investigate whether there was an association between participants’ cardiopulmonary resuscitation training and their practical cardiopulmonary resuscitation test results. This comparative study was conducted at the 2014 EuroHeartCare meeting in Stavanger ( n=133) and the 2008 Spring Meeting on Cardiovascular Nursing in Malmö ( n=85). Participants performed cardiopulmonary resuscitation for three consecutive minutes CPR training manikins from Laerdal Medical®. Data were collected with a questionnaire on demographics and participants’ level of cardiopulmonary resuscitation training. Most participants were female (78%) nurses (91%) from Nordic countries (77%), whose main role was in nursing practice (63%), and 71% had more than 11 years’ experience ( n=218). Participants who conducted cardiopulmonary resuscitation training once a year or more ( n=154) performed better regarding ventilation volume than those who trained less (859 ml vs. 1111 ml, p=0.002). Those who had cardiopulmonary resuscitation training offered at their workplace ( n=161) also performed better regarding ventilation volume (889 ml vs. 1081 ml, p=0.003) and compression rate per minute (100 vs. 91, p=0.04) than those who had not. Our study indicates a positive association between participants’ performance on the practical cardiopulmonary resuscitation test and the frequency of cardiopulmonary resuscitation training and whether cardiopulmonary resuscitation training was offered in the workplace. Large ventilation volumes were the most common error at both measuring points.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.AUCC.2018.08.005
Abstract: Perceived control is strongly associated with health-related quality of life (HRQOL) among patients with chronic conditions, and it is possible to increase perceived control with appropriate intervention. Little is known about the relationship between perceived control and HRQOL in implantable cardioverter defibrillator (ICD) recipients. To determine the relationship of perceived control with quality of life in ICD recipients and to determine predictors of perceived control in this population. A total of 263 ICD recipients (63% male, age 61 ± 14 years) completed the Control Attitude Scale-Revised to measure perceived control and completed self-reported measures on potential correlates of perceived control (i.e., depressive symptoms, anxiety, social support, and ICD concerns). The EuroQol-5D was used to measure HRQOL. Regression analysis was used to determine predictors of perceived control and its relationship to HRQOL, controlling for covariates. Lower perceived control (β = 0.30, p < .01), and higher levels of depression (β = -0.30, p < .01) and anxiety (β = -0.18, p < .05) predicted lower levels of HRQOL. Higher anxiety (β = -0.17, p < .05), higher depression (β = -0.23, p < .05), lower social support (β = 0.26, p < .01), and higher ICD-related concerns (β = -0.16, p < .05) independently predicted lower perceived control. Interventions targeting patients' ICD concerns and psychosocial factors before, and continuing after, ICD insertion are needed to improve ICD recipients' perceived control and, in turn, their HRQOL.
Publisher: Wiley
Date: 07-10-2009
Publisher: Wiley
Date: 27-08-2003
Publisher: Hindawi Limited
Date: 02-08-2020
DOI: 10.1111/JONM.13077
Publisher: Wiley
Date: 07-02-2013
DOI: 10.1111/JOCN.12073
Abstract: To compare the efficacy of chronic heart failure management programmes (CHF-MPs) according to a scoring algorithm used to quantify the level of applied interventions-the Heart Failure Intervention Score (HF-IS). The overall efficacy of heart failure programmes has been proven in several meta-analyses. However, the debate continues as to which components are essential in a heart failure programme to improve patient outcomes. Prospective cohort study of patients participating in heart failure programmes. Forty-eight of 62 (77%) programmes in Australia participating in a national register of CHF-MPs were evaluated using the HF-IS: derived from a summed and weighted score of each intervention applied by the CHF-MP (27 interventions overall). The CHF-MPs were prospectively categorised as relatively low (HF-IS < 190 - n = 39 programmes & 407 patients) or high (HF-IS ≥ 190 - n = 9 programmes & 166 patients) in complexity. Six-month morbidity and mortality rates in 573 consecutively recruited patients with systolic dysfunction and in New York Heart Association Class II-IV were prospectively examined. Patients exposed to CHF-MPs with a high HF-IS had a lower rate of unplanned, all-cause hospitalisation (n = 24, 14% vs. n = 102, 25%) compared with CHF-MPs with a low HF-IS within six months. On an adjusted basis, CHF-MPs with a high HF-IS were associated with a reduced risk of unplanned hospitalisation and/or death within six months and remained event-free longer. High complexity CHF-MPs applying more evidence-based interventions are associated with a higher event-free survival over six months. The HF-IS is an easy-to-use evidence-based tool to assist programme coordinators to improve the quality of their heart failure programme which may also improve patient outcomes.
Publisher: Oxford University Press (OUP)
Date: 02-2008
Publisher: Informa UK Limited
Date: 03-2021
DOI: 10.1080/13548506.2021.1894343
Abstract: Type 2 diabetes is a chronic condition primarily self-managed by the in idual. Mastery is a protective factor linked to better control of chronic conditions, effective self-management and improved medication adherence. Mastery appears increasingly important as treatment regimens and self-management demands become more complex and burdensome. Diabetes distress negatively impacts self-management, glycaemic control and treatment adherence. Understanding the relationship between diabetes distress and mastery may provide opportunities to improve condition management and adherence . This relationship may be impacted by other factors affecting the in idual's perceived sense of control over their condition. This study examined the role of diabetes empowerment and depression in the relationship between diabetes distress and mastery. Data were drawn from a randomised controlled trial of 131 adults with type 2 diabetes transitioning to injection therapy. Participants completed measures of diabetes distress , mastery , depression and empowerment . Diabetes distress and depression were negatively associated with mastery, whilst diabetes empowerment was positively associated . A significant interaction effect (
Publisher: Elsevier BV
Date: 11-2021
Publisher: OSA
Date: 2018
Publisher: Wiley
Date: 05-1998
Publisher: Oxford University Press (OUP)
Date: 29-02-2012
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.JPSYCHORES.2005.06.071
Abstract: The aim of this study is to examine the association between changes in misconceived or maladaptive beliefs about angina and patients' functional and psychological status. The method used was a prospective follow-up study over 1 year of 133 people with angina. Beliefs about angina were significantly associated with functional and psychological status. People with more misconceived or maladaptive beliefs were more anxious and physically limited than were people with fewer such beliefs, with differences in physical functioning that were clinically significant. Change in angina beliefs over 1 year was the most significant predictor for physical functioning at follow-up, after controlling for the effects of demographic variables and the outcome variable at baseline, whereas change in the frequency of angina did not contribute significantly to this model. Misconceived and maladaptive beliefs about angina are associated with reductions in both functional and psychological status. These beliefs are easily and quickly identified using a simple questionnaire and should be corrected.
Publisher: SAGE Publications
Date: 09-1999
Publisher: Elsevier BV
Date: 02-2021
Publisher: Frontiers Media SA
Date: 05-12-2017
Publisher: S. Karger AG
Date: 15-12-2023
DOI: 10.1159/000528624
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.PEC.2013.02.017
Abstract: Clinicians worldwide seek to educate and support heart failure patients to engage in self-care. We aimed to describe self-care behaviors of patients from 15 countries across three continents. Data on self-care were pooled from 5964 heart failure patients from the United States, Europe, Australasia and South America. Data on self-care were collected with the Self-care of Heart Failure Index or the European Heart Failure Self-care Behavior Scale. In all the s les, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 s les, more than 50% of the patients reported low exercise levels. In 16 s les, less than half of the patients weighed themselves regularly, with large differences among the countries. Self-care with regard to receiving an annual flu shot and following a low sodium diet varied most across the countries. Self-care behaviors are sub-optimal in heart failure patients and need to be improved worldwide. Interventions that focus on specific self-care behaviors may be more effective than general educational programs. Changes in some health care systems and national policies are needed to support patients with heart failure to increase their self-care behavior.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.APNR.2016.07.015
Abstract: The aim of this study was to assess the validity and reliability of psychological screening tools in outpatient heart transplant recipients. Forty-eight heart transplant recipients completed the Patient Health Questionnaire 9-item scale (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Kessler Psychological Distress 10-item Scale (K-10) and Medical Outcomes Short Form 36-item Health Survey. A structured psychological interview (Mini International Neuropsychiatric Interview Version 6) was conducted after completion of the questionnaires. Internal consistency, criterion validity and construct validity of the PHQ-9, GAD-7 and K-10 were evaluated. Internal consistency supported the reliability of the screening tools. The optimal cut-off on the PHQ-9 for depression was 10 (sensitivity=0.86 specificity=0.93). A score of 6 on the GAD-7 maximized sensitivity (0.75) and specificity (0.89) for anxiety. A score of 17 on the K-10 was the optimal cut-off for diagnosis of either anxiety or depression (sensitivity=0.83 specificity=0.84). Increasing scores on the screening tools were associated with lower health-related quality of life. Psychometric analyses support the reliability and validity of the PHQ-9, GAD-7 and K-10 as screening tools for detection of anxiety and depression in heart transplant recipients.
Publisher: Springer Science and Business Media LLC
Date: 02-02-2017
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.HRTLNG.2019.04.008
Abstract: Health practitioners' values, attitudes and beliefs largely determine their referrals to cardiac rehabilitation (CR). To develop and test the Recommending Cardiac Rehabilitation scale (ReCaRe), designed to assess health professionals attitudes, values and beliefs to CR referral. ReCaRe was appraised for: content validity (Delphi method, expert panel) interpretability and face validity (interview, health professionals) factor structure and internal consistency (survey, health professionals) and test-retest reliability (survey, health professionals). Normative scores were collated. ReCaRe initially comprised 75 items. Initially, a Content Validity Index (CVI) was calculated for ratings of item relevance (CVI range 0.27-1.0), which resulted in the removal of 19 items. After preliminary validation and psychometric testing, 34 items were factor-analysed (n = 24) providing a 17-item, four-factor scale: perceived severity and susceptibility (α = 0.93, κ = 0.37) perceived service accessibility (α = 0.91, κ = 0.67) perceived benefit (α = 0.97, κ = 0.47) perceived barriers and attitudes (α = 0.82, κ = 0.49). ReCaRe normative scores (n = 75) are reported. This psychometric analysis found ReCaRe to demonstrate good face validity, internal consistency and fair to substantial test-retest reliability. The next step is to validate these initial findings on a larger s le size to confirm whether ReCaRe can enable identification of factors impacting CR referral.
Publisher: Elsevier BV
Date: 03-2007
DOI: 10.1016/J.NEPR.2006.06.006
Abstract: This paper examines the typical and varying routes to doctoral degrees in the UK and other developed countries. It raises the important question of whether university schools of nursing should offer a whole range of options with the potential for sub-optimal higher degree training and therefore "mediocre" academics, or resist the "path of least resistance" and offer more limited pathways that ensure that only the highest quality training and candidates are associated with what should be the pinnacle of the profession. As such, it seeks to clarify which of the commonly offered routes to doctoral degrees might be most suited to the academic integrity and value of the profession to our patients and the health care system.
Publisher: Elsevier BV
Date: 1986
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.HRTLNG.2019.04.006
Abstract: Recent guidelines highlight the need for clinician-patient discussions regarding end-of-life (EOL) choices prior to implantable cardioverter defibrillator (ICD) implantation. Health literacy could affect the quality and quantity of such discussions. Our objective was to determine the association of health literacy with experiences, attitudes, and knowledge of the ICD at EOL. In this cross-sectional study, we used validated instruments to measure health literacy and patient experiences, attitudes, and knowledge of the ICD at EOL. Of the 240 ICD recipients, 76% of participants reported never having discussed the implications of a future withdrawal of defibrillation therapy with their healthcare provider. Increased odds of choosing to maintain defibrillation therapy were associated with female gender and lower ICD knowledge. From patients' perspectives, EOL discussions with providers were minimal. Most patients hold misperceptions about ICD function that could interfere with optimal EOL care, particularly for those with inadequate health literacy.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2008
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.HRTLNG.2014.05.001
Abstract: To investigate the factors that influence medication adherence in Chinese community-dwelling older adults with hypertension. A cross-sectional study was conducted with a convenience s le of 382 older adults with hypertension recruited from six health centers in Macao, China. Chinese versions of the Morisky 4-Item Self-Report Measure of Medication-Taking Behavior, Fear of Intimacy with Helping Professionals scale and Exercise of Self-care Agency scale were administered to participants. Participants older than 65 years (β = .118, p = .017), with a low level of education (β = .128, p = .01), who had more than one other common disease (β = .120, p = .015), were on long-term medication (β = .221, p < .001) and who reported higher self-care (β = .188, p = .001), had better medication adherence. Health care professionals should consider these factors when planning medication regimens for Chinese older adults with hypertension, to enhance medication adherence and improve patient outcomes.
Publisher: Wiley
Date: 18-08-2004
Publisher: Elsevier BV
Date: 12-2002
DOI: 10.1016/S0022-3999(02)00344-6
Abstract: To examine the characteristics, subsequent resource use and outcome of a consecutive cohort of admissions with acute chest pain not due to myocardial infarction. Subjects (N=356) identified in the course of a epidemiological study of myocardial infarction were interviewed and completed HAD, SF-36 and other self-report information in hospital and at 3 months and 1 year. Hospital casenotes were reviewed at 1 year. A total of 218 subjects were given cardiac diagnoses and 138 noncardiac diagnoses. Cardiac subjects were more distressed and disabled and used more resources. Those in the noncardiac group reported distress and disability and resource use comparable to infarct admissions. Awareness of psychosocial variables would aid in the assessment and management of those with and without ischaemic heart disease.
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1080/01612840590959452
Abstract: This study describes the psychological problems of heart transplant recipients. Using a qualitative research approach, interviews were conducted with 42 patients(35 men and 7 women). Analysis of the data revealed concerns about the donor's heart and how receiving somebody else's heart might affect the recipient's own personality feelings of guilt for the donor's death and feelings of gratitude towards the donor's family and concerns about the recipient's own heart. These findings provide health care professionals with pointers that may aid improved information provision and maximise the use of existing coping strategies.
Publisher: Elsevier BV
Date: 03-2008
Publisher: Oxford University Press (OUP)
Date: 09-2006
DOI: 10.1016/J.EJCNURSE.2006.04.002
Abstract: The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe. A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes and a survey to describe the content in countries where at least 30% of the hospitals had a programme. Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding. Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries.
Publisher: Springer Science and Business Media LLC
Date: 2010
DOI: 10.1007/S11936-009-0053-1
Abstract: Heart failure (HF) self-care relates to the decisions made outside clinical settings by the in idual with HF to maintain life, healthy functioning, and well-being. The people who help patients most (ie, caregivers/family members) should be involved in care, and general principles of health behavior change should be used to guide support. Medicines should be prescribed with once-daily dosing, with pharmacists providing medication review and support. Pill boxes should be provided and patients' health literacy levels assessed. Psychosocial interventions for smoking cessation should be undertaken. Regular aerobic exercise may benefit patients with mild to moderate HF and some with severe but stable HF therefore, referral to cardiac rehabilitation should be considered. Exercise regimen must take into account patient-related factors, including functional status, comorbid conditions, and patient preferences. Intake of salt, alcohol, and fluid should be restricted, although these steps are supported by limited evidence. Patients should be educated on appropriate sources of help. They should seek help immediately for persistent chest pain, palpitations, syncope, breathlessness at rest, or a weight increase of ≥ 2 lb. Depression, if present, should be addressed with antidepressants (sertraline and citalopram), cognitive behavioral therapy, and regular exercise. HF disease management programs should be offered if available.
Publisher: Oxford University Press (OUP)
Date: 23-11-2012
Publisher: Cambridge University Press (CUP)
Date: 03-2015
DOI: 10.1017/S1355617715000119
Abstract: Although cognitive deficits are common in patients with chronic heart failure (CHF), no study to date has investigated whether these deficits extend to the capacity to execute delayed intentions (prospective memory, PM). This is a surprising omission given the critical role PM plays in correctly implementing many important CHF self-care behaviors. The present study aimed to provide the first empirical assessment of PM function in people with CHF. The key dependent measure was a laboratory measure of PM that closely simulates PM tasks in daily life – Virtual Week. A group comparison design was used, with 30 CHF patients compared to 30 demographically matched controls. Background measures assessing executive functions, working memory, and verbal memory were also administered. The CHF group exhibited significant PM impairment, with difficulties generalizing across different types of PM tasks (event, time, regular, irregular). The CHF group also had moderate deficits on several of the background cognitive measures. Given the level of impairment remained consistent even on tasks that imposed minimal demands on memory for task content, CHF-related difficulties most likely reflects problems with the prospective component. However, exploratory analyses suggest that difficulties with retrospective memory and global cognition (but not executive control), also contribute to the PM difficulties seen in this group. The implications of these data are discussed, and in particular, it is argued that problems with PM may help explain why patient engagement in CHF self-care behaviors is often poor. ( JINS , 2015, 21 , 1–10)
Publisher: Wiley
Date: 02-2004
DOI: 10.1348/135910704322778696
Abstract: This study was designed to validate the Cardiac Depression Scale (CDS) in a UK cardiac population. A battery of questionnaires (the Medical Outcomes Study Short-Form 36 [SF-36] Health Survey, the Beck Depression Inventory [BDI], the Hospital Anxiety and Depression Scale [HADS] and the Cardiac Depression Scale [CDS]) was mailed to 487 in iduals with coronary heart disease (CHD) recruited from cardiac support groups. The process was repeated on a subs le of 80 participants four-six weeks later for the purpose of test-retest analysis. The response rate from the first administration was 81% and from the test-retest subs le 54%. Factor analysis revealed a one-factor solution with a high internal reliability (Cronbach's alpha = 0.93) and an acceptable test-retest reliability (0.79). Concurrent validation against the SF-36, BDI and HADS demonstrated strong correlations. The CDS is both a reliable and sensitive instrument for measuring depression in cardiac patients.
Publisher: Wiley
Date: 10-1995
DOI: 10.1046/J.1365-2648.1995.22040707.X
Abstract: The purpose of this study was to explore any patterns that may be evident in the experiences of 20 patients and their partners 1 month after a first heart attack. An interpretive research approach was used to illuminate the illness experience of patients and its impact on their partners. Semi-structured interviews were conducted with the participants, and qualitative analysis of the data revealed six major categories. These were: expectations about advice and information feelings about the future reactions of the partner playing down the significance of the heart attack wanting to get back to normal and the effect on the couple's relationship. These findings are discussed in relation to the theoretical literature and other empirical research. The results of this study may provide pointers to the implications for practice of nurses, particularly on ways to improve support for patients and their partners during early convalescence.
Publisher: Springer Science and Business Media LLC
Date: 29-04-2015
Publisher: BMJ
Date: 25-10-2018
DOI: 10.1136/BMJ.K4270
Publisher: Elsevier BV
Date: 07-2014
Publisher: Wiley
Date: 06-03-2008
DOI: 10.1111/J.1365-2753.2007.00863.X
Abstract: Patient-reported outcomes such as health-related quality of life (HRQL) describe or characterize what patients have experienced as a result of their health care. However, treatment outcome comparisons among different pure or mixed populations of patients with myocardial infarction, angina or heart failure cannot be made using existing coronary heart disease (CHD)-specific HRQL instruments. The aim of this study was to evaluate the psychometric properties of the Chinese version of the MacNew in a cohort of Hong Kong patients diagnosed with CHD. Chinese translations of a CHD-specific HRQL instrument, the MacNew Heart Disease HRQL questionnaire (MacNew), the Short-form 36 Health Survey and the Hospital Anxiety and Depression Scale were administered to 365 Chinese-speaking patients with CHD at baseline and again 3 months later (n = 363). The Medical Outcomes Trust Scientific Advisory Committee criteria were used to examine the psychometric properties of the Chinese MacNew Heart Disease HRQL questionnaire. The results warrant recommending the use of the MacNew as an outcome measure to enhance treatment evaluation in Chinese patients with CHD and a diagnosis of myocardial infarction, angina or heart failure, substantiating previous psychometric data on the MacNew in a number of different studies in patients speaking seven different languages. The MacNew questionnaire may have value as a core CHD questionnaire for treatment outcome comparisons among pure or mixed populations of patients with myocardial infarction, angina or heart failure.
Publisher: Wiley
Date: 10-06-2008
Publisher: Wiley
Date: 17-02-2005
DOI: 10.1016/J.EJHEART.2004.10.008
Abstract: Few studies have examined the potential benefits of specialist nurse-led programs of care involving home and clinic-based follow-up to optimise the post-discharge management of chronic heart failure (CHF). To determine the effectiveness of a hybrid program of clinic plus home-based intervention (C+HBI) in reducing recurrent hospitalisation in CHF patients. CHF patients with evidence of left ventricular systolic dysfunction admitted to two hospitals in Northern England were assigned to a C+HBI lasting 6 months post-discharge (n=58) or to usual, post-discharge care (UC: n=48) via a cluster randomization protocol. The co-primary endpoints were death or unplanned readmission (event-free survival) and rate of recurrent, all-cause readmission within 6 months of hospital discharge. During study follow-up, more UC patients had an unplanned readmission for any cause (44% vs. 22%: P=0.019, OR 1.95 95% CI 1.10-3.48) whilst 7 (15%) versus 5 (9%) UC and C+HBI patients, respectively, died (P=NS). Overall, 15 (26%) C+HBI versus 21 (44%) UC patients experienced a primary endpoint. C+HBI was associated with a non-significant, 45% reduction in the risk of death or readmission when adjusting for potential confounders (RR 0.55, 95% CI 0.28-1.08: P=0.08). Overall, C+HBI patients accumulated significantly fewer unplanned readmissions (15 vs. 45: P<0.01) and days of recurrent hospital stay (108 vs. 459 days: P<0.01). C+HBI was also associated with greater uptake of beta-blocker therapy (56% vs. 18%: P<0.001) and adherence to Na restrictions (P<0.05) during 6-month follow-up. This is the first randomised study to specifically examine the impact of a hybrid, C+HBI program of care on hospital utilisation in patients with CHF. Its beneficial effects on recurrent readmission and event-free survival are consistent with those applying either a home or clinic-based approach.
Publisher: Oxford University Press (OUP)
Date: 23-10-2013
Abstract: To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined with the increasing opportunities and challenges in multidisciplinary research, the Science Committee of the Council on Cardiovascular Nursing and Allied Professionals (CCNAP) recognised the need for a position statement to guide researchers, policymakers and funding bodies to contribute to the advancement of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given.
Publisher: Wiley
Date: 20-12-2006
Publisher: Wiley
Date: 2005
Publisher: Oxford University Press (OUP)
Date: 19-05-2021
Abstract: Although systematic reviews are the method of choice to synthesize scientific evidence, they can take years to complete and publish. Clinicians, managers, and policy-makers often need input from scientific evidence in a more timely and resource-efficient manner. For this purpose, rapid reviews are conducted. Rapid reviews are performed using an accelerated process. However, they should not be less systematic than standard systematic reviews, and the introduction of bias must be avoided. In this article, we describe what rapid reviews are, present their characteristics, give some ex les, highlight potential pitfalls, and draw attention to the importance of evidence summaries in order to facilitate adoption in clinical decision-making.
Publisher: Wiley
Date: 13-01-2013
DOI: 10.1111/JAN.12021
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.JVS.2011.12.019
Abstract: Compression therapy is not common for venous leg ulcer patients in Hong Kong. This randomized controlled trial compared the clinical effectiveness of compression bandaging using four-layer bandaging (4LB) or short-stretch bandaging (SSB) and usual care (moist wound healing dressing without compression). The 24-week study looked at venous leg ulcer patients aged >60 years in a community setting. The primary parameter was time to ulcer healing. Secondary parameters were ulcer area and pain reduction comparing week 0 (start) vs week 24 (end), measuring results per group and between groups. Intention-to-treat analysis involved descriptive statistics, survival analysis, and repeated measures analysis of variance. The log-rank test was used for univariable analysis. All withdrawn patients had a negative outcome score over the whole study duration. Of 321 patients who received randomized treatment, 45 (14%) did not complete the 24-week study period. At 24 weeks, Kaplan-Meier analysis on healing time was statistically significant (P < .001) in favor of the compression groups. The mean (SD) healing time in the SSB group (9.9 [0.77]) was shorter than that of the 4LB group (10.4 [0.80]) and the usual care group (18.3 [0.86]). Pain reduction was significant (P < .001) for the compression-treated groups only. Compression bandaging was more effective than usual care without compression. Both compression systems were safe and feasible for venous ulcer patients in a community setting in Hong Kong.
Publisher: Springer Science and Business Media LLC
Date: 26-01-2006
Abstract: The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression. Recent studies of the HADS in coronary heart disease (CHD) patients in European countries suggest it comprises three, rather than two, underlying sub-scale dimensions. The factor structure of the Chinese version of the HADS was evaluated in patients with CHD in mainland China. Confirmatory factor analysis (CFA) was conducted on self-report HADS forms from 154 Chinese CHD patients. Little difference was observed in model fit between best performing three-factor and two-factor models. The current observations are inconsistent with recent studies highlighting a dominant underlying tri-dimensional structure to the HADS in CHD patients. The Chinese version of the HADS may perform differently to European language versions of the instrument in patients with CHD.
Publisher: Wiley
Date: 2006
DOI: 10.1002/GPS.1611
Abstract: To compare the perception of quality of life (QoL) between depressed and non-depressed Chinese older people in Hong Kong and examined the factors that influence this perception. A cross-sectional study was conducted with a convenience s le of 80 older people with a diagnosis of depression and 179 non-depressed controls. The depressed group had a lower rating in perceived QoL in all aspects than the non-depressed group. Level of depression and functional abilities were predictors of quality of life ratings for the both groups and activities of daily living was the predictor of quality of life for the depressed group only. The study identified the subjective perception of QoL amongst depressed older people is significantly lower than that amongst non-depressed older people. Depression affects the bio-psychosocial status of Chinese older people. This study provides insight for healthcare professionals in planning innovative services to meet their health needs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2011
Publisher: Wiley
Date: 06-08-2009
DOI: 10.1111/J.1365-2702.2009.02807.X
Abstract: To evaluate further the psychometric properties of the Chinese version of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for anxiety and depression in Chinese patients with coronary heart disease in Xian, China. There is considerable evidence that anxiety and depression are common in patients with coronary heart disease (CHD) and are associated with increased morbidity and mortality. A valid, reliable and sensitive screening tool that can be used readily on this group of patients would be useful for assessment, intervention and outcome evaluation. A single group, cross-sectional study. Measurement performance was tested on 314 Chinese patients with coronary heart disease and repeated on 173 of them two weeks later. The Chinese version of HADS (C-HADS) had acceptable internal consistency and test-retest reliability, with a Cronbach alpha of 0.85 and intraclass correlation coefficient of 0.90, respectively. There was acceptable concurrent validity with significant (p < 0.05) correlations between the anxiety and depression subscales of the C-HADS and CHD patients' perceived health status as measured by the Chinese Mandarin version of the Short Form-36 health survey (CM:SF-36). Principal components analysis revealed a three-factor solution accounting for 53% of the total variance. The three underlying sub-scale dimensions are depression, psychic anxiety and psychomotor anxiety. The responsiveness of the C-HADS was also satisfactory with significant correlation between the changes in the C-HADS score and the changes in the Mental Health domain of the CM:SF-36 (p < 0.01). Finally, over one-third of the patients demonstrated psychological distress. Conclusion. Empirical data support the C-HADS as a reliable and valid screening instrument for the assessment of anxiety and depression in Chinese-speaking patients with CHD. A tri-dimensional scoring approach should be considered as potentially clinically useful for this group of patients. The C-HADS can guide and evaluate the delivery of psychological care for Chinese patients with CHD.
Publisher: FapUNIFESP (SciELO)
Date: 2023
Publisher: Elsevier BV
Date: 11-2014
Publisher: American Medical Association (AMA)
Date: 05-1996
Publisher: Wiley
Date: 18-02-2014
DOI: 10.1111/INR.12091
Abstract: Hospital and home-based cardiac rehabilitation programmes improve the health outcomes of cardiac patients. Both types of programmes include patient education as a core component. However, many patients do not attend cardiac rehabilitation programmes for a variety of reasons. In Singapore, where cardiac rehabilitation is comparatively uncommon, patient education is usually delivered face-to-face by healthcare professionals because educational materials designed specifically for cardiac patients recovering at home are not available. This paper describes the development of a patient education booklet designed to aid recovery at home after a myocardial infarction in Singapore. The conception and development of this evidence-based Heart Recovery Education Booklet was based on patient need and current clinical guidelines pertaining to cardiac rehabilitation and planned in consultation with specialists such as cardiologists, psychiatrists and physiotherapists. The booklet is a patient resource to aid recovery at home after an myocardial infarction. It is interactive, based on identified need and aims to guide and assist the patient in performing their usual activities of daily living and adhering to treatment regimens, including exercise. This booklet is a resource for patients with myocardial infarction and healthcare professionals and its effectiveness in improving health-related quality of life, psychological status and coronary risk profile is to be tested in a randomized controlled trial. Policy makers in health and nursing must find ways of developing and implementing cardiac rehabilitation programmes that aid recovery from myocardial infarction. This education booklet offers one way to do this.
Publisher: Elsevier BV
Date: 08-2013
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2013
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Funder: National Health and Medical Research Council
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Funder: Australian Catholic University
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Funder: Department of Health
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Funder: National Heart Foundation of Australia
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Funder: Lee Hysan Foundation
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Funder: Health and Health Services Research Fund
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Funder: National Heart Foundation of Australia: Beyond Blue
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Funder: National Health and Medical Research Council
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Funder: Australian Catholic University
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Funder: National Health and Medical Research Council
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Funder: Australian Catholic University
View Funded ActivityStart Date: 2013
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Funder: National Health and Medical Research Council
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Funder: National Heart Foundation of Australia
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Funder: Australian Catholic University
View Funded ActivityStart Date: 2018
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Funder: Interreg
View Funded ActivityStart Date: 2018
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Funder: Department of Health, State Government of Victoria
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Funder: Northern Ireland Chest Heart and Stroke
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Funder: Research Grants Council
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Funder: HCF Research Foundation
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