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Al-Mayahi AMM, Al-Jubouri MB, Jaafar SA. Healthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic. Rev Bras Enferm 2023; 76Suppl 1:e20220372. [PMID: 37820104 PMCID: PMC10561924 DOI: 10.1590/0034-7167-2022-0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 02/23/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE Cardiovascular diseases are the first ranked cause of death worldwide. Adhering to health promoting lifestyle behaviors will maintain an individual's cardiovascular health and decrease the risk of cardiovascular diseases. METHODS In this descriptive study, 150 nursing faculty were surveyed via a non-probability (purposive) sampling method to assess their adherence to health promoting lifestyle in order to know the risk of cardiovascular diseases. The Arabic version of Health-Promoting Lifestyle Profile II (HPLP-II) was used to achieve this goal. RESULTS Seventy-two nursing faculty completed the survey. The results indicated that the study sample had moderate level of health promotion based on Health-Promoting Lifestyle Profile II. CONCLUSION Nursing faculty are at risk of developing cardiovascular diseases based on their health promoting lifestyle behaviors as they scored low level of "health responsibility", "physical activity", and "stress management ". Encouraging healthy behaviors is recommended to prevent chronic diseases such as cardiovascular diseases.
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Al-Smadi AM, Ashour AF, Fitzsimons D, Slater P, O'Neill B, Ajlouni W, Shajrawi AM. High levels of risk factors and poor secondary prevention for coronary heart disease patients in public hospitals: A descriptive repeated measures study. Int J Nurs Pract 2023; 29:e13111. [PMID: 36329669 DOI: 10.1111/ijn.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/28/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Secondary prevention is a priority after coronary revascularization for effective long-term cardiovascular care. Coronary Heart Disease is a major health problem in Jordan, but little is known about the current provision of secondary prevention. AIM The aim of this study was to evaluate risk factors and explore the current provision of secondary Coronary Heart Disease prevention among patients presenting with first-time Coronary Heart Disease at two time points: during hospitalization (Time 1) and 6 months later (Time 2), in multicentre settings in Jordan. METHODS A descriptive, repeated measures research study design was applied to a consecutive sample of 180 patients with first-time Coronary Heart Disease. Demographic and clinical details were recorded from medical files. Self-administered questionnaires developed by the researchers were used to measure secondary prevention information related to Coronary Heart Disease, including secondary prevention services, lifestyle advice received and medical advice topics. A short form of the International Physical Activity Questionnaire was used to measure physical activity. Participants were assessed at Times 1 and 2. RESULTS Unstructured lifestyle advice given to the patients at Times 1 and 2 most frequently related to medications, smoking, diet and blood lipids control advice topics, with no statistically significant improvement in cardiovascular risk factors among patients between Times 1 and 2. CONCLUSION Despite an extremely high prevalence of risk factors in this population, the provision of secondary prevention is poor in Jordan, which requires urgent improvement, and the contribution of nurses' to secondary prevention should be enhanced.
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Affiliation(s)
| | - Ala Fawzi Ashour
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Donna Fitzsimons
- School of Nursing, Ulster University, Jordanstown, UK.,Queen's University of Belfast, Belfast, UK
| | - Paul Slater
- School of Nursing, Ulster University, Jordanstown, UK
| | - Brenda O'Neill
- School of Health Sciences, Ulster University, Jordanstown, UK
| | - Wisal Ajlouni
- Jordan University of Science and Technology, Irbid, Jordan
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Vanzella LM, Pakosh M, Oh P, Ghisi G. Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:3398-3409. [PMID: 36167758 DOI: 10.1016/j.pec.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations. METHODS Five databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively. RESULTS Of 35,698 initial records, 19 studies were included, most in observational design and classified as "fair" quality. Underserved populations - women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status - presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals' needs were assessed and reported. CONCLUSION Underserved populations with CVD have unique information needs and preferences that should be address during their care. PRACTICAL IMPLICATION Information from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.
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Affiliation(s)
| | - Maureen Pakosh
- Library & Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Paul Oh
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
| | - Glm Ghisi
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada.
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Shahid A, Sept B, Kupsch S, Brundin-Mather R, Piskulic D, Soo A, Grant C, Leigh JP, Fiest KM, Stelfox HT. Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients. World J Crit Care Med 2022; 11:255-268. [PMID: 36051938 PMCID: PMC9305680 DOI: 10.5492/wjccm.v11.i4.255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/06/2022] [Accepted: 06/18/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients leaving the intensive care unit (ICU) often experience gaps in care due to deficiencies in discharge communication, leaving them vulnerable to increased stress, adverse events, readmission to ICU, and death. To facilitate discharge communication, written summaries have been implemented to provide patients and their families with information on medications, activity and diet restrictions, follow-up appointments, symptoms to expect, and who to call if there are questions. While written discharge summaries for patients and their families are utilized frequently in surgical, rehabilitation, and pediatric settings, few have been utilized in ICU settings. AIM To develop an ICU specific patient-oriented discharge summary tool (PODS-ICU), and pilot test the tool to determine acceptability and feasibility. METHODS Patient-partners (i.e., individuals with lived experience as an ICU patient or family member of an ICU patient), ICU clinicians (i.e., physicians, nurses), and researchers met to discuss ICU patients' specific informational needs and design the PODS-ICU through several cycles of discussion and iterative revisions. Research team nurses piloted the PODS-ICU with patient and family participants in two ICUs in Calgary, Canada. Follow-up surveys on the PODS-ICU and its impact on discharge were administered to patients, family participants, and ICU nurses. RESULTS Most participants felt that their discharge from the ICU was good or better (n = 13; 87.0%), and some (n = 9; 60.0%) participants reported a good understanding of why the patient was in ICU. Most participants (n = 12; 80.0%) reported that they understood ICU events and impacts on the patient's health. While many patients and family participants indicated the PODS-ICU was informative and useful, ICU nurses reported that the PODS-ICU was "not reasonable" in their daily clinical workflow due to "time constraint". CONCLUSION The PODS-ICU tool provides patients and their families with essential information as they discharge from the ICU. This tool has the potential to engage and empower patients and their families in ensuring continuity of care beyond ICU discharge. However, the PODS-ICU requires pairing with earlier discharge practices and integration with electronic clinical information systems to fit better into the clinical workflow for ICU nurses. Further refinement and testing of the PODS-ICU tool in diverse critical care settings is needed to better assess its feasibility and its effects on patient health outcomes.
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Affiliation(s)
- Anmol Shahid
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Rebecca Brundin-Mather
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Danijela Piskulic
- Department of Psychiatry, Hotchkiss Brain Institute, Calgary T2N 4Z6, Alberta, Canada
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Christopher Grant
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Jeanna Parsons Leigh
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
- School of Health Administration, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary T2N 4Z6, Alberta, Canada
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Habibzadeh H, Bagherzadi A, Didarloo A, Khalkhali H. The effect of patient education based on health belief model on hospital readmission preventive behaviors and readmission rate in patients with a primary diagnosis of acute coronary syndrome: a quasi-experimental study. BMC Cardiovasc Disord 2021; 21:595. [PMID: 34915850 PMCID: PMC8674864 DOI: 10.1186/s12872-021-02413-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The health belief model is one of the applicable methods of training health preventive behaviors, especially in patients with cardiovascular diseases. Therefore, this study aimed to determine the effect of patient education based on the health belief model on readmission preventive behaviors and readmission rate in patients with a primary diagnosis of acute coronary syndrome. METHODS The present quasi-experimental study was conducted in 2020 on patients with a primary diagnosis of acute coronary syndrome who were discharging from Seyed Al-Shohada Hospital, Urmia, Iran. In this study, a total of 70 samples were recruited using convenience sampling and then randomly assigned to two groups of intervention and control (n = 35 in each group). A total of 7 face-to-face group training sessions were held with the participation of the patients and one of their family members during 14 days after hospital discharge. These sessions were conducted along with concentration on the structures of the health belief model. Data were collected at three time points of immediately before, one month, and three months after the intervention using a demographic questionnaire, a researcher-made questionnaire of readmission preventive behaviors in cardiovascular diseases, and a checklist of hospital readmission. Data were analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA). RESULTS The results showed that there was a statistically significant difference in the mean score of preventive behaviors between the two groups at time points of one month and three months after the intervention (p < .05). However, there was no statistically significant difference in the readmission rate between the two groups after the intervention (p > .05). CONCLUSION Health belief model-based education was shown to be effective on readmission preventive behaviors in patients with acute coronary syndrome, although this model had no effect on the readmission rate in these patients. Other factors affecting the readmission rate are recommended to be investigated.
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Affiliation(s)
- Hossein Habibzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Aynaz Bagherzadi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Alireza Didarloo
- Department of Public Health, Faculty of Health Sciences, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Hamidreza Khalkhali
- Department of Biostatistics and Epidemiology, School of Medicine, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
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Perceived Learning Needs of Patients With Heart Failure in Jordan: Perspectives of Patients, Caregivers, and Nurses: A Cross-Sectional Survey. J Cardiovasc Nurs 2021; 35:273-279. [PMID: 32282519 DOI: 10.1097/jcn.0000000000000681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identifying learning needs is an important component of care among patients with heart failure (HF). There is a discrepancy in the level of importance of information as perceived by patients, caregivers, and nurses. No studies have been conducted to identify learning needs among patients with HF in Jordan. OBJECTIVE The aim of this study was to identify the learning needs of patients with HF in Jordan from the perspective of patients, family caregivers, and their nurses. METHODS A descriptive comparative design using a convenience sample of 67 patients with HF, 67 family caregivers, and 67 nurses was used. The Heart Failure Learning Needs Inventory was used to identify the learning needs. The mean scores were compared among the 3 groups and ranked by importance for each item to determine the most important areas of perceived needs for each group. RESULTS All groups had high total Heart Failure Learning Needs mean scores: patients, 4.12 ± 0.92; caregivers, 4.14 ± 0.65; and nurses, 4.08 ± 0.54. The top priority learning need for both patients and caregivers was "the recommended daily salt intake," whereas for nurses, it was "why I am taking each medication and its side effects"; nurses significantly perceived it as more important to learn than patients and caregivers did. Younger and employed patients requested more information than other patients. CONCLUSIONS Although some similarities exist, there are important differences among the 3 groups on perceived importance of information. Understanding these differences may be critical in developing a tailored educational program for patients and caregivers and improving nursing practice.
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Joseph L, Lavis A, Greenfield S, Boban D, Humphries C, Jose P, Jeemon P, Manaseki-Holland S. Systematic review on the use of patient-held health records in low-income and middle-income countries. BMJ Open 2021; 11:e046965. [PMID: 34475153 PMCID: PMC8413937 DOI: 10.1136/bmjopen-2020-046965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/14/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs). METHODS The literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar. RESULTS Six observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients' experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition. CONCLUSION Limited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions. PROSPERO REGISTRATION NUMBER CRD42019139365.
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Affiliation(s)
- Linju Joseph
- Institute of Applied Health Research, University of Birmingham Edgbaston Campus, Birmingham, UK
- Centre for Chronic Disease Control, Delhi, India
| | - Anna Lavis
- Institute of Applied Health Research, University of Birmingham Edgbaston Campus, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham Edgbaston Campus, Birmingham, UK
| | - Dona Boban
- Amrita Institute of Medical Sciences, Cochin, India
| | | | - Prinu Jose
- Public Health Foundation of India, New Delhi, India
| | - Panniyammakal Jeemon
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Semira Manaseki-Holland
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham Edgbaston Campus, Birmingham, UK
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Humphries C, Jaganathan S, Panniyammakal J, Singh S, Dorairaj P, Price M, Gill P, Greenfield S, Lilford R, Manaseki-Holland S. Investigating discharge communication for chronic disease patients in three hospitals in India. PLoS One 2020; 15:e0230438. [PMID: 32294091 PMCID: PMC7159187 DOI: 10.1371/journal.pone.0230438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/29/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Poor discharge communication is associated with negative health outcomes in high-income countries. However, quality of discharge communication has received little attention in India and many other low and middle-income countries. PRIMARY OBJECTIVE To investigate verbal and documented discharge communication for chronic non-communicable disease (NCD) patients. SECONDARY OBJECTIVE To explore the relationship between quality of discharge communication and health outcomes. METHODS DESIGN Prospective study. SETTING Three public hospitals in Himachal Pradesh and Kerala states, India. PARTICIPANTS 546 chronic NCD (chronic respiratory disease, cardiovascular disease or diabetes) patients. Piloted questionnaires were completed at admission, discharge and five and eighteen-week follow-up covering health status, discharge communication practices and health-seeking behaviour. Logistic regression was used to explore the relationship between quality of discharge communication and health outcomes. OUTCOME MEASURES PRIMARY Patient recall and experiences of verbal and documented discharge communication. SECONDARY Death, hospital readmission and self-reported deterioration of NCD/s. RESULTS All patients received discharge notes, predominantly on sheets of paper with basic pre-printed headings (71%) or no structure (19%); 31% of notes contained all the following information required for facilitating continuity of care: diagnosis, medication information, lifestyle advice, and follow-up instructions. Patient reports indicated notable variations in verbal information provided during discharge consultations; 50% received ongoing treatment/management information and 23% received lifestyle advice. Within 18 weeks of follow-up, 25 (5%) patients had died, 69 (13%) had been readmitted and 62 (11%) reported that their chronic NCD/s had deteriorated. Significant associations were found between low-quality documented discharge communication and death (AOR = 3.00; 95% CI 1.27,7.06) and low-quality verbal discharge communication and self-reported deterioration of chronic NCD/s (AOR = 0.46; 95% CI 0.25,0.83) within 18-weeks of follow-up. CONCLUSIONS Sub-optimal discharge practices may be compromising continuity and safety of chronic NCD patient care. Structured protocols, documents and training are required to improve discharge communication, healthcare integration and NCD management.
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Affiliation(s)
- Claire Humphries
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Suganthi Jaganathan
- Public Health Foundation of India, Delhi, India
- Centre for Chronic Disease Control, Delhi, India
| | - Jeemon Panniyammakal
- Public Health Foundation of India, Delhi, India
- Centre for Chronic Disease Control, Delhi, India
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, India
| | - Sanjeev Singh
- Hospital Administration, Amrita Institute of Medical Sciences, Kochi, India
| | - Prabhakaran Dorairaj
- Public Health Foundation of India, Delhi, India
- Centre for Chronic Disease Control, Delhi, India
| | - Malcolm Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, England, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, United Kingdom
| | - Paramjit Gill
- Academic Unit of Primary Care, University of Warwick, Coventry, England, United Kingdom
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Richard Lilford
- Centre for Applied Health Research and Delivery, University of Warwick, Coventry, England, United Kingdom
| | - Semira Manaseki-Holland
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
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Shmidt EA, Berns SA, Ponasenko AV, Klimenkova AV, Tumanova SA, Litvinova MN, Barbarash OL. [Predicting the development of adverse events in patients with acute coronary syndrome including genetics in the long-term follow-up]. ACTA ACUST UNITED AC 2020; 60:77-85. [PMID: 32394861 DOI: 10.18087/cardio.2020.4.n635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/02/2019] [Accepted: 10/08/2019] [Indexed: 11/18/2022]
Abstract
Aim To study a relationship of several factors (clinical and genetical markers) with unfavorable outcomes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in long-term follow-up.Material and methods This full-design, prospective study included 415 patients with NSTE-ACS. 266 patients were evaluated for the presence of multifocal atherosclerosis (MFA). Typing of polymorphic variants rs1041981 LTA, rs1800629 TNF, rs4986790, and rs498679 TLR4, and also rs3024491 and rs1800872 IL10 was performed. Follow-up period lasted for 67±4 months. By the end of this period, information about clinical outcomes for 396 patients became available.Results During the entire follow-up period, unfavorable outcomes were observed in 239 (57.5 %) patients with NSTE-ACS. The following clinical signs were associated with unfavorable outcomes: history of myocardial infarction, age >56 years, left ventricular ejection fraction (LV EF) ≤50 % and GRACE score ≥100, significant stenosis of brachiocephalic arteries, MFA, carriage of genotype А / А rs1041981 LTA (OR, 6.1; р=0.02) and allele А (OR, 1.9; р=0.01). According to results of a multifactorial analysis, the most significant predictors included LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.Conclusion Stratification of patients with NSTE-ACS into groups of high or low risk for having an unfavorable outcome within the next 6 years is possible using the prognostic model developed and presented in this study. The model includes the following signs: LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.
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Affiliation(s)
- E A Shmidt
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - S A Berns
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A V Ponasenko
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A V Klimenkova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - S A Tumanova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - M N Litvinova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - O L Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
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Impacts of Treatment Modalities on Physical Activity After First Acute Myocardial Infarction in Jordan. Dimens Crit Care Nurs 2020; 38:284-292. [PMID: 31593066 DOI: 10.1097/dcc.0000000000000382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Promoting physical activity is a priority after coronary revascularisation for effective long-term cardiovascular care and to avoid further disease progression and complications. But little is known about the effect of different types of acute myocardial infarction (AMI) treatment modalities in changes in physical activity level post-AMI. OBJECTIVE This study aimed to examine changes in physical activity among patients treated with different treatment modalities post-first AMI during early recovery phase at week 2 (time 1) and week 6 (Time 2) after hospitalization. METHODS A descriptive study was done using a repeated-measures design. Physical activity was measured by a body-worn activity monitor (activPAL3 monitor) for 24 hours a day for full 7 consecutive days at time 1 and time 2 after hospitalization. Demographic and clinical data were collected from patients' records. The study was conducted in 1 setting in Jordan. Participants were met at time 1 and time 2. The study recruited a convenience sample of 94 patients with AMI. Participants did not have access to cardiac rehabilitation. The participants were categorized according to type of AMI treatment modalities into 3 groups: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non-ST-elevation myocardial infarction treated by medication. RESULTS Patients treated by primary percutaneous coronary intervention had a statistically significant effect on changes in mean steps count and mean stepping time per day better than patients treated by other treatment modalities between weeks 2 and 6 after hospitalization. CONCLUSION The study showed that patients treated with primary percutaneous coronary intervention had better mean steps count and mean stepping time per day between weeks 2 and 6 after hospitalization in comparison with other treatment modalities. These findings could be used for development of effective intervention in the future. Further research using different research methods such as longitudinal studies among different cultures to confirm the finding of this study is recommended.
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Gass JD, Semrau K, Sana F, Mankar A, Singh VP, Fisher-Bowman J, Neal BJ, Tuller DE, Kumar B, Lipsitz S, Sharma N, Kodkany B, Kumar V, Gawande A, Hirschhorn LR. Evaluation of a call center to assess post-discharge maternal and early neonatal outcomes of facility-based childbirth in Uttar Pradesh, India. PLoS One 2018; 13:e0207987. [PMID: 30481209 PMCID: PMC6258538 DOI: 10.1371/journal.pone.0207987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/09/2018] [Indexed: 11/18/2022] Open
Abstract
Background Maternal and neonatal outcomes in the immediate post-delivery period are critical indicators of quality of care. Data on childbirth outcomes in low-income settings usually require home visits, which can be constrained by cost and access. We report on the use of a call center to measure post-discharge outcomes within a multi-site improvement study of facility-based childbirth in Uttar Pradesh, India. Methods Of women delivering at study sites eligible for inclusion, 97.9% (n = 157,689) consented to follow-up. All consenting women delivering at study facilities were eligible to receive a phone call between days eight and 42 post-partum to obtain outcomes for the seven-day period after birth. Women unable to be contacted via phone were visited at home. Outcomes, including maternal and early neonatal mortality and maternal morbidity, were ascertained using a standardized script developed from validated survey questions. Data Quality Assurance (DQA) included accuracy (double coding of calls) and validity (consistency between two calls to the same household). Regression models were used to identify factors associated with inconsistency. Findings Over 23 months, outcomes were obtained by the call center for 98.0% (154,494/157,689) consenting women and their neonates. 87.9% of call center-obtained outcomes were captured by phone call alone and 12.1% required the assistance of a field worker. An additional 1.7% were obtained only by a field worker, 0.3% were lost-to-follow-up, and only 0.1% retracted consent. The call center captured outcomes with a median of 1 call (IQR 1–2). DQA found 98.0% accuracy; data validation demonstrated 93.7% consistency between the first and second call. In a regression model, significant predictors of inconsistency included cases with adverse outcomes (p<0.001), and different respondents on the first and validation call (p<0.001). Conclusions In areas with widespread mobile cell phone access and coverage, a call center is a viable and efficient approach for measurement of post-discharge childbirth outcomes.
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Affiliation(s)
- Jonathon D. Gass
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Katherine Semrau
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Fatima Sana
- Population Services International- India, New Delhi, India
| | - Anup Mankar
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Jennifer Fisher-Bowman
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Brandon J. Neal
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Danielle E. Tuller
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Bharath Kumar
- Population Services International- India, New Delhi, India
| | - Stuart Lipsitz
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Bhala Kodkany
- Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | | | - Atul Gawande
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Lisa R. Hirschhorn
- Ariadne Labs, Brigham & Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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12
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Tang YH, Chong MC, Chua YP, Chui PL, Tang LY, Rahmat N. The effect of mobile messaging apps on cardiac patient knowledge of coronary artery disease risk factors and adherence to a healthy lifestyle. J Clin Nurs 2018; 27:4311-4320. [DOI: 10.1111/jocn.14538] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 03/28/2018] [Accepted: 05/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yea Hung Tang
- Department of Nursing Science; Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Mei Chan Chong
- Department of Nursing Science; Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Yan Piaw Chua
- Faculty of Education; Institute of Educational Leadership; University of Malaya; Kuala Lumpur Malaysia
| | - Ping Lei Chui
- Department of Nursing Science; Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Li Yoong Tang
- Faculty of Education; Institute of Educational Leadership; University of Malaya; Kuala Lumpur Malaysia
| | - Norsiah Rahmat
- Department of Nursing Science; Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
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13
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Prediction of the development of metabolic syndrome by the Markov model based on a longitudinal study in Dalian City. BMC Public Health 2018; 18:707. [PMID: 29879952 PMCID: PMC5992701 DOI: 10.1186/s12889-018-5599-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 05/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background Metabolic syndrome (MetS) increases the incidence of cardiovascular disease and diabetes mellitus. It is essential to study the natural progression of MetS in the interest of prevention. Information on the dynamic changes in MetS in developing countries is limited. This study aimed to simulate the progression of each component of MetS and explore the potential role of these components in early prevention and intervention. Methods This study involved 5881 individuals, aged 20 to 60 at study entry, who underwent at least two consecutive years of health check-ups in the seven-year study period at our institution’s health check-up center. Participants were divided into four groups by age (a 20- to- 40-year-old group and a 40- to 60-year-old group) and gender. A Markov model containing 7 stages (no components, isolated hypertension, isolated obesity, isolated hyperglycemia, isolated dyslipidemia, a 2-component state, and the MetS state) was constructed for each group. Results In women and young men (20- to 40-year-old men), dyslipidemia and obesity were the two most probable states for individuals who were transitioning from no components to one of the other six states. Among those who had no components and were 30 years old at study entry, MetS was estimated to develop within 10 years in 11.42% of men and 3.04% of women. Among those who had no components and were 50 years old at study entry, MetS was estimated to develop within 10 years in 25.04% of men and 7.09% of women. The estimated prevalence of MetS over the next 10 years was higher in individuals starting with the obesity component than in individuals starting with any other isolated component. In a comparison of interventions targeting single components, simulations showed that the obesity intervention produced the largest relative reduction in the prevalence of MetS. Conclusion Markov models are suitable for describing and predicting the dynamic development of MetS. The occurrence of MetS most frequently began with dyslipidemia or obesity. Obesity played a predominant role in the development of MetS. Early obesity intervention was extremely important for MetS prevention. Electronic supplementary material The online version of this article (10.1186/s12889-018-5599-y) contains supplementary material, which is available to authorized users.
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Lotfi M, Ghahremaneian A, Aghazadeh A, Jamshidi F. The Effect of Pre-Discharge Training on the Quality of Life of Burn Patients. J Caring Sci 2018; 7:107-112. [PMID: 29977882 PMCID: PMC6029655 DOI: 10.15171/jcs.2018.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/27/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: Many physical, psychological, social and economic complications have been reported after discharge, which have a negative impact on the quality of life of burn patients. The present research examines the effect of pre-discharge training program on the life quality of patients with burns.
Methods: This is a pre and post-experimental study with control group that was conducted in 2015 in teaching hospital Sina. The control group received the typical instructions upon being discharged from hospital while the experimental group received in-person training in the form of question-answer, pamphlets and a researcher-made instruction booklet. The patients’ life quality was evaluated when they were being discharged, a month and then three months after they were discharged.
Results: The result showed that the quality of life has a significant statistical difference across the three time points. And these differences are compared using Bonferroni’s adjustment multiple comparisons indicating that pre-discharge training affects the quality of life scores and this effect continues over time.
Conclusion: The results show that the pre-discharge training has significantly improved the life quality among the burns patients. The improvement of life quality is also correlated with the quantitative variable of total body surface area percent (TBSA %). Thus, planning and designing in-discharge training programs based on the existing context, combined with training packages focusing on the patients’ needs could be a very significant step in more successful implementation of the follow-up programs on the burn patients and improving their quality of life.
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Affiliation(s)
- Mojgan Lotfi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahremaneian
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Aghazadeh
- Departement of Basic sciences, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jamshidi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Eshah NF. Investigating cardiovascular patients' preferences and expectations regarding the use of social media in health education. Contemp Nurse 2018; 54:52-63. [PMID: 29490562 DOI: 10.1080/10376178.2018.1444497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND To reach more people in the community, health educators have considered employing social media alongside traditional health education methods. AIMS To understand the preferences and expectations of patients with cardiovascular diseases (CVDs) regarding the use of social media in health education. To assess the association between patients' socio-demographics with their preferences and expectations about the use of social media in health education. METHODS This is a cross-sectional descriptive study, which included 135 subjects with an established diagnosis of CVDs. The subjects were met at three cardiac outpatient clinics and recruited through a convenience sampling technique. They were recruited if they were adults, oriented and diagnosed with the CVDs for at least six months. RESULTS Most subjects (50.3%) were interested in receiving health education through social media, and 74.8% of them felt that using social media in health education would improve the process and lead to better outcomes. Preference for social media was significantly related to younger age, higher education, lower income, watching health education programmes on television, positive family history of CVDs, and currently has a job. Furthermore, higher positive expectations regarding using social media in health education were significantly related to higher education, watching health education programmes on television, being single, and currently has a job. CONCLUSIONS Subjects with CVDs are enthusiastic about health education through social media, believing that it will be good for educating them and providing them with the up-to-date information they need to live with their diseases. Findings of this study may positively contribute to the international efforts of improving health education through employing social media to improve accessibility to health education materials, and consequently decrease the burden of CVDs.
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Affiliation(s)
- Nidal F Eshah
- a Faculty of Nursing , Zarqa University , PO Box 132222, 13132 Zarqa , Jordan
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16
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Andjelkovic M, Mitrovic M, Nikolic I, Jovanovic DB, Zelen I, Zaric M, Canovic P, Kovacevic A, Jankovic S. Older Hypertensive Patients’ Adherence to Healthy Lifestyle Behaviors. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Non-pharmacological treatment including diet, body weight reduction, smoking cessation and physical activity, is very important part of hypertension treatment. The objective of this study was to investigate the adherence to healthy lifestyle behavior in the representative sample of the older hypertensive patients, and to investigate factors associated with adherence in the studied older population. The study was conducted on random sample of 362 long term hypertensive (> five years) patients older than 65 years of age, at Health Care Center of Kragujevac. Adherence was assessed using the structured questionnaire for the analysis of the implementation of both hypertension and diabetes guidelines in the primary care. Both bivariate and multivariate analyses were conducted. Nearly 35% of examined patients were highly adherent; they exercised regularly, avoided smoking for at least five years and consumed special healthy diet prescribed for hypertension. Another 35.6% of the cases reported exercising regularly, 39.5% followed the recommended diet for the hypertension, while 23.4% of the patients have still consumed cigarettes. Multivariate logistic regression demonstrated that received counseling on healthy lifestyle behaviors by physicians and lack of education predicted high adherence to healthy lifestyle behavior. In order to improve adherence of elderly hypertensive patients to healthy lifestyle, strengthening patient-physician relationships through efforts to enhance communication may be a promising strategy to enhance patients’ engagement in healthy lifestyle behaviors for hypertension. Such an improvement could be achieved through the education of both the physicians and patients.
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Affiliation(s)
- Marija Andjelkovic
- Department of Laboratory Diagnostics, Clinical Center Kragujevac , Kragujevac , Serbia
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | - Marina Mitrovic
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | - Ivana Nikolic
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | | | - Ivanka Zelen
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | - Milan Zaric
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | - Petar Canovic
- Department of Biochemistry, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
| | | | - Slobodan Jankovic
- Department of Pharmacology, Clinical Center Kragujevac, Faculty of medical sciences , University of Kragujevac , Kragujevac , Serbia
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Eshah NF, Froelicher ES. Knowledge, attitudes, beliefs and patterns of waterpipe use among Jordanian adults who exclusively smoke waterpipes. Eur J Cardiovasc Nurs 2017; 17:85-92. [PMID: 28671481 DOI: 10.1177/1474515117719592] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Widespread waterpipe smoking (WPS) is reported worldwide. Although remarkable numbers of waterpipe smokers do not smoke cigarettes, very few studies have explored the phenomenon of WPS in people who smoke water pipes exclusively. The aim of this study was to assess levels of knowledge, attitudes, beliefs and patterns of WPS among Jordanian waterpipe-only smokers. METHODS A cross-sectional descriptive design was used; with 247 participants who were recruited through convenience sampling from 23 cafés offering waterpipes. An interview and self-reported questionnaire was used to collect data. RESULTS The average age for starting WPS was 19.4 ± 5.6 years, of whom 71% started as teenagers. Participants like WPS because they like its flavor and social environment (46.3% and 29.5% respectively). The majority of participants reported that they smoked a waterpipe for the first time with their friends (66.8%), they usually smoke in the company of others (63.2%), and believe that quitting cigarettes smoking is harder than quitting WPS (61.6%). More than half (56.7%) of participants have extremely poor knowledge about the health effects of WPS. Participants who had smoked cigarettes in the past, were more knowledgeable than those who had never smoked cigarettes. The majority of participants, and specifically women, have high positive feelings and emotions (attitude) toward WPS, and 88.3% of them reported that it is a socially acceptable behavior. CONCLUSIONS Waterpipe smoking participants started WPS at an early age, and are attracted to the social environment that accompanies WPS. Participants have high positive attitude about WPS however they lack knowledge about harmful health effects of WPS.
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Affiliation(s)
| | - Erika S Froelicher
- 2 Department of Physiological Nursing, Department of Epidemiology & Biostatistics, Schools of Nursing & Medicine, University of California San Francisco, CA, USA
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18
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Anderson L, Brown JP, Clark AM, Dalal H, Rossau HK, Bridges C, Taylor RS. Patient education in the management of coronary heart disease. Cochrane Database Syst Rev 2017; 6:CD008895. [PMID: 28658719 PMCID: PMC6481392 DOI: 10.1002/14651858.cd008895.pub3] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is a complex multifaceted intervention which aims to improve the health outcomes of people with CHD. Cardiac rehabilitation consists of three core modalities: education, exercise training and psychological support. This is an update of a Cochrane systematic review previously published in 2011, which aims to investigate the specific impact of the educational component of cardiac rehabilitation. OBJECTIVES 1. To assess the effects of patient education delivered as part of cardiac rehabilitation, compared with usual care on mortality, morbidity, health-related quality of life (HRQoL) and healthcare costs in patients with CHD.2. To explore the potential study level predictors of the effects of patient education in patients with CHD (e.g. individual versus group intervention, timing with respect to index cardiac event). SEARCH METHODS We updated searches from the previous Cochrane review, by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library, Issue 6, 2016), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) in June 2016. Three trials registries, previous systematic reviews and reference lists of included studies were also searched. No language restrictions were applied. SELECTION CRITERIA 1. Randomised controlled trials (RCTs) where the primary interventional intent was education delivered as part of cardiac rehabilitation.2. Studies with a minimum of six-months follow-up and published in 1990 or later.3. Adults with a diagnosis of CHD. DATA COLLECTION AND ANALYSIS Two review authors independently screened all identified references for inclusion based on the above inclusion criteria. One author extracted study characteristics from the included trials and assessed their risk of bias; a second review author checked data. Two independent reviewers extracted outcome data onto a standardised collection form. For dichotomous variables, risk ratios and 95% confidence intervals (CI) were derived for each outcome. Heterogeneity amongst included studies was explored qualitatively and quantitatively. Where appropriate and possible, results from included studies were combined for each outcome to give an overall estimate of treatment effect. Given the degree of clinical heterogeneity seen in participant selection, interventions and comparators across studies, we decided it was appropriate to pool studies using random-effects modelling. We planned to undertake subgroup analysis and stratified meta-analysis, sensitivity analysis and meta-regression to examine potential treatment effect modifiers. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the quality of the evidence and the GRADE profiler (GRADEpro GDT) to create summary of findings tables. MAIN RESULTS This updated review included a total of 22 trials which randomised 76,864 people with CHD to an education intervention or a 'no education' comparator. Nine new trials (8215 people) were included for this update. We judged most included studies as low risk of bias across most domains. Educational 'dose' ranged from one 40 minute face-to-face session plus a 15 minute follow-up call, to a four-week residential stay with 11 months of follow-up sessions. Control groups received usual medical care, typically consisting of referral to an outpatient cardiologist, primary care physician, or both.We found evidence of no difference in effect of education-based interventions on total mortality (13 studies, 10,075 participants; 189/5187 (3.6%) versus 222/4888 (4.6%); random effects risk ratio (RR) 0.80, 95% CI 0.60 to 1.05; moderate quality evidence). Individual causes of mortality were reported rarely, and we were unable to report separate results for cardiovascular mortality or non-cardiovascular mortality. There was evidence of no difference in effect of education-based interventions on fatal and/or non fatal myocardial infarction (MI) (2 studies, 209 participants; 7/107 (6.5%) versus 12/102 (11.8%); random effects RR 0.63, 95% CI 0.26 to 1.48; very low quality of evidence). However, there was some evidence of a reduction with education in fatal and/or non-fatal cardiovascular events (2 studies, 310 studies; 21/152 (13.8%) versus 61/158 (38.6%); random effects RR 0.36, 95% CI 0.23 to 0.56; low quality evidence). There was evidence of no difference in effect of education on the rate of total revascularisations (3 studies, 456 participants; 5/228 (2.2%) versus 8/228 (3.5%); random effects RR 0.58, 95% CI 0.19 to 1.71; very low quality evidence) or hospitalisations (5 studies, 14,849 participants; 656/10048 (6.5%) versus 381/4801 (7.9%); random effects RR 0.93, 95% CI 0.71 to 1.21; very low quality evidence). There was evidence of no difference between groups for all cause withdrawal (17 studies, 10,972 participants; 525/5632 (9.3%) versus 493/5340 (9.2%); random effects RR 1.04, 95% CI 0.88 to 1.22; low quality evidence). Although some health-related quality of life (HRQoL) domain scores were higher with education, there was no consistent evidence of superiority across all domains. AUTHORS' CONCLUSIONS We found no reduction in total mortality, in people who received education delivered as part of cardiac rehabilitation, compared to people in control groups (moderate quality evidence). There were no improvements in fatal or non fatal MI, total revascularisations or hospitalisations, with education. There was some evidence of a reduction in fatal and/or non-fatal cardiovascular events with education, but this was based on only two studies. There was also some evidence to suggest that education-based interventions may improve HRQoL. Our findings are supportive of current national and international clinical guidelines that cardiac rehabilitation for people with CHD should be comprehensive and include educational interventions together with exercise and psychological therapy. Further definitive research into education interventions for people with CHD is needed.
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Affiliation(s)
- Lindsey Anderson
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
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Okrainec K, Lau D, Abrams HB, Hahn-Goldberg S, Brahmbhatt R, Huynh T, Lam K, Bell CM. Impact of patient-centered discharge tools: A systematic review. J Hosp Med 2017; 12:110-117. [PMID: 28182809 DOI: 10.12788/jhm.2692] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patient-centered discharge tools provide an opportunity to engage patients, enhance patient understanding, and improve capacity for self-care and postdischarge outcomes. PURPOSE To review studies that engaged patients in the design or delivery of discharge instruction tools and that tested their effect among hospitalized patients. DATA SOURCES We conducted a search of 12 databases and journals from January 1994 through May 2014, and references of retrieved studies. STUDY SELECTION English-language studies that tested discharge tools meant to engage patients were selected. Studies that measured outcomes after 3 months or without a control group or period were excluded. DATA EXTRACTION Two independent reviewers assessed the full-text papers and extracted data on features of patient engagement. DATA SYNTHESIS Thirty articles met inclusion criteria, 28 of which examined educational tools. Of these, 13 articles involved patients in content creation or tool delivery, with only 6 studies involving patients in both. While many of these studies (10 studies) demonstrated an improvement in patient comprehension, few studies found improvement in patient adherence despite their engagement. A few studies demonstrated an improvement in self-efficacy (2 studies) and a reduction in unplanned visits (3 studies). CONCLUSIONS Improving patient engagement through the use of media, visual aids, or by involving patients when creating or delivering a discharge tool improves comprehension. However, further studies are needed to clarify the effect on patient experience, adherence, and healthcare utilization postdischarge. Better characterization of the level of patient engagement when designing discharge tools is needed given the heterogeneity found in current studies. Journal of Hospital Medicine 2017;12:110-117.
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Affiliation(s)
- Karen Okrainec
- University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Ontario, Canada
- OpenLab, University Health Network, Toronto, Ontario, Canada
| | - Davina Lau
- Samuel Lunenfeld Research Institute/Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Howard B Abrams
- University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Ontario, Canada
- OpenLab, University Health Network, Toronto, Ontario, Canada
| | | | - Ronak Brahmbhatt
- OpenLab, University Health Network, Toronto, Ontario, Canada, USA
| | - Tai Huynh
- OpenLab, University Health Network, Toronto, Ontario, Canada, USA
| | - Kenneth Lam
- Department of Medicine, University of Toronto, Ontario, Canada
| | - Chaim M Bell
- Department of Medicine, University of Toronto, Ontario, Canada
- Samuel Lunenfeld Research Institute/Mount Sinai Hospital, Toronto, Ontario, Canada
- University of Toronto Institute of Health Policy, Management and Evaluation, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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20
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Moradi A, Moeini M, Sanei H. The Effect of Interactive Text Message Follow-up on Health Promoting Lifestyle of Patients with Acute Coronary Syndrome. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:287-293. [PMID: 28904541 PMCID: PMC5590358 DOI: 10.4103/ijnmr.ijnmr_89_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Lifestyle modification is an essential factor in the promotion of health in patients with acute coronary syndrome (ACS). One of the interventions to promote lifestyle is interactive follow-up, which, according to the traditional methods, requires spending significant amount of time and cost. Therefore, this study aimed to determine the effectiveness of interactive text message follow-up on health promoting lifestyle of patients with ACS. Materials and Methods: This was a randomized controlled trial among 100 patients suffering from ACS during October–February 2016. The participants were randomly assigned to the experimental and control groups. Collection of data on lifestyle was performed before, 3, and 4 months after the beginning of the intervention using Walker's Health Promoting lifestyle questionnaire. Six messages were sent to the intervention groups each week, and participants asked the questions by sending text message, each week 1 message were sent to the control group for 12 weeks. The statistical analysis of data was performed using independent t-test, Chi-square, Mann–Whitney U test, and repeated measures analysis of variance (ANOVA). Results: Before the intervention, there was no significant difference between the mean score of lifestyle of the two groups, however, 3 months and 4 months after the beginning of the intervention, the mean score of lifestyle in the intervention group was significantly higher than that of the control group (P < 0.001). Conclusion: The interactive text message follow-up is effective in promoting the lifestyle of patients with ACS and can be considered in the planning of follow-up of patients with ACS.
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Affiliation(s)
- Akram Moradi
- Postgraduate Nursing Student, Department of Adult Health Nursing, Faculty of Nursing and midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Mahin Moeini
- Assistant Professor, Ulcer Repair Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Hamid Sanei
- Associated Professor, Cardiology Department Faculty of Medicin, Isfahan University of Medical Science, Isfahan, Iran
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21
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Siegmund LA, Naylor J, Bena J, McClelland M. The relationship between Metabolic Syndrome and adherence to cardiac rehabilitation. Physiol Behav 2016; 169:41-45. [PMID: 27840095 DOI: 10.1016/j.physbeh.2016.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/09/2016] [Accepted: 11/09/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Lee Anne Siegmund
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States.
| | - Jonathan Naylor
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
| | - James Bena
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
| | - Mark McClelland
- Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States
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Mosleh S, Eshah N, Darawad M. Percutaneous coronary intervention and heart surgery learning needs of patients in Jordan. Int Nurs Rev 2016; 63:562-571. [DOI: 10.1111/inr.12318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S.M. Mosleh
- Department of Adult Nursing; Faculty of Nursing; Mutah University; Karak Jordan
| | - N.F. Eshah
- Faculty of Nursing; Zarqa University; Jordan
| | - M. Darawad
- Clinical Nursing Department; School of Nursing-The University of Jordan; Amman Jordan
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Mosleh SM, Eshah NF, Almalik MMA. Perceived learning needs according to patients who have undergone major coronary interventions and their nurses. J Clin Nurs 2016; 26:418-426. [DOI: 10.1111/jocn.13417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Sultan M Mosleh
- Department of Adult Nursing; Faculty of Nursing; Mutah University; Karak Jordan
| | | | - Mona MA Almalik
- Department of Maternal and Child Health Nursing; Faculty of Nursing; Mutah University; Karak Jordan
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Awareness of modifiable acute myocardial infarction risk factors has little impact on risk perception for heart attack among vulnerable patients. Heart Lung 2015; 44:183-8. [DOI: 10.1016/j.hrtlng.2015.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 02/24/2015] [Accepted: 02/27/2015] [Indexed: 11/17/2022]
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