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Sun CX, Ni XY, Gui SJ, Wu F, Pan RJ, Gui M, Lei XH, Wang MY, Li XS, Zeng GQ. Effects of an explain-simulate-practice-communicate-support intervention on quality of life for patients with chronic heart failure: A randomized control trial. Heliyon 2024; 10:e25313. [PMID: 38333861 PMCID: PMC10850896 DOI: 10.1016/j.heliyon.2024.e25313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Background Patients with New York Heart Association (NYHA) grade III chronic heart failure (CHF) present with low capacity for daily activities, severe self-perceived burden, and poor quality of life. Effective nursing interventions may reduce patients' self-perceived burden and improve their quality of life. Objectives To explore the effects of an explain-simulate-practice-communicate-support intervention on the self-perceived burden, cardiac function, and activities of daily living (ADL) ability in patients with New York Heart Association grade III chronic heart failure. Methods Of the 100 patients with New York Heart Association grade III chronic heart failure who were electronically randomized and equally divided into control and intervention groups, data from 88 patients who completed our study were analyzed. The primary outcome was quality of life; secondary outcomes were self-perceived burden, 6-min walking test distances, serum N-terminal pro-brain natriuretic peptide levels, New York Heart Association cardiac function classification, and ability to perform activities of daily living. Results After 12 weeks' intervention, the intervention group had significantly lower self-perceived burden, Minnesota Living with Heart Failure Questionnaire scores, N-terminal pro-brain natriuretic peptide levels, and New York Heart Association grades compared with the control group, while 6-min walking test distances, left ventricular ejection fraction, and modified Barthel Index scale scores were significantly higher than those in the control group (P > 0.05). Conclusions The explain-simulate-practice-communicate-support intervention improved patients' quality of life through reducing the level of self-perceived burden, and improving cardiac function and activities of daily living ability. This intervention was found to be effective for patients with New York Heart Association grade III chronic heart failure.
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Affiliation(s)
- Cai-Xia Sun
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
| | - Xiao-Yan Ni
- The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Si-Jie Gui
- The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Fei Wu
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
| | - Rong-Jia Pan
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Min Gui
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiu-Hong Lei
- The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Man-Yi Wang
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiao-Shan Li
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Gu-Qing Zeng
- The First Affiliated Hospital, School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Joint Training Base for Nursing Postgraduates By University of South China and TD Care, Intelligent Nursing Research Center of Hunan Province, Hengyang, Hunan, 421001, China
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A Comprehensive Risk Score to Predict Prolonged Hospital Length of Stay After Heart Transplantation. Ann Thorac Surg 2017; 105:83-90. [PMID: 29100644 DOI: 10.1016/j.athoracsur.2017.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/30/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prolonged hospital length of stay (PLOS) after heart transplantation increases cost and morbidity. To better inform care, we developed a risk score to identify patients at risk for PLOS after heart transplantation. METHODS We queried the United Network for Organ Sharing Scientific Registry of Transplant Recipients database for adult patients who underwent isolated heart transplantation from 2003 to 2012. The population was randomly divided into a derivation cohort (80%) and a validation cohort (20%). The outcome of interest was PLOS, defined as a posttransplant hospital length of stay of more than 30 days. Associated univariables (p < 0.20) in the derivation cohort were included in a multivariable model, and a risk index was derived from the adjusted odds ratios of significant covariates. RESULTS During the study period, 16,723 patients underwent heart transplantation with an average PLOS of 19 ± 21 days, and 2,020 orthotopic heart transplant recipients (12%) had PLOS. Baseline characteristics were similar between the derivation and validation cohorts. Twenty-four recipient and nine donor variables, cold ischemic time, and center volume were tested as univariables. Seventeen covariates significantly affected PLOS and comprised the prolonged hospitalization after heart transplant risk score, which was stratified into three risk groups. The risk model was subsequently validated, and predicted rates of PLOS correlated well with observed rates (R = 0.79). Rates of PLOS in the validation cohort were 8.3%, 11%, and 22% for low, moderate, and high risk groups, respectively. CONCLUSIONS The risk of PLOS after heart transplantation can be determined at the time of transplant. The prolonged hospitalization after heart transplant score may lead to individualized postoperative management strategies to reduce duration of hospitalization for patients at high risk.
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Simultaneous total cavopulmonary connection and cardiac re-synchronisation therapy. Cardiol Young 2017; 27:1235-1238. [PMID: 28318481 DOI: 10.1017/s1047951117000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report the simultaneous use of cardiac re-synchronisation therapy and total cavopulmonary connection in a patient with dyssynchrony, wide QRS, and cardiac failure. To our knowledge, this simultaneous approach has not been reported previously. On follow-up, we noted that QRS width and brain natriuretic peptide levels improved. In addition, speckle tracking revealed improved synchronisation of ventricular wall motion.
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Han Z, Chen Z, Lan R, Di W, Li X, Yu H, Ji W, Zhang X, Xu B, Xu W. Sex-specific mortality differences in heart failure patients with ischemia receiving cardiac resynchronization therapy. PLoS One 2017; 12:e0180513. [PMID: 28683134 PMCID: PMC5500352 DOI: 10.1371/journal.pone.0180513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/18/2017] [Indexed: 01/01/2023] Open
Abstract
Background Recent studies have reported prognosis differences between male and female heart failure patients following cardiac resynchronization therapy (CRT). However, the potential clinical factors that underpin these differences remain to be elucidated. Methods A meta-analysis was performed to investigate the factors that characterize sex-specific differences following CRT. This analysis involved searching the Medline (Pubmed source) and Embase databases in the period from January 1980 to September 2016. Results Fifty-eight studies involving 33445 patients (23.08% of whom were women) were analyzed as part of this study. Only patients receiving CRT with follow-up greater than six months were included in our analysis. Compared with males, females exhibited a reduction of 33% (hazard ratio, 0.67; 95% confidence interval, 0.62–0.73; P < 0.0001) and 42% (hazard ratio, 0.58; 95% confidence interval, 0.46–0.74; P = 0.003) in all-cause mortality and heart failure hospitalization or heart failure, respectively. Following a stratified analysis of all-cause mortality, we observed that ischemic causes (p = 0.03) were likely to account for most of the sex-specific differences in relation to CRT. Conclusion These data suggest that women have a reduced risk of all-cause mortality and heart failure hospitalization or heart failure following CRT. Based on the results from the stratified analysis, we observed more optimal outcomes for females with ischemic heart disease. Thus, ischemia are likely to play a role in sex-related differences associated with CRT in heart failure patients. Further studies are required to determine other indications and the potential mechanisms that might be associated with sex-specific CRT outcomes.
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Affiliation(s)
- Zhonglin Han
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Zheng Chen
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Rongfang Lan
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Wencheng Di
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Xiaohong Li
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Hongsong Yu
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Wenqing Ji
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Xinlin Zhang
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Biao Xu
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
| | - Wei Xu
- Department of Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
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van der Bijl P, Khidir M, Leung M, Mertens B, Ajmone Marsan N, Delgado V, Bax JJ. Impact of QRS complex duration and morphology on left ventricular reverse remodelling and left ventricular function improvement after cardiac resynchronization therapy. Eur J Heart Fail 2017; 19:1145-1151. [DOI: 10.1002/ejhf.769] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/21/2016] [Accepted: 12/29/2016] [Indexed: 12/21/2022] Open
Affiliation(s)
- Pieter van der Bijl
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Mand Khidir
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Melissa Leung
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Bart Mertens
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Nina Ajmone Marsan
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Victoria Delgado
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
| | - Jeroen J. Bax
- The Department of Cardiology, Heart Lung Centre; Leiden University Medical Centre; Albinusdreef 2 2300 RC Leiden the Netherlands
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Hatfield LA, Kramer DB, Volya R, Reynolds MR, Normand SLT. Geographic and Temporal Variation in Cardiac Implanted Electric Devices to Treat Heart Failure. J Am Heart Assoc 2016; 5:e003532. [PMID: 27468928 PMCID: PMC5015279 DOI: 10.1161/jaha.116.003532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/05/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cardiac implantable electric devices are commonly used to treat heart failure. Little is known about temporal and geographic variation in use of cardiac resynchronization therapy (CRT) devices in usual care settings. METHODS AND RESULTS We identified new CRT with pacemaker (CRT-P) or defibrillator generators (CRT-D) implanted between 2008 and 2013 in the United States from a commercial claims database. For each implant, we characterized prior medication use, comorbidities, and geography. Among 17 780 patients with CRT devices (median age 69, 31% women), CRT-Ps were a small and increasing share of CRT devices, growing from 12% to 20% in this study period. Compared to CRT-D recipients, CRT-P recipients were older (median age 76 versus 67), and more likely to be female (40% versus 30%). Pre-implant use of β-blockers and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers was low in both CRT-D (46%) and CRT-P (31%) patients. The fraction of CRT-P devices among all new implants varied widely across states. Compared to the increasing national trend, the share of CRT-P implants was relatively increasing in Kansas and relatively decreasing in Minnesota and Oregon. CONCLUSIONS In this large, contemporary heart failure population, CRT-D use dwarfed CRT-P, though the latter nearly doubled over 6 years. Practice patterns vary substantially across states and over time. Medical therapy appears suboptimal in real-world practice.
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Affiliation(s)
| | - Daniel B Kramer
- Harvard Medical School, Boston, MA Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | - Sharon-Lise T Normand
- Harvard Medical School, Boston, MA Harvard T. H. Chan School of Public Health, Boston, MA
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Marasco SF, Summerhayes R, Quayle M, McGiffin D, Luthe M. Cost comparison of heart transplant vs. left ventricular assist device therapy at one year. Clin Transplant 2016; 30:598-605. [DOI: 10.1111/ctr.12725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Silvana F. Marasco
- Department of Cardiothoracic Surgery; The Alfred Hospital; Prahran Melbourne Vic. Australia
- Department of Surgery; Monash University; Melbourne Vic. Australia
| | - Robyn Summerhayes
- Department of Cardiothoracic Surgery; The Alfred Hospital; Prahran Melbourne Vic. Australia
| | - Margaret Quayle
- Department of Cardiothoracic Surgery; The Alfred Hospital; Prahran Melbourne Vic. Australia
| | - David McGiffin
- Department of Cardiothoracic Surgery; The Alfred Hospital; Prahran Melbourne Vic. Australia
- Department of Surgery; Monash University; Melbourne Vic. Australia
| | - Marco Luthe
- Finance Department; The Alfred Hospital; Prahran Melbourne Vic. Australia
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