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Foley MJ, Rajkumar CA, Ahmed-Jushuf F, Simader FA, Chotai S, Pathimagaraj RH, Mohsin M, Salih A, Wang D, Dixit P, Davies JR, Keeble TR, Cosgrove C, Spratt JC, O'Kane PD, De Silva R, Hill JM, Nijjer SS, Sen S, Petraco R, Mikhail GW, Khamis R, Kotecha T, Harrell FE, Kellman P, Francis DP, Howard JP, Cole GD, Shun-Shin MJ, Al-Lamee RK. Coronary sinus reducer for the treatment of refractory angina (ORBITA-COSMIC): a randomised, placebo-controlled trial. Lancet 2024; 403:1543-1553. [PMID: 38604209 DOI: 10.1016/s0140-6736(24)00256-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The coronary sinus reducer (CSR) is proposed to reduce angina in patients with stable coronary artery disease by improving myocardial perfusion. We aimed to measure its efficacy, compared with placebo, on myocardial ischaemia reduction and symptom improvement. METHODS ORBITA-COSMIC was a double-blind, randomised, placebo-controlled trial conducted at six UK hospitals. Patients aged 18 years or older with angina, stable coronary artery disease, ischaemia, and no further options for treatment were eligible. All patients completed a quantitative adenosine-stress perfusion cardiac magnetic resonance scan, symptom and quality-of-life questionnaires, and a treadmill exercise test before entering a 2-week symptom assessment phase, in which patients reported their angina symptoms using a smartphone application (ORBITA-app). Patients were randomly assigned (1:1) to receive either CSR or placebo. Both participants and investigators were masked to study assignment. After the CSR implantation or placebo procedure, patients entered a 6-month blinded follow-up phase in which they reported their daily symptoms in the ORBITA-app. At 6 months, all assessments were repeated. The primary outcome was myocardial blood flow in segments designated ischaemic at enrolment during the adenosine-stress perfusion cardiac magnetic resonance scan. The primary symptom outcome was the number of daily angina episodes. Analysis was done by intention-to-treat and followed Bayesian methodology. The study is registered with ClinicalTrials.gov, NCT04892537, and completed. FINDINGS Between May 26, 2021, and June 28, 2023, 61 patients were enrolled, of whom 51 (44 [86%] male; seven [14%] female) were randomly assigned to either the CSR group (n=25) or the placebo group (n=26). Of these, 50 patients were included in the intention-to-treat analysis (24 in the CSR group and 26 in the placebo group). 454 (57%) of 800 imaged cardiac segments were ischaemic at enrolment, with a median stress myocardial blood flow of 1·08 mL/min per g (IQR 0·77-1·41). Myocardial blood flow in ischaemic segments did not improve with CSR compared with placebo (difference 0·06 mL/min per g [95% CrI -0·09 to 0·20]; Pr(Benefit)=78·8%). The number of daily angina episodes was reduced with CSR compared with placebo (OR 1·40 [95% CrI 1·08 to 1·83]; Pr(Benefit)=99·4%). There were two CSR embolisation events in the CSR group, and no acute coronary syndrome events or deaths in either group. INTERPRETATION ORBITA-COSMIC found no evidence that the CSR improved transmural myocardial perfusion, but the CSR did improve angina compared with placebo. These findings provide evidence for the use of CSR as a further antianginal option for patients with stable coronary artery disease. FUNDING Medical Research Council, Imperial College Healthcare Charity, National Institute for Health and Care Research Imperial Biomedical Research Centre, St Mary's Coronary Flow Trust, British Heart Foundation.
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Affiliation(s)
- Michael J Foley
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Christopher A Rajkumar
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Shayna Chotai
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rachel H Pathimagaraj
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Muhammad Mohsin
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ahmed Salih
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Danqi Wang
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Prithvi Dixit
- National Heart and Lung Institute, Imperial College London, London, UK
| | - John R Davies
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK; Medical Technology Research Centre, Anglia Ruskin University School of Medicine, Chelmsford, UK
| | - Tom R Keeble
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK; Medical Technology Research Centre, Anglia Ruskin University School of Medicine, Chelmsford, UK
| | - Claudia Cosgrove
- St George's University Hospitals NHS Foundation Trust, London, UK; St George's, University of London, London, UK
| | - James C Spratt
- St George's University Hospitals NHS Foundation Trust, London, UK; St George's, University of London, London, UK
| | - Peter D O'Kane
- University Hospitals of Dorset NHS Foundation Trust, Bournemouth, UK
| | - Ranil De Silva
- The Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jonathan M Hill
- The Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Sayan Sen
- Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Ramzi Khamis
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Frank E Harrell
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Peter Kellman
- Department of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Darrel P Francis
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - James P Howard
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Graham D Cole
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Matthew J Shun-Shin
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Rasha K Al-Lamee
- National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK.
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Freene N, Carroll SJ, Flynn A, Bowen S, Holley R, Rodway K, Niyonsenga T, Davey R. Activity counseling early postelective percutaneous coronary intervention (ACE-PCI): Mixed-methods pilot randomized controlled trial. Health Sci Rep 2024; 7:e1963. [PMID: 38505683 PMCID: PMC10948586 DOI: 10.1002/hsr2.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/12/2024] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Background Physical activity (PA) levels of people with coronary heart disease are low in the first 30 days after percutaneous coronary intervention (PCI), increasing the risk of recurrent cardiac events. Following PCI, PA counseling delivered by a physiotherapist before discharge may increase the PA levels of patients. Preliminary work is required to determine the effects of the counseling session compared to usual care. Objectives To investigate the feasibility and potential efficacy of a brief physiotherapist-led PA counseling session immediately after an elective PCI compared to usual care for improved PA early post-PCI. Methods Using concealed allocation and blinded assessments, eligible participants (n = 30) were randomized to a physiotherapist-led PA counseling session (30 min) or usual care (nurse-led PA advice < 5 min). The primary outcome was daily minutes of moderate-to-vigorous PA (accelerometry; 3 weeks). Secondary outcomes included cardiac rehabilitation intention, anxiety and depression levels (Hospital Anxiety and Depression Scale), and quality-of-life (MacNew questionnaire). Recruitment, retention, and attrition were assessed for feasibility. Semistructured interviews were conducted with 13 participants to determine intervention acceptability, and barriers and enablers to PA. Results Between and within-group comparisons were not significant in intention-to-treat analyses. All feasibility criteria were met except for retention and attrition of participants. At 3 weeks, only 25% of participants were planning to attend cardiac rehabilitation, with no between-group differences. Increased PA at 3 weeks was associated with participants that were younger, without other chronic disease,s and more active immediately following discharge. Interviews revealed personal, environmental, and program-based themes for barriers and enablers to PA. Conclusions A physiotherapist-led PA counseling session may not improve PA levels early post-elective PCI compared to very brief PA advice delivered by nurses. A larger multicentre randomized controlled trial is feasible with minor modifications to participant follow-up. Further research is required.
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Affiliation(s)
- Nicole Freene
- Department of PhysiotherapyUniversity of CanberraBruceAustralian Capital TerritoryAustralia
- Health Research InstituteUniversity of CanberraBruceAustralian Capital TerritoryAustralia
| | - Suzanne J. Carroll
- Health Research InstituteUniversity of CanberraBruceAustralian Capital TerritoryAustralia
| | - Allyson Flynn
- Department of PhysiotherapyUniversity of CanberraBruceAustralian Capital TerritoryAustralia
| | - Sarah Bowen
- National Capital Private HospitalGarranAustralian Capital TerritoryAustralia
| | - Roslyn Holley
- National Capital Private HospitalGarranAustralian Capital TerritoryAustralia
| | - Kerry Rodway
- National Capital Private HospitalGarranAustralian Capital TerritoryAustralia
| | - Theo Niyonsenga
- Health Research InstituteUniversity of CanberraBruceAustralian Capital TerritoryAustralia
| | - Rachel Davey
- Health Research InstituteUniversity of CanberraBruceAustralian Capital TerritoryAustralia
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Kirchberger I, Fischer S, Raake P, Linseisen J, Meisinger C, Schmitz T. Depression mediates the association between health literacy and health-related quality of life after myocardial infarction. Front Psychiatry 2024; 15:1341392. [PMID: 38419900 PMCID: PMC10899501 DOI: 10.3389/fpsyt.2024.1341392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction So far, health literacy (HL) and its related factors in patients with acute myocardial infarction received little attention. Thus, the objective of this study was to investigate the associations between the different dimensions of HL and disease-specific health-related quality of life (HRQOL), and factors that may affect these relations in patients after acute myocardial infarction (AMI). Methods All survivors of AMI between June 2020 and September 2021, from the Myocardial Infarction Registry Augsburg (n=882) received a postal questionnaire on HL [Health Literacy Questionnaire (HLQ)], HRQOL (MacNew Heart Disease HRQOL questionnaire) and depression (Patient Health Questionnaire). From the 592 respondents, 546 could be included in the analysis. Multivariable linear regression models were performed to investigate the associations between the nine subscales of the HLQ and the total score and three subscales of the MacNew questionnaire. A mediation analysis was performed to estimate direct and indirect effects of HL on HRQOL taking into account the mediating effect of depression. Results In the sample of 546 patients (72.5% male, mean age 68.5 ± 12.2 years), patients with poor education showed significantly lower HLQ scores. Significant associations between the subscales of the HLQ and the MacNew were found, which remained significant after adjustment for sociodemographic variables with few exceptions. More than 50% of the association between HL and HRQOL was mediated by depression in seven HLQ subscales and a complete mediating effect was found for the HLQ subscales 'Actively managing my health' and 'Appraisal of health information'. Discussion Depression mediates the associations between HL and disease-specific HRQOL in patients with myocardial infarction.
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Affiliation(s)
- Inge Kirchberger
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Simone Fischer
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Philip Raake
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - Jakob Linseisen
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Christine Meisinger
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Timo Schmitz
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Su JJ, Wong AKC, Zhang LP, Bayuo J, Lin R, Abu-Odah H, Batalik L. Technology-assisted cardiac rehabilitation for coronary heart disease patients with central obesity: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:95-103. [PMID: 38059577 PMCID: PMC10936668 DOI: 10.23736/s1973-9087.23.08111-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Limited empirical evidence is available regarding the effect of technology-assisted cardiac rehabilitation (TACR) among coronary heart disease (CHD) patients with central obesity. AIM To determine the effects of 12-week TACR on health outcomes of patients with CHD. DESIGN Two-arm randomized controlled trial. SETTING Cardiovascular department of a regional hospital. POPULATION Coronary heart disease patients with central obesity. METHODS The study randomized 78 hospitalized CHD patients to receive either the 12-week TACR intervention or usual care. Guided by social cognitive theory, the intervention began with an in-person assessment and orientation session to assess and identify individual risks and familiarize with the e-platform/device before discharge. After discharge, patients were encouraged to visit the interactive CR website for knowledge and skills acquisition, data uploading, use the pedometer for daily step tracking, and interact with peers and professionals via social media for problem-solving and mutual support. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). RESULTS Participants in the intervention group showed significant improvement in daily steps at six weeks but not 12 weeks (T1: β=2713.48, P=0.03; T2:β=2450.70, P=0.08), weekly sitting minutes (T1: β=-665.17, P=0.002; T2: β=-722.29, P=0.02), and total (vigorous, moderate, and walking) exercise at 12-week (β=-2445.99, P=0.008). Improvement in health-promoting lifestyle profile (T1: β=24.9, P<0.001; T2: β=15.50, P<0.001), smoking cessation (T2: β=-2.28, P<0.04), self-efficacy (T2: β=0.63, P=0.02), body mass index (T1:β =-0.97, P=0.03; T2: β=-0.73, P=0.04) and waist circumferences (T1: β =-1.97, P=0.003; T2: β =-3.14, P=0.002) were identified. CONCLUSIONS Results indicated the effectiveness of the TACR intervention in improving healthy behaviors and anthropometric parameters for CHD patients with central obesity. Individual assessment, collaborative action planning, and ongoing obesity management support should be highlighted in TACR programs for CHD patients. CLINICAL REHABILITATION IMPACT Central obesity should be assessed and highlighted in TACR intervention as an independent risk factor that requires corresponding behavior change and body fat management.
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Affiliation(s)
- Jing-Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Li-Ping Zhang
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Rose Lin
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic -
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Patel V, Unai S, Moore R, Layoun H, Harb S, Tong MZ, Karamlou T, Najm HK, Svensson LG, Rajeswaran J, Blackstone EH, Pettersson GB. The Ozaki Procedure: Standardized Protocol Adoption of a Complex Innovative Procedure. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2024; 8:100217. [PMID: 38283567 PMCID: PMC10818143 DOI: 10.1016/j.shj.2023.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/30/2023] [Accepted: 08/10/2023] [Indexed: 01/30/2024]
Abstract
Background The Ozaki procedure using autologous pericardium is an interesting but complex alternative for aortic valve replacement. We present a standardized approach to minimize the learning curve and confirm reproducibility. Methods After careful preparation, from May 2015 to February 2021, an Ozaki procedure was performed on 46 patients age 51 ± 14 years. Seven had unicuspid (15%), 29 bicuspid (63%), and 10 tricuspid (22%) aortic valves, and 2 patients had endocarditis. Endpoints were operative learning curves, perioperative outcomes, intermediate-term valve hemodynamics, reintervention, health-related quality of life (MacNew Heart Disease Health-Related Quality of Life questionnaire), and mortality. Results Cardiopulmonary bypass and aortic clamp times decreased from 145 to 125 minutes and 120 to 100 minutes, respectively, over the first 20 cases, reflecting the learning curve. There was no major perioperative morbidity or mortality. Median postoperative stay was 6.9 days. Aortic regurgitation was mild or less in all but 2 patients who developed moderate aortic regurgitation. Mean aortic valve gradient was 7.9 mmHg postoperatively, 9.2 mmHg by 6 months, and constant thereafter. Left ventricular ejection fraction was 58% preoperatively, 60% at 6 months, and remained stable thereafter. One patient developed infective endocarditis 7 months postoperatively, failed medical management, and underwent valve replacement at 14 months. Two-year survival was 96%, with 1 noncardiac death at 16 months. Health-related quality of life in mental, physical, and emotional domains was better than matched norms, global 6.2 vs. 5.0 (p < 0.0001). Conclusions Using a well-prepared standardized approach, the Ozaki procedure is reproducible with a short learning curve, excellent hemodynamic performance, and good quality of life.
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Affiliation(s)
- Viral Patel
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shinya Unai
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ryan Moore
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Habib Layoun
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Serge Harb
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Michael Z.Y. Tong
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tara Karamlou
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hani K. Najm
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Lars G. Svensson
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jeevanantham Rajeswaran
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Eugene H. Blackstone
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gösta B. Pettersson
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Eglin M, Schmid JP, Ronel J, Khatami R, Leiggener C, Koenig HG, Hefti R. Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in a Swiss study. Int J Psychiatry Med 2023:912174231225801. [PMID: 38156371 DOI: 10.1177/00912174231225801] [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: 12/30/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR). METHODS The study has a prospective design. A convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL) and exercise capacity (6-min walk test, cycle ergometer test) were assessed. RESULTS Social support was significantly associated with less anxiety (P < .01), less depression (P < .01), and better QoL (P < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression (P < .001). Religiosity/spirituality was significantly associated with less depression (P < .05), better QoL (P < .05), and better exercise capacity (P < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant associations of social support or R/S with the course of CR measured by change in QoL or exercise capacity. CONCLUSION Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.
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Affiliation(s)
- Micha Eglin
- University of Basel, Faculty of Medicine, Basel, Switzerland
| | | | - Joram Ronel
- Department of Psychosomatic Medicine and Psychotherapy, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Ramin Khatami
- Centre of Sleep Medicine and Sleep Research, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Christoph Leiggener
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Department of Oral- and Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Harold G Koenig
- Departments of Medicine and Psychiatry, Duke University Health System, Durham, NC, USA
- Department of Medicine, Division of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - René Hefti
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
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Yakut Ozdemir H, Ozalevli S, Felekoglu E, Baskurt AA, Dursun H. Kinesiophobia and Associated Factors in Patients With Myocardial Infarction. Percept Mot Skills 2023; 130:2564-2581. [PMID: 37909184 DOI: 10.1177/00315125231204059] [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] [Indexed: 11/02/2023]
Abstract
Kinesiophobia is a well-known barrier to positive clinical outcomes among patients with various diseases, but there remain few comprehensive studies of kinesiophobia among patients with myocardial infarction (MI). In this cross-sectional study, we investigated the presence of kinesiophobia and its relationship with clinical outcomes among 42 patients with MI who completed the Tampa Scale of Kinesiophobia Swedish Version for Heart (TSK-SV Heart) the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Six-Minute Walk Test (6MWT), the Hospital Anxiety and Depression Scale (HADS), the modified Medical Research Council (mMRC) Dyspnea Scale, the Charlson Comorbidity Index (CCI), and the MacNew Heart Disease Health-Related Quality of Life Questionnaire. The participants' mean TSK-SV Heart score was 39.24 (SD = 6.65), and 71.4% of these patients reported a high level of kinesiophobia. The TSK-SV Heart score demonstrated a strong correlation with the IPAQ-SF, 6MWT walking distance, and mMRC score (p < .001), and a moderate correlation with the HADS, CCI, and MacNew Heart Disease HRQoL (p < .05). Patients with a high level of kinesiophobia had lower IPAQ-SF, 6MWT walking distance, and HRQoL and higher mMRC, CCI, and HADS scores than patients with low levels of kinesiophobia (p < .05). Kinesiophobia was common and represented a considerable risk factor for physical-psychosocial dysfunctions in these patients with MI. To maintain functional independence and to increase physical activity level, clinicians should consider kinesiophobia from early to late-stage disease and should add a treatment focus that seeks to eliminate kinesiophobia in cardiac rehabilitation programs.
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Affiliation(s)
- Hazal Yakut Ozdemir
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Deomkrasi University, Izmir, Turkey
| | - Sevgi Ozalevli
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Elvan Felekoglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Çelebi University, Izmir, Turkey
| | - Ahmet Anıl Baskurt
- Faculty of Medicine, Department of Cardiology, Dokuz Eylul University, Izmir, Turkey
| | - Huseyin Dursun
- Faculty of Medicine, Department of Cardiology, Dokuz Eylul University, Izmir, Turkey
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Reynolds AN, Hood F, Wilson R, Ross A, Neumann S, Turner R, Iosua E, Katare R, Shahin A, Kok ZY, Chan H, Coffey S, Mann J. Healthy grocery delivery in the usual care for adults recovering from an acute coronary event: protocol for a three-arm randomised controlled trial. BMJ Open 2023; 13:e074278. [PMID: 38035748 PMCID: PMC10689354 DOI: 10.1136/bmjopen-2023-074278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Coronary heart disease is a major contributor to the global burden of disease. Appropriate nutrition is a cornerstone of the prevention and treatment of coronary heart disease; however, barriers including cost and access to recommended foods limits long-term adherence for many. We are conducting, in adults with coronary heart disease, a randomised controlled trial comparing usual care with two dietary interventions in which usual care is augmented by 12 weeks free delivered groceries. METHODS AND ANALYSIS Three hundred adults recovering from an acute coronary event will be recruited from outpatient cardiovascular services in three regions of Aotearoa New Zealand. Participants will be randomly allocated to three arms: usual care (control group), usual care and the free delivery of foods high in dietary fibre or usual care and the free delivery of foods high in unsaturated fats. Interventions duration is 12 weeks, with a further 12 months follow-up. The primary outcome measures are change in low-density lipoprotein (LDL) cholesterol concentration following the intervention, and a cost-effectiveness analysis of healthcare access and social costs in the year after the intervention. A broad range of secondary outcome measures include other blood lipids, anthropometry, glycaemia, inflammatory markers, gut microbiome, dietary biomarkers, food acceptability, dietary change and the facilitators and barriers to dietary change. The trial will determine whether the free provision of groceries known to reduce cardiovascular risk within usual care will be clinically beneficial and justify the cost of doing so. Results may also provide an indication of the relative benefit of foods rich in dietary fibre or unsaturated fats in coronary heart disease management. ETHICS AND DISSEMINATION This trial, The Healthy Heart Study, has Health and Disability Ethics Committee approval (20/NTB/121), underwent Māori consultation, and has locality authority to be conducted in Canterbury, Otago and Southland. TRIAL REGISTRATION NUMBER ACTRN12620000689976, U1111-1250-1499.
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Affiliation(s)
- Andrew N Reynolds
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Fiona Hood
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Ross Wilson
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Alastair Ross
- Metabolomics Laboratory, AgResearch Ltd, Lincoln, New Zealand
| | - Silke Neumann
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Robin Turner
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Ella Iosua
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Rajesh Katare
- Department of Physiology, University of Otago, Dunedin, New Zealand
| | - Aysu Shahin
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Zi-Yi Kok
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Huan Chan
- Te Whatu Ora Health New Zealand Waitaha Canterbury, Christchurch, New Zealand
| | - Sean Coffey
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Jim Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Riddet Institute, Palmerston North, New Zealand
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Maleki M, Mardani A, Iloonkashkooli R, Khachian A, Glarcher M, Vaismoradi M. The effect of hospital-to-home transitional care using a digital messaging application on the health outcomes of patients undergoing CABG and their family caregivers: a randomized controlled trial study protocol. Front Cardiovasc Med 2023; 10:1224302. [PMID: 38028499 PMCID: PMC10644205 DOI: 10.3389/fcvm.2023.1224302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Given the increasing trend of care transition from healthcare settings to patients' own home, patients and their family caregivers should take more responsibilities for care at own home. This study is going to investigate the effect of a transitional care program from hospital to own home using a digital messaging application on patients' undergoing coronary artery bypass graft (CABG) surgery and their family caregivers' health outcomes. Methods A parallel randomized controlled trial study will be conducted in a hospital in a metropolis located in southwestern Iran. Sampling will be performed sequentially and the eligible dyad of patients and family caregivers will be randomly assigned to intervention and control groups. The intervention group will receive a transitional care program for 8 weeks using the WhatsApp on the mobile phone based on the person-centered care approach, but the control group will receive routine care for patient's transition. Data collection will be conducted at baseline, immediately after the intervention, and two months after the intervention using demographic questionnaire, Cardiac Self-Efficacy Scale (CSES), MacNew Heart Disease Health-Related Quality of Life questionnaire (MNHD-Q), Cardiac Symptom Scale (CSS), Morisky Medication Adherence Scale, and Caregiver Burden Scale (CBS). Descriptive and inferential statistics will be used for data analysis. Conclusions The results of this study will allow evaluating the effectiveness of an innovative transitional care program to patients' own home using a digital messaging application. If the transitional program is shown feasible and effective it can be incorporated into existing care programs and stimulate further studies on the use of digital solutions for improving the continuity of care in own home.
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Affiliation(s)
- Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Alice Khachian
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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10
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McDonagh ST, Dalal H, Moore S, Clark CE, Dean SG, Jolly K, Cowie A, Afzal J, Taylor RS. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2023; 10:CD007130. [PMID: 37888805 PMCID: PMC10604509 DOI: 10.1002/14651858.cd007130.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Cardiovascular disease is the most common cause of death globally. Traditionally, centre-based cardiac rehabilitation programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based and technology-supported cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation, especially during the SARS-CoV-2 pandemic. This is an update of a review previously published in 2009, 2015, and 2017. OBJECTIVES To compare the effect of home-based (which may include digital/telehealth interventions) and supervised centre-based cardiac rehabilitation on mortality and morbidity, exercise-capacity, health-related quality of life, and modifiable cardiac risk factors in patients with heart disease SEARCH METHODS: We updated searches from the previous Cochrane Review by searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) on 16 September 2022. We also searched two clinical trials registers as well as previous systematic reviews and reference lists of included studies. No language restrictions were applied. SELECTION CRITERIA We included randomised controlled trials that compared centre-based cardiac rehabilitation (e.g. hospital, sports/community centre) with home-based programmes (± digital/telehealth platforms) in adults with myocardial infarction, angina, heart failure, or who had undergone revascularisation. DATA COLLECTION AND ANALYSIS Two review authors independently screened all identified references for inclusion based on predefined inclusion criteria. Disagreements were resolved through discussion or by involving a third review author. Two authors independently extracted outcome data and study characteristics and assessed risk of bias. Certainty of evidence was assessed using GRADE. MAIN RESULTS We included three new trials in this update, bringing a total of 24 trials that have randomised a total of 3046 participants undergoing cardiac rehabilitation. A further nine studies were identified and are awaiting classification. Manual searching of trial registers until 16 September 2022 revealed a further 14 clinical trial registrations - these are ongoing. Participants had a history of acute myocardial infarction, revascularisation, or heart failure. Although there was little evidence of high risk of bias, a number of studies provided insufficient detail to enable assessment of potential risk of bias; in particular, details of generation and concealment of random allocation sequencing and blinding of outcome assessment were poorly reported. No evidence of a difference was seen between home- and centre-based cardiac rehabilitation in our primary outcomes up to 12 months of follow-up: total mortality (risk ratio [RR] = 1.19, 95% confidence interval [CI] 0.65 to 2.16; participants = 1647; studies = 12/comparisons = 14; low-certainty evidence) or exercise capacity (standardised mean difference (SMD) = -0.10, 95% CI -0.24 to 0.04; participants = 2343; studies = 24/comparisons = 28; low-certainty evidence). The majority of evidence (N=71 / 77 comparisons of either total or domain scores) showed no significant difference in health-related quality of life up to 24 months follow-up between home- and centre-based cardiac rehabilitation. Trials were generally of short duration, with only three studies reporting outcomes beyond 12 months (exercise capacity: SMD 0.11, 95% CI -0.01 to 0.23; participants = 1074; studies = 3; moderate-certainty evidence). There was a similar level of trial completion (RR 1.03, 95% CI 0.99 to 1.08; participants = 2638; studies = 22/comparisons = 26; low-certainty evidence) between home-based and centre-based participants. The cost per patient of centre- and home-based programmes was similar. AUTHORS' CONCLUSIONS This update supports previous conclusions that home- (± digital/telehealth platforms) and centre-based forms of cardiac rehabilitation formally supported by healthcare staff seem to be similarly effective in improving clinical and health-related quality of life outcomes in patients after myocardial infarction, or revascularisation, or with heart failure. This finding supports the continued expansion of healthcare professional supervised home-based cardiac rehabilitation programmes (± digital/telehealth platforms), especially important in the context of the ongoing global SARS-CoV-2 pandemic that has much limited patients in face-to-face access of hospital and community health services. Where settings are able to provide both supervised centre- and home-based programmes, consideration of the preference of the individual patient would seem appropriate. Although not included in the scope of this review, there is an increasing evidence base supporting the use of hybrid models that combine elements of both centre-based and home-based cardiac rehabilitation delivery. Further data are needed to determine: (1) whether the short-term effects of home/digital-telehealth and centre-based cardiac rehabilitation models of delivery can be confirmed in the longer term; (2) the relative clinical effectiveness and safety of home-based programmes for other heart patients, e.g. post-valve surgery and atrial fibrillation.
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Affiliation(s)
- Sinead Tj McDonagh
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Hasnain Dalal
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Sarah Moore
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Christopher E Clark
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Sarah G Dean
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Aynsley Cowie
- Cardiac Rehabilitation, University Hospital Crosshouse, NHS Ayrshire and Arran, Kilmarnock, UK
| | | | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
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11
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Bermudez T, Maercker A, Bierbauer W, Bernardo A, Fleisch-Silvestri R, Hermann M, Schmid JP, Scholz U. The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients. Psychol Med 2023; 53:5992-6001. [PMID: 37743836 PMCID: PMC10520595 DOI: 10.1017/s0033291722003154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Physical activity (PA) is crucial in the treatment of cardiac disease. There is a high prevalence of stress-response and affective disorders among cardiac patients, which might be negatively associated with their PA. This study aimed at investigating daily differential associations of International Classification of Diseases (ICD)-11 adjustment disorder, depression and anxiety symptoms with PA and sedentary behaviour (SB) during and right after inpatient cardiac rehabilitation. METHODS The sample included N = 129 inpatients in cardiac rehabilitation, Mage = 62.2, s.d.age = 11.3, 84.5% male, n = 2845 days. Adjustment disorder, depression and anxiety symptoms were measured daily during the last 7 days of rehabilitation and for 3 weeks after discharge. Moderate-to-vigorous PA (MVPA), light PA (LPA) and SB were measured with an accelerometer. Bayesian lagged multilevel regressions including all three symptoms to obtain their unique effects were conducted. RESULTS On days with higher adjustment disorder symptoms than usual, patients engaged in less MVPA, and more SB. Patients with overall higher depression symptoms engaged in less MVPA, less LPA and more SB. On days with higher depression symptoms than usual, there was less MVPA and LPA, and more SB. Patients with higher anxiety symptoms engaged in more LPA and less SB. CONCLUSIONS Results highlight the necessity to screen for and treat adjustment disorder and depression symptoms during cardiac rehabilitation.
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Affiliation(s)
- Tania Bermudez
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- Department Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Andreas Maercker
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
- Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland
| | - Walter Bierbauer
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | | | | | - Matthias Hermann
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | | | - Urte Scholz
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
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12
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Alhotye M, Evans R, Ng A, Singh SJ. Cardiac rehabilitation for heart failure and atrial fibrillation: a propensity- matched study. Open Heart 2023; 10:e002372. [PMID: 37567605 PMCID: PMC10423825 DOI: 10.1136/openhrt-2023-002372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is common in individuals with heart failure (HF). Individuals with HF and AF may have a reduced functional capacity and quality of life (QoL) which leads to hospital admission and burden on clinical services. Evidence supported the effect of exercise training in individuals with HF. However, there is no existing data on the effectiveness of comprehensive cardiac rehabilitation (CR) in individuals with coexisting HF and AF. AIM To explore the effect of CR in individuals with HF and AF compared with those with HF and no-coexisting AF. METHODS Using CR database, individuals with HF and AF were identified and propensity matched to those with no coexisting AF. The change in incremental shuttle walking test, Heart Disease Quality of Life questionnaire, Hospital Anxiety and Depression Scores were compared between groups pre-CR and post-CR. RESULTS 149 individuals were propensity matched from each group. The mean±SD age of the matched sample was 73.4±8 years, body mass index 29±5.5 kg/m2, left ventricular ejection fraction 35.2±9.8% and 56% were male.A statistically significant improvements in exercise capacity, heart disease QoL, anxiety and depression scores were observed within each group. There were no significant differences between groups for any of these outcome measures. CONCLUSIONS Individuals with HF and AF gain a similar improvement in exercise capacity and health related QoL outcomes as individuals with no coexisting AF following CR. The presence of AF did not compromise the effectiveness of CR.
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Affiliation(s)
- Munyra Alhotye
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Respiratory Therapy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rachael Evans
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Andre Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- Department of Cardiovascular Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, UK
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13
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The Effect of Exercise-Based Cardiac Rehabilitation on Neutrophil to Lymphocyte Ratio in Patients with Coronary Artery Disease. COR ET VASA 2023. [DOI: 10.33678/cor.2022.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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14
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den Uijl I, Ter Hoeve N, Sunamura M, Stam HJ, Boersma E, Lenzen MJ, Brouwers RWM, Tenbült-van Limpt NCCW, Ista E, van den Berg-Emons RJG. Cardiac rehabilitation designed for patients with obesity: OPTICARE XL RCT results on health-related quality of life and psychosocial well-being. Disabil Rehabil 2023; 45:1046-1055. [PMID: 35311438 DOI: 10.1080/09638288.2022.2050428] [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] [Indexed: 11/03/2022]
Abstract
Purpose We studied the effectiveness of a new cardiac rehabilitation (CR) program developed for patients with obesity compared with standard CR on HRQOL and psychosocial well-being.Materials and methods OPTICARE XL was a multicentre RCT in patients with cardiac disease and obesity (Netherlands Trial Register: NL5589). Patients were randomized to OPTICARE XL CR (n = 102) or standard CR (n = 99). The one-year OPTICARE XL CR group program included endurance and resistance exercises, behavioural coaching, and after-care. Standard CR consisted of a 6- to 12-week endurance exercise group program, and cardiovascular lifestyle education. Primary endpoint was HRQOL (MacNew) at six months post CR. Second, we assessed anxiety and depression (both HADS), fatigue (FSS), and participation in society (USER-P).Results In both groups, improvements in HRQOL were observed six months post CR. Mean HRQOL improved from 4.92 to 5.40 in standard CR [mean change (95% CI): 0.48 (0.28, 0.67)] and from 4.96 to 5.45 in OPTICARE XL CR (mean change (95% CI): 0.49 (0.29, 0.70), without between-group differences. Psychosocial well-being improvements within both groups were obtained at six months post CR, regardless of allocated program.Conclusions OPTICARE XL CR did not have added value in improving HRQOL and psychosocial well-being in patients with obesity.Implications for rehabilitationMore than a third of cardiac patients suffers from obesity, and standard cardiac rehabilitation (CR) programs are suboptimal in this increasing patient population.The OPTICARE XL CR program is a state-of-the art, one-year CR program designed for patients with obesity including aerobic and strength exercises, behavioural coaching towards a healthy diet and an active lifestyle, and after-care.Improvements in HRQOL and psychosocial well-being were comparable between patients with obesity allocated to standard CR and OPTICARE XL CR.Therefore, there was no additional benefit of OPTICARE XL CR.
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Affiliation(s)
- Iris den Uijl
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Capri Cardiac Rehabilitation, Rotterdam, The Netherlands
| | - Nienke Ter Hoeve
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Capri Cardiac Rehabilitation, Rotterdam, The Netherlands
| | | | - Henk J Stam
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Mattie J Lenzen
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | | | - Erwin Ista
- Department of Internal Medicine, Nursing Science, Erasmus University Medical Centre, Rotterdam, The Netherlands
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15
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Menezes HJ, D' Souza SRB, Padmakumar R, Babu AS, Rao RR, Kamath VG, Kamath A, Grace SL. Technology-based Comprehensive Cardiac Rehabilitation Therapy (TaCT) for women with cardiovascular disease in a middle-income setting: A randomized controlled trial protocol. Res Nurs Health 2023; 46:13-25. [PMID: 36371623 DOI: 10.1002/nur.22276] [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: 06/16/2022] [Revised: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022]
Abstract
Women are underrepresented in cardiac rehabilitation (CR) despite the benefits, and this is exacerbated in lower-resource settings where CR is insufficiently available. In this randomized controlled trial, the effectiveness of the Technology-based Comprehensive Cardiac Rehabilitation Therapy (TaCT) electronic cardiac rehabilitation (eCR) intervention on functional capacity, risk factors, quality of life, heart-health behaviors, symptoms, and morbidity will be tested among women with CVD in a middle-income country. Following a pilot study, a single-center, single-blinded, 2 parallel-arm (1:1 SNOSE) superiority trial comparing an eCR intervention (TaCT) to usual care, with assessments pre-intervention and at 3 and 6 months will be undertaken. One hundred adult women will be recruited. Permuted block (size 10) randomization will be applied. The 6-month intervention comprises an app, website, SMS texts with generic heart-health management advice, and bi-weekly 1:1 telephone calls with a nurse trainee. Individualized exercise prescriptions will be developed based on an Incremental Shuttle Walk Test (primary outcome) and dietary plans based on 24 h dietary recall. A yoga/relaxation video will be provided via WhatsApp, along with tobacco cessation support and a moderated group chat. At 3 months, intervention engagement and acceptability will be assessed. Analyses will be conducted based on intent-to-treat. If results of this novel trial of women-focused eCR in a middle-income country demonstrate clinically-significant increases in functional capacity, this could represent an important development for the field considering this would be an important outcome for women and would translate to lower mortality.
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Affiliation(s)
- Henita Joshna Menezes
- Department of Obstetric and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Sonia R B D' Souza
- Department of Obstetric and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Ramachandran Padmakumar
- Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Abraham Samuel Babu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Rohini R Rao
- Department of Computer Applications, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Veena G Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Asha Kamath
- Department of Data Science, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sherry L Grace
- Faculty of Health, York University, Toronto, Ontario, Canada.,KITE and Director Cardiac Rehabilitation Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
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16
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Jellestad L, Auschra B, Zuccarella-Hackl C, Princip M, von Känel R, Euler S, Hermann M. Sex and age as predictors of health-related quality of life change in Phase II cardiac rehabilitation. Eur J Prev Cardiol 2023; 30:128-136. [PMID: 36065084 DOI: 10.1093/eurjpc/zwac199] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 01/29/2023]
Abstract
AIMS Cardiac rehabilitation (CR) not only improves cardiovascular outcomes, but also health-related quality of life (HRQOL). Unfortunately, CR is still underutilized, especially among women and older patients. Aim of this study was to highlight age- and sex-specific effects of inpatient CR on HRQOL. METHODS AND RESULTS From 2012 to 2018, 18 459 patients were prospectively assessed in six Swiss CR clinics. Of these, we retrospectively analysed a final sample of 8286 patients with a mean (standard deviation) age of 67.8 (11.3) in men and 72.2 (11.3) in women. HRQOL was measured at CR entry and discharge. In multivariable analyses, sex- and age-specific changes in HRQOL throughout CR were estimated, adjusting for baseline HRQOL and clinical characteristics. Participants of both sexes improved significantly (P < 0.001) in all domains of HRQOL during CR. Women reported significantly lower social (P < 0.001) and emotional (P < 0.001) HRQOL than men at CR entry. Female sex predicted greater improvement in social (F = 19.63, P < 0.001), emotional (F = 27.814, P < 0.001), and physical HRQOL (F = 20.473, P < 0.001). In a subgroup of n = 2632 elderly patients (>75 years), female sex predicted greater changes in emotional (F = 15.738, P < 0.001) and physical (F = 6.295, P = 0.012), but not in social HRQOL. CONCLUSION Women report poorer HRQOL at CR entry compared with men, but in turn particularly benefit from CR in this regard. Our results indicate that sex- and age-specific needs of patients should be considered.
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Affiliation(s)
- Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Hermann
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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17
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Bjarnason-Wehrens B, Schwaab B. Individually tailored cardiac rehabilitation: will the dream come true by identifying sex- and age-related differences by assessing health-related quality of life at entry? Eur J Prev Cardiol 2023; 30:125-127. [PMID: 36052671 DOI: 10.1093/eurjpc/zwac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Birna Bjarnason-Wehrens
- Department of Preventive and Rehabilitative Sport and Exercise Medicine, Institute for Cardiology and Sports Medicine, German Sport University Cologne, D-50933 Köln, Germany
| | - Bernhard Schwaab
- Cuschmann Klinik, Saunaring 6, D-23669 Timmendorfer strand; Universität zu Lübeck, Medical Department, Ratzeburger-Allee 160, D-23562 Lübeck, Germany
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18
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Heart Failure-Smart Life: a randomized controlled trial of a mobile app for self-management in patients with heart failure. BMC Cardiovasc Disord 2023; 23:7. [PMID: 36624373 PMCID: PMC9827017 DOI: 10.1186/s12872-023-03039-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND It is an important strategy for healthcare providers to support heart failure patients with comprehensive aspects of self-management. A practical alternative to a comprehensive and user-friendly self-management program for heart failure patients is needed. This study aimed to develop a mobile self-management app program for patients with heart failure and to identify the impact of the program. METHODS We developed a mobile app, called Heart Failure-Smart Life. The app was to provide educational materials using a daily health check-up diary, Q & A, and 1:1 chat, considering individual users' convenience. An experimental study was employed using a randomized controlled trial to evaluate the effects of the program in patients with heart failure from July 2018 to June 2019. The experimental group (n = 36) participated in using the mobile app that provided feedback on their self-management and allowed monitoring of their daily health status by cardiac nurses for 3 months, and the control group (n = 38) continued to undergo their usual care. The differences in the physical, psychosocial, and behavioral factors between the two groups over time were analyzed using the analysis of covariance. RESULTS After 3 months of intervention, significant differences between experimental and control groups were shown in the New York Heart Association functional class (p = 0.003) and cardiac diastolic function (p = 0.024). The improvements over time in the experimental group tended to be higher than those in the control group in considered variables. However, no changes in psychosocial and behavioral variables were observed between the groups over time. CONCLUSIONS This study provides evidence that the mobile app program may provide benefits to its users, specifically improvements of symptom and cardiac diastolic function in patients with heart failure. Healthcare providers can effectively and practically guide and support patients with heart failure using comprehensive and convenient self-management tools such as smartphone apps.
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Developing an Australian utility value set for MacNew-7D health states. Qual Life Res 2022; 32:1151-1163. [PMID: 36542299 DOI: 10.1007/s11136-022-03325-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND A new preference-based measure (MacNew-7D) has recently been developed to allow condition-specific data to be used to capture the quality of life in health economic evaluations in cardiology; however, a general population value set has not yet been developed. This study developed a population utility value set for the MacNew-7D heart disease-specific instrument. METHODS The discrete choice experiments (DCE) technique was chosen as the preference-elicitation method. The DCE asked respondents to compare two options and to state their preferences. The survey was conducted using an online panel of respondents, with quota sampling using age groups, sex and jurisdictions to achieve representativeness of the Australian population. The total design consisted of 200 choice sets, of which each respondent answered eight. Additionally, each respondent answered two quality control choice sets. The best-fitting models were selected on the basis of consistency, parsimony, and goodness of fit. RESULTS In total, 1903 respondents were included in the analyses. The MacNew-7D utility value set ranged from -0.4456 to 1.000 for health states defined by the classification system. The best-fitting model retained all levels for five dimensions and collapsed one adjacent level for the other two dimensions. Findings were robust to sensitivity analyses related to the inclusion or exclusion of dominancy and repeat tasks. CONCLUSION Findings indicated that the MacNew-7D utility value set is likely suitable for estimating quality-adjusted life years derived from the MacNew heart disease health-related quality-of-life questionnaire. This value set was derived from an Australian population-based sample and may not be generalisable to dissimilar populations.
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KÖhn S, Schlumbohm A, Marquardt M, Scheel-Sailer A, Tobler S, Vontobel J, Menzi L. Predicting non-response in patient-reported outcome measures: results from the Swiss quality assurance programme in cardiac inpatient rehabilitation. Int J Qual Health Care 2022; 34:6833162. [PMID: 36399024 PMCID: PMC9729760 DOI: 10.1093/intqhc/mzac093] [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: 06/08/2022] [Revised: 09/30/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Quality assurance programmes measure and compare certain health outcomes to ensure high-quality care in the health-care sector. The outcome of health-related quality of life is typically measured by patient-reported outcome measures (PROMs). However, certain patient groups are less likely to respond to PROMs than others. This non-response bias can potentially distort results in quality assurance programmes. OBJECTIVE Our study aims to identify relevant predictors of non-response during assessment using the PROM MacNew Heart Disease questionnaire in cardiac rehabilitation. METHODS This is a cross-sectional study based on data from the Swiss external quality assurance programme. All patients aged 18 years or older who underwent inpatient cardiac rehabilitation in 16 Swiss rehabilitation clinics between 2016 and 2019 were included. Patients' socio-demographic and basic medical data were analysed descriptively by comparing two groups: non-responders and responders. We used a random intercept logistic regression model to estimate the associations of patient characteristics and clinic differences with non-response. RESULTS Of 24 572 patients, there were 33.3% non-responders and 66.7% responders. The mean age was 70 years, and 31.0% were women. The regression model showed that being female was associated with non-response [odds ratio (OR) 1.22; 95% confidence interval (CI) 1.14-1.30], as well as having no supplementary health insurance (OR 1.49; 95% CI 1.39-1.59). Each additional year of age increased the chance of non-response by an OR of 1.02 (95% CI 1.02-1.02). Not being a first language speaker of German, French or Italian increased the chance of non-response by an OR of 6.94 (95% CI 6.03-7.99). Patients admitted directly from acute care had a higher chance of non-response (OR 1.23; 95% CI 1.10-1.38), as well as patients being discharged back into acute care after rehabilitation (OR 3.89; 95% CI 3.00-5.04). Each point on the cumulative illness rating scale total score increased the chance of non-response by an OR of 1.05 (95% CI 1.04-1.05). Certain diagnoses also influenced the chance of non-response. Even after adjustment for known confounders, response rates differed substantially between the 16 clinics. CONCLUSION We have found significant non-response bias among certain patient groups, as well as across different treatment facilities. Measures to improve response rates among patients with known barriers to participation, as well as among different treatment facilities, need to be considered, particularly when PROMs are being used for comparison of providers in quality assurance programmes or outcome evaluation.
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Affiliation(s)
- Stefanie KÖhn
- Address reprint requests to: Stefanie Köhn, Institut für Medizinische Soziologie und Rehabilitationswissenschaften, Abteilung Rehabilitationsforschung, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany. Tel: +49 30 450 517 156; Fax: +49 30 450 517 932; E-mail:
| | - Anna Schlumbohm
- Abteilung Rehabilitationsforschung, Institute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany
| | - Manuela Marquardt
- Abteilung Rehabilitationsforschung, Institute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Guido-A.-Zäch-Strasse 1, Nottwil CH-6207, Switzerland
| | - Stephan Tobler
- Kliniken Valens, Taminaplatz 1, Valens CH-7317, Switzerland
| | - Jan Vontobel
- Hochgebirgsklinik Davos AG, Herman-Burchard-Strasse 1, Davos CH-7265, Switzerland
| | - Luise Menzi
- Swiss National Association for Quality Development in Hospitals and Clinics - ANQ, Weltpoststrasse 5, Bern CH-3015, Switzerland
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21
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Freene N, McManus M, Mair T, Tan R, Davey R. Association of device-measured physical activity and sedentary behaviour with cardiovascular risk factors, health-related quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees with coronary heart disease. BMC Sports Sci Med Rehabil 2022; 14:169. [PMID: 36071477 PMCID: PMC9454132 DOI: 10.1186/s13102-022-00562-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022]
Abstract
Background Few studies have considered the relationship between risk factors, physical activity and sedentary behaviour in people with heart disease. Here we examine the independent relationship of device-measured physical activity and sedentary behaviour on risk factors, quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees. Methods Hospital-based phase II cardiac rehabilitation participants with coronary heart disease were assessed at the start and end of cardiac rehabilitation (6-weeks), 6 and 12-months. Physical activity (moderate-to-vigorous (MVPA), light-intensity (LIPA); min/day) and sedentary behaviour (min/day, bouts, breaks) were measured using an ActiGraph accelerometer. Risk factors included waist circumference, body mass index, systolic blood pressure (SBP), fasting blood lipid and glucose levels, anxiety and depression. Quality-of-life and exercise capacity were also collected. Associations were assessed with Generalized Estimating Equation modeling. Results Sixty-seven participants were included (mean age = 64 (SD 9) years; 81% male). An association was found between higher MVPA and lower high density lipoprotein (p ≤ 0.001). No significant (p ≤ 0.001) associations were found between sedentary behaviour variables and other outcomes. At p < 0.05 several associations were significant. Increased MVPA and LIPA were associated with decreased total cholesterol. Higher MVPA was associated with decreased SBP, whereas higher LIPA was associated with decreased waist circumference and body mass index. Higher sedentary behaviour bouts and breaks were associated with increased total cholesterol, anxiety and depression, and decreased SBP over time. Conclusions Any intensity of physical activity was associated with decreased total cholesterol. Increased LIPA was associated with improved measures of adiposity, while breaking up sedentary behaviour and increasing MVPA may decrease SBP over time. Further investigation of MVPA, LIPA and the distribution of sedentary behaviour is indicated in cardiac rehabilitation attendees to explore their relationship with risk factors. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615000995572, http://www.ANZCTR.org.au/ACTRN12615000995572.aspx. Registered 22 September 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00562-7.
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Affiliation(s)
- Nicole Freene
- Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia. .,Health Research Institute, University of Canberra, Bruce, ACT, Australia.
| | | | - Tarryn Mair
- Exercise Physiology, Canberra Health Services, Garran, ACT, Australia
| | - Ren Tan
- Canberra Health Services, Garran, ACT, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
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22
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Sadeh M, Agay N, Brauer M, Chudnovsky A, Ziv A, Dankner R. Is health-related quality of life 1-year after coronary artery bypass graft surgery associated with living in a greener environment? ENVIRONMENTAL RESEARCH 2022; 212:113364. [PMID: 35487257 DOI: 10.1016/j.envres.2022.113364] [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: 02/08/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Greenery in the residential environment and in the hospital has been associated with improved surgical outcomes and recovery. We investigated the association between the level of residential greenness of patients with coronary disease and their heart disease-related Quality of Life (HRQoL) 1-year after a coronary artery bypass grafting (CABG) surgery. METHODS Participants in a prospective cohort study who underwent CABG surgery at seven cardiothoracic units throughout Israel during the years 2004-2007 filled in the MacNew HRQoL one day before and one year after surgery. Successful recovery was defined as ≥0.5 increase in the MacNew score between baseline and follow-up. Exposure to residential greenness in 90 m and 300 m buffers around the patient's home was assessed with Linear Spectral Unmixing analysis of Landsat 30 m imagery. RESULTS The cohort comprised of 861 patients (22% female) with a mean age of 65.5 years, and 59.2% classified as low-income. In the total cohort, higher residential greenness was associated with an improvement in emotional HRQoL (OR = 1.33 (95%CI: 0.99-1.79)), adjusting for demographic and socio-economic factors, living in the periphery/center, presence of diabetes, attending cardiac rehabilitation following surgery, BMI, and change in physical fitness and depression over the 1-year follow-up. Although no association was found between greenness and change in the physical or social subscales, a positive association was specifically observed among the low-income patients for the global HRQoL score, OR = 1.42 (95%CI: 0.97-2.10), as compared to the higher-income patients, p for interaction = 0.03. CONCLUSIONS Residential greenness is associated with improvement in HRQoL 1-year after CABG surgery, but not the physical and social scales, only in low-income patients. Ensuring greenery in the living environment may act as a social intervention that supports human health and disease recovery.
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Affiliation(s)
- Maya Sadeh
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
| | - Nirit Agay
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Michael Brauer
- School of Population & Public Health, University of British Columbia, Canada
| | - Alexandra Chudnovsky
- AIR-O Lab, Porter School of Environment and Earth Sciences, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Israel
| | - Arnona Ziv
- Unit for Data Management and Computerization, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Rachel Dankner
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel; Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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23
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Manresa-Rocamora A, Sarabia JM, Guillen-Garcia S, Pérez-Berbel P, Miralles-Vicedo B, Roche E, Vicente-Salar N, Moya-Ramón M. Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10463. [PMID: 36078179 PMCID: PMC9518028 DOI: 10.3390/ijerph191710463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The objective of this research was to investigate whether heart rate variability (HRV)-guided training improves mortality predictors to a greater extent than predefined training in coronary artery disease patients. Twenty-one patients were randomly allocated to the HRV-guided training group (HRV-G) or the predefined training group (PRED-G). They measured their HRV at home daily and trained three times a week for six weeks. Resting heart rate, isolated vagal-related HRV indices (i.e., RMSSD, HF, and SD1), weekly averaged RMSSD, heart rate recovery, and maximum oxygen uptake were assessed before and after the training period. There was a statistically significant difference (p = 0.034) in the change in weekly averaged RMSSD in favor of the HRV-G, while no differences were found in the remaining analyzed variables (p > 0.050). Regardless of the training prescription method, exercise training decreased resting heart rate (p = 0.001; -4.10 [95% CI = -6.37--1.82] beats per minute (bpm)), and increased heart rate recovery at 2 min (p = 0.010; 4.33 [95% CI = 1.15-7.52] bpm) and maximum oxygen uptake (p < 0.001; 3.04 [95% CI = 1.70-4.37] mL·kg-1·min-1). HRV-guided training is superior to predefined training in improving vagal-related HRV when methodological factors are accounted for.
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Affiliation(s)
- Agustín Manresa-Rocamora
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
| | - José Manuel Sarabia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
| | | | - Patricio Pérez-Berbel
- Department of Cardiology, Hospital Clínico Universitario San Juan, 03550 San Juan de Alicante, Spain
- Department of Cardiology, Hospital Universitario del Vinalopó, 03293 Elche, Spain
| | | | - Enrique Roche
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University of Elche, 03202 Elche, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Néstor Vicente-Salar
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Manuel Moya-Ramón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
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24
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Shen BJ, Tan JJL, Xu Y, Tay HY. Poor Sleep Quality Predicts Decline in Physical Health Functioning in Patients with Coronary Heart Disease and Moderating Role of Social Support. Behav Med 2022; 48:294-304. [PMID: 33750280 DOI: 10.1080/08964289.2021.1895050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although sleep problems are common among patients with coronary heart disease (CHD), there is a lack of prospective research examining its influence on health consequences over time. This study investigated whether poor sleep quality predicted patients' decline in physical health functioning over 6 months and whether social support buffered its detrimental effect. Participants were 185 patients with CHD, who completed measures of sleep, psychosocial characteristics, and physical health functioning at baseline and 6 months. Hierarchical regression analyses were conducted to examine whether global sleep index and its subscales, including sleep efficiency, perceived sleep quality, and daily disturbances (sleep disturbances and daytime dysfunction), predicted the decline of physical health functioning at 6 months. Social support was examined for its moderating effect in buffering the negative influence of poor sleep quality on physical health functioning over 6 months. Findings showed that poorer global sleep index, especially subscales of daily disturbances and lower sleep efficiency, significantly predicted greater decline of physical health functioning at 6 months, even after adjusting for covariates, including baseline functioning and depression. Moreover, social support was found to buffer the detrimental impact of poor sleep quality, especially low sleep efficiency, on 6-month physical health functioning. Findings suggest that improving sleep quality for patients with CHD may be promising to facilitate their long-term health maintenance.
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Affiliation(s)
- Biing-Jiun Shen
- Psychology Program, Nanyang Technological University, Singapore
| | | | - Yue Xu
- Psychology Program, Nanyang Technological University, Singapore
| | - Hung Yong Tay
- Heart Wellness Centre, Singapore Heart Foundation, Singapore
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25
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Krzowski B, Peller M, Boszko M, Hoffman P, Żurawska N, Jaruga K, Skoczylas K, Osak G, Kołtowski Ł, Grabowski M, Opolski G, Balsam P. Mobile app and digital system for patients after myocardial infarction (afterAMI): study protocol for a randomized controlled trial. Trials 2022; 23:522. [PMID: 35729626 PMCID: PMC9210045 DOI: 10.1186/s13063-022-06463-x] [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: 09/14/2021] [Accepted: 06/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Treatment of acute myocardial infarction has been the subject of studies over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient’s prognosis. It is extremely important to take care of all cardiovascular risk factors and undergo a full rehabilitation program. Telemedical solutions are becoming more and more relevant in everyday practice. We describe a protocol of a study evaluating the use of the mobile application “afterAMI” in patients after myocardial infarction. The app offers an educational mode, calendar, vital signs diary, medication reminders, medical history card, and healthcare professional contact panel. It offers several solutions, which individually proved to be effective and improve a patient’s prognosis. Despite general promising results from previous studies regarding telemedical tools, there is a paucity of evidence when it comes to prospective randomized trials. Our aim was to perform a comprehensive evaluation of a newly developed mobile application in the clinical setting. Methods A group of 100 patients with myocardial infarction on admission at the 1st Chair and Department of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analyzed, along with rehospitalizations, the patients’ knowledge regarding cardiovascular risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1 and 6 months after inclusion into the study. Discussion This project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients. Trial registration ClinicalTrials.govNCT04793425. Registered on 11 March 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06463-x.
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Affiliation(s)
- Bartosz Krzowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Michał Peller
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland.
| | - Maria Boszko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Paulina Hoffman
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Natalia Żurawska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Karolina Jaruga
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Kamila Skoczylas
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Gabriela Osak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Łukasz Kołtowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Paweł Balsam
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
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26
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Okur I, Aksoy CC, Yaman F, Sen T. Which high-intensity interval training program is more effective in patients with coronary artery disease? Int J Rehabil Res 2022; 45:168-175. [PMID: 35191412 DOI: 10.1097/mrr.0000000000000524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of the study is to examine high-intensity interval training (HIIT) programs and a moderate-intensity continuous training (MICT) program, which are frequently used in cardiac rehabilitation programs in terms of their effects on the functional capacity and quality of life of patients with coronary artery disease (CAD). The study included 20 patients with CAD (mean age, 60.95 ± 5.08 years) who had undergone revascularization surgery. The participants were randomized into HIIT-short, HIIT-long, and MICT groups. All the groups participated in a 24-session exercise-based cardiac rehabilitation program. The participants' exercise capacity was evaluated using the maximal exercise test and estimated VO2max values, functional capacity using the 6-min walk test (6MWT), and quality of life using the Short Form-36 survey and MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire. It was determined that the estimated VO2max values statistically significantly improved after treatment (P < 0.05), and both HIIT groups were superior to the MICT group (P < 0.05). Only the HIIT groups achieved the minimal clinically important difference in the 6MWT distance. After treatment, only the MICT group had a statistically significant improvement in quality of life. There was no statistically significant difference between the groups in relation to the improvement in the 6MWT distance and quality of life (P > 0.05). The results of our study showed that both HIIT programs were superior to MICT in improving the maximal exercise capacity of patients with CAD, and the three programs had a similar effect on quality of life.
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Affiliation(s)
- Ismail Okur
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University
| | - Cihan Caner Aksoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University
| | - Fatima Yaman
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University
| | - Taner Sen
- Department of Cardiology, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
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27
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Tremblay MA, Denis I, Turcotte S, DeGrâce M, Tully PJ, Foldes-Busque G. Cognitive-Behavioral Therapy for Panic Disorder in Patients with Stable Coronary Artery Disease: A Feasibility Study. J Clin Psychol Med Settings 2022; 30:28-42. [PMID: 35543901 PMCID: PMC9093559 DOI: 10.1007/s10880-022-09876-7] [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] [Accepted: 04/10/2022] [Indexed: 11/18/2022]
Abstract
Implementing cognitive-behavioral therapy (CBT), the first-line psychological treatment for panic disorder (PD), may be challenging in patients with comorbid coronary artery disease (CAD).This study aimed at assessing the feasibility and acceptability of a CBT for PD protocol that was adapted to patients suffering from comorbid CAD. It also aimed at evaluating the efficacy of the intervention to reduce PD symptomatology and psychological distress and improve quality of life. This was a single-case experimental design with pre-treatment, post-treatment and 6-month follow-up measures. Patients with PD and stable CAD received 14 to 17 individual, 1-h sessions of an adapted CBT for PD protocol. They completed interviews and questionnaires at pre-treatment, post-treatment and at a 6-month follow-up assessing intervention acceptability, PD symptomatology, psychological distress and quality of life. A total of 6 patients out of 7 completed the intervention and 6-month follow-up, indicating satisfactory feasibility. Acceptability was high (medians of ≥ 8.5 out of 9 and ≥ 80%) both at pre and post treatment. Remission rate was of 83% at post-treatment and 6-month follow-up. The intervention appeared to have positive effects on comorbid anxiety and depression symptoms and quality of life. The intervention appeared feasible and acceptable in patients with comorbid CAD. The effects of the adapted CBT protocol on PD symptoms, psychological distress and quality of life are promising and were maintained at the 6-month follow-up. Further studies should aim at replicating the present results in randomized-controlled trials
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Affiliation(s)
- Marie-Andrée Tremblay
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.,Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Isabelle Denis
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.,Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Stéphane Turcotte
- Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Michel DeGrâce
- Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Phillip J Tully
- Faculty of Health and Medical Sciences, The University of Adelaide, 30 Frome Road, Adelaide, SA, 5000, Australia
| | - Guillaume Foldes-Busque
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada. .,Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada. .,Research Center of the Quebec Heart and Lung Institute, 2725, chemin Sainte-Foy, Quebec, QC, G1V 4G5, Canada.
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28
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Ventura F, Sousa P, Dixe MA, Ferreira P, Martinho R, Dias SS, Morais J, Gonçalves LM. A Clinical Decision Support System for Remote Monitoring of Cardiovascular Disease Patients: A Clinical Study Protocol. Front Public Health 2022; 10:859890. [PMID: 35615041 PMCID: PMC9124932 DOI: 10.3389/fpubh.2022.859890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/29/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction Cardiovascular diseases (CVD) are the leading cause of death globally, taking an estimated 17. 9 million lives each year. Cardiac rehabilitation is shown to reduce mortality and hospital readmissions, while improving physical fitness and quality of life. Despite the recommendations and proven benefits, acceptance and adherence remain low. Mobile health (mHealth) solutions may contribute to more personalized and tailored patient recommendations according to their specific needs. This study protocol aims to assess the effectiveness of a user-friendly, comprehensive Clinical Decision Support System (CDSS) for remote patient monitoring of CVD patients, primarily on the reduction of recurrent cardiovascular events. Methods and Analysis The study will follow a multicenter randomized controlled design involving two cardiology units in the Center Region of Portugal. Prospective CVD patients will be approached by the healthcare staff at each unit and checked for eligibility according to the predefined inclusion/exclusion criteria. The CDSS will suggest a monitoring plan for the patient, will advise the mHealth tools (apps and wearables) adapted to patient needs, and will collect data. The clinical study will start in January 2023. Discussion The success of the mHeart.4U intervention will be a step toward the use of technological interfaces as an integrating part of CR programs. Ethics and Dissemination The study will undergo ethical revision by the Ethics Board of the two hospital units where the study will unfold. The study was registered in ClinicalTrials.gov on 18th January 2022 with the number NCT05196802. The study findings will be published in international peer-reviewed scientific journals and encounters and in a user-friendly manner to the society.
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Affiliation(s)
- Filipa Ventura
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Pedro Sousa
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- *Correspondence: Pedro Sousa
| | - Maria Anjos Dixe
- Center for Innovative Care and Health Technology (ciTechcare), School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Paulo Ferreira
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Ricardo Martinho
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal
- CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Sara Simões Dias
- Center for Innovative Care and Health Technology (ciTechcare), School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - João Morais
- Center for Innovative Care and Health Technology (ciTechcare), School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Cardiology Division, Leiria Hospital Center, Leiria, Portugal
| | - Lino M. Gonçalves
- Cardiology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Ahmadikhatir S, Ostadrahimi A, Safaiyan A, Ahmadikhatir S, Farrin N. Saffron ( Crocus sativus L.) supplements improve quality of life and appetite in atherosclerosis patients: A randomized clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:30. [PMID: 35548173 PMCID: PMC9081510 DOI: 10.4103/jrms.jrms_1253_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 10/28/2021] [Accepted: 11/10/2021] [Indexed: 11/04/2022]
Abstract
Background Atherosclerosis is the most common cause of the cardiovascular disease. Saffron is a traditional food that affects many diseases and disorders. Therefore, the aim of this study was to identify the effects of Saffron (Crocus sativus L.) on quality of life (QOL) and appetite in patients with atherosclerosis. Materials and Methods This was a randomized, double-blind, placebo-controlled clinical trial. A total of 63 participants with atherosclerosis were recruited from Emam Sajjad Hospital, Valiasr Hospital, and Zafaranieyh Clinic in Tehran, Iran. The participants were divided randomly into two groups. Participants received 100 mg/d saffron or placebo capsule for 6 weeks. QOL and appetite levels were measured by the McNew QOL questionnaire, and visual analog scale questionnaire, respectively. Furthermore, anthropometric indices of participants were measured before and after the intervention. Results Statistical analysis showed that there was a statistically significant difference between atherosclerosis patients who received placebo and those who consumed saffron in terms of the physical domain (P = 0.008) and social domain (P = 0.012) of QOL. In the saffron group increased score in Total score Macnew (P < 0.001), physical domain (P = 0.025), and social domain (P < 0.001) was significant after the intervention. Moreover, the consumption of saffron did not significantly affect emotional domains of QOL, and appetite levels. Conclusion Saffron may be considered as a novel agent in patients with atherosclerosis to improve the QOL. A great deal of further research will be needed to critically validate the efficacy of saffron and its mechanisms in atherosclerosis.
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Affiliation(s)
- Shonaz Ahmadikhatir
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolrasoul Safaiyan
- Department of Vital Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shoyar Ahmadikhatir
- Department of Ophthalmology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Nazila Farrin
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Quality of Life Assessment in Patients Undergoing Trans-Catheter Aortic Valve Implantation Using MacNew Questionnaire. Am J Cardiol 2022; 164:103-110. [PMID: 34819234 DOI: 10.1016/j.amjcard.2021.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 11/20/2022]
Abstract
The MacNew questionnaire is a disease-specific quality of life measure that has been used in patients with myocardial infarction and heart failure. We aimed to investigate the impact of transcatheter aortic valve implantation (TAVI) on health-related quality of life (HRQoL) using MacNew Questionnaire and identify predictors associated with a change in its score. This was a prospective multi-center study performed across 5 National Health Service hospitals in the United Kingdom performing TAVI between 2016 and 2018. HRQoL was assessed using MacNew Questionnaire, Euro Quality of Life-5D-5L, and Short Form 36 questionnaires collected at baseline, 3-, 6- and 12 months after the procedure. Out of 225 recruited patients, 19 did not have TAVI and 4 withdrew their consent, and hence 202 patients were included. HRQoL was assessed in 181, 161, and 147 patients at 3, 6, and 12 months, respectively. Using MacNew, there was a significant improvement in all domains of HRQoL as early as 3 months after TAVI which was sustained up to 12 months with improved discrimination of change in HRQoL compared with other scales. Poor mobility at baseline and history of myocardial infarction were independent predictors of reduced improvement in HRQoL at 3 months. HRQoL increased in all subgroups of patients including frail ones. In conclusion, the MacNew assessment tool performed well in a representative TAVI cohort and could be used as an alternative disease-specific method for assessing HRQoL change after TAVI.
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Aljabery MA, Rajeh Saifan A, Alrimawi I, Alzoubi AM, Atout M. The Associations Between Patients' Characteristics and the Quality of Life Among Acute Coronary Syndrome Patients in Jordan: A Cross-Sectional Study. SAGE Open Nurs 2022; 8:23779608221129129. [PMID: 36187078 PMCID: PMC9523843 DOI: 10.1177/23779608221129129] [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: 02/04/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Acute coronary syndrome (ACS) is one of the most significant leading causes of death and disability in the world. The quality of life (QoL) score is used to evaluate the impact of ACS treatments on the patients' physical, emotional, and social functioning. It is considered a significant indicator of the progress of the patients' health status and is useful in predicting patients' needs for continuing, modifying, or changing their treatment plans. Objective To identify the associations between patients' characteristics and the QoL among ACS patients in Jordan. Methods A descriptive cross-sectional study was conducted using a convenience sample of 372 participants with ACS from six referral hospitals in Jordan. Results Jordanian patients with higher educational level and exercise had significant and positive association with QoL (β = 0.257, p < .001), (β = 0.191, p < .001), respectively. Also, patients who reported having dyslipidaemia and having unstable angina (UA) had lower score of QoL (β = -0.165, p < .001), (β = -0.149, p < .001), respectively. Finally, gender and working status did not significantly appear to have an association with the total QoL. Conclusions This study sheds light on the importance of increasing the level of patients' awareness about their illness by educating them about it and encouraging them to engage in physical activity programs.
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Affiliation(s)
| | | | - Intima Alrimawi
- Department of Professional Nursing Practice, Georgetown University, Washington, DC, USA
| | | | - Maha Atout
- Nursing School, Philadelphia University, Amman, Jordan
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Fattirolli F, Argirò A, Angelino ME, Balestroni G, Giallauria F, Miani D, Vigorito C, Piccioli L, Genta FT, Höfer S, Marchionni N, Oldridge N. Validation of the Italian HeartQoL: a short health-related quality of life questionnaire for patients with ischemic heart disease. Intern Emerg Med 2022; 17:123-134. [PMID: 34110564 PMCID: PMC8841307 DOI: 10.1007/s11739-021-02780-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/27/2021] [Indexed: 01/16/2023]
Abstract
The psychometric properties of the core disease-specific 14-item Italian HeartQoL health-related quality of life questionnaire have been evaluated in this study. The Italian version of the HeartQoL, the MacNew questionnaire, and the Hospital Anxiety and Depression Scale were completed by 472 patients (angina, N = 183; myocardial infarction, N = 167; or ischemic heart failure, N = 122) who were recruited in five Italian centers (Florence, Veruno, Turin, Udine, and Naples) between 2015 and 2017. Patients with myocardial infarction reported significantly higher HeartQoL scores than patients with angina or ischemic heart failure. Floor and ceiling effects were always minor on the HeartQoL global scale and physical subscale with moderate ceiling effects on the emotional subscale in the total group and in patients with myocardial infarction. The bifactorial structure of the original HeartQoL questionnaire was confirmed with strong physical, emotional, and global scale H coefficients (> 0.50). The HeartQoL scales demonstrated optimal internal consistency (Cronbach's alpha > 0.84). Convergent and divergent validity were confirmed. Discriminative validity was not confirmed for age, largely confirmed for sex, and fully confirmed for anxiety, depression, and distress. The Italian HeartQoL questionnaire demonstrated adequate key psychometric attributes of internal consistency reliability and validity in Italian-speaking patients with ischemic heart disease.
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Affiliation(s)
- Francesco Fattirolli
- Department of Experimental and Clinical Medicine, University of Florence and Cardiothoracovascular Department Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50141, Firenze, Italy.
| | - Alessia Argirò
- Department of Experimental and Clinical Medicine, University of Florence and Cardiothoracovascular Department Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50141, Firenze, Italy
| | | | | | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Daniela Miani
- Cardiology Unit, University Hospital S. Maria Della Misericordia, Udine, Italy
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Lucrezia Piccioli
- Department of Experimental and Clinical Medicine, University of Florence and Cardiothoracovascular Department Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50141, Firenze, Italy
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Turin, Italy
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Veruno, Italy
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Franco Tarro Genta
- Department of Cardiology Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Stefan Höfer
- Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Niccolò Marchionni
- Department of Experimental and Clinical Medicine, University of Florence and Cardiothoracovascular Department Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50141, Firenze, Italy
| | - Neil Oldridge
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Chaudhury S, Sowmya AV, Khan A, Vijay P, Javadekar A, Chigullapalli S, Saldanha D. Evaluation of quality of life, type D personality and emotional factors in patients undergoing angioplasty- A Prospective study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_918_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Health-related quality of life increases after first-time acute myocardial infarction: A population-based study. Zdr Varst 2021; 61:24-31. [PMID: 35111263 PMCID: PMC8776287 DOI: 10.2478/sjph-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Acute myocardial infarction (AMI) affects patients’ health-related quality of life (HRQOL). AMI may decrease HRQOL, thus negatively affecting QOL. However, the improvements in interventional treatment and early rehabilitation after AMI may have a positive effect on HRQOL. Aim We evaluated HRQOL in patients after the first AMI treated in a reference cardiology centre in Poland and assessed which clinical variables affect HRQOL after AMI. Material and methods We prospectively evaluated HRQOL in 60 consecutive patients suffering after their first AMI during the index hospitalisation and again after 6 months, using: (i) MacNew, (ii) World Health Organization Quality of Life (WHOQOL) BREF, and (iii) Short Form (SF) 36. Results As measured by the MacNew questionnaire, global, social, and physical functioning did not change (p≥0.063), whereas emotional functioning improved 6 months after AMI, compared to index hospitalisation (p=0.002). As measured by WHOQOL BREF, physical health, psychological health, and environmental functioning did not change (p≥0.321), whereas social relationships improved 6 months after AMI (p=0.042). As assessed by SF-36, the global HRQOL improved after AMI (p=0.044). Patients with improved HRQOL in SF-36 often had a higher baseline body mass index (p=0.046), dyslipidaemia (p=0.046), and lower left ventricle ejection fraction (LVEF; p=0.013). LVEF<50% was the only variable associated with improved HRQOL in multivariate analysis (OR 4.463, 95% CI 1.045 - 19.059, p=0.043). Conclusions HRQOL increased 6 months after the first AMI, especially in terms of emotional functioning and social relationships. Patients with LVEF<50% were likely to have improved HRQOL.
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PSYChosomatic Medicine in ONcologIc and Cardiac Disease (PSYCHONIC) Study-A Retrospective and Prospective Observational Research Protocol. J Clin Med 2021; 10:jcm10245786. [PMID: 34945081 PMCID: PMC8709231 DOI: 10.3390/jcm10245786] [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: 08/27/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
Psychosocial factors play an important role in non-communicable diseases (NCDs). This observational study is primarily aimed at assessing the relationship of psychological characteristics of patients with the outcomes of different NCDs, and to assess short-term psychotherapy (STP) efficacy in the real world. Methods: One hundred and forty patients with recent acute myocardial infarction, Takotsubo syndrome, or non-metastatic breast cancer and a control group of 140 age and sex-matched healthy subjects, will be enrolled. All subjects will be administered psychometric tests, quality of life tests, a specific body perception questionnaire, a dream questionnaire, and a projective test, the Six Drawing test at baseline and follow-up. All subjects with medical conditions will be asked to freely choose between an ontopsychological STP along with standard medical therapy and, whenever indicated, rehabilitation therapy or medical therapy plus rehabilitation alone. The study endpoints will be to evaluate: the relationship of the psychological characteristics of enrolled subjects with the outcomes of different NCDs, predictors of the choice of psychotherapy, and the efficacy of ontopsychological intervention on psychological and medical outcomes. Conclusion: This study will generate data on distinctive psychological characteristics of patients suffering from different CDs and their relationship with medical outcomes, as well as explore the efficacy of ontopsychological STP in these patients in the real world. (Number of registration: NCT03437642).
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Schönfelder M, Oberreiter H, Egger A, Tschentscher M, Droese S, Niebauer J. Effect of Different Endurance Training Protocols During Cardiac Rehabilitation on Quality of Life. Am J Med 2021; 134:805-811. [PMID: 33359274 DOI: 10.1016/j.amjmed.2020.10.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study aimed to assess the effect of different types of endurance training during outpatient cardiac rehabilitation on patients' health-related quality of life (HRQL). METHODS The MacNew Heart Disease HRQL questionnaire and the Hospital Anxiety and Depression Scale were used to assess changes in HRQL in 66 patients before and after 6 weeks of cardiac rehabilitation. Patients were randomized to 1 of 3 types of supervised endurance training: continuous endurance training, high-intensity interval training, and pyramid training. Two-way analysis of variance for repeated measure and chi-square test were used to analyze changes before and after rehabilitation. RESULTS Attendance rate during the 6 weeks of exercise training was 99.2%. Physical work capacity increased from 136.1 to 165.5 watts (+22.9%; P < .001), and there were no statistical differences between training protocols. Fully completed questionnaires at both time points were available in 46 patients (73.9%; 61.3±11.6 years, 34 males, 12 females). Regardless of the type of supervised endurance training, there was significant improvement during rehabilitation in each of the categories of the MacNew questionnaire (ie, emotion, physical, social, global; all P < .05) and the Hospital Anxiety and Depression Scale (anxiety: P = .05; depression: P = .032), without significant differences between protocols. CONCLUSIONS All 3 types of endurance training led to significant and well comparable increases in physical work capacity, which was associated with an increase in HRQL independent of the type of training. Our findings support further individualization of training regimes, which could possibly lead to better compliance during life-long home-based exercise training.
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Affiliation(s)
- Martin Schönfelder
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria; Exercise Biology Group, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Hubert Oberreiter
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - Andreas Egger
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - Marcus Tschentscher
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - Silke Droese
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Austria; Exercise Biology Group, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany; Ludwig Boltzmann Institute for Digital Health and Prevention.
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Development of a preference-based heart disease-specific health state classification system using MacNew heart disease-related quality of life instrument. Qual Life Res 2021; 31:257-268. [PMID: 34037917 DOI: 10.1007/s11136-021-02884-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The MacNew Heart Disease Health-Related Quality of Life Instrument (MacNew) is a validated, clinically sensitive, 27-item disease-specific questionnaire. This study aimed to develop a new heart disease-specific classification system for the MacNew amenable for use in health state valuation. METHODS Patients with heart disease attending outpatient clinics and inpatient wards in Brisbane, Australia, completed MacNew. The development of the new disease-specific classification system included three stages. First, a principal component analysis (PCA) established dimensionality. Second, Rasch analysis was used to select items for each dimension. Third, Rasch analysis was used to explore response-level reduction. In addition, clinician and patient judgement informed item selection. RESULTS Participants included 685 patients (acute coronary 6%, stable coronary 41%, chronic heart failure 20%). The PCA identified 4 dimensions (restriction, emotion, perception of others, and symptoms). The restriction dimension was divided into physical and social dimensions. One item was selected from each to be included in the classification system. Three items from the emotional dimension and two symptom items were also selected. The final classification system had seven dimensions with four severity levels in each: physical restriction; excluded from doing things with other people; worn out or low in energy; frustrated, impatient or angry; unsure and lacking in self-confidence; shortness of breath; and chest pain. CONCLUSION This study generated a brief heart disease-specific classification system, consisting of seven dimensions with four severity levels in each. The classification system is amenable to valuation to enable the generation of utility value sets to be developed for use in economic evaluation.
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Freene N, Brown R, Collis P, Bourke C, Silk K, Jackson A, Davey R, Northam HL. An Aboriginal and Torres Strait Islander Cardiac Rehabilitation program delivered in a non-Indigenous health service (Yeddung Gauar): a mixed methods feasibility study. BMC Cardiovasc Disord 2021; 21:222. [PMID: 33932992 PMCID: PMC8088627 DOI: 10.1186/s12872-021-02016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 04/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited evidence of Aboriginal and Torres Strait Islander people attending cardiac rehabilitation (CR) programs despite high levels of heart disease. One key enabler for CR attendance is a culturally safe program. This study evaluates improving access for Aboriginal and Torres Strait Islander women to attend a CR program in a non-Indigenous health service, alongside improving health workforce cultural safety. METHODS An 18-week mixed-methods feasibility study was conducted, with weekly flexible CR sessions delivered by a multidisciplinary team and an Aboriginal and/or Torres Strait Islander Health Worker (AHW) at a university health centre. Aboriginal and Torres Strait Islander women who were at risk of, or had experienced, a cardiac event were recruited. Data was collected from participants at baseline, and at every sixth-session attended, including measures of disease risk, quality-of-life, exercise capacity and anxiety and depression. Cultural awareness training was provided for health professionals before the program commenced. Assessment of health professionals' cultural awareness pre- and post-program was evaluated using a questionnaire (n = 18). Qualitative data from participants (n = 3), the AHW, health professionals (n = 4) and referrers (n = 4) was collected at the end of the program using yarning methodology and analysed thematically using Charmaz's constant comparative approach. RESULTS Eight referrals were received for the CR program and four Aboriginal women attended the program, aged from 24 to 68 years. Adherence to the weekly sessions ranged from 65 to 100%. At the program's conclusion, there was a significant change in health professionals' perception of social policies implemented to 'improve' Aboriginal people, and self-reported changes in health professionals' behaviours and skills. Themes were identified for recruitment, participants, health professionals and program delivery, with cultural safety enveloping all areas. Trust was a major theme for recruitment and adherence of participants. The AHW was a key enabler of cultural authenticity, and the flexibility of the program contributed greatly to participant perceptions of cultural safety. Barriers for attendance were not unique to this population. CONCLUSION The flexible CR program in a non-Indigenous service provided a culturally safe environment for Aboriginal women but referrals were low. Importantly, the combination of cultural awareness training and participation in the program delivery improved health professionals' confidence in working with Aboriginal people. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) 12618000581268, http://www.ANZCTR.org.au/ACTRN12618000581268.aspx , registered 16 April 2018.
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Affiliation(s)
- Nicole Freene
- Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
- Health Research Institute, University of Canberra, Bruce, ACT, Australia.
| | - Roslyn Brown
- Ngunnawal Centre, Office of Aboriginal and Torres Strait Islander Leadership and Strategy, University of Canberra, Bruce, ACT, Australia
| | - Paul Collis
- Faculty of Arts and Design, University of Canberra, Bruce, ACT, Australia
| | - Chris Bourke
- Australian Healthcare and Hospitals Association, Deakin, ACT, Australia
| | - Katharine Silk
- Australian Healthcare and Hospitals Association, Deakin, ACT, Australia
| | - Alicia Jackson
- Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
| | - Holly L Northam
- Nursing, Midwifery and Public Health, Faculty of Health, University of Canberra, Bruce, ACT, Australia
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Gomes L, Liébana-Presa C, Araújo B, Marques F, Fernández-Martínez E. Heart Disease, Now What? Improving Quality of Life through Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063077. [PMID: 33802701 PMCID: PMC8002524 DOI: 10.3390/ijerph18063077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
Introduction: The management of chronic illness assumes a level of demand for permanent care and reaches a priority dimension in the health context. Given the importance of nursing care to post-acute coronary syndrome patients, the objective of this study is to evaluate the impact of an educational intervention program on quality of life in patients after acute coronary syndrome. Method: Quasi-experimental study with two groups: an experimental group exposed to the educational intervention program and the control group without exposure to the educational intervention program. Results: The results showed statistically significant differences between both groups (p < 0.001). Although only valid for the specific group of subjects studied, the educational intervention program enabled significant gains in quality of life. Conclusions: According to the findings of the study, a systematized and structured educational program, integrated into the care organization and based on transition processes, is effective in developing self-care skills and improves the quality of life in patients after acute coronary syndrome.
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Affiliation(s)
- Lisa Gomes
- Nursing School, Minho University, 4710-057 Braga, Portugal;
| | - Cristina Liébana-Presa
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, Universidad de León, 24401 Ponferrada, Spain
- Correspondence:
| | - Beatriz Araújo
- Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Fátima Marques
- Intensive Care Coronary Unit, Centro Hospitalar De Trás-Os-Montes E Alto Douro, E.P.E., 5000-508 Vila Real, Portugal;
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Dunford EC, Valentino SE, Dubberley J, Oikawa SY, McGlory C, Lonn E, Jung ME, Gibala MJ, Phillips SM, MacDonald MJ. Brief Vigorous Stair Climbing Effectively Improves Cardiorespiratory Fitness in Patients With Coronary Artery Disease: A Randomized Trial. Front Sports Act Living 2021; 3:630912. [PMID: 33665614 PMCID: PMC7921461 DOI: 10.3389/fspor.2021.630912] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/26/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Cardiac rehabilitation exercise reduces the risk of secondary cardiovascular disease. Interval training is a time-efficient alternative to traditional cardiac rehabilitation exercise and stair climbing is an accessible means. We aimed to assess the effectiveness of a high-intensity interval stair climbing intervention on improving cardiorespiratory fitness (V˙O2peak) compared to standard cardiac rehabilitation care. Methods: Twenty participants with coronary artery disease (61 ± 7 years, 18 males, two females) were randomly assigned to either traditional moderate-intensity exercise (TRAD) or high-intensity interval stair climbing (STAIR). V˙O2peak was assessed at baseline, following 4 weeks of six supervised exercise sessions and after 8 weeks of ~24 unsupervised exercise sessions. TRAD involved a minimum of 30 min at 60–80%HRpeak, and STAIR consisted of three bouts of six flights of 12 stairs at a self-selected vigorous intensity (~90 s/bout) separated by recovery periods of walking (~90 s). This study was registered as a clinical trial at clinicaltrials.gov (NCT03235674). Results: Two participants could not complete the trial due to the time commitment of the testing visits, leaving n = 9 in each group who completed the interventions without any adverse events. V˙O2peak increased after supervised and unsupervised training in comparison to baseline for both TRAD [baseline: 22.9 ± 2.5, 4 weeks (supervised): 25.3 ± 4.4, and 12 weeks (unsupervised): 26.5 ± 4.8 mL/kg/min] and STAIR [baseline: 21.4 ± 4.5, 4 weeks (supervised): 23.4 ± 5.6, and 12 weeks (unsupervised): 25 ± 6.2 mL/kg/min; p (time) = 0.03]. During the first 4 weeks of training (supervised) the STAIR vs. TRAD group had a higher %HRpeak (101 ± 1 vs. 89 ± 1%; p ≤ 0.001), across a shorter total exercise time (7.1 ± 0.1 vs. 36.7 ± 1.1 min; p = 0.009). During the subsequent 8 weeks of unsupervised training, %HRpeak was not different (87 ± 8 vs. 96 ± 8%; p = 0.055, mean ± SD) between groups, however, the STAIR group continued to exercise for less time per session (10.0 ± 3.2 vs. 24.2 ± 17.0 min; p = 0.036). Conclusions: Both brief, vigorous stair climbing, and traditional moderate-intensity exercise are effective in increasing V˙O2peak, in cardiac rehabilitation exercise programmes.
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Affiliation(s)
- Emily C Dunford
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | | | | | - Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | - Eva Lonn
- Hamilton Health Sciences, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Gao L, Luo W, Tonmukayakul U, Moodie M, Chen G. Mapping MacNew Heart Disease Quality of Life Questionnaire onto country-specific EQ-5D-5L utility scores: a comparison of traditional regression models with a machine learning technique. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:341-350. [PMID: 33438134 DOI: 10.1007/s10198-020-01259-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 12/10/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND This study aims to derive country-specific EQ-5D-5L health status utility (HSU) from the MacNew Heart Disease Health-related Quality of Life questionnaire (MacNew) using both traditional regression analyses, as well as a machine learning technique. METHODS Data were drawn from the Multi-Instrument Comparison (MIC) survey. The EQ-5D-5L was scored using 4 country-specific tariffs (United States, United Kingdom, Germany, and Canada). The traditional regression techniques, as well as a machine learning technique, deep neural network (DNN), were adopted to directly predict country-specific EQ-5D-5L HSUs (i.e. a direct mapping approach). An indirect response mapping was undertaken additionally. The optimal algorithm was identified based on three goodness-of-fit tests, namely, the mean absolute error (MAE), mean error (ME) and root mean square error (RMSE), with the first being the primary criteria. Internal validation was undertaken. RESULTS Indirect response mapping and direct mapping (via betamix with MacNew items as the key predictors) were found to produce the optimal mapping algorithms with the lowest MAE when EQ-5D-5L were scored using three country-specific tariffs (United Kingdom, Canada, and Germany for the former and United Kingdom, United States, Canada and Germany for the latter approach). DNN approach generated the lowest MAE and RMSE when using the Germany-specific tariff. CONCLUSIONS Among different approaches been explored, there is not a conclusive conclusion regarding the optimal method for developing mapping algorithms. A machine learning approach represents an alternative mapping approach that should be explored further. The reported algorithms from response mapping have the potential to be more widely used; however, the performance needs to be externally validated.
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Affiliation(s)
- Lan Gao
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
| | - Wei Luo
- School of Information Technology, Deakin University, Geelong, VIC, Australia
| | - Utsana Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
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Ebrahimi H, Abbasi A, Bagheri H, Basirinezhad MH, Shakeri S, Mohammadpourhodki R. The role of peer support education model on the quality of life and self-care behaviors of patients with myocardial infarction. PATIENT EDUCATION AND COUNSELING 2021; 104:130-135. [PMID: 32826102 DOI: 10.1016/j.pec.2020.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/27/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study aimed to assess the effect of peer education on the quality of life and self-care behaviors of patients with myocardial infarction. METHODS In this clinical trial, 70 patients with myocardial infarction meeting the inclusion criteria were assigned to experimental (n = 35) or control (n = 35) groups using block randomization. Patients in the intervention group received two one-hour training sessions on the third day after myocardial infarction during the CCU stay along with routine care. Education intervention was performed by peers. The control group will follow routine care. All patients selected were assessed using McNews' quality of life questionnaire and Miller self-care questionnaire, respectively before the intervention and also one month after discharge. Chi-square and t-test were used to analyze the data. RESULTS After the intervention, the mean of quality of life and the mean score of self-care behaviors in the experimental group were significantly higher compared to the control group. CONCLUSIONS According to the results, to improve the quality of life and promote the self-care behaviors in such patients, using peer education along with healthcare professionals is recommended. PRACTICE IMPLICATION This patient education approach had a significant impact on quality of life and self-care behavior.
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Affiliation(s)
- Hossein Ebrahimi
- Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Abbasi
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Bagheri
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Shakeri
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Mohammadpourhodki
- Department of Nursing, Kashmar Center of Higher Health Education, Mashhad University of Medical Sciences, Mashhad, Iran.
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Liang G, Huang X, Hirsch J, Mehmi S, Fonda H, Chan K, Huang NF, Aalami O, Froelicher VF, Lee DP, Myers J, Lee AS, Nguyen PK. Modest Gains After an 8-Week Exercise Program Correlate With Reductions in Non-traditional Markers of Cardiovascular Risk. Front Cardiovasc Med 2021; 8:669110. [PMID: 34222367 PMCID: PMC8245677 DOI: 10.3389/fcvm.2021.669110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Although engaging in physical exercise has been shown to reduce the incidence of cardiovascular events, the molecular mechanisms by which exercise mediates these benefits remain unclear. Based on epidemiological evidence, reductions in traditional risk factors only accounts for 50% of the protective effects of exercise, leaving the remaining mechanisms unexplained. The objective of this study was to determine whether engaging in a regular exercise program in a real world clinical setting mediates cardiovascular protection via modulation of non-traditional risk factors, such as those involved in coagulation, inflammation and metabolic regulation. Methods and Results: We performed a prospective, cohort study in 52 sedentary patients with cardiovascular disease or cardiovascular risk factors at two tertiary medical centers between January 1, 2016 and December 31, 2019. Prior to and at the completion of an 8-week exercise program, we collected information on traditional cardiovascular risk factors, exercise capacity, and physical activity and performed plasma analysis to measure levels of fibrinolytic, inflammatory and metabolic biomarkers to assess changes in non-traditional cardiovascular risk factors. The median weight change, improvement in physical fitness, and change in physical activity for the entire cohort were: -4.6 pounds (IQR: +2 pounds, -11.8 pounds), 0.37 METs (IQR: -0.076 METs, 1.06 METs), and 252.7 kcals/week (IQR: -119, 921.2 kcals/week). In addition to improvement in blood pressure and cholesterol, patients who lost at least 5 pounds, expended at least 1,000 additional kcals/week, and/or achieved ≥0.5 MET increase in fitness had a significant reduction in plasminogen activator inhibitor-1 [9.07 ng/mL (95% CI: 2.78-15.35 ng/mL); P = 0.026], platelet derived growth factor beta [376.077 pg/mL (95% CI: 44.69-707.46 pg/mL); P = 0.026); and angiopoietin-1 [(1104.11 pg/mL (95% CI: 2.92-2205.30 pg/mL); P = 0.049)]. Conclusion: Modest improvements in physical fitness, physical activity, and/or weight loss through a short-term exercise program was associated with decreased plasma levels of plasminogen activator inhibitor, platelet derived growth factor beta, and angiopoietin, which have been associated with impaired fibrinolysis and inflammation.
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Affiliation(s)
- Grace Liang
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
| | - Xianxi Huang
- Department of Critical Care Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Stanford Cardiovascular Institute, Stanford, CA, United States
| | - James Hirsch
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Sanjeev Mehmi
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Holly Fonda
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Khin Chan
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Ngan F. Huang
- Department of Cardiovascular Surgery, Stanford University, Stanford, CA, United States
| | - Oliver Aalami
- Vascular Surgery Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Victor F. Froelicher
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - David P. Lee
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
| | - Jonathan Myers
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
- Stanford Cardiovascular Institute, Stanford, CA, United States
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
| | - Andrew S. Lee
- Stanford Cardiovascular Institute, Stanford, CA, United States
- Department of Pathology, Stanford University, Stanford, CA, United States
| | - Patricia K. Nguyen
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States
- Stanford Cardiovascular Institute, Stanford, CA, United States
- Cardiology Section, Department of Veteran Affairs, Palo Alto, CA, United States
- *Correspondence: Patricia K. Nguyen
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Huber A, Höfer S, Saner H, Oldridge N. A little is better than none: the biggest gain of physical activity in patients with ischemic heart disease. Wien Klin Wochenschr 2020; 132:726-735. [PMID: 33259002 PMCID: PMC7732791 DOI: 10.1007/s00508-020-01767-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/31/2020] [Indexed: 11/25/2022]
Abstract
Background: There is a relationship between physical activity and health-related quality of life (HRQL) in healthy people and in patients with ischemic heart disease (IHD). The purpose of this study was to determine whether this relationship between sports or recreational physical activity levels and HRQL has a dose-response gradient in patients with IHD. Methods: Using one generic and three IHD-specific HRQL questionnaires, differences in HRQL scores (adjusted for confounders) were determined for physically a) inactive vs. active patients and b) inactive vs. patients being active 1–2, 3–5, or >5 times per week. Results: Data were provided by 6143 IHD-patients (angina: N = 2033; myocardial infarction: N = 2266; ischemic heart failure: N = 1844). Regardless of diagnosis or instrument used, when patients were dichotomized as either inactive or active, the latter reported throughout higher physical and emotional HRQL (all p < 0.001; d = 0.25–0.70). When categorized by physical activity levels, there was a positive HRQL dose-response gradient by increasing levels of physical activity that was most marked between inactive patients and those being active 1–2 times per week (63 82%). Conclusions: Using generic and IHD-specific HRQL questionnaires, there seems to be an overall dose-dependent gradient betweenincreasing levels of sports or recreational physical activity and higher HRQL in patients with angina, myocardial infarction, and ischemic heart failure. The greatest bang for the public health buck still lies on putting all the effort in changing sedentary lifestyle to at least a moderate active one (1–2 times per week), in particular in cardiac rehabilitation settings.
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Affiliation(s)
- Alexandra Huber
- Department of Medical Psychology, Medical University of Innsbruck, Christoph-Probst-Platz 1, 6020, Innsbruck, Austria
| | - Stefan Höfer
- Department of Medical Psychology, Medical University of Innsbruck, Christoph-Probst-Platz 1, 6020, Innsbruck, Austria.
| | - Hugo Saner
- Preventive Cardiology and Sports Medicine, Clinic for Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Neil Oldridge
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Freene N, van Berlo S, McManus M, Mair T, Davey R. A Behavioral Change Smartphone App and Program (ToDo-CR) to Decrease Sedentary Behavior in Cardiac Rehabilitation Participants: Prospective Feasibility Cohort Study. JMIR Form Res 2020; 4:e17359. [PMID: 33141091 PMCID: PMC7671837 DOI: 10.2196/17359] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/12/2020] [Accepted: 10/02/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cardiac rehabilitation participants are encouraged to meet physical activity guidelines to reduce the risk of repeat cardiac events. However, previous studies have found that physical activity levels are low and sedentary behavior is high, both during and after cardiac rehabilitation. There is potential for smartphone apps to be effective in reducing sedentary behavior, although among the few studies that have investigated smartphone apps in cardiac rehabilitation, none targeted sedentary behavior. OBJECTIVE This study aims to evaluate the feasibility of a behavioral smartphone app (Vire) and a web-based behavior change program (ToDo-CR) to decrease sedentary behavior in cardiac rehabilitation participants. METHODS Using a single-center, pre-post design, participants were recruited by nursing staff on admission to cardiac rehabilitation. All eligible participants installed the Vire app, were given a Fitbit Flex, and received the 6-week ToDo-CR program while attending cardiac rehabilitation. The ToDo-CR program uses personalized analytics to interpret important behavioral aspects (physical activity, variety, and social opportunity) and real-time information for generating and suggesting context-specific actionable microbehavioral alternatives (Do's). Do's were delivered via the app, with participants receiving 14 to 19 Do's during the 6-week intervention period. Outcome measures were collected at 0, 6, and 16 weeks. The assessors were not blinded. Feasibility outcomes included recruitment and follow-up rates, resource requirements, app usability (Unified Theory of Acceptance and Use of Technology 2 [UTAUT2] questionnaire), and objectively measured daily minutes of sedentary behavior (ActiGraph) for sample size estimation. Secondary outcomes included functional aerobic capacity (6-min walk test), quality of life (MacNew Heart Disease Health-Related Quality of Life Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale questionnaire), BMI, waist circumference, waist-to-hip ratio, and blood pressure. RESULTS Between January and May 2019, 20 participants were recruited consecutively. One-third of people who commenced cardiac rehabilitation were eligible to participate. Other than declining to take part in the study (15/40, 38%), not having a smartphone was a major reason for exclusion (11/40, 28%). Those excluded without a smartphone were significantly older than participants with a smartphone (mean difference 20 [SD 5] years; P<.001). Participants were, on average, aged 54 (SD 13) years, mostly male (17/20, 85%), and working (12/20, 67%). At 6 weeks, 95% (19/20) of participants were assessed, and 60% (12/20) of participants were assessed at 16 weeks. Participants were relatively satisfied with the usability of the app (UTAUT2 questionnaire). Overall, participants spent 11 to 12 hours per day sitting. There was a medium effect size (Cohen d=0.54) for the reduction in sedentary behavior (minutes per day) over 16 weeks. CONCLUSIONS The use of a behavioral smartphone app to decrease sitting time appears to be feasible in cardiac rehabilitation. A larger randomized controlled trial is warranted to determine the effectiveness of the app.
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Affiliation(s)
- Nicole Freene
- Physiotherapy, University of Canberra, Bruce, Australia.,Health Research Institute, University of Canberra, Bruce, Australia
| | | | | | - Tarryn Mair
- Exercise Physiology, Canberra Health Services, Garran, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, Australia
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Höfer S. Health-related quality of life in heart disease. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.repce.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Höfer S. Health-related quality of life in heart disease. Rev Port Cardiol 2020; 39:375-376. [DOI: 10.1016/j.repc.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Saba MA, Goharpey S, Attarbashi Moghadam B, Salehi R, Afshani SM. Validation and responsiveness of the Persian version of HeartQoL questionnaire in cardiac rehabilitation after coronary artery bypass grafting: An observational study. ARYA ATHEROSCLEROSIS 2020; 16:170-177. [PMID: 33598037 PMCID: PMC7867308 DOI: 10.22122/arya.v16i4.2098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/22/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Decision making and the quality of care provided for chronic diseases have been shown to improve through patient participation. The HeartQoL questionnaire is a core health-related quality of life (HRQOL) tool specifically designed for individuals with ischemic heart disease (IHD) who have undergone interventions such as cardiac rehabilitation (CR). METHODS In this observational and multicenter study, 150 patients were recruited. The participants completed the HeartQoL, MacNew Heart Disease Questionnaire, and Short Form Health Survey (SF-36) on entering CR for validity assessment. The HeartQoL along with a Global Rating of Change (GRoC) scale (for responsiveness measurement) were completed by 100 participants 3 months later. RESULTS The mean age of all participants in validity assessment was 61.87 ± 8.13 years. Cronbach's alphas of the total scales ranged from 0.70 to 0.81 and of the subscales from 0.70 to 0.82. The Pearson correlation coefficient was used to determine construct validity; similar constructs were confirmed with correlation coefficients ranging from 0.50 to 0.69 and dissimilar constructs with correlation coefficients ranging from 0.28 to 0.29 (P < 0.010). The assessment of the responsiveness of the questionnaire indicated that the area under curve (AUC) was greater than 0.70 (range: 0.74 to 0.91) and the optimal cut-off point was 0.65. CONCLUSION The Persian version of the HeartQoL questionnaire demonstrated satisfactory psychometric properties in the sample of participants admitted to CR after coronary artery bypass grafting (CABG). The present study results showed that the HRQOL can be used by clinicians and researchers in conjunction with other outcome measures to gain additional information about symptoms relevant to HRQOL in patients referred to CR and to evaluate change over time.
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Affiliation(s)
- Maryam A. Saba
- PhD Candidate, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahin Goharpey
- Assistant Professor, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behrouz Attarbashi Moghadam
- Associate Professor, Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Associate Professor, Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sayed Mohammadreza Afshani
- Assistant Professor, Department of Cardiovascular Disease, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Steinmetz C, Bjarnason-Wehrens B, Baumgarten H, Walther T, Mengden T, Walther C. Prehabilitation in patients awaiting elective coronary artery bypass graft surgery - effects on functional capacity and quality of life: a randomized controlled trial. Clin Rehabil 2020; 34:1256-1267. [PMID: 32546065 PMCID: PMC7477776 DOI: 10.1177/0269215520933950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG). Design: A two-group randomized controlled trail. Setting: Ambulatory prehabilitation. Subjects: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115). Intervention: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care. Main measures: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire). Results: A total of 171 patients (IG, n = 81; CG, n = 90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWTIG: 443.0 ± 80.1 m to 493.5 ± 75.5 m, P = 0.003; TUGIG: 6.9 ± 2.0 s to 6.1 ± 1.8 s, P = 0.018) and QoL (IG: 5.1 ± 0.9 to 5.4 ± 0.9, P < 0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWDIG: Δ-64.7 m, pT1–T3 = 0.013; Δ+47.2 m, pT1–T4 < 0.001; TUGIG: Δ+1.4 s, pT1–T3 = 0.003). Conclusions: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery. ID: NCT04111744 (www.ClinicalTrials.gov; Preoperative Exercise Training for Patients Undergoing Coronary Artery Bypass Graft Surgery- A Prospective Randomized Trial)
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Affiliation(s)
- Carolin Steinmetz
- Institute of Sport Science, Department of Training Science and Kinesiology, University of Göttingen, Göttingen, Germany
- Carolin Steinmetz, Institute of Sport Science, Department of Training Science and Kinesiology, University of Göttingen, Sprangerweg 2, Göttingen, 37075, Germany.
| | - Birna Bjarnason-Wehrens
- Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Heike Baumgarten
- Kerckhoff Heart Center, Department of Cardiothoracic Surgery, Bad Nauheim, Germany
| | - Thomas Walther
- Department of Cardiothoracic Surgery, University of Frankfurt, Frankfurt am Main, Germany
| | - Thomas Mengden
- Kerckhoff Heart Center, Department of Rehabilitation, Bad Nauheim, Germany
| | - Claudia Walther
- Department of Cardiology, University of Frankfurt, Frankfurt am Main, Germany
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Assessing the quality of life and depression among patients with heart failure and heart attack. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.95910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundHealth-related quality and of life and depression are major issues among patients with heart diseases. The aim of the current study was to assess the levels of quality of life and depression among patients with heart failure and heart attack as well as the correlation between these domains and the differences in both categories.Participants and procedureIn this cross-sectional study the following tools were used: a) the Missoula-VITAS Quality of Life Index (MVQoLI-15), which examines 5 domains of quality of life, and b) the Center for Epidemiological Studies Depression Scale (CES-D), which measures depression among patients. Finally, a questionnaire about sociodemographic elements was completed by the patients. Data were analyzed through IBM Statistics SPSS 20.0. The statistical level was set at 0.05%.ResultsThe mean value of CES-D Total and MVQoLI-15 were higher for the patients suffering from heart failure than those suffering from a heart attack. However, the dimensions of MVQoLI-15 Interpersonal Relationships, Well-Being and Transcendence were lower for heart failure patients compared to the levels of the patients suffering from a heart attack. According to the Pearson r test, there was a statistically significant negative correlation be-tween the quality of life and depression (p = .001) in the overall sample.ConclusionsPatients with heart failure experience more depression and lower quality of life than heart attack patients.
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