1
|
Thompson DR, Ski CF, Clark AM. Advancing health equity in cardiovascular care. Eur J Cardiovasc Nurs 2024; 23:e23-e25. [PMID: 38079193 DOI: 10.1093/eurjcn/zvad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Affiliation(s)
- David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Alexander M Clark
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| |
Collapse
|
2
|
Ski CF, Taylor RS, McGuigan K, Long L, Lambert JD, Richards SH, Thompson DR. Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation. Cochrane Database Syst Rev 2024; 4:CD013508. [PMID: 38577875 PMCID: PMC10996021 DOI: 10.1002/14651858.cd013508.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Depression and anxiety occur frequently (with reported prevalence rates of around 40%) in individuals with coronary heart disease (CHD), heart failure (HF) or atrial fibrillation (AF) and are associated with a poor prognosis, such as decreased health-related quality of life (HRQoL), and increased morbidity and mortality. Psychological interventions are developed and delivered by psychologists or specifically trained healthcare workers and commonly include cognitive behavioural therapies and mindfulness-based stress reduction. They have been shown to reduce depression and anxiety in the general population, though the exact mechanism of action is not well understood. Further, their effects on psychological and clinical outcomes in patients with CHD, HF or AF are unclear. OBJECTIVES To assess the effects of psychological interventions (alone, or with cardiac rehabilitation or pharmacotherapy, or both) in adults who have a diagnosis of CHD, HF or AF, compared to no psychological intervention, on psychological and clinical outcomes. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2009 to July 2022. We also searched three clinical trials registers in September 2020, and checked the reference lists of included studies. No language restrictions were applied. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing psychological interventions with no psychological intervention for a minimum of six months follow-up in adults aged over 18 years with a clinical diagnosis of CHD, HF or AF, with or without depression or anxiety. Studies had to report on either depression or anxiety or both. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were depression and anxiety, and our secondary outcomes of interest were HRQoL mental and physical components, all-cause mortality and major adverse cardiovascular events (MACE). We used GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS Twenty-one studies (2591 participants) met our inclusion criteria. Sixteen studies included people with CHD, five with HF and none with AF. Study sample sizes ranged from 29 to 430. Twenty and 17 studies reported the primary outcomes of depression and anxiety, respectively. Despite the high heterogeneity and variation, we decided to pool the studies using a random-effects model, recognising that the model does not eliminate heterogeneity and findings should be interpreted cautiously. We found that psychological interventions probably have a moderate effect on reducing depression (standardised mean difference (SMD) -0.36, 95% confidence interval (CI) -0.65 to -0.06; 20 studies, 2531 participants; moderate-certainty evidence) and anxiety (SMD -0.57, 95% CI -0.96 to -0.18; 17 studies, 2235 participants; moderate-certainty evidence), compared to no psychological intervention. Psychological interventions may have little to no effect on HRQoL physical component summary scores (PCS) (SMD 0.48, 95% CI -0.02 to 0.98; 12 studies, 1454 participants; low-certainty evidence), but may have a moderate effect on improving HRQoL mental component summary scores (MCS) (SMD 0.63, 95% CI 0.01 to 1.26; 12 studies, 1454 participants; low-certainty evidence), compared to no psychological intervention. Psychological interventions probably have little to no effect on all-cause mortality (risk ratio (RR) 0.81, 95% CI 0.39 to 1.69; 3 studies, 615 participants; moderate-certainty evidence) and may have little to no effect on MACE (RR 1.22, 95% CI 0.77 to 1.92; 4 studies, 450 participants; low-certainty evidence), compared to no psychological intervention. AUTHORS' CONCLUSIONS Current evidence suggests that psychological interventions for depression and anxiety probably result in a moderate reduction in depression and anxiety and may result in a moderate improvement in HRQoL MCS, compared to no intervention. However, they may have little to no effect on HRQoL PCS and MACE, and probably do not reduce mortality (all-cause) in adults who have a diagnosis of CHD or HF, compared with no psychological intervention. There was moderate to substantial heterogeneity identified across studies. Thus, evidence of treatment effects on these outcomes warrants careful interpretation. As there were no studies of psychological interventions for patients with AF included in our review, this is a gap that needs to be addressed in future studies, particularly in view of the rapid growth of research on management of AF. Studies investigating cost-effectiveness, return to work and cardiovascular morbidity (revascularisation) are also needed to better understand the benefits of psychological interventions in populations with heart disease.
Collapse
Affiliation(s)
- Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
- Australian Centre for Heart Health, Deakin University, Melbourne, Australia
| | - 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
| | - Karen McGuigan
- Queen's Communities and Place, Queen's University Belfast, Belfast, UK
| | - Linda Long
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
3
|
O'Brien CL, Apputhurai P, Knowles SR, Jenkins ZM, Ski CF, Thompson DR, Moore G, Ward G, Loh M, Castle DJ. Initial evaluation of the Optimal Health Program for people with diabetes: 12-month outcomes of a randomised controlled trial. Psychol Health 2024; 39:358-378. [PMID: 35465777 DOI: 10.1080/08870446.2022.2060507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to evaluate if a new Mental health IN DiabeteS Optimal Health Program (MINDS OHP) compared with usual care in adults with Type 1 and Type 2 diabetes would improve psychosocial outcomes including self-efficacy and quality of life.Design and Main Outcome Measures This initial randomised controlled trial evaluated MINDS OHP compared with usual care. Participants were recruited through outpatient clinics and community organisations. The intervention group received nine sessions with assessments over twelve months. Primary outcomes were self-efficacy and quality of life. Secondary outcomes included diabetes distress and anxiety. RESULTS There were 51 participants in the control group (mean age = 52) and 55 in the intervention group (mean age = 55). There were significant main effects of time in general self-efficacy, diabetes distress, diabetes self-efficacy, and illness perceptions, however no significant between-group differences in primary or secondary outcomes. Post-hoc analyses revealed MINDS OHP improved diabetes self-efficacy for participants with mild to severe depression and anxiety, with a small effect. CONCLUSION Initial evaluation found MINDS OHP was associated with improved diabetes self-efficacy for adults with diabetes, for people with mild to severe levels of distress, with small effect. Further research is required to explore whether this disease-specific, collaborative care-focused intervention benefits the mental health of people with diabetes.
Collapse
Affiliation(s)
- Casey L O'Brien
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service St. Vincent's Hospital, Mental Health Service, Melbourne, Australia
| | - Pragalathan Apputhurai
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Simon R Knowles
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service St. Vincent's Hospital, Mental Health Service, Melbourne, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Zoe M Jenkins
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service St. Vincent's Hospital, Mental Health Service, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gaye Moore
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service St. Vincent's Hospital, Mental Health Service, Melbourne, Australia
| | - Glenn Ward
- Department of Endocrinology, St. Vincent's Hospital, Melbourne, Australia
| | - Margaret Loh
- Department of Endocrinology, St. Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service St. Vincent's Hospital, Mental Health Service, Melbourne, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| |
Collapse
|
4
|
Al-Jabr H, Windle K, Clifton A, Thompson DR, Castle DJ, Ski CF. Patient experiences of the Long COVID-Optimal Health Programme: a qualitative interview study in community settings. BJGP Open 2024:BJGPO.2023.0137. [PMID: 37907337 DOI: 10.3399/bjgpo.2023.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Long COVID (LC) symptoms persist 12 weeks or more beyond the acute infection. To date, no standardised diagnostic or treatment pathways exist. However, a holistic approach has been recommended. This study explored participants' experiences of a Long COVID-Optimal Health Programme (LC-OHP); a psychoeducational self-efficacy programme. AIM To explore perceptions and experiences of people with LC regarding the LC-OHP and identify suggestions to further improve the programme. DESIGN & SETTING Qualitative study with patients with LC recruited through community settings. METHOD This study is part of a wider randomised controlled trial. Eligible participants were aged ≥18 years, have LC, and attended a minimum of five LC-OHP sessions plus a booster session. We interviewed those randomised to the intervention group. Interviews were conducted by an independent researcher and thematically analysed to identify common, emerging themes. RESULTS Eleven participants were interviewed, mostly women from a White British ethnic group (n = 10). Four main themes were identified, reflecting programme benefits and suggestions for improvement. The programme demonstrated potential for assisting patients in managing their LC, including physical health and mental wellbeing. Participants found the programme to be flexible and provided suggestions to adapting it for future users. CONCLUSION Findings support the acceptability of the LC-OHP to people living with LC. The programme has shown several benefits in supporting physical health and mental wellbeing. Suggestions made to further adapt the programme and improve its delivery will be considered for future trials.
Collapse
Affiliation(s)
- Hiyam Al-Jabr
- Primary Community and Social Care, University of Keele, Keele, UK
- Midlands Partnership University NHS Foundation Trust, St Georges Hospital, Stafford, UK
| | - Karen Windle
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Andrew Clifton
- School of Health and Sports Sciences, University of Suffolk, Ipswich, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Department of Psychiatry, University of Tasmania, Tasmania, Australia
- Centre for Mental Health Service Innovation, Tasmania, Australia
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
5
|
Conquer S, Iles R, Windle K, Heathershaw R, Ski CF. Transforming Integrated Care Through Co-production: A Systematic Review Using Meta-ethnography. Int J Integr Care 2024; 24:17. [PMID: 38463747 PMCID: PMC10921964 DOI: 10.5334/ijic.7603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 02/29/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction There is a requirement for health and care systems and services to work on an equitable basis with people who use and provide integrated care. In response, co-production has become essential in the design and transformation of services. Globally, an array of approaches have been implemented to achieve this. This unique review explores multi-context and multi-method examples of co-production in integrated care using an exceptional combination of methods. Aim To review and synthesise evidence that examines how co-production with service users, unpaid carers and members of staff can affect the design and transformation of integrated care services. Methods Systematic review using meta-ethnography with input from a patient and public involvement (PPI) co-production advisory group. Meta-ethnography can generate theories by interpreting patterns between studies set in different contexts. Nine academic and four grey literature databases were searched for publications between 2012-2022. Data were extracted, analysed, translated and interpreted using the seven phases of meta-ethnography and PPI. Findings A total of 2,097 studies were identified. 10 met the inclusion criteria. Studies demonstrated a variety of integrated care provisions for diverse populations. Co-production was most successful through person-centred design, innovative planning, and collaboration. Key impacts on service transformation were structural changes, accessibility, and acceptability of service delivery. The methods applied organically drew out new interpretations, namely a novel cyclic framework for application within integrated care. Conclusion Effective co-production requires a process with a well-defined focus. Implementing co-delivery, with peer support, facilitates service user involvement to be embedded at a higher level on the 'ladder of co-production'. An additional step on the ladder is proposed; a cyclic co-delivery framework. This innovative and operational development has potential to enable better-sustained person-centred integrated care services.
Collapse
|
6
|
Clark AM, Sousa BJ, Ski CF, Redfern J, Neubeck L, Allana S, Peart A, MacDougall D, Thompson DR. Main Mechanisms of Remote Monitoring Programs for Cardiac Rehabilitation and Secondary Prevention: A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev 2023; 43:412-418. [PMID: 37890176 DOI: 10.1097/hcr.0000000000000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
PURPOSE The objective of this report was to identify the main mechanisms of home-based remote monitoring programs for cardiac rehabilitation (RM CR) and examine how these mechanisms vary by context. METHODS This was a systematic review using realist synthesis. To be included, articles had to be published in English between 2010 and November 2020 and contain specific data related to mechanisms of effect of programs. MEDLINE All (1946-) via Ovid, Embase (1974-) via Ovid, APA PsycINFO (1806-), CINAHL via EBSCO, Scopus databases, and gray literature were searched. RESULTS From 13 747 citations, 91 focused on cardiac conditions, with 23 reports including patients in CR. Effective RM CR programs more successfully adapted to different patient home settings and broader lives, incorporated individualized patient health data, and had content designed specifically for patients in cardiac rehabilitation. Relatively minor but common technical issues could significantly reduce perceived benefits. Patients and families were highly receptive to the programs and viewed themselves as fortunate to receive such services. The RM CR programs could be improved via incorporating more connectivity to other patients. No clear negative effects on perceived utility or outcomes occurred by patient age, ethnicity, or sex. Overall, the programs were seen to best suit highly motivated patients and consolidated rather than harmed existing relationships with health care professionals and teams. CONCLUSIONS Remote monitoring CR programs are perceived by patients to be beneficial and attractive. Future RM CR programs should consider adaptability to different home settings, incorporate individualized health data, and contain content specific to patient needs.
Collapse
Affiliation(s)
- Alexander M Clark
- Faculty of Health Disciplines, Athabasca University, Edmonton, Canada (Dr Clark); Office of the Provost and VP Academic, University of Alberta, Edmonton, Canada (Ms Sousa); Integrated Care Academy, University of Suffolk, Ipswich, England (Dr Ski); Faculty of Medicine and Health, The University of Sydney, Sydney, Australia (Dr Redfern); School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland (Dr Neubeck); School of Nursing, Western University, London, Ontario, Canada (Dr Allana), Eastern Health Clinical School, Monash University, Melbourne, Australia (Ms Peart); Canadian Agency for Drugs and Technologies in Health, Ottawa, Canada (Ms MacDougall); and School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland (Dr Thompson)
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Kennelly CE, Nguyen ATP, Sheikhan NY, Strudwick G, Ski CF, Thompson DR, Bartram M, Soklaridis S, Rossell SL, Castle D, Hawke LD. The lived experience of long COVID: A qualitative study of mental health, quality of life, and coping. PLoS One 2023; 18:e0292630. [PMID: 37831706 PMCID: PMC10575511 DOI: 10.1371/journal.pone.0292630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
The majority of people who contract COVID-19 experience a short period of symptomatic infection. However, symptoms persist for months or years following initial exposure to the virus in some cases. This has been described as long COVID. Little is known about the lived experience of this condition, as it has only recently emerged. This study aimed to explore the experiences of mental health, quality of life, and coping among people living with long COVID. A sample of 47 adults with lived experience participated in web-based focus groups. Separate focus groups were held for 24 individuals with pre-existing mental health conditions and 23 individuals without pre-existing mental health conditions. Data were analyzed using a codebook thematic analysis approach. Five themes were identified as integral to the long COVID experience: The Emotional Landscape of Long COVID, New Limits to Daily Functioning, Grief and Loss of Former Identity, Long COVID-related Stigmatization, and Learning to Cope with Persisting Symptoms. These findings illustrate the immense impact of long COVID on mental health and quality of life. Minimal differences were found between those with and those without pre-existing mental health conditions, as both groups were substantially impacted by the condition. Attention to the perspectives of people with lived experience of long COVID is necessary to inform future directions for research and clinical practice.
Collapse
Affiliation(s)
- Colleen E. Kennelly
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anh T. P. Nguyen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Natasha Yasmin Sheikhan
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gillian Strudwick
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Chantal F. Ski
- Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - David R. Thompson
- Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
| | - Sophie Soklaridis
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Susan L. Rossell
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - David Castle
- University of Tasmania, Hobart, Tasmania, Australia
| | - Lisa D. Hawke
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
8
|
Hawke LD, Nguyen ATP, Sheikhan NY, Strudwick G, Rossell SL, Soklaridis S, Kloiber S, Shields R, Ski CF, Thompson DR, Castle D. Swept under the carpet: a qualitative study of patient perspectives on Long COVID, treatments, services, and mental health. BMC Health Serv Res 2023; 23:1088. [PMID: 37821939 PMCID: PMC10568931 DOI: 10.1186/s12913-023-10091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND A constellation of often disabling long-term physical symptoms enduring after an acute SARS-COV-2 infection is commonly referred to as Long COVID. Since Long COVID is a new clinical entity, research is required to clarify treatment needs and experiences of individuals affected. This qualitative descriptive study aimed to provide insight into Long COVID treatment and service experiences and preferences of individuals experiencing Long COVID and the intersections with mental health. METHODS The study was conducted out of a tertiary care mental health hospital, with online recruitment from the community across Canada. A total of 47 individuals (average age = 44.9) participated in one of 11 focus groups between June and December 2022. Five focus groups were conducted with participants who had pre-existing mental health concerns prior to contracting SARS-CoV-2, and six were with people with Long COVID but without pre-existing mental health concerns. A semi-structured interview guide asked about service experiences and service preferences, including mental health and well-being services. Discussions were recorded, transcribed, and analyzed using codebook thematic analysis. RESULTS When accessing services for Long COVID, patients experienced: (1) systemic barriers to accessing care, and (2) challenges navigating the unknowns of Long COVID, leading to (3) negative impacts on patient emotional well-being and recovery. Participants called for improvements in Long COVID care, with a focus on: (1) developing Long COVID-specific knowledge and services, (2) enhancing support for financial well-being, daily living, and building a Long COVID community, and (3) improving awareness and the public representation of Long COVID. CONCLUSIONS Substantial treatment barriers generate considerable burden for individuals living with Long COVID. There is a pressing need to improve treatment, social supports, and the social representation of Long COVID to create integrated, accessible, responsive, and ongoing support systems.
Collapse
Affiliation(s)
- Lisa D Hawke
- University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
| | - Anh T P Nguyen
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Natasha Yasmin Sheikhan
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Gillian Strudwick
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Sophie Soklaridis
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Stefan Kloiber
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Roslyn Shields
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David Castle
- University of Tasmania, Hobart, Australia
- Tasmanian Centre for Mental Health Service Innovation, Hobart, Australia
| |
Collapse
|
9
|
Al‐Jabr H, Thompson DR, Castle DJ, Ski CF. Experiences of people with long COVID: Symptoms, support strategies and the Long COVID Optimal Health Programme (LC-OHP). Health Expect 2023; 27:e13879. [PMID: 37751413 PMCID: PMC10726154 DOI: 10.1111/hex.13879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Long COVID (LC) is a multisystem illness, with fluctuating symptoms that affect the daily activities of patients. There are still no standardised diagnostic criteria or treatment approaches for managing LC. The LC-Optimal Health Programme (LC-OHP) was designed to support the mental wellbeing and physical health of people with LC. Gaining an in-depth understanding of patients' experiences and support strategies is imperative to identifying appropriate supports to guide them through their recovery. This study aimed to elicit the experiences and perceptions of adults with LC regarding symptoms, support strategies and the LC-OHP. METHODS As part of a wider randomised controlled trial of the LC-OHP, participants in the intervention group had their sessions audio-recorded. Transcripts were thematically analysed to identify common emergent themes. FINDINGS The LC-OHP was delivered to 26 participants. Data were collected between January 2022 and February 2023. Four main themes emerged: 'Symptoms and impact of LC'; 'Other sources of support and perceived challenges'; 'Strategies to support LC' and 'Perceptions of the LC-OHP'. CONCLUSION LC experiences were mostly described as fluctuating and burdensome that significantly impacted daily activities, and physical and mental health. The LC-OHP was perceived as beneficial. Access and experiences of other sources of support were varied. Increasing LC awareness amongst health practitioners and the wider community has the potential to improve the experiences of those affected by LC. PATIENT OR PUBLIC CONTRIBUTION The LC-OHP was derived from the OHP. It was adapted to people with LC following consultation with practitioners at an LC clinic. Additionally, the mode and timing of delivering the programme to this population were taken into account for its delivery at the convenience of participating patients. While considering that fatigue and brain fog are amongst the most reported complaints of people with LC, public members with LC were not involved directly in this study; however, feedback obtained from practitioners working with this population was implemented in amending the programme and its delivery. Additionally, feedback from patients with other chronic health conditions who used the OHP in previous studies has been implemented to make the programme more user-friendly. Moreover, feedback obtained from participants receiving this programme in this study was implanted immediately and shared with other participants. Finally, this study was overviewed by a data management committee that included two public members with LC, who contributed and provided guidance to support this study.
Collapse
Affiliation(s)
- Hiyam Al‐Jabr
- Primary Community and Social CareFaculty of Medicine and Health SciencesUniversity of KeeleKeeleUK
| | | | - David J. Castle
- Department of PsychiatryUniversity of TasmaniaHobartTasmaniaAustralia
- Centre for Mental Health Service InnovationHobartTasmaniaAustralia
| | - Chantal F. Ski
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
| |
Collapse
|
10
|
Le Grande MR, Murphy BM, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Jackson AC. Development of a short form of the Cardiac Distress Inventory. BMC Cardiovasc Disord 2023; 23:408. [PMID: 37596516 PMCID: PMC10439557 DOI: 10.1186/s12872-023-03439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Cardiac distress may be viewed as a persistent negative emotional state that spans multiple psychosocial domains and challenges a patient's capacity to cope with living with their heart condition. The Cardiac Distress Inventory (CDI) is a disease-specific clinical assessment tool that captures the complexity of this distress. In busy settings such as primary care, cardiac rehabilitation, and counselling services, however, there is a need to administer briefer tools to aid in identification and screening. The aim of the present study was to develop a short, valid screening version of the CDI. METHODS A total of 405 participants reporting an acute coronary event in the previous 12 months was recruited from three hospitals, through social media and by direct enrolment on the study website. Participants completed an online survey which included the full version of the CDI and general distress measures including the Kessler K6, Patient Health Questionnaire-4, and Emotion Thermometers. Relationship of the CDI with these instruments, Rasch analysis model fit and clinical expertise were all used to select items for the short form (CDI-SF). Construct validity and receiver operating characteristics in relation to the Kessler K6 were examined. RESULTS The final 12 item CDI-SF exhibited excellent internal consistency indicative of unidimensionality and good convergent and discriminant validity in comparison to clinical status measures, all indicative of good construct validity. Using the K6 validated cutoff of ≥ 18 as the reference variable, the CDI-SF had a very high Area Under the Curve (AUC) (AUC = 0.913 (95% CI: 0.88 to 0.94). A CDI-SF score of ≥ 13 was found to indicate general cardiac distress which may warrant further investigation using the original CDI. CONCLUSION The psychometric findings detailed here indicate that the CDI-SF provides a brief psychometrically sound screening measure indicative of general cardiac distress, that can be used in both clinical and research settings.
Collapse
Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia
- Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Victorian Heart Institute, Clayton, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
- Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.
- Centre on Behavioral Health, University of Hong Kong, Hong Kong, China.
| |
Collapse
|
11
|
Clerkin N, Ski CF, Brennan PC, Strudwick R. Radiographers filling the mammography screening gap, but where's the evidence? Radiography (Lond) 2023; 29:827-828. [PMID: 37364980 DOI: 10.1016/j.radi.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Affiliation(s)
- N Clerkin
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich, United Kingdom.
| | - C F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - P C Brennan
- University of Sydney, Cumberland Campus, 75 East St, Lidcombe, Sydney, Australia
| | - R Strudwick
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich, United Kingdom
| |
Collapse
|
12
|
Knowles SR, Apputhurai P, Jenkins Z, O'flaherty E, Ierino F, Langham R, Ski CF, Thompson DR, Castle DJ. Impact of chronic kidney disease on illness perceptions, coping, self-efficacy, psychological distress and quality of life. PSYCHOL HEALTH MED 2023; 28:1963-1976. [PMID: 36794381 DOI: 10.1080/13548506.2023.2179644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Chronic kidney disease (CKD) negatively impacts psychological well-being and quality of life (QoL). Underpinned by the Common Sense Model (CSM), this study evaluated the potential mediating role of self-efficacy, coping styles and psychological distress on the relationship between illness perceptions and QoL in patients living with CKD. Participants were 147 people with stage 3-5 kidney disease. Measures included eGFR, illness perceptions, coping styles, psychological distress, self-efficacy and QoL. Correlational analyses were performed, followed by regression modelling. Poorer QoL was associated with greater distress, engagement in maladaptive coping, poorer illness perceptions and lower self-efficacy. Regression analysis revealed that illness perceptions predicted QoL, with psychological distress acting as a mediator. The proportion of variance explained was 63.8%. These findings suggest that psychological interventions are likely to enhance QoL in CKD, if they target the mediating psychological processes associated with illness perceptions and psychological distress.
Collapse
Affiliation(s)
- Simon R Knowles
- School of Health Sciences, Swinburne University, Melbourne, Australia
| | | | - Zoe Jenkins
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
| | - Emmet O'flaherty
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco Ierino
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Robyn Langham
- St. Vincent's Hospital, University of Melbourne Department of Medicine, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| |
Collapse
|
13
|
Al-Jabr H, Hawke LD, Thompson DR, Clifton A, Shenton M, Castle DJ, Ski CF. Interventions to support mental health in people with long COVID: a scoping review. BMC Public Health 2023; 23:1186. [PMID: 37340400 DOI: 10.1186/s12889-023-16079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Long COVID (LC) is a multisystem disease with symptoms lasting weeks or months beyond the acute COVID-19 infection. Several manifestations are reported by people with LC, including effects on mental health, with varying degrees of psychological distress and disturbances to daily activities. Research conducted to identify effective interventions to support mental health among people with LC has been limited by the breadth and scope of studies. AIM This review aims to identify interventions being tested to support mental health of people with LC. METHODS A scoping review was conducted by searching five databases for articles published between January 2020 and early October 2022 to identify research evaluating interventions focused on improving mental health symptoms associated with LC. Results from all sources were checked for eligibility by two reviewers, and agreements were resolved by discussion. Gray literature and reference list of included studies and relevant reviews were scrutinised to identify any additional studies. Data extraction was conducted by one reviewer and checked by another reviewer for accuracy. RESULTS Of the 940 studies identified, 17 were included, the design of which varied but included mainly case studies (n = 6) and clinical trials (n = 5). Several interventions were described, ranging from single interventions (e.g., pharmacologic) to more holistic, comprehensive suites of services (pharmacologic and non-pharmacologic). Several mental health outcomes were measured, mostly anxiety and depression. All included studies were reported to be associated with improvements in participants' mental health outcomes. CONCLUSION This scoping review identified studies reporting on a variety of interventions to support mental health among people with LC. Although positive changes were reported by all studies, some were case studies and thus their findings must be interpreted with caution. There is a need for more research to be conducted to identify the impact of interventions on mental health of people with LC.
Collapse
Affiliation(s)
- Hiyam Al-Jabr
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Canada
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Andrew Clifton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Mark Shenton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David J Castle
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
14
|
Steiner B, Neumann A, Pelz Y, Ski CF, Hill L, Thompson DR, Fitzsimons D, Dixon LJ, Brandts J, Verket M, Schütt K, Eurlings CGMJ, Boyne JJJ, Gingele AJ, De Maesschalck L, Murphy M, Furtado da Luz E, Barrett M, Windle K, Hoedemakers T, Helms TM, Brunner-La Rocca HP, Zippel-Schultz B. Challenges in heart failure care in four European countries: a comparative study. Eur J Public Health 2023:7159692. [PMID: 37164632 DOI: 10.1093/eurpub/ckad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. METHODS A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. RESULTS The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. CONCLUSION Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills.
Collapse
Affiliation(s)
- Bianca Steiner
- German Foundation for the Chronically Ill, Berlin, Germany
| | - Anne Neumann
- German Foundation for the Chronically Ill, Berlin, Germany
| | - Yannick Pelz
- German Foundation for the Chronically Ill, Berlin, Germany
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Loreena Hill
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Lana J Dixon
- Belfast Health and Social Care Trust, A Floor, Belfast City Hospital, Belfast, UK
| | - Julia Brandts
- Department of Cardiology, University Hospital Aachen, Aachen, Germany
| | - Marlo Verket
- Department of Cardiology, University Hospital Aachen, Aachen, Germany
| | - Katharina Schütt
- Department of Cardiology, University Hospital Aachen, Aachen, Germany
| | - Casper G M J Eurlings
- Cardiology Department, Laurentius Hospital Roermond, Roermond, The Netherlands
- Cardiology Department, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Josiane J J Boyne
- Department of Health Services Research, CAPHIRI, Maastricht University, Maastricht, The Netherlands
| | - Arno J Gingele
- Cardiology Department, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Marguerite Murphy
- Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland
| | | | - Matthew Barrett
- Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland
| | - Karen Windle
- Integrated Care Academy, University of Suffolk, Ipswich, UK
- Centre for Applied Dementia Studies, Wolfson Centre for Applied Health Research, University of Bradford, Bradford, UK
| | | | - Thomas M Helms
- German Foundation for the Chronically Ill, Berlin, Germany
| | | | | |
Collapse
|
15
|
Clerkin N, Ski CF, Brennan PC, Strudwick R. Identification of factors associated with diagnostic performance variation in reporting of mammograms: A review. Radiography (Lond) 2023; 29:340-346. [PMID: 36731351 DOI: 10.1016/j.radi.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/13/2022] [Accepted: 01/04/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This narrative review aims to identify what factors are linked to diagnostic performance variation for those who interpret mammograms. Identification of influential factors has potential to contribute to the optimisation of breast cancer diagnosis. PubMed, ScienceDirect and Google Scholar databases were searched using the following terms: 'Radiology', 'Radiologist', 'Radiographer', 'Radiography', 'Mammography', 'Interpret', 'read', 'observe' 'report', 'screen', 'image', 'performance' and 'characteristics.' Exclusion criteria included articles published prior to 2000 as digital mammography was introduced at this time. Non-English articles language were also excluded. 38 of 2542 studies identified were analysed. KEY FINDINGS Influencing factors included, new technology, volume of reads, experience and training, availability of prior images, social networking, fatigue and time-of-day of interpretation. Advancements in breast imaging such as digital breast tomosynthesis and volume of mammograms are primary factors that affect performance as well as tiredness, time-of-day when images are interpreted, stages of training and years of experience. Recent studies emphasised the importance of social networking and knowledge sharing if breast cancer diagnosis is to be optimised. CONCLUSION It was demonstrated that data on radiologist performance variability is widely available but there is a paucity of data on radiographers who interpret mammographic images. IMPLICATIONS FOR PRACTICE This scarcity of research needs to be addressed in order to optimise radiography-led reporting and set baseline values for diagnostic efficacy.
Collapse
Affiliation(s)
- N Clerkin
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich IP4 1QJ, United Kingdom.
| | - C F Ski
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich IP4 1QJ, United Kingdom
| | - P C Brennan
- University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia
| | - R Strudwick
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich IP4 1QJ, United Kingdom
| |
Collapse
|
16
|
Kemp BJ, Thompson DR, McGuigan K, Watson CJ, Heron N, Woodside JV, Devaney FK, Harrison N, Neill DT, Cutting D, Ski CF. Families' expectations of an eHealth family-based cardiovascular disease-risk reduction programme. Eur J Cardiovasc Nurs 2023; 22:82-88. [PMID: 35670143 DOI: 10.1093/eurjcn/zvac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 01/14/2023]
Abstract
AIM Research has shown that families' participation in a cardiovascular disease (CVD) prevention programme could boost early adoption of healthy lifestyle behaviours in families. Behaviour-based, eHealth interventions are a potential means of achieving this. This study aimed to explore expectations of families-parents and children-at risk of CVD towards the design and functionality of an eHealth family-based CVD-risk reduction programme 'Health-e-Hearts'. METHODS AND RESULTS Three online focus groups were conducted with six families comprising at least one parent at risk of CVD and at least one child aged 5-17 years. The focus groups were video and audio recorded and transcribed. Content analysis was used to synthesize and identify key categories and subcategories regarding development of and engagement with an eHealth programme. Three categories emerged: experiences of health apps and devices; eHealth application needs of family members; and motivators for using an eHealth programme. Experiences included using health apps individually and inconsistently. Needs included personalization, free and easy-to-use, time efficient, and multiple content formats. Motivators for engaging with the programme included goal setting, rewards, and competition. CONCLUSION Families' expectations of an eHealth family-based CVD-risk reduction programme include the incorporation of personalized, easy-to-use design features and motivators for engaging with the programme. Family involvement in the development of an eHealth programme such as 'Health-e-Hearts' has the potential to boost early adoption of healthy lifestyle behaviours among all family members.
Collapse
Affiliation(s)
- Bridie J Kemp
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Karen McGuigan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Chris J Watson
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Neil Heron
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Francis K Devaney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Nick Harrison
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Danielle T Neill
- School of Electronics, Electrical Engineering and Computer Science, Queen's University Belfast, Belfast, UK
| | - David Cutting
- School of Electronics, Electrical Engineering and Computer Science, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| |
Collapse
|
17
|
Ski CF, Cartledge S, Foldager D, Thompson DR, Fredericks S, Ekman I, Hendriks JM. Integrated care in cardiovascular disease: a statement of the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology. Eur J Cardiovasc Nurs 2023:6973027. [PMID: 36617217 DOI: 10.1093/eurjcn/zvad009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
In a rapidly changing health and care landscape, there is acknowledgement that the organisation of care should be integrated with the patient placed at the centre. In reality, care systems are often fragmented, disjointed and focused on the condition rather than the patient. The Science Committee of the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology recognises the need for a statement on integrated care to guide health professionals caring for people with cardiovascular disease. This statement outlines the evidence for integrated cardiovascular care, identifies challenges and offers advice for practice, education and research.
Collapse
Affiliation(s)
- Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Susie Cartledge
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dan Foldager
- Patient representative, Association of Cardiovascular Nursing and Allied Professions, European Society of Cardiology
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Suzanne Fredericks
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada
| | - Inger Ekman
- Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| |
Collapse
|
18
|
McMahon J, Thompson DR, Brazil K, Ski CF. Co-Design of an eHealth Intervention to Reduce Cardiovascular Disease Risk in Male Taxi Drivers: ManGuard. Int J Environ Res Public Health 2022; 19:15278. [PMID: 36429995 PMCID: PMC9690601 DOI: 10.3390/ijerph192215278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
Taxi driving, a male-dominated occupation, is associated with an increased risk of cardiovascular disease (CVD). The increased risk is linked to a high prevalence of modifiable CVD risk factors including overweight/obesity, poor nutrition, smoking, excessive alcohol consumption and physical inactivity. Behaviour change interventions may prove advantageous, yet little research has been conducted to reduce CVD risk in this population. The purpose of this study was to co-design an eHealth intervention, 'ManGuard', to reduce CVD risk in male taxi drivers. The IDEAS framework was utilised to guide the development of the eHealth intervention, with the Behaviour Change Wheel (BCW) incorporated throughout to ensure the intervention was underpinned by behaviour change theory. Development and refinement of ManGuard was guided by current literature, input from a multidisciplinary team, an online survey, a systematic review and meta-analysis, and focus groups (n = 3) with male taxi drivers. Physical inactivity was identified as the prime behavior to change in order to reduce CVD risk in male taxi drivers. Male taxi drivers indicated a preference for an eHealth intervention to be delivered using smartphone technology, with a simple design, providing concise, straightforward, and relatable content, and with the ability to track and monitor progress.
Collapse
Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK
| | - David R. Thompson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK
| | - Chantal F. Ski
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK
- Integrated Care Academy, University of Suffolk, Ipswich IP4 1QJ, UK
| |
Collapse
|
19
|
Jackson AC, Grande MRL, Rogerson MC, Ski CF, Amerena J, Smith JA, Hoover V, Alvarenga ME, Higgins RO, Thompson DR, Murphy BM. The cardiac distress inventory: A new measure of psychosocial distress associated with an acute cardiac event. BMC Cardiovasc Disord 2022; 22:460. [PMID: 36329396 PMCID: PMC9633013 DOI: 10.1186/s12872-022-02897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many challenges are posed by the experience of a heart attack or heart surgery which can be characterised as ‘cardiac distress’. It spans multiple psychosocial domains incorporating patients’ responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to their cardiac event and their recovery. Although some measures of the psychological and emotional impacts of a cardiac event exist, none provides a comprehensive assessment of cardiac distress. To address this gap, the study aimed to develop a Cardiac Distress Inventory (CDI) using best practice in instrument design. Method An item pool was generated through analysis of cognate measures, mostly in relation to other health conditions and through focus group and individual review by a multidisciplinary development team, cardiac patients, and end-users including cardiac rehabilitation co-ordinators. The resulting 144 items were reduced through further reviews to 74 for testing. The testing was carried out with 405 people recruited from three hospitals, through social media and by direct enrolment on the study website. A two-stage psychometric evaluation of the 74 items used exploratory factor analysis to extract the factors followed by Rasch analysis to confirm dimensionality within factors. Results Psychometric analysis resulted in the identification of 55 items comprising eight subscales, to form the CDI. The subscales assess fear and uncertainty, disconnection and hopelessness, changes to roles and relationships, overwhelm and depletion, cognitive challenges, physical challenges, health system challenges, and death concerns. Validation against the Kessler 6 supports the criterion validity of the CDI. Conclusion The CDI reflects a nuanced understanding of cardiac distress and should prove to be a useful clinical assessment tool, as well as a research instrument. Individual subscales or the complete CDI could be used to assess or monitor specific areas of distress in clinical practice. Development of a short form screening version for use in primary care, cardiac rehabilitation and counselling services is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02897-y.
Collapse
Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia. .,Centre on Behavioral Health, University of Hong Kong, Hong Kong SAR, China.
| | - Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Integrated Care Academy, University of Suffolk, Ipswich, UK.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - John Amerena
- Barwon Health, Geelong, VIC, Australia.,Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian A Smith
- Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC, Australia.,Department of Surgery, School of Clinical Sciences at Monash Health), Monash University, Clayton, VIC, Australia
| | - Valerie Hoover
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia.,Victorian Heart Institute, Clayton, VIC, Australia.,Monash Health & Department of Medicine, Monash University, Clayton, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
20
|
Boyne JJ, Ski CF, Fitzsimons D, Amin H, Hill L, Thompson DR. The changing role of patients, and nursing and medical professionals as a result of digitalization of health and heart failure care. J Nurs Manag 2022; 30:3847-3852. [PMID: 36329647 PMCID: PMC10098485 DOI: 10.1111/jonm.13888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/16/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM The aim of the study is to discuss the changing role of patients, nurses and doctors in an era of digital health and heart failure care. BACKGROUND With a growing demand for heart failure care and a shortage of health care professionals to meet it, digital technologies offer a potential solution to overcoming these challenges. EVALUATION In reviewing pertinent research evidence and drawing on our collective clinical and research experiences, including the co-design and development of an autonomous remote system, DoctorME, we offer some reflections and propose some practical suggestions for nurturing truly collaborative heart failure care. KEY ISSUES Digital health offers real opportunities to deliver heart failure care, but patients and health care professionals will require digital skills training and appropriate health services technological infrastructure. CONCLUSIONS Heart failure care is being transformed by digital technologies, and innovations such as DoctorME have profound implications for patients, nurses and doctors. These include major cultural change and health service transformation. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should create inclusive and supportive working environments where collaborative working and digital technologies in heart failure care are embraced. Nurse managers need to recognize, value and communicate the importance of digital health in heart failure care, ensuring that staff have appropriate digital skills training.
Collapse
Affiliation(s)
- Josiane J Boyne
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Hesam Amin
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Loreena Hill
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
21
|
Hawke LD, Nguyen ATP, Ski CF, Thompson DR, Ma C, Castle D. Interventions for mental health, cognition, and psychological wellbeing in long COVID: a systematic review of registered trials. Psychol Med 2022; 52:2426-2440. [PMID: 35768406 PMCID: PMC9300978 DOI: 10.1017/s0033291722002203] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Among patients diagnosed with COVID-19, a substantial proportion are experiencing ongoing symptoms for months after infection, known as 'long COVID'. Long COVID is associated with a wide range of physical and neuropsychological symptoms, including impacts on mental health, cognition, and psychological wellbeing. However, intervention research is only beginning to emerge. This systematic review synthesizes currently registered trials examining interventions for mental health, cognition, and psychological wellbeing in patients with long COVID. METHODS Standard systematic review guidelines were followed. Trials registered in two large trial registries in 2020 to May 2022 were reviewed. Included studies were narratively synthesized by type of intervention and a risk-of-bias assessment was conducted. RESULTS Forty-two registered trials were included, with a total target sample size of 5814 participants. These include 11 psychological interventions, five pharmacological and other medical interventions, and five evaluating herbal, nutritional, or natural supplement interventions. An additional nine trials are examining cognitive and neurorehabilitation interventions and 12 are examining physiotherapy or physical rehabilitation. Most trials are randomized, but many are feasibility trials; trials are evaluating a wide spectrum of outcomes. CONCLUSIONS While there is a newly emerging body of research testing interventions for mental health, cognition, and psychological wellbeing in long COVID, the breadth and scope of the research remains limited. It is urgently incumbent on researchers to expand upon the intervention research currently under way, in order to generate high-quality evidence on a wide range of candidate interventions for diverse long COVID patient populations.
Collapse
Affiliation(s)
- Lisa D. Hawke
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anh T. P. Nguyen
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Chantal F. Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R. Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Clement Ma
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
22
|
Hawke LD, Brown EE, Rodak T, Rossell S, Ski CF, Strudwick G, Thompson DR, Wang W, Xu D, Castle D. Protocol for a systematic review of interventions targeting mental health, cognition or psychological well-being among individuals with long COVID. BMJ Open 2022; 12:e063846. [PMID: 36175088 PMCID: PMC9527745 DOI: 10.1136/bmjopen-2022-063846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION For some people, COVID-19 infection leads to negative health impacts that can last into the medium or long term. The long-term sequelae of COVID-19 infection, or 'long COVID', negatively affects not only physical health, but also mental health, cognition or psychological well-being. Complex, integrated interventions are recommended for long COVID, including psychological components; however, the effectiveness of such interventions has yet to be critically evaluated. This protocol describes a systematic review to be conducted of scientific literature reporting on clinical trials of interventions to promote mental health, cognition or psychological well-being among individuals with long COVID. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A health sciences librarian will identify the relevant literature through comprehensive systematic searches of Medline, Embase, APA PsycINFO, Cumulative Index to Nursing and Allied Health Literature, medRxiv, PsyArXiv, China National Knowledge Internet and WANFANG Data databases, as well as The Cochrane Central Register of Controlled Trials, clinicaltrials.gov and the WHO International Clinical Trials Registry Platform. Studies will be selected through a title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Data extracted will include intervention descriptions and efficacy metrics. Data will be narratively synthesised; if the data allow, a meta-analysis will be conducted. Risk of bias assessment will be conducted using the Cochrane Risk of Bias 2.0 tool. ETHICS AND DISSEMINATION Ethical approval for systematic reviews is not required. As researchers and clinicians respond to the new clinical entity that long COVID represents, this review will synthesise a rapidly emerging evidence base describing and testing interventions to promote mental health, cognition or psychological well-being. Results will therefore be disseminated through an open-access peer-reviewed publication and conference presentations to inform research and clinical practice. PROSPERO REGISTRATION NUMBER CRD42022318678.
Collapse
Affiliation(s)
- Lisa D Hawke
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Eric E Brown
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Terri Rodak
- CAMH Library, Department of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Susan Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Gillian Strudwick
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Wei Wang
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dandan Xu
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
23
|
R Thompson D, F Ski C, M Clark A, M Dalal H, S Taylor R. Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation? Card Fail Rev 2022; 8:e28. [PMID: 36303590 PMCID: PMC9585646 DOI: 10.15420/cfr.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022] Open
Abstract
Many people with heart failure do not receive cardiac rehabilitation despite a strong evidence base attesting to its effectiveness, and national and international guideline recommendations. A more holistic approach to heart failure rehabilitation is proposed as an alternative to the predominant focus on exercise, emphasising the important role of education and psychosocial support, and acknowledging that this depends on patient need, choice and preference. An individualised, needs-led approach, exploiting the latest digital technologies when appropriate, may help fill existing gaps, improve access, uptake and completion, and ensure optimal health and wellbeing for people with heart failure and their families. Exercise, education, lifestyle change and psychosocial support should, as core elements, unless contraindicated due to medical reasons, be offered routinely to people with heart failure, but tailored to individual circumstances, such as with regard to age and frailty, and possibly for recipients of cardiac implantable electronic devices or left ventricular assist devices.
Collapse
Affiliation(s)
- David R Thompson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Alexander M Clark
- School of Health Disciplines, Athabasca University, Edmonton, Canada
| | - Hasnain M Dalal
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rodney S Taylor
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
24
|
McMahon J, Thompson DR, Brazil K, Ski CF. An eHealth intervention (ManGuard) to reduce cardiovascular disease risk in male taxi drivers: protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud 2022; 8:209. [PMID: 36104740 PMCID: PMC9472349 DOI: 10.1186/s40814-022-01163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Men are at higher risk then women of developing cardiovascular disease (CVD), and male taxi drivers are a particularly high-risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which reported a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more acceptable and effective. The aim of this study is to assess the feasibility an eHealth intervention (ManGuard) to reduce CVD risk in male taxi drivers. Methods A randomised wait-list controlled trial will be conducted with a sample of 30 male taxi drivers to establish feasibility, including recruitment, engagement, and retention rates. Program usability and participant satisfaction will be assessed by a survey completed by all participants at 3 months after allocation. Additionally, an in-depth qualitative process evaluation to explore acceptability of the intervention will be conducted with a subset of participants by semi-structured telephone interviews. Preliminary efficacy of ManGuard for improving key CVD-related outcomes will be assessed, including biomarkers (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and total/HDL cholesterol ratio), blood pressure, anthropometry (body mass index, body fat percentage, and waist circumference), physical activity (accelerometery, and self-report) and psychosocial status (health-related quality of life, self-efficacy, and social support). Outcomes will be assessed at baseline, 7 weeks, and 3 months after group allocation. The wait-list control group will be offered access to the intervention at the completion of data collection. Discussion eHealth interventions show potential for promoting behaviour change and reducing CVD risk in men, yet there remains a paucity of robust evidence pertaining to male taxi drivers, classified as a high-risk group. This study uses a randomised controlled trial to assess the feasibility of ManGuard for reducing CVD risk in male taxi drivers. It is envisaged that this study will inform a fully powered trial that will determine the effectiveness of eHealth interventions for this high risk and underserved population. Trial registration This trial has been registered prospectively on the ISRCTN registry on 5 January 2022, registration number ISRCTN29693943 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01163-4.
Collapse
|
25
|
Koson N, Srisuk N, Rattanaprom A, Thompson DR, Ski CF. Psychometric evaluation of the Thai version of the Self-Care of Coronary Heart Disease Inventory Version 3 (SC-CHDI-V3). Eur J Cardiovasc Nurs 2022; 22:311-319. [PMID: 35881525 DOI: 10.1093/eurjcn/zvac069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/14/2022]
Abstract
AIMS Engaging in self-care is an important aspect of the prevention and management of coronary heart disease (CHD), the leading cause of premature death in Thailand. As no validated tool exists to measure self-care in Thai people with CHD, we translated and examined the psychometric properties of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI) Version 3 (V3) in a Thai population. METHODS AND RESULTS The SC-CHDI-V3 was translated into Thai using the standard forward and backward translation procedure for self-care instruments. A cross-sectional design was used to examine the psychometric properties of the Thai version of the SC-CHDI-V3 in 250 patients with confirmed CHD in a tertiary hospital in Southern Thailand. Cronbach's alpha and McDonald's omega coefficients were used to assess internal consistency, and confirmatory factor analysis was performed to assess construct validity. The Thai version of the SC-CHDI-V3 demonstrated acceptable internal consistency (Cronbach's alpha and McDonald's omega coefficients of each scale ranged from 0.821 - 0.910). Reliability estimates were adequate for each scale (range 0.863 - 0.906). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.996 - 1.000; root-mean-square error of approximation = <0.001 - 0.040). CONCLUSIONS The Thai version of the SC-CHDI-V3 appears to be a valid and reliable instrument for measuring engagement in self-care maintenance, self-care monitoring and self-care management among Thai people with CHD.
Collapse
Affiliation(s)
- Naruebeth Koson
- Cardiothoracic Intensive Care Unit, Suratthani Hospital, Surat Thani, Thailand
| | - Nittaya Srisuk
- Faculty of Nursing, Surat Thani Rajabhat University, Surat Thani, Thailand
| | | | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| |
Collapse
|
26
|
Habota T, Cameron J, Thompson DR, Ski CF. Prospective memory impairment in chronic heart failure: a replication study. PSYCHOL HEALTH MED 2022; 27:1277-1285. [DOI: 10.1080/13548506.2020.1867317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Tina Habota
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Australia
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - Jan Cameron
- Australian Centre for Heart Health, Deakin University, Melbourne, Australia
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - David R. Thompson
- Australian Centre for Heart Health, Deakin University, Melbourne, Australia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Chantal F. Ski
- Australian Centre for Heart Health, Deakin University, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| |
Collapse
|
27
|
Kemp BJ, Thompson DR, Mcguigan K, Watson CJ, Ski CF. Perceptions of an eHealth family-based cardiovascular disease risk reduction intervention: a mixed methods study. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Department for the Economy, Northern Ireland
Introduction
Controllable cardiovascular disease (CVD) risk factors are often initiated in the family home, yet risk reduction is seldom targeted toward families. Participatory design of eHealth interventions with end-users has potential to increase acceptability and adherence of such interventions. Despite their shared risk of developing CVD, few eHealth interventions target both parents and children at CVD risk. Therein lies an evidence gap; the need for coproduction of a family-based eHealth intervention aimed at early CVD prevention.
Purpose
The aim of this study was to identify the perceptions of families towards the design, functionality and acceptability of an eHealth, family-based, CVD prevention intervention.
Methods
Thee online focus groups comprising six families were conducted between April and May 2021. Families consisted of at least one parent who met CVD risk factor criteria, and at least one child aged five to 17 years. Content analysis and narrative synthesis were used to identify categories and subcategories regarding development of and engagement with the proposed intervention. Additionally, quantitative, and demographic measures were used to determine psychosocial and health profiles.
Results
Three categories were identified from the focus groups:
1) previous experiences of using health-related apps or devices
2) expectations of a newly developed eHealth family-based CVD prevention intervention
3) motivators for engagement with the intervention
Goal setting, rewards, accountability, adaptability, recording achievements and competition were considered crucial motivators for engagement for both parents and children. Participants welcomed the intervention, and advised they would prefer a free, personalised, easy-to-use, non-time-consuming intervention, with multiple content formats, and additional information available should they seek to access it. Parents conveyed satisfactory general self-efficacy and quality of life, low anxiety and depression and high perceived social support.
Conclusions
Overall, families were constructive and forthcoming towards the idea of an eHealth, family-based CVD prevention intervention. These findings informed a prototype of a family-based eHealth intervention aimed at early CVD prevention. The prototype is currently being developed with plans for piloting via a randomised controlled trial in the home environment, by families as an early intervention for the prevention of CVD.
Collapse
Affiliation(s)
- B J Kemp
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - D R Thompson
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - K Mcguigan
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - C J Watson
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - C F Ski
- University of Suffolk , Suffolk, Ipswich , United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
28
|
Ski CF, Mcmahon J, Mcmahon J, Brazil K, Brazil K, Thompson DR, Thompson DR. ManGuard an eHealth intervention to reduce cardiovascular risk in male taxi drivers: a pilot randomised controlled trial protocol. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy, Northern Ireland
Background
Men are at higher risk then women of developing cardiovascular disease (CVD) and male taxi drivers are a particularly high risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and a sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which had a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more user-friendly and effective.
Purpose
The aim of this study is to assess the feasibility of a randomised controlled trial (RCT) of an eHealth intervention – ManGuard – to reduce CVD risk in male taxi drivers.
Methods
A wait-list controlled trial of 30 male taxi drivers in Belfast, Northern Ireland, will be assigned randomly to an intervention or usual care group. The ManGuard Application comprises seven modules: i) introduction and goal setting, ii) being active iii) eating well, iv) managing stress, v) smoking, vi) alcohol and vii) keep accelerating, the latter to be used as a re-cap module. This trial will establish feasibility, including recruitment, engagement and retention rates, program usability and participant satisfaction, as well as preliminary efficacy of ManGuard in improving key outcomes. Primary outcome is to determine the feasibility of an eHealth intervention for reducing CVD risk in male taxi drivers by assessing the following outcome measures:
o Acceptability, recruitment, retention and engagement rates
o Usability and participant satisfaction, process evaluation and survey
The secondary outcome is to evaluate the preliminary efficacy of ManGuard compared to usual care in improving the following outcomes:
o Clinical indices: CVD biomarkers (cholesterol, glucose), blood pressure, anthropometry (BMI, waist circumference, body fat percentage)
o Physical activity
o Psychosocial status: health related quality of life, self-efficacy, social support
An in-depth qualitative process evaluation to explore acceptability of the intervention will also be conducted.
Trial registration: This trial has been registered prospectively on the ISRCTN registry on 5 January 2022
Conclusion
eHealth interventions have been shown to promote behaviour change and reduce CVD risk in men, but there is a lack of robust evidence for this in male taxi drivers, a high-risk group. This study aims to assess the feasibility of a future RCT assessing the impact of ManGuard on CVD risk in male taxi drivers. This study will inform a fully-powered trial that will provide robust evidence for eHealth interventions for this underserved population.
Collapse
Affiliation(s)
- C F Ski
- University of Suffolk , Ipswich , United Kingdom of Great Britain & Northern Ireland
| | - J Mcmahon
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - J Mcmahon
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - K Brazil
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - K Brazil
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - D R Thompson
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - D R Thompson
- Queen's University of Belfast , Belfast , United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
29
|
Al-Jabr H, Windle K, Thompson DR, Jenkins ZM, Castle DJ, Ski CF. Long COVID Optimal Health Programme (LC-OHP) to enhance psychological and physical health: a feasibility randomised controlled trial protocol (Preprint). JMIR Res Protoc 2022; 11:e36673. [PMID: 35468586 PMCID: PMC9106280 DOI: 10.2196/36673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, which continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far is the adoption of holistic management approaches. The Optimal Health Program (OHP) is a brief 5-session, plus booster, psychosocial program designed to support mental and physical well-being that has been used effectively for a range of chronic conditions. Objective This study examines the feasibility and acceptability of employing an especially customized version of OHP (long COVID OHP [LC-OHP]) to improve psychological and physical health of people with long COVID. Methods This is a feasibility randomized controlled trial that will be running from November 2021 to February 2023. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. A total of 60 participants will be randomized into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the program (primary); and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy, and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the program. Quantitative data will be analyzed using SPSS, and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analyzed to identify common emerging themes. Results This is an ongoing study, which began in November 2021. Conclusions Long COVID has a significant impact on an individual’s mental and physical functioning. The LC-OHP has a potential to provide people living with long COVID with additional support and to improve self-efficacy. The findings of this study would identify the feasibility of delivering this program to this population and will provide an indication for the program’s effectiveness. Trial Registration ISRCTN Registry ISRCTN38746119; https://www.isrctn.com/ISRCTN38746119 International Registered Report Identifier (IRRID) DERR1-10.2196/36673
Collapse
Affiliation(s)
- Hiyam Al-Jabr
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| | - Karen Windle
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Zoe M Jenkins
- Mental Health Service, St Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| |
Collapse
|
30
|
Lee KS, Oh O, Miller J, Hammash M, Thompson DR, Ski CF, Cameron J, Hwang SY, Moser DK. Patients' openness to discussing implantable cardioverter defibrillator deactivation at end of life: a cross-sectional study. Eur J Cardiovasc Nurs 2022; 21:687-693. [PMID: 35018427 DOI: 10.1093/eurjcn/zvab130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/15/2021] [Accepted: 12/20/2021] [Indexed: 11/14/2022]
Abstract
AIMS It is recommended that patients and clinicians discuss end-of-life deactivation of their implantable cardioverter defibrillator (ICD) prior to device implantation and throughout the illness trajectory to facilitate shared decision-making. However, such discussions rarely occur, and little is known about patients' openness to this discussion. The purpose of this study was to explore factors associated with patients' openness to discussing end-of-life ICD deactivation with clinicians. METHODS AND RESULTS This cross-sectional study recruited 293 patients with an ICD from outpatient clinics in the USA, Australia, and South Korea. Patients were classified into an open or resistant group based on their desire to discuss device deactivation at end of life with clinicians. Multivariable logistic regression was used to explore factors related to patients' openness to this discussion.About half of the participants (57.7%) were open to discussing such issues with their clinicians. Factors related to patients' openness to discussing device deactivation at end of life were living with someone, not having severe comorbid conditions (cancer and/or chronic kidney disease), greater ICD knowledge, and more experience discussing end-of-life issues with clinicians (odds ratio: 0.479, 0.382, 1.172, 1.332, respectively). CONCLUSION Approximately half of the ICD recipients were reluctant to discuss device deactivation at end of life with clinicians. Unmodifiable factors were their living arrangement and severe comorbidity. ICD knowledge and prior experience discussing end-of-life issues were potentially modifiable factors in the future. These factors should be addressed when assessing patients' readiness for a shared discussion about device deactivation at end of life.
Collapse
Affiliation(s)
- Kyoung Suk Lee
- College of Nursing, Seoul National University, 103 Daehak-ro, Jong-ro, Seoul 03080, South Korea
| | - Oonjee Oh
- College of Nursing, Seoul National University, 103 Daehak-ro, Jong-ro, Seoul 03080, South Korea
| | - Jennifer Miller
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, USA
| | - Muna Hammash
- School of Nursing, University of Louisville, 555 S Floyd St, Louisville, KY 40202, USA
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast 97 Lisburn Rd, Belfast BT9 7BL, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, 19 Neptune Quay, Ipswich IP4 1QJ, UK
| | - Jan Cameron
- School of Clinical Sciences at Monash Health, Monash University, 27-31 Wright Street, Clayton VIC 3168, Australia
| | - Seon Young Hwang
- College of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, South Korea
| | - Debra K Moser
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, USA
| |
Collapse
|
31
|
Allana S, Ski CF, Thompson DR, Clark AM. Bringing Intersectionality to Cardiovascular Health Research in Canada. CJC Open 2022; 3:S4-S8. [PMID: 34993427 PMCID: PMC8712551 DOI: 10.1016/j.cjco.2021.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/28/2021] [Indexed: 01/10/2023] Open
Affiliation(s)
- Saleema Allana
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.,Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Alexander M Clark
- Faculty of Health Disciplines, Athabasca University. Edmonton, Alberta, Canada
| |
Collapse
|
32
|
Jackson AC, Rogerson MC, Amerena J, Smith J, Hoover V, Alvarenga ME, Higgins RO, Grande MRL, Ski CF, Thompson DR, Murphy BM. Unraveling the Complexity of Cardiac Distress: A Study of Prevalence and Severity. Front Psychiatry 2022; 13:808904. [PMID: 35432039 PMCID: PMC9009040 DOI: 10.3389/fpsyt.2022.808904] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/23/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way. METHOD A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress. RESULTS Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were "being physically restricted" (66%), "lacking energy" (60%), "being short of breath" (60%), "thinking I will never be the same again" (57%), and "not sleeping well" (51%). While less prevalent, "not having access to the health care I need," "being concerned about my capacity for sexual activity," and "being unsupported by family and friends" were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress. CONCLUSION AND IMPLICATIONS Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery.
Collapse
Affiliation(s)
- Alun C Jackson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Center on Behavioral Health, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | | | - John Amerena
- Barwon Health, Geelong, VIC, Australia.,Deakin School of Medicine, University Hospital Geelong, Geelong, VIC, Australia
| | - Julian Smith
- Department of Cardiothoracic Surgery, Monash Health, Melbourne, VIC, Australia.,Department of Surgery, School of Clinical Sciences, Monash Health, Melbourne, VIC, Australia
| | - Valerie Hoover
- Psychiatry and Behavioral Sciences, Stanford Women's Heart Health Clinic, Stanford, CA, United States
| | - Marlies E Alvarenga
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,School of Health and Life Sciences, Federation University Australia, Berwick, VIC, Australia.,Victorian Heart Institute, Melbourne, VIC, Australia.,Monash Health & Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Rosemary O Higgins
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychology, Deakin University, Geelong, VIC, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Michael R Le Grande
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Chantal F Ski
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - David R Thompson
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Barbara M Murphy
- Australian Centre for Heart Health, Melbourne, VIC, Australia.,Center on Behavioral Health, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychology, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
33
|
McVeigh C, Ace L, Ski CF, Carswell C, Burton S, Rej S, Noble H. Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review. Healthcare (Basel) 2021; 9:1493. [PMID: 34828538 PMCID: PMC8621067 DOI: 10.3390/healthcare9111493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management of anxiety, depression and wellbeing, thereby reducing stress in healthcare provider populations. The aim of this narrative review was to synthesize and provide a critical overview of the current evidence in relation to mindfulness-based interventions for UG nursing students in a university setting. (2) Methods: A review of the literature was conducted in March 2020 and updated in May 2021, utilising the databases CINAHL, Medline and PsycINFO. (3) Results: Fifteen studies were included in the review, with three common themes identified: (i) the positive impact of mindfulness on holistic wellbeing, (ii) mindfulness-based techniques as a positive coping mechanism within academic and clinical practice, and (iii) approaches to the delivery of mindfulness-based interventions. (4) Conclusions: Mindfulness-based interventions are effective strategies for the management of stress, development of self-awareness and enhanced academic and clinical performance in undergraduate nursing students. No ideal approach to delivery or duration of these interventions was evident from the literature. Best practice in relation to delivery of mindfulness-based interventions for nursing students is recommended for future studies.
Collapse
Affiliation(s)
- Clare McVeigh
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (L.A.); (C.C.); (S.B.); (H.N.)
| | - Lindsay Ace
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (L.A.); (C.C.); (S.B.); (H.N.)
| | - Chantal F. Ski
- Integrated Care Academy, University of Suffolk, Ipswich IP4 1QJ, UK;
| | - Claire Carswell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (L.A.); (C.C.); (S.B.); (H.N.)
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Stephanie Burton
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (L.A.); (C.C.); (S.B.); (H.N.)
| | - Soham Rej
- McGill Meditation and Mind-Body Medicine Research Clinic (MMMM-RC) and Geri-PARTy Research Group, Jewish General Hospital/Lady Davis Institute, Montreal, QC H3T 1E2, Canada;
- Department of Psychiatry, McGill University, Montreal, QC H3A 0GA, Canada
| | - Helen Noble
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (L.A.); (C.C.); (S.B.); (H.N.)
| |
Collapse
|
34
|
Kemp BJ, Thompson DR, Watson CJ, McGuigan K, Woodside JV, Ski CF. Effectiveness of family-based eHealth interventions in cardiovascular disease risk reduction: A systematic review. Prev Med 2021; 149:106608. [PMID: 33984372 DOI: 10.1016/j.ypmed.2021.106608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/03/2021] [Accepted: 05/09/2021] [Indexed: 11/15/2022]
Abstract
Family-based eHealth interventions to reduce cardiovascular disease risk have potential as a primary prevention strategy to improve the health of parents and their children. This systematic review evaluated the effectiveness of such interventions in modifying parent and child/adolescent risk factors such as body mass index, physical activity, dietary intakes and alcohol use. Five electronic databases were searched up to April 2020. Of 2193 articles identified, seven randomised controlled trials met inclusion criteria and were reviewed. Data were extracted regarding study setting, design, methods, eHealth technology used, intervention and control group components, retention rates, outcome measures, incentives and limitations. Risk of bias and quality assessment were carried out using Cochrane methods. A qualitative narrative data synthesis of the studies was conducted. Our review found that three studies showed an improvement in alcohol use among parents and adolescents as a result of the eHealth intervention. Among children/adolescents, two studies showed an improvement in dietary intake, one study showed an improvement in physical activity, and one study showed an improvement in body mass index as a result of the eHealth intervention. Interventions appeared more likely to be effective if they were theory-based, had longer follow-up periods, were incentivised and included regular interaction. Our findings suggest that, despite a paucity of high-quality trials, there is some evidence that family-based eHealth interventions have potential to reduce cardiovascular disease risk. However, more sufficiently powered, higher-quality trials with theory driven, clearly described interventions and unambiguous outcomes are needed.
Collapse
Affiliation(s)
- Bridie J Kemp
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chris J Watson
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Karen McGuigan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK.
| |
Collapse
|
35
|
Oh OJ, Lee KS, Miller J, Hammash M, Thompson DR, Ski CF, Cameron J, Moser DK. Patient experiences of shared decision-making are associated with implantable cardioverter defibrillator recipients" openness to discuss device deactivation at end-of-life. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): In Australia, this study received funding from a faculty grand by Australian University Faculty of Health Sciences Research grant. In the United States, the study was funded by a research professor award from University of Kentucky.
Background. Shared decision-making is important for ICD recipients to fully contemplate and rationally decide about ICD deactivation at end-of-life. Although discussions about device deactivation at end-of-life are recommended to be held before ICD implantation and throughout the illness trajectory, such discussions rarely occur in clinical practice.
Purpose. To identify whether ICD recipients’ experiences of end-of-life discussions with clinicians are associated with openness to discussing ICD deactivation at end-of-life.
Methods. This cross-sectional study included 293 ICD recipients living in the United States, Australia, and South Korea (mean age 59, 22.5% female, mean ICD implantation 10 years). Hierarchical logistic regression was used to determine whether patients’ experiences of shared decision-making were associated with openness to discuss device deactivation at end-of-life after controlling for relevant covariates (i.e. age, gender, ICD implantation years, ICD shock experience, general ICD experience, ICD knowledge, and concerns related to the ICD).
Results. About half of the participants (57.7%) were open to discussing ICD deactivation at end-of-life with clinicians. Almost one-quarter (23.5%) had no prior experience of discussing any end-of-life issues with clinicians. Patients’ past experiences of end-of-life discussions with clinicians were significantly associated with openness to discuss device deactivation at end-of-life (OR: 1.30) after adjusting for covariates.
Conclusion. Our results highlight that clinicians’ willingness to discuss sensitive end-of-life issues such as battery replacement and deactivation of defibrillation therapy empowers patients to actively engage in end-of-life discussions.
Collapse
Affiliation(s)
- OJ Oh
- Seoul National University, College of Nursing, Seoul, Korea (Republic of)
| | - KS Lee
- Seoul National University, College of Nursing, Seoul, Korea (Republic of)
| | - J Miller
- University of Kentucky, College of Nursing, Lexington, United States of America
| | - M Hammash
- University of Louisville School of Nursing, Louisville, United States of America
| | - DR Thompson
- Queen"s University of Belfast, School of Nursing and Midwifery, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - CF Ski
- University of Suffolk, Integrated Care Academy, Ipswich, United Kingdom of Great Britain & Northern Ireland
| | - J Cameron
- Monash University , School of Clinical Sciences, Department of Medicine , Clayton, Australia
| | - DK Moser
- University of Kentucky, College of Nursing, Lexington, United States of America
| |
Collapse
|
36
|
Palant A, Zippel-Schultz B, Ski CF, Brandts J, Eurlings C, Furtado Da Luz Brzychcyk E, Hill L, Dixon L, Fitzsimons D, Thompson D, Mueller-Wieland D, Schuett KA, Hoedemakers T, Brunner La-Rocca HP, Helms TM. Understanding needs and expectations of heart failure patients and their caregivers regarding digital health - the PASSION-HF project. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): INTERREG-NWE
Background/Introduction
Current heart failure (HF) healthcare provision is not sufficient. Due to demographic changes and subsequent increases in comorbidities, along with unequal distribution of medical care in rural areas, alternative approaches need be sought. The use of eHealth applications has potential to enable patients to become more self-sufficient. The "PASSION-HF" project aims to develop an interactive decision-making system – a virtual doctor – that provides solutions based on current guidelines and artificial intelligence. Patient independence is maximized through 24/7 access to personalized HF-management. Furthermore, the application defines decision points, where medical professionals need to be included.
Purpose
To understand needs and expectations of HF patients and their informal caregivers in regard to a virtual doctor.
Methods
We conducted an exploratory mixed-methods study within the Netherlands, UK, Ireland and Germany. Semi-structured qualitative interviews were supplemented by a standardized questionnaire. The interviews focused on i) acceptance and motivation to use a virtual doctor and ii) experience and perception of current health care provision. The interviews were analysed using the content analysis according to Mayring (2010) with the help of "ATLAS.TI" software. Additional information about the role of informal caregivers, technology acceptance and decision-making processes was collected via questionnaires.
Results
A total of 49 patients and 33 informal caregivers were interviewed. Most patients were male (76%), aged between 60 and 69 years (43%). Three key themes were identified in regard to an interactive decision-making system: 1) Reassurance, because patients felt uncertain about their condition and their symptoms, they had a strong desire for an application that could monitor their health 24/7, was able to spot deteriorations, before they occured and gave them instant feedback about their current health status; 2) Personalized advice, e.g. patients wanted the virtual doctor to adapt medication, sport activities and food recommendations to their current health status; and 3) Transparency, e.g. patients wanted to know, where the recommendations are coming from and justifications for management modifications. Interview findings also identified that the HF-nurses play a significant role in the care and management of the condition. Across all countries with HF-nurses, they were the primary point of contact, when patients had any HF related concerns.
Conclusion
The findings provide valuable information for the development and implementation of eHealth solutions. Patients want reassurance, independently of the availability of healthcare services, combined with personalized advice regarding day-to-day management of their HF. For the next step, we are planning a multicentre clinical trial to test the prototype of the application. Here all decisions are examined by a clinical committee and benefits are evaluated.
Collapse
Affiliation(s)
- A Palant
- German foundation for the chronically III, Berlin, Germany
| | | | - CF Ski
- University of Suffolk, Integrated Care Academy, Ipswich, United Kingdom of Great Britain & Northern Ireland
| | - J Brandts
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | - C Eurlings
- Laurentius Hospital Roermond, Cardiology Department, Roermond, Netherlands (The)
| | | | - L Hill
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - L Dixon
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Fitzsimons
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Thompson
- Belfast Health and Social Care Trust, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - D Mueller-Wieland
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | - KA Schuett
- RWTH University Hospital Aachen, Department of Cardiology, Aachen, Germany
| | | | - H-P Brunner La-Rocca
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - TM Helms
- German foundation for the chronically III, Berlin, Germany
| |
Collapse
|
37
|
Mcmahon J, Thompson DR, Pascoe MC, Brazil K, Ski CF. eHealth interventions for reducing cardiovascular disease risk in men: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy (DfE) studentships
Background. Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear.
Purpose. To conduct a systematic review and meta-analysis to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men.
Methods. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and principles laid out by the Cochrane Handbook for Systematic Reviews of Interventions. A search of published randomised controlled trials (RCTs) with no date restrictions up to July 2020 was conducted across five electronic databases: Cochrane Central register of Controlled Trials (CENTRAL), Medline, CINAHL Plus, PsycINFO and SCOPUS. Reference lists of relevant systematic reviews and meta-analyses were manually searched for additional trials not identified during the database search. Eligible studies were RCTs that focused on the use of eHealth to improve a minimum of two major CVD related risk factors in males aged 18 years or older.
Results. A total of 3168 records were retrieved from the online database search, with nine trials meeting the inclusion criteria following screening and full-text assessment. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p = 0.01), body weight (Z=-3.25, p = 0.01), waist circumference (Z=-2.30, p = 0.02) and systolic (Z=-3.57, p = 0.01) and diastolic (Z=-3.56, p = 0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group.
Conclusion. This was the first systematic review and meta-analysis conducted on the effectiveness of eHealth interventions for reducing CVD risk in men. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.
Collapse
Affiliation(s)
- J Mcmahon
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - DR Thompson
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - MC Pascoe
- Victoria University, Melbourne, Australia
| | - K Brazil
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - CF Ski
- University of Suffolk, Ipswich, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
38
|
Kemp B, Thompson DR, Mc Guigan K, Watson CJ, Woodside JV, Ski CF. Family-based eHealth interventions to reduce cardiovascular disease risk: a systematic review. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Department for the Economy, Northern Ireland
Background
Family-based eHealth interventions have potential to reduce cardiovascular disease (CVD) risk and improve health of parents and children.
Purpose
To evaluate the effectiveness of family-based eHealth interventions to reduce parent and child CVD risk.
Methods
Systematic review. Five electronic databases were searched (CENTRAL; MEDLINE; CINAHL; EMBASE; PsycINFO) up to April 2020. Data extraction included: study design, setting, methodology, eHealth technology, experiment/control group constituents, risk factors, outcomes, incentivisation and limitations. Data were synthesised narratively. Cochrane methodology was used to assess risk of bias and reporting quality.
Results
In total, 2193 articles were screened and seven trials included for review. The most consistently improved CVD risk factor across parents and children was reduced alcohol use, whilst reduction in BMI the least consistently improved. Behaviour-change theoretical underpinning, extended follow-up duration, interactivity and incentivisation were identified as effective components of these interventions. Four studies were assessed as overall ‘low risk’ of bias and three studies had concerns with randomisation and intention-to-treat analysis. Conclusions: This is the first systematic review to evaluate family-based eHealth interventions to reduce CVD risk. Despite a paucity in high-quality trials, there is evidence of their potential effectiveness. Recommended, more high quality, behaviour-change-theory-based, clearly reported interventions with explicit outcomes.
Collapse
Affiliation(s)
- B Kemp
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - DR Thompson
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - K Mc Guigan
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - CJ Watson
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - JV Woodside
- Queen"s University of Belfast, Belfast, United Kingdom of Great Britain & Northern Ireland
| | - CF Ski
- University of Suffolk, Suffolk, Ipswich, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
39
|
Srisuk N, Wichit N, Thompson DR, Ski CF. A psychometric evaluation of the Caregiver Contribution to Self-Care of Heart Failure Index in a Thai population. Health Qual Life Outcomes 2021; 19:177. [PMID: 34246255 PMCID: PMC8272368 DOI: 10.1186/s12955-021-01814-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. METHODS The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. RESULTS The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald's omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98-1.00; root-mean-square error of approximation = 0.00-0.07). CONCLUSIONS The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.
Collapse
Affiliation(s)
- Nittaya Srisuk
- Faculty of Nursing, Surat Thani Rajabhat University, Surat Thani, Thailand
| | - Nutchanath Wichit
- Faculty of Nursing, Surat Thani Rajabhat University, Surat Thani, Thailand
| | - David R Thompson
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| |
Collapse
|
40
|
Zippel-Schultz B, Palant A, Eurlings C, F Ski C, Hill L, Thompson DR, Fitzsimons D, Dixon LJ, Brandts J, Schuett KA, de Maesschalck L, Barrett M, Furtado da Luz E, Hoedemakers T, Helms TM, Brunner-La Rocca HP. Determinants of acceptance of patients with heart failure and their informal caregivers regarding an interactive decision-making system: a qualitative study. BMJ Open 2021; 11:e046160. [PMID: 34135043 PMCID: PMC8211061 DOI: 10.1136/bmjopen-2020-046160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Heart failure is a growing challenge to healthcare systems worldwide. Technological solutions have the potential to improve the health of patients and help to reduce costs. Acceptability is a prerequisite for the use and a successful implementation of new disruptive technologies. This qualitative study aimed to explore determinants that influence the acceptance of patients and their informal caregivers regarding a patient-oriented digital decision-making solution-a doctor-at-home system. DESIGN We applied a semistructured design using an interview guide that was based on a theoretical framework influenced by established acceptance theories. The interviews were analysed using a content analysis. SETTING A multicentred study in four European countries. PARTICIPANTS We interviewed 49 patients and 33 of their informal caregivers. Most of the patients were male (76%) and aged between 60 and 69 years (43%). Informal caregivers were mostly female (85%). The majority of patients (55%) suffered from heart failure with mild symptoms. RESULTS Four main categories emerged from the data: needs and expectations, preferences regarding the care process, perceived risk and trust. Participants expressed clear wishes and expectations regarding a doctor-at-home, especially the need for reassurance and support in the management of heart failure. They were receptive to changes to the current healthcare processes. However, trust was identified as an important basis for acceptance and use. Finally, perceived risk for decision-making errors is a crucial topic in need of attention. CONCLUSION Patients and informal caregivers see clear benefits of digitalisation in healthcare. They perceive that an interactive decision-making system for patients could empower and enable effective self-care. Our results provide important insights for development processes of patient-centred decision-making systems by identifying facilitators and barriers for acceptance. Further research is needed, especially regarding the influence and mitigation of patients and informal caregivers' perceived risks.
Collapse
Affiliation(s)
| | | | - Casper Eurlings
- Cardiology Department, Laurentius Hospital, Roermond, The Netherlands
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Loreena Hill
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - Lana J Dixon
- Belfast Health and Social Care Trust, Belfast, UK
| | - Julia Brandts
- Department of Cardiology, University Hospital Aachen, Aachen, Germany
| | | | | | - Matthew Barrett
- Catherine McAuley Education and Research Centre, University College of Dublin, Dublin, Ireland
| | | | | | | | | |
Collapse
|
41
|
Ferrier L, Ski CF, O'Brien C, Jenkins Z, Thompson DR, Moore G, Ward G, Castle DJ. Bridging the gap between diabetes care and mental health: perspectives of the Mental health IN DiabeteS Optimal Health Program (MINDS OHP). BMC Endocr Disord 2021; 21:96. [PMID: 33964904 PMCID: PMC8105945 DOI: 10.1186/s12902-021-00760-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mental health problems are highly prevalent in people with type 1 diabetes mellitus (T1DM), which adversely impact physical health and quality of life. This study aimed to explore the experiences of people with T1DM who had completed the Mental health IN DiabeteS Optimal Health Program (MINDS OHP), a novel intervention developed to bridge the gap between physical and mental health care. METHOD Participants with T1DM were invited to take part in a focus group or semi-structured interviews. Participants were recruited from outpatient and community settings. The focus group and interviews were audio-recorded and transcribed verbatim. Thematic content analysis was used and identified themes were cross-validated by researchers and member-checked by participants. RESULTS Ten people with T1DM were included. Two key themes emerged: 'MINDS OHP experiences' and 'lived experiences of diabetes'. MINDS OHP experiences included five sub-themes: program benefits, follow-up and timing, suggested improvements, collaborative partners, and materials suitability. Lived experiences also included five sub-themes: bridging the gap between mental and physical health, support networks, stigma and shame, management intrusiveness, and adolescence and critical life points. CONCLUSIONS The MINDS OHP for people with T1DM was generally well received, though study findings suggest a number of improvements could be made to the program, such as including family members, and consideration being given to its routine early inclusion in diabetes management, ideally in primary care.
Collapse
Affiliation(s)
- Lucienne Ferrier
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.
- Integrated Care Academy, University of Suffolk, Ipswich, UK.
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Casey O'Brien
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - Zoe Jenkins
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gaye Moore
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - Glenn Ward
- Department of Endocrinology, St. Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| |
Collapse
|
42
|
McMahon J, Thompson DR, Pascoe MC, Brazil K, Ski CF. eHealth interventions for reducing cardiovascular disease risk in men: A systematic review and meta-analysis. Prev Med 2021; 145:106402. [PMID: 33388336 DOI: 10.1016/j.ypmed.2020.106402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/02/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. Although men often indicate a preference for gender-specific information and support, this rarely occurs. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Therefore, the aim of this systematic review and meta-analysis was to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. A search of published randomised controlled trials with no date restrictions up to July 2020 was conducted to identify those targeting at least two major CVD risk factors. Nine trials were identified and reviewed. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p=0.01), body weight (Z=-3.25, p=0.01), waist circumference (Z=-2.30, p=0.02) and systolic (Z=-3.57, p=0.01) and diastolic (Z=-3.56, p=0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.
Collapse
Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Michaela C Pascoe
- Institute for Health & Sport, Victoria University, Melbourne, Australia
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK; Integrated Care Academy, University of Suffolk, Ipswich, UK.
| |
Collapse
|
43
|
McGuigan K, Hill A, Coates V, O'Kane M, Thompson DR, Ski CF, McCay D. Moderating the relationship between diabetes distress and mastery: the role of depression and empowerment. PSYCHOL HEALTH MED 2021; 27:838-847. [PMID: 33641545 DOI: 10.1080/13548506.2021.1894343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Type 2 diabetes is a chronic condition primarily self-managed by the individual. Mastery is a protective factor linked to better control of chronic conditions, effective self-management and improved medication adherence. Mastery appears increasingly important as treatment regimens and self-management demands become more complex and burdensome. Diabetes distress negatively impacts self-management, glycaemic control and treatment adherence. Understanding the relationship between diabetes distress and mastery may provide opportunities to improve condition management and adherence . This relationship may be impacted by other factors affecting the individual's perceived sense of control over their condition. This study examined the role of diabetes empowerment and depression in the relationship between diabetes distress and mastery. Data were drawn from a randomised controlled trial of 131 adults with type 2 diabetes transitioning to injection therapy. Participants completed measures of diabetes distress , mastery , depression and empowerment . Diabetes distress and depression were negatively associated with mastery, whilst diabetes empowerment was positively associated . A significant interaction effect (b = .024, t(112) = 3.79, p = <.005) confirmed the relationship between diabetes distress and mastery was moderated by depression. Findings highlight the additive deleterious effects of depression. Interventions to improve mastery among those living with type 2 diabetes should address diabetes distress and depression to optimise outcomes.
Collapse
Affiliation(s)
- Karen McGuigan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Alyson Hill
- School of Biomedical Sciences (NICHE), Ulster University, Coleraine, UK
| | - Vivien Coates
- Western Health & Social Care Trust, Londonderry, UK.,School of Nursing, Ulster University, Coleraine, UK
| | | | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Deirdre McCay
- School of Biomedical Sciences (NICHE), Ulster University, Coleraine, UK
| |
Collapse
|
44
|
Jenkins ZM, Tan EJ, O'Flaherty E, Knowles S, Thompson DR, Ski CF, Rossell SL, Coco C, Ierino FL, Gock H, Castle DJ. A psychosocial intervention for individuals with advanced chronic kidney disease: A feasibility randomized controlled trial. Nephrology (Carlton) 2021; 26:442-453. [PMID: 33484221 DOI: 10.1111/nep.13850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/17/2022]
Abstract
AIM The current study evaluated the feasibility and preliminary efficacy of a psychosocial intervention, the Kidney Optimal Health Program, in reducing symptoms of depression and anxiety in individuals with advanced chronic kidney disease. METHODS Patients with stage 4 or 5 chronic kidney disease were randomized to either a nine-session psychosocial intervention programme or usual care. Feasibility was assessed through recruitment and retention rates and programme acceptability. Participants completed assessments of depression, anxiety and psychosocial health at baseline and at 3-, 6- and 12-month follow-up. A repeated-measures analysis of variance was used to compare groups on outcomes over time. RESULTS One hundred and twenty-eight patients were screened for eligibility; 84 consented to participant and were randomized to receive the intervention (N = 42) or usual care (N = 42). 27 (32.1%) participants withdrew prior to baseline assessment. Of those who completed the baseline assessment (N = 57), trial retention was high (75.4% at 3-month, 80.7% at 6-month and 70.2% at 12-month follow-up). Participants reported high levels of programme acceptability. The patients who completed the intervention (N = 17) demonstrated significantly decreased depression at 12-month follow-up compared to the usual care group (N = 13). CONCLUSION The results support the feasibility of the Kidney Optimal Health Program intervention in recruitment, retention and programme acceptability with an improved screening protocol. Preliminary support is provided for improvement in depressive symptoms in patients with advanced chronic kidney disease. Further investigation through a fully powered randomized controlled trial is warranted.
Collapse
Affiliation(s)
- Zoe M Jenkins
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Eric J Tan
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Emmet O'Flaherty
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia
| | - Simon Knowles
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Department of Psychology, Swinburne University of Technology, Melbourne, Australia
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,University of Suffolk, Integrated Care Academy, Ipswich, UK
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,University of Suffolk, Integrated Care Academy, Ipswich, UK
| | - Susan L Rossell
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Carolee Coco
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco L Ierino
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia.,Department of Nephrology, University of Melbourne, Melbourne, Australia
| | - Hilton Gock
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Canada
| |
Collapse
|
45
|
Ski CF, Zippel-Schultz B, De Maesschalck L, Hoedemakers T, Schütt K, Thompson DR, Brunner La-Rocca HP. COVID-19 shapes the future for management of patients with chronic cardiac conditions. Digit Health 2021; 7:2055207621991711. [PMID: 33623705 PMCID: PMC7876750 DOI: 10.1177/2055207621991711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast,
UK
| | | | | | | | | | - David R Thompson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast,
UK
| | | |
Collapse
|
46
|
Corones-Watkins K, Cooke M, Theobald K, White K, Thompson DR, Ski CF, King-Shier K, Conway A, Ramis MA. Effectiveness of nurse-led clinics in the early discharge period after percutaneous coronary intervention: A systematic review. Aust Crit Care 2020; 34:510-517. [PMID: 33272768 DOI: 10.1016/j.aucc.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Readmission after percutaneous coronary intervention is common in the early postdischarge period, often linked to limited opportunity for education and preparation for self-care. Attending a nurse-led clinic within 30 d after discharge has the potential to enhance health outcomes. OBJECTIVE The aim of the study was to synthesise the available literature on the effectiveness of nurse-led clinics, during early discharge (up to 30 d), for patients who have undergone percutaneous coronary intervention. REVIEW METHOD USED A systematic review of randomised and quasi-randomised controlled trials was undertaken. DATA SOURCES The databases included PubMed, OVID, CINAHL, EMBASE, the Cochrane Library, SCOPUS, and ProQuest. REVIEW METHODS Databases were searched up to November 2018. Two independent reviewers assessed studies using the Cochrane risk-of-bias tool. RESULTS Of 2970 articles screened, only four studies, representing 244 participants, met the review inclusion criteria. Three of these studies had low to moderate risk of bias, with the other study unclear. Interventions comprised physical assessments and individualised education. Reported outcomes included quality of life, medication adherence, cardiac rehabilitation attendance, and psychological symptoms. Statistical pooling was not feasible owing to heterogeneity across interventions, outcome measures, and study reporting. Small improvements in quality of life and some self-management behaviours were reported, but these changes were not sustained over time. CONCLUSIONS This review has identified an important gap in the research examining the effectiveness of early postdischarge nurse-led support after percutaneous coronary intervention on outcomes for patients and health services. More robust research with sufficiently powered sample sizes and clearly defined interventions, comparison groups, and outcomes is recommended to determine effectiveness of nurse-led clinics in the early discharge period.
Collapse
Affiliation(s)
| | - Marie Cooke
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Karen Theobald
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Katherine White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK; Integrated Care Academy, University of Suffolk, Ipswich, UK.
| | | | - Aaron Conway
- Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Mary-Anne Ramis
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
47
|
|
48
|
Ski CF, Taylor RS, McGuigan K, Lambert JD, Richards SH, Thompson DR. Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation. Hippokratia 2020. [DOI: 10.1002/14651858.cd013508.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Chantal F Ski
- School of Nursing and Midwifery; Queen's University Belfast; Belfast 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
| | - Karen McGuigan
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| | | | | | - David R Thompson
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| |
Collapse
|
49
|
Abstract
Meditation is a popular practice for reducing stress and improving mental health and wellbeing. Its effects are mediated largely by the endocrine system, including the hypothalamic-pituitary-adrenal axis, the hypothalamic-pituitary-thyroid axis, and the renin-angiotensin-aldosterone system, and energy homeostasis. The limited evidence available indicates that changes associated with endocrine function following meditation correspond with improvements in mental health. However, this field of study is hampered by a lack of consensus as to definition and types of meditation and the mixed quality of reported studies. Moreover, the exact mechanisms by which meditation operates remain unclear and more robust studies are required to explore this by delineating the target populations, forms, dosages, and modes of delivery of meditation, comparison groups, and health experiences and outcomes used.
Collapse
Affiliation(s)
- Michaela C Pascoe
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia.
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, Australia; School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, Australia; School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
50
|
McBride R, Ski CF, Thompson DR, Quinn T, Wilson MH. Championing survival: connecting the unknown network of responders to address out-of-hospital cardiac arrest. Scand J Trauma Resusc Emerg Med 2020; 28:49. [PMID: 32493504 PMCID: PMC7271506 DOI: 10.1186/s13049-020-00748-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
Early intervention for out-of-hospital cardiac arrest (OHCA) presents a challenge for Emergency Medical Services (EMS) across Europe. Strategies designed to address this include education and training initiatives for citizens and building CPR skills capacity and awareness amongst health care professionals. However, there is a need to improve access to volunteer first responders who can commence CPR and defibrillate before the arrival of EMS. In the UK, initiatives such GoodSAM have integrated crowdsourcing technology with ambulance services to allow them autonomy in alerting responders to OHCAs which is parallel to an EMS dispatch. These services are building capacity to improve the initial 'call for help' and time to commence CPR and defibrillation if indicated. The next step is to identify and implement appropriate methods for public engagement, involvement and eventual networking of resources with statutory bodies such as local EMS. As crowdsourcing volunteer responders is at an early stage, there is a need to determine whether crowdsourcing is associated with patient outcomes, what its impact is on those responding to OHCA, whether it facilitates or impedes current services, and whether it is a safe and cost effective way to involve citizens to intervene in the community during cardiac arrest or other medical emergencies? Addressing such issues is likely to provide further insight into the role and effectiveness of new technologies and their potential impact on the wider community.
Collapse
Affiliation(s)
- Ronan McBride
- Ronan McBride, Anaesthetics, Theatres and Intensive Care Services, Southern Health and Social Care Trust, Portadown, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Rd, Belfast, UK.
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Rd, Belfast, UK
| | - Tom Quinn
- Emergency, Cardiovascular and Critical Care Research Group, Kingston University London and St George's, London, UK
| | - Mark H Wilson
- Department of Neurosurgery, Imperial College London, London, UK
| |
Collapse
|