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Chioncel O, Čelutkienė J, Bělohlávek J, Kamzola G, Lainscak M, Merkely B, Miličić D, Nessler J, Ristić AD, Sawiełajc L, Uchmanowicz I, Uuetoa T, Turgonyi E, Yotov Y, Ponikowski P. Heart failure care in the Central and Eastern Europe and Baltic region: status, barriers, and routes to improvement. ESC Heart Fail 2024. [PMID: 38520086 DOI: 10.1002/ehf2.14687] [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: 03/27/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 03/25/2024] Open
Abstract
Despite improvements over recent years, morbidity and mortality associated with heart failure (HF) are higher in countries in the Central and Eastern Europe and Baltic region than in Western Europe. With the goal of improving the standard of HF care and patient outcomes in the Central and Eastern Europe and Baltic region, this review aimed to identify the main barriers to optimal HF care and potential areas for improvement. This information was used to suggest methods to improve HF management and decrease the burden of HF in the region that can be implemented at the national and regional levels. We performed a literature search to collect information about HF epidemiology in 11 countries in the region (Bulgaria, Croatia, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Serbia, and Slovenia). The prevalence of HF in the region was 1.6-4.7%, and incidence was 3.1-6.0 per 1000 person-years. Owing to the scarcity of published data on HF management in these countries, we also collected insights on local HF care and management practices via two surveys of 11 HF experts representing the 11 countries. Based on the combined results of the literature review and surveys, we created national HF care and management profiles for each country and developed a common patient pathway for HF for the region. We identified five main barriers to optimal HF care: (i) lack of epidemiological data, (ii) low awareness of HF, (iii) lack of national HF strategies, (iv) infrastructure and system gaps, and (v) poor access to novel HF treatments. To overcome these barriers, we propose the following routes to improvement: (i) establish regional and national prospective HF registries for the systematic collection of epidemiological data; (ii) establish education campaigns for the public, patients, caregivers, and healthcare professionals; (iii) establish formal HF strategies to set clear and measurable policy goals and support budget planning; (iv) improve access to quality-of-care centres, multidisciplinary care teams, diagnostic tests, and telemedicine/telemonitoring; and (v) establish national treatment monitoring programmes to develop policies that ensure that adequate proportions of healthcare budgets are reserved for novel therapies. These routes to improvement represent a first step towards improving outcomes in patients with HF in the Central and Eastern Europe and Baltic region by decreasing disparities in HF care within the region and between the region and Western Europe.
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Affiliation(s)
- Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu', Bucharest, Romania
- Carol Davila University of Medicine, Bucharest, Romania
| | - Jelena Čelutkienė
- Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University/State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Jan Bělohlávek
- Second Department of Medicine, Cardiovascular Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czechia
| | - Ginta Kamzola
- Latvian Centre of Cardiology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | - Béla Merkely
- Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Davor Miličić
- Department of Cardiovascular Diseases, University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Jadwiga Nessler
- Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Arsen D Ristić
- Department of Cardiology, University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | | | | | - Yoto Yotov
- First Department of Internal Diseases, Faculty of Medicine, Medical University of Varna, Varna, Bulgaria
| | - Piotr Ponikowski
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
- Wrocław Medical University, Wrocław, Poland
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Kwaśny A, Uchmanowicz I, Juárez-Vela R, Młynarska A, Łokieć K, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in heart failure: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:176-187. [PMID: 37226867 DOI: 10.1093/eurjcn/zvad050] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
AIMS A nutritional status is related to the length of hospitalization and in-hospital mortality of patients with heart failure (HF). The aim of this study is to assess the prognostic impact of nutritional status and body mass index (BMI) on in-hospital mortality among patients with HF relative to their sex. METHODS AND RESULTS We conducted a retrospective study and analysis of 809 medical records of patients admitted to the Institute of Heart Disease of the University Clinical Hospital in Wroclaw (Poland). Women were statistically significantly older than men (74.67 ± 11.15 vs. 66.76 ± 17.78; P < 0.001). In unadjusted model, significant predictors of the odds of in-hospital mortality for men were underweight (OR = 14.81, P = 0.001) and the risk of malnutrition (OR = 8.979, P < 0.001). In the case of women, none of the traits analysed was significant. In age-adjusted model, significant independent predictors of the odds of in-hospital mortality in the case of men were BMI < 18.5 (OR = 15.423, P = 0.001) and risk of malnutrition (OR = 5.557, P = 0.002). In the case of women, none of the nutritional status traits analysed were significant. In multivariable-adjusted model in men, significant independent predictors of the odds of in-hospital mortality were BMI < 18.5 (OR = 15.978, P = 0.007) compared with having normal body weight and the risk of malnutrition (OR = 4.686, P = 0.015). In the case of women, none of the nutritional status traits analysed were significant. CONCLUSION Both underweight and the risk of malnutrition are direct predictors of the odds of in-hospital mortality in men, but not in women. The study did not find a relationship between nutritional status and in-hospital mortality in women.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, The Academy of Business and Health Science, 90-361 Lodz, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
| | - Agnieszka Młynarska
- Department Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
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Caggianelli G, Alivernini F, Chirico A, Iovino P, Lucidi F, Uchmanowicz I, Rasero L, Alvaro R, Vellone E. The relationship between caregiver contribution to self-care and patient quality of life in heart failure: A longitudinal mediation analysis. PLoS One 2024; 19:e0300101. [PMID: 38470867 PMCID: PMC10931462 DOI: 10.1371/journal.pone.0300101] [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: 08/12/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Patients with heart failure may experience poor quality of life due to a variety of physical and psychological symptoms. Quality of life can improve if patients adhere to consistent self-care behaviors. Patient outcomes (i.e., quality of life) are thought to improve as a result of caregiver contribution to self-care. However, uncertainty exists on whether these outcomes improve as a direct result of caregiver contribution to self-care or whether this improvement occurs indirectly through the improvement of patient heart failure self-care behaviors. AIMS To investigate the influence of caregiver contribution to self-care on quality of life of heart failure people and explore whether patient self-care behaviors mediate such a relationship. METHODS This is a secondary analysis of the MOTIVATE-HF randomized controlled trial (Clinicaltrials.gov registration number: NCT02894502). Data were collected at baseline and 3 months. An autoregressive longitudinal path analysis model was conducted to test our hypotheses. RESULTS We enrolled a sample of 510 caregivers [mean age = 54 (±15.44), 24% males)] and 510 patients [mean age = 72.4 (±12.28), 58% males)]. Patient self-care had a significant and direct effect on quality of life at three months (β = 0.20, p < .01). Caregiver contribution to self-care showed a significant direct effect on patient self-care (β = 0.32, p < .01), and an indirect effect on patient quality of life through the mediation of patient self-care (β = 0.07, p < .001). CONCLUSION Patient quality of life is influenced by self-care both directly and indirectly, through the mediation of caregiver contribution to self-care. These findings improve our understanding on how caregiver contribution to self-care improves patient outcomes.
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Affiliation(s)
| | - Fabio Alivernini
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Szczepanowski R, Uchmanowicz I, Pasieczna-Dixit AH, Sobecki J, Katarzyniak R, Kołaczek G, Lorkiewicz W, Kędras M, Dixit A, Biegus J, Wleklik M, Gobbens RJJ, Hill L, Jaarsma T, Hussain A, Barbagallo M, Veronese N, Morabito FC, Kahsin A. Application of machine learning in predicting frailty syndrome in patients with heart failure. ADV CLIN EXP MED 2024; 33:309-315. [PMID: 38530317 DOI: 10.17219/acem/184040] [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: 08/20/2023] [Accepted: 02/13/2024] [Indexed: 03/27/2024]
Abstract
Prevention and diagnosis of frailty syndrome (FS) in patients with heart failure (HF) require innovative systems to help medical personnel tailor and optimize their treatment and care. Traditional methods of diagnosing FS in patients could be more satisfactory. Healthcare personnel in clinical settings use a combination of tests and self-reporting to diagnose patients and those at risk of frailty, which is time-consuming and costly. Modern medicine uses artificial intelligence (AI) to study the physical and psychosocial domains of frailty in cardiac patients with HF. This paper aims to present the potential of using the AI approach, emphasizing machine learning (ML) in predicting frailty in patients with HF. Our team reviewed the literature on ML applications for FS and reviewed frailty measurements applied to modern clinical practice. Our approach analysis resulted in recommendations of ML algorithms for predicting frailty in patients. We also present the exemplary application of ML for FS in patients with HF based on the Tilburg Frailty Indicator (TFI) questionnaire, taking into account psychosocial variables.
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Affiliation(s)
- Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | | | - Janusz Sobecki
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Radosław Katarzyniak
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Grzegorz Kołaczek
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Wojciech Lorkiewicz
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Maja Kędras
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Anant Dixit
- Department of Computer Science and Systems Engineering, Wroclaw University of Science and Technology, Poland
| | - Jan Biegus
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
- Institute for Heart Diseases, Wroclaw Medical University, Poland
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands
- Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
| | - Loreena Hill
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | | | - Amir Hussain
- School of Computing, Edinburgh Napier University, UK
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Italy
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Hill L, McNulty A, McMahon J, Mitchell G, Farrell C, Uchmanowicz I, Castiello T. Heart Failure Nurses within the Primary Care Setting. Card Fail Rev 2024; 10:e01. [PMID: 38464555 PMCID: PMC10918528 DOI: 10.15420/cfr.2023.15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/27/2023] [Indexed: 03/12/2024] Open
Abstract
Cardiology services within primary care often focus on disease prevention, early identification of illness and prompt referral for diagnosis and specialist treatment. Due to advances in pharmaceuticals, implantable cardiac devices and surgical interventions, individuals with heart failure are living longer, which can place a significant strain on global healthcare resources. Heart failure nurses in a primary care setting offer a wealth of clinical knowledge and expertise across all phases of the heart failure trajectory and are able to support patients, family members and other community services, including general practitioners. This review examines the recently published evidence on the current and potential future practice of heart failure nurses within primary care.
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Affiliation(s)
- Loreena Hill
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
- College of Nursing and Midwifery, Mohammed Bin Rashid UniversityDubai, United Arab Emirates
| | - Anne McNulty
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Cathy Farrell
- Errigal Chronic Disease Management Hub, LetterkennyDonegal, Ireland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wrocław Medical UniversityWrocław, Poland
- Institute of Heart Diseases, University HospitalWrocław, Poland
| | - Teresa Castiello
- Department of Cardiovascular Imaging, King's College LondonLondon, UK
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Uchmanowicz I. Navigating the uncharted waters: a commentary on communicating about sexual activity and intimacy post-heart attack among Australian health professionals. Eur J Cardiovasc Nurs 2024:zvae001. [PMID: 38294027 DOI: 10.1093/eurjcn/zvae001] [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] [Received: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024]
Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, 51-618 Wroclaw, Poland
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Woźniak A, Janc J, Łysenko L, Leśnik P, Słabisz N, Oleksy-Wawrzyniak M, Uchmanowicz I. How to Defeat Multidrug-Resistant Bacteria in Intensive Care Units. A Lesson from the COVID-19 Pandemic. Prevention, Reservoirs, and Implications for Clinical Practice. Int J Med Sci 2024; 21:530-539. [PMID: 38250609 PMCID: PMC10797677 DOI: 10.7150/ijms.88519] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/18/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Intensive care unit (ICU) patients are at high risk of infection due to multiple invasive procedures, malnutrition, or immunosuppression. The rapid increase in infections with multidrug-resistant organisms (MDRO) during the COVID-19 pandemic caused a dilemma, as the rules of the sanitary regime in ICU rooms were strictly adhered to in the prevailing epidemiological situation. The combat to reduce the number of infections and pathogen transmission became a priority for ICU staff. This study aimed to assess whether eliminating environmental reservoirs and implementing improved procedures for patient care and decontamination and washing equipment in the ICU reduced the incidence of infections caused by MDR strains. Material and methods: The study retrospectively analyzed data in the ICU during the COVID-19 pandemic. The samples were collected based on microbiological culture and medical records in the newly opened ICU (10 stations) and hospital wards where COVID-19 patients were hospitalized. Environmental inoculations were performed during the COVID-19 pandemic every 4-6 weeks unless an increase in the incidence of infections caused by MDR strains was observed. Through microbiological analysis, environmental reservoirs of MDR pathogens were identified. The observation time was divided into two periods, before and after the revised procedures. The relationship between isolated strains of Klebsiella pneumoniae NDM from patients and potential reservoirs within the ICU using ERIC-PCR and dice methods was analyzed. Results: An increased frequency of infections and colonization caused by MDRO was observed compared to the preceding years. A total of 23,167 microbiological tests and 6,985 screening tests for CPE and MRSA bacilli were collected. The pathogen spread was analyzed, and the findings indicated procedural errors. Assuming that the transmission of infections through the staff hands was significantly limited by the restrictive use of personal protective equipment, the search for a reservoir of microorganisms in the environment began. MDR strains were grown from the inoculations collected from the hand-wash basins in the wards and from inside the air conditioner on the ceiling outside the patient rooms. New types of decontamination mats were used in high-risk areas with a disinfectant based on Glucoprotamine. Active chlorine-containing substances were widely used to clean and disinfect surfaces. Conclusions: Infections with MDR strains pose a challenge for health care. Identification of bacterial reservoirs and comprehensive nursing care significantly reduce the number of nosocomial infections.
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Affiliation(s)
- Anna Woźniak
- Department of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland
| | - Jarosław Janc
- Department of Anaesthesiology and Intensive Therapy, Hospital of Ministry of the Interior and Administration, Wroclaw, Poland
| | - Lidia Łysenko
- Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Patrycja Leśnik
- Department of Microbiology, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Słabisz
- Department of Laboratory Diagnostics, 4th Military Clinical Hospital, Wroclaw, Poland
| | - Monika Oleksy-Wawrzyniak
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland
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Uchmanowicz I, Lisiak M, Wleklik M, Pawlak AM, Zborowska A, Stańczykiewicz B, Ross C, Czapla M, Juárez-Vela R. The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review. Med Sci Monit 2024; 30:e942031. [PMID: 38196186 PMCID: PMC10787575 DOI: 10.12659/msm.942031] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Rationing of nursing care (RONC) has been associated with poor patient outcomes and is a growing concern in healthcare. The aim of this systematic study was to investigate the connection between patient safety and the RONC. MATERIAL AND METHODS A thorough search of electronic databases was done to find research that examined the relationship between restricting nurse services and patient safety. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (M.L. and A.P.) independently screened the titles and abstracts, and full-text articles were assessed for eligibility. Data were extracted, and a quality assessment was performed using appropriate techniques. RESULTS A total of 15 studies met the inclusion criteria. The studies included in the review demonstrated a correlation between rationing of nursing care and patient safety. The results of these studies revealed that there is an inverse relationship between rationing of nursing care and patient safety. The review found that when nursing care is rationed, there is a higher incidence of falls, medication errors, pressure ulcers, infections, and readmissions. In addition, the review identified that the work characteristics of nurses, such as workload, staffing levels, and experience, were associated with RONC. CONCLUSIONS RONC has a negative impact on patient safety outcomes. It is essential for healthcare organizations to implement effective strategies to prevent the RONC. Improving staffing levels, workload management, and communication amo0ng healthcare providers are some of the strategies that can support this.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Magdalena Lisiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
| | - Andrzej Maciej Pawlak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Agnieszka Zborowska
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Bartłomiej Stańczykiewicz
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wrocław Medical University, Wrocław, Poland
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wrocław, Poland
- Department of Emergency Medical Service, Wrocław Medical University, Wrocław, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
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Kałużna-Oleksy M, Krysztofiak H, Sawczak F, Kukfisz A, Szczechla M, Soloch A, Cierzniak M, Szubarga A, Przytarska K, Dudek M, Uchmanowicz I, Straburzyńska-Migaj E. Sex differences in the nutritional status and its association with long-term prognosis in patients with heart failure with reduced ejection fraction: a prospective cohort study. Eur J Cardiovasc Nurs 2024:zvad105. [PMID: 38170824 DOI: 10.1093/eurjcn/zvad105] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 01/05/2024]
Abstract
AIMS Many studies show the association between malnutrition and poor prognosis in heart failure (HF) patients. Our research aimed to analyse sex differences in patients with HF with reduced ejection fraction (HFrEF), emphasizing nutritional status and the influence of selected parameters on the prognosis. METHODS AND RESULTS We enrolled 276 consecutive patients diagnosed with HFrEF. Nutritional status was assessed using Mini Nutritional Assessment (MNA), geriatric nutritional risk index (GNRI), and body mass index (BMI). The mean follow-up period was 564.4 ± 346.3 days. The analysed group included 81.2% of men. The median age was 58, interquartile range (IQR) 49-64 years. Among all patients, almost 60% were classified as NYHA III or IV. Half of the participants were at risk of malnutrition, and 2.9% were malnourished. During follow-up, 72 (26.1%) patients died. The female sex was not associated with a higher occurrence of malnutrition (P = 0.99) or nutritional risk (P = 0.85), according to MNA. Coherently, GNRI scores did not differ significantly between the sexes (P = 0.29). In contrast, BMI was significantly higher in males (29.4 ± 5.3 vs. 25.9 ± 4.7; P < 0.001). Impaired nutritional status assessed with any method (MNA, GNRI, BMI) was not significantly associated with a worse prognosis. In multivariable analysis, NYHA class, lower estimated glomerular filtration rate, higher B-type natriuretic peptide (BNP), higher N-terminal fragment of proBNP, and higher uric acid were independent of sex and age predictors of all-cause mortality. CONCLUSION There were no sex differences in the nutritional status in the HFrEF patients, apart from lower BMI in females. Impaired nutritional status was not associated with mortality in both men and women.
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Affiliation(s)
- Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Helena Krysztofiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Filip Sawczak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Agata Kukfisz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Curie-Sklodowska 9, 41-800 Zabrze, Poland
| | - Magdalena Szczechla
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Aleksandra Soloch
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Maria Cierzniak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Alicja Szubarga
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Katarzyna Przytarska
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Magdalena Dudek
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, Bartla 5, 51-618 Wroclaw, Poland
| | - Ewa Straburzyńska-Migaj
- 1st Department of Cardiology, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
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10
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Jędrzejczyk M, Guzak B, Czapla M, Ross C, Vellone E, Juzwiszyn J, Chudiak A, Sadowski M, Uchmanowicz I. Rationing of nursing care in Internal Medicine Departments-a cross-sectional study. BMC Nurs 2023; 22:455. [PMID: 38044434 PMCID: PMC10694866 DOI: 10.1186/s12912-023-01617-x] [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: 08/19/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients' needs. PURPOSE To examine the factors influencing the rationing of nursing care, nurses' assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments. METHODS A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used. RESULTS Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16-20 years (regression parameter: 0.387) and a Bachelor's degree in nursing (regression parameter: 0.139). Nurses' assessment of the quality of patient care ratings were increased by having a Master's degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16-20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master's degree and long-shift working patterns. CONCLUSION The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master's degree in nursing indicates improved nurses' assessment of the quality of patient care.
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Affiliation(s)
- Maria Jędrzejczyk
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Beata Guzak
- Center of Postgraduate Education for Nurses and Midwives, Warsaw, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, 50-566, Poland.
- Department of Emergency Medical Service, Wroclaw Medical University, ul. Parkowa 34, Wroclaw, 51-616, Poland.
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, 26006, Spain.
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - Ercole Vellone
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy
| | - Jan Juzwiszyn
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Chudiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Mikołaj Sadowski
- Department of Anaesthesiology and Intensive Care, University Hospital, Wrocław, 50-556, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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11
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Neubeck L, Ross C, Jones J, Simpson M, Mindham R, Jaarsma T, Uchmanowicz I, Hinterbuchner L, Astin F. The Core Curriculum for Cardiovascular Nurses and Allied Professionals. Eur J Cardiovasc Nurs 2023; 22:e62-e113. [PMID: 37067252 DOI: 10.1093/eurjcn/zvad035] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023]
Abstract
This 2023 update of the Core Curriculum in Cardiovascular Nursing (2015) embraces the formation of the Association of Cardiovascular Nursing and Allied Professionals and reflects the diverse professional backgrounds of our members, including nurses, allied health professionals, and healthcare scientists (in this document referred to collectively as Nurses and Allied Professionals).
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Affiliation(s)
- Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, UK
| | - Catherine Ross
- Centre for Cardiovascular Health, Edinburgh Napier University, UK
| | | | | | | | - Tiny Jaarsma
- Department of Health Medicine and Caring Sciences, University of Linköping, Sweden
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
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12
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Locatelli G, Iovino P, Jurgens CY, Alvaro R, Uchmanowicz I, Rasero L, Riegel B, Vellone E. The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care: A Longitudinal Mediation Analysis. J Cardiovasc Nurs 2023:00005082-990000000-00115. [PMID: 37550831 DOI: 10.1097/jcn.0000000000001024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Patients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. OBJECTIVES The aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. METHODS In this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. RESULTS On average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). CONCLUSIONS This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.
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Nessler J, Krawczyk K, Leszek P, Rubiś P, Rozentryt P, Gackowski A, Pawlak A, Straburzyńska-Migaj E, Jankowska EA, Brzęk A, Piotrowicz E, Mastalerz-Migas A, Windak A, Tomasik T, Uchmanowicz I, Lelonek M. Expert opinion of the Heart Failure Association of the Polish Society of Cardiology, the College of Family Physicians in Poland, and the Polish Society of Family Medicine on the peri discharge management of patients with heart failure. Kardiol Pol 2023; 81:824-844. [PMID: 37489831 DOI: 10.33963/kp.a2023.0163] [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] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 07/26/2023]
Abstract
Despite advances in the treatment of heart failure (HF), the rate of hospitalisation for exacerbations of the disease remains high. One of the underlying reasons is that recommended guidelines for the management of HF are still too rarely followed in daily practice. Disease exacerbation requiring inpatient treatment is always afactor that worsens the prognosis, and thus signals disease progression. This is also akey moment when therapy should be modified for HF exacerbation, or initiated in the case of newly diagnosed disease. Inpatient treatment and the peri‑discharge period is the time when the aetiology and mechanism of HF decompensation should be established. Therapy should be individualised based on aetiology, HF phenotype, and comorbidities; it should take into account the possibilities of modern treatment. According to the recommendations of the European Society of Cardiology (ESC), patients with HF should receive multidisciplinary management. Cooperation between the various members of the multidisciplinary team taking care of patients with HF improves the efficiency and quality of treatment. This document expands and details the information on the peri‑discharge management of HF contained in the 2021 ESC guidelines and the 2022 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) guidelines.
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Affiliation(s)
- Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Krzysztof Krawczyk
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Emergency Medicine, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Pola
| | - Przemysław Leszek
- Department of Heart Failure and Transplantation Medicine, Cardinal Stefan Wyszynski Institute of Cardiology in Warsaw, Warszawa, Poland
| | - Paweł Rubiś
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Rozentryt
- 3rd Chair and Clinical Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Andrzej Gackowski
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Pawlak
- Department Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warszawa, Poland
| | - Ewa Straburzyńska-Migaj
- 1st Chair and Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
- University Hospital of Lord's Transfiguration, Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa A Jankowska
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital in Wroclaw, Wrocław, Poland
| | - Anna Brzęk
- Department of Physiotherapy, Chair of Physiotherapy, Faculty of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Ewa Piotrowicz
- Telecardiology Centre, National Institute of Cardiology, Warszawa, Poland
| | | | - Adam Windak
- Chair of Family Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Tomasik
- Chair of Family Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Izabella Uchmanowicz
- Department of Internal Medicine Nursing, Chair of Nursing and Midwifery, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
- Heart Institute, University Clinical Hospital in Wrocław, Wrocław, Poland
| | - Małgorzata Lelonek
- Department of Non Invasive Cardiology, Medical University of Lodz, Łódź, Poland
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14
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Locatelli G, Rebora P, Occhino G, Ausili D, Riegel B, Cammarano A, Uchmanowicz I, Alvaro R, Vellone E, Zeffiro V. The Impact of an Intervention to Improve Caregiver Contribution to Heart Failure Self-care on Caregiver Anxiety, Depression, Quality of Life, and Sleep. J Cardiovasc Nurs 2023:00005082-990000000-00090. [PMID: 37204336 DOI: 10.1097/jcn.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Better caregiver contribution to self-care in heart failure is associated with better patient outcomes. However, caregiver contribution to self-care is also associated with high anxiety and depression, poor quality of life, and poor sleep in caregivers. It is still unclear whether interventions that encourage caregivers to contribute more to patient self-care might increase caregivers' anxiety and depression and decrease their quality of life and sleep. OBJECTIVE The aim of this study was to assess the impact of a motivational interview intervention aimed at improving caregiver contribution to self-care in heart failure on caregivers' anxiety, depression, quality of life, and sleep. METHODS This is a secondary outcome analysis of the MOTIVATE-HF trial. Patients with heart failure and their caregivers were randomized into arm 1 (motivational interview to patients), arm 2 (motivational interview to patients and caregivers), and arm 3 (standard care). Data were collected between June 2014 and October 2018. The article has been prepared following the Consolidated Standards of Reporting Trials checklist. RESULTS A sample of 510 patient-caregiver dyads was enrolled. Over the year of the study, the levels of anxiety, depression, quality of life, and sleep in caregivers did not significantly change among the 3 arms. CONCLUSIONS Motivational interview aimed at improving caregiver contribution to self-care does not seem to increase caregiver anxiety and depression, nor decrease their quality of life and sleep. Thus, such an intervention might be safely delivered to caregivers of patients with heart failure, although further studies are needed to confirm our findings.
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15
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Pasieczna AH, Szczepanowski R, Sobecki J, Katarzyniak R, Uchmanowicz I, Gobbens RJJ, Kahsin A, Dixit A. Importance analysis of psychosociological variables in frailty syndrome in heart failure patients using machine learning approach. Sci Rep 2023; 13:7782. [PMID: 37179399 PMCID: PMC10182994 DOI: 10.1038/s41598-023-35037-3] [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] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
The prevention and diagnosis of frailty syndrome (FS) in cardiac patients requires innovative systems to support medical personnel, patient adherence, and self-care behavior. To do so, modern medicine uses a supervised machine learning approach (ML) to study the psychosocial domains of frailty in cardiac patients with heart failure (HF). This study aimed to determine the absolute and relative diagnostic importance of the individual components of the Tilburg Frailty Indicator (TFI) questionnaire in patients with HF. An exploratory analysis was performed using machine learning algorithms and the permutation method to determine the absolute importance of frailty components in HF. Based on the TFI data, which contain physical and psychosocial components, machine learning models were built based on three algorithms: a decision tree, a random decision forest, and the AdaBoost Models classifier. The absolute weights were used to make pairwise comparisons between the variables and obtain relative diagnostic importance. The analysis of HF patients' responses showed that the psychological variable TFI20 diagnosing low mood was more diagnostically important than the variables from the physical domain: lack of strength in the hands and physical fatigue. The psychological variable TFI21 linked with agitation and irritability was diagnostically more important than all three physical variables considered: walking difficulties, lack of hand strength, and physical fatigue. In the case of the two remaining variables from the psychological domain (TFI19, TFI22), and for all variables from the social domain, the results do not allow for the rejection of the null hypothesis. From a long-term perspective, the ML based frailty approach can support healthcare professionals, including psychologists and social workers, in drawing their attention to the non-physical origins of HF.
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Affiliation(s)
| | - Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland.
| | - Janusz Sobecki
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Radosław Katarzyniak
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
| | | | - Anant Dixit
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
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16
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Gobbens RJ, Santiago LM, Uchmanowicz I, van der Ploeg T. Predicting Disability Using a Nomogram of the Tilburg Frailty Indicator (TFI). Healthcare (Basel) 2023; 11:healthcare11081150. [PMID: 37107984 PMCID: PMC10137888 DOI: 10.3390/healthcare11081150] [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: 02/12/2023] [Revised: 03/02/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop nomograms with items of the Tilburg Frailty Indicator (TFI) as predictors by using cross-sectional and longitudinal data (follow-up of five and nine years), focusing on the prediction of total disability, disability in activities of daily living (ADL), and disability in instrumental activities of daily living (IADL). At baseline, 479 Dutch community-dwelling people aged ≥75 years participated. They completed a questionnaire that included the TFI and the Groningen Activity Restriction Scale to assess the three disability variables. We showed that the TFI items scored different points, especially over time. Therefore, not every item was equally important in predicting disability. 'Difficulty in walking' and 'unexplained weight loss' appeared to be important predictors of disability. Healthcare professionals need to focus on these two items to prevent disability. We also conclude that the points given to frailty items differed between total, ADL, and IADL disability and also differed regarding years of follow-up. Creating one monogram that does justice to this seems impossible.
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Affiliation(s)
- Robbert J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands
| | - Livia M Santiago
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-912, Brazil
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Tjeerd van der Ploeg
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
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17
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Wleklik M, Denfeld Q, Czapla M, Jankowska EA, Piepoli MF, Uchmanowicz I. A patient with heart failure, who is frail: How does this affect therapeutic decisions? Cardiol J 2023; 30:825-831. [PMID: 37067336 PMCID: PMC10635718 DOI: 10.5603/cj.a2023.0027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023] Open
Abstract
Patients with heart failure (HF) are heterogeneous, not only related to comorbidities but also in the presentation of frailty syndrome. Frailty syndrome also affects patients with HF across the lifespan. Frailty in patients with HF has a significant impact on clinical features, diagnosis, management, adverse medical outcomes and costs. In everyday clinical practice, frail patients with HF require an individualized approach, often imposing the need to modify therapeutic decisions. The aim of this review is to illustrate how frailty and multimorbidity in HF can affect therapeutic decisions. The scientific evidence underlying this publication was obtained from an analysis of papers indexed in the PubMed database. The search was limited to articles published between 1990 and July 2022. The search was limited to full-text papers published in English. The database was searched for relevant MeSH phrases and their combinations and keywords including: "elderly, frail"; "frailty, elderly"; "frail older adults"; "frailty, older adults"; "adult, frail older"; "frailty, heart failure"; "frailty, multimorbidity"; "multimorbidity, heart failure"; "multimorbidity, elderly"; "older adults, cardiovascular diseases". In therapeutic decisions regarding patients with HF, additionally burdened with multimorbidity and frailty, it becomes necessary to individualize the approach in relation to optimization and treatment of coexisting diseases, frailty assessment, pharmacological and non-pharmacological treatment and in the implementation of invasive procedures in the form of implantable devices or cardiac surgery.
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Affiliation(s)
- Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Quin Denfeld
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
| | - Michal Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland.
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, Spain.
| | - Ewa A Jankowska
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Massimo Francesco Piepoli
- Dipartimento delle Scienze Biomediche per la Salute, University of Milan, Via Festa del Perdono, Milan, Italy
- Cardiology Unit, IRCCS Policlinico San Donato Milanese, Milan, Italy
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
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18
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Sroka M, Lis Ł, Witkiewicz W, Uchmanowicz I, Hruby Z. Prevalence of Nondiabetic Glomerular Diseases in Patients with Type 2 Diabetes Mellitus. Turk J Nephrol 2023. [DOI: 10.5152/turkjnephrol.2023.21142209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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19
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Uchmanowicz I, Rosano G, Francesco Piepoli M, Vellone E, Czapla M, Lisiak M, Diakowska D, Prokopowicz A, Aleksandrowicz K, Nowak B, Wleklik M, Faulkner KM. The concurrent impact of mild cognitive impairment and frailty syndrome in heart failure. Arch Med Sci 2023; 19:912-920. [PMID: 37560724 PMCID: PMC10408025 DOI: 10.5114/aoms/162369] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/19/2023] [Indexed: 08/11/2023] Open
Abstract
Pathological processes associated with ageing increase the risk of cognitive deficits and dementia. Frailty syndrome, also known as weakness or reserve depletion syndrome, may significantly accelerate these pathological processes in the elderly population. Frailty syndrome is characterized by decreased physiological function and neuropsychiatric symptoms, including cognitive decline and depressive states. In people with cardiovascular disease, the risk of frailty is 3 times higher. Frailty syndrome is particularly prevalent in severe heart failure, which increases the risk of mortality, increases hospital readmission, and reduces patients' quality of life. In addition, co-occurrence of cognitive impairment and frailty syndrome significantly increases the risk of dementia and other adverse outcomes, including mortality, in the heart failure population.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Giuseppe Rosano
- Centre for Clinical & Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
| | - Massimo Francesco Piepoli
- Dipartimento delle Scienze Biomediche per la Salute, University of Milan, Via Festa del Perdono, Milan, Italy
- Cardiology Unit, IRCCS Policlinico San Donato Milanese, Milan, Italy
| | - Ercole Vellone
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, Spain
| | - Magdalena Lisiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Diakowska
- Department of Basic Science, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Prokopowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Aleksandrowicz
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Bernadetta Nowak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
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Kubielas G, Diakowska D, Czapla M, Uchmanowicz B, Berezowski J, Uchmanowicz I. Comprehensive Cardiac Care: How Much Does It Cost? Int J Environ Res Public Health 2023; 20:4980. [PMID: 36981889 PMCID: PMC10049416 DOI: 10.3390/ijerph20064980] [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: 01/17/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The benefits of coordinating care between healthcare professionals and institutions are the main drivers behind reforms to the payment and delivery system for healthcare services. The purpose of this study was to analyse the costs incurred by the National Health Fund in Poland related to the comprehensive care model for patients after myocardial infarction (CCMI, in Polish: KOS-Zawał). METHODS The analysis involved data from 1 October 2017 to 31 March 2020 for 263,619 patients who received treatment after a diagnosis of first or recurrent myocardial infarction as well as data for 26,457 patients treated during that period under the CCMI programme. RESULTS The average costs of treating patients covered by the full scope of comprehensive care and cardiac rehabilitation under the programme (EUR 3113.74/person) were higher than the costs of treating patients outside of that programme (EUR 2238.08/person). At the same time, a survival analysis revealed a statistically significantly lower probability of death (p < 0.0001) in the group of patients covered by CCMI compared to the group not covered by the programme. CONCLUSIONS The coordinated care programme introduced for patients after myocardial infarction is more expensive than the care for patients who do not participate in the programme. Patients covered by the programme were more often hospitalised, which might have been due to the good coordination between specialists and responses to sudden changes in patients' conditions.
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Affiliation(s)
- Grzegorz Kubielas
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
- Department of Health Care Services, Polish National Health Fund, Central Office in Warsaw, 02-528 Warsaw, Poland
| | - Dorota Diakowska
- Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Michał Czapla
- Department of Emergency Medical Service, Faculty of Health Sciences, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, 26006 Logrono, Spain
| | - Bartosz Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | | | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
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21
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Wagner-Łosieczka B, Kolarczyk E, Młynarska A, Owczarek D, Sadowski M, Kowalczuk K, Guzak B, Czapla M, Uchmanowicz I. The variables in the rationing of nursing care in cardiology departments. BMC Nurs 2023; 22:59. [PMID: 36869327 PMCID: PMC9983219 DOI: 10.1186/s12912-023-01222-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The rationing of nursing care is a complex process that affects the quality of medical services. PURPOSE An assessment of the impact of nursing care rationing on burnout and life satisfaction in cardiology departments. METHODS The study included 217 nurses working in the cardiology department. The Perceived Implicit Rationing of Nursing Care, the Maslach Burnout Inventory, and the Satisfaction with Life Scale were used. RESULTS A greater emotional exhaustion, the more frequently the rationing of nursing care (r = 0.309, p < 0.061) and the lower the job satisfaction (r=-0.128, p = 0.061). Higher life satisfaction was associated with less frequent rationing of nursing care (r=-0.177, p = 0.01), better quality of care provided (r = 0.285, p < 0.001), and higher job satisfaction (r = 0.348, p < 0.01). CONCLUSION Higher levels of burnout contribute to more frequent rationing of nursing care, poorer evaluation of the quality of care provided, and lower job satisfaction. Life satisfaction is associated with less frequent rationing of care, better evaluation of the quality of care provided, and greater job satisfaction.
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Affiliation(s)
- Barbara Wagner-Łosieczka
- grid.4495.c0000 0001 1090 049XDepartment of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Ewelina Kolarczyk
- grid.411728.90000 0001 2198 0923Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Młynarska
- grid.411728.90000 0001 2198 0923Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Darek Owczarek
- grid.412700.00000 0001 1216 0093Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Mikołaj Sadowski
- grid.412700.00000 0001 1216 0093Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Krystyna Kowalczuk
- grid.48324.390000000122482838Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Beata Guzak
- Center of Postgraduate Education for Nurses and Midwives, Warsaw, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland. .,Department of Emergency Medical Service, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland. .,Group of Research in Care (GRUPAC), Faculty of Nursing, University of La Rioja, Logroño, Spain.
| | - Izabella Uchmanowicz
- grid.4495.c0000 0001 1090 049XDepartment of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland ,grid.412700.00000 0001 1216 0093Institute of Heart Diseases, University Hospital, Wroclaw, Poland
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22
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Lomper K, Ross C, Uchmanowicz I. Anxiety and Depressive Symptoms, Frailty and Quality of Life in Atrial Fibrillation. Int J Environ Res Public Health 2023; 20:1066. [PMID: 36673821 PMCID: PMC9858928 DOI: 10.3390/ijerph20021066] [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] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Introduction: Symptoms of atrial fibrillation (AF) can significantly affect functioning in daily life and reduce patients’ quality of life (QoL). The severity and type of AF symptoms affects not only patient’s QoL, but can be a cause of the development of emotional and psychological disorders. In addition, frailty syndrome (FS) plays important role from the point of view of developing disability and dependence on others, as well as reducing QoL. Aim: To assess the symptoms of anxiety and depression, to evaluate the co-occurrence of frailty syndrome and the impact of these factors on the quality of life of patients with AF. Methods: The study used a Polish adaptation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia part III (ASTA part III), the Tilburg Frailty Indicator (TFI) and the Hospital Anxiety Depression Scale (HADS). Results: Analysis showed that anxiety symptoms and depressive symptoms correlate significantly (p < 0.05) and positively with the physical (r = 0.24; p < 0.001, r = 0.29, p = 0.002, respectively), psychological (r = 0.34, p < 0.001, r = 0.49 p < 0.001, respectively) and total quality of life (r = 0.31, p = 0.001, r = 0.414; p < 0.001, respectively) ASTA III domains. A significant (p < 0.05) positive correlation was observed between the TFI total score and the physical (r = 0.34, p < 0.001), psychological (r = 0.36, p < 0.001) and overall quality of life (r = 0.38, p < 0.001) in ASTA III domains. Conclusions: Both FS and depressive and anxiety symptoms significantly affect QoL. Understanding the relationship between anxiety and depressive symptoms, FS and QoL may allow for a more targeted approach to the treatment and care of patients with AF.
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Affiliation(s)
- Katarzyna Lomper
- Department of Clinical Nursing, Medical University, K. Bartla 5, 51-616 Wroclaw, Poland
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, UK
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Medical University, K. Bartla 5, 51-616 Wroclaw, Poland
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23
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Gobbens RJJ, Uchmanowicz I. Frailty Viewed From a Nursing Perspective. SAGE Open Nurs 2023; 9:23779608221150598. [PMID: 36636626 PMCID: PMC9829991 DOI: 10.1177/23779608221150598] [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: 07/25/2022] [Revised: 11/18/2022] [Accepted: 12/24/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction More and more researchers are convinced that frailty should refer not only to physical limitations but also to psychological and social limitations that older people may have. Such a broad, or multidimensional, definition of frailty fits better with nursing, in which a holistic view of human beings, and thus their total functioning, is the starting point. Purpose In this article, which should be considered a Practice Update, we aim at emphasizing the importance of the inclusion of other domains of human functioning in the definition and measurement of frailty. In addition, we provide a description of how district nurses view frailty in older people. Finally, we present interventions that nurses can perform to prevent or delay frailty or its adverse outcomes. We present, in particular, results from studies in which the Tilburg Frailty Indicator, a multidimensional frailty instrument, was used. Conclusion The importance of a multidimensional assessment of frailty was demonstrated by usually satisfactory results concerning adverse outcomes of mortality, disability, an increase in healthcare utilization, and lower quality of life. Not many studies have been performed on nurses' opinions about frailty. Starting from a multidimensional definition of frailty, encompassing physical, psychological, and social domains, nurses are able to assess and diagnose frailty and conduct a variety of interventions to prevent or reduce frailty and its adverse effects. Because nurses come into frequent contact with frail older people, we recommend future studies on opinions of nurses about frailty (e.g., screening, prevention, and addressing).
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Affiliation(s)
- Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of
Applied Sciences, Amsterdam, the Netherlands,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands,Department of Family Medicine and Population Health, Faculty of
Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg
University, Tilburg, the Netherlands,Robbert J. J. Gobbens, Faculty of Health,
Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan
1109, 1081 HV Amsterdam, the Netherlands.
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences,
Wroclaw
Medical University, Wroclaw, Poland,Institute of Heart Diseases, University Hospital, Wroclaw,
Poland
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Prokopowicz A, Stańczykiewicz B, Uchmanowicz I. Anxiety and Psychological Flexibility in Women After Childbirth in the Rooming-in Unit during the COVID-19 Pandemic. J Midwifery Womens Health 2023; 68:107-116. [PMID: 36565212 PMCID: PMC9880685 DOI: 10.1111/jmwh.13445] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has intensified perinatal anxiety disorders. Psychological flexibility (PF), considered a specific mental toughness, has not been examined with regard to its relationship with anxiety in women after childbirth. We aimed to compare levels of anxiety, PF, and pain in women depending on the mode of birth, parity, and the magnitude of risk of developing an anxiety disorder. We also investigated the association of anxiety with PF and pain. METHODS A total of 187 women after childbirth completed validated questionnaires for anxiety (State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale-Anxiety, Numerical Rating Scale for anxiety [NRS-A]), PF, and pain (Numerical Rating Scale for pain). Specific postpartum anxieties were assessed with a numerical scale from 0 to 10. The relationship of anxiety with PF and pain was examined. Women at low and high risk of developing anxiety disorder were compared in terms of PF, anxiety, and pain. RESULTS On the second postpartum day, women after cesarean birth demonstrated significantly greater anxiety on NRS-A and pain than those after vaginal birth. Primiparous women experienced significantly greater anxieties and pain compared to multiparous women. The higher the PF patients demonstrated, the less anxiety and pain they had. Patients at high risk of developing an anxiety disorder had a lower level of PF (P < .001) and higher levels of anxiety (P < .001) and pain (P < .01) than patients at low risk of developing an anxiety disorder. No difference in the anxiety of getting COVID-19 was observed between the groups (P > .05). CONCLUSIONS PF is an important psychological construct related to the mental and physical condition of women after childbirth. Increasing PF in women after childbirth may be considered as an important goal of preventive and intervention measures.
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Affiliation(s)
- Anna Prokopowicz
- Division of Midwifery and Gynaecological Nursing, Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Bartłomiej Stańczykiewicz
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Izabella Uchmanowicz
- Division of Internal Medicine Nursing, Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
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25
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Wysocki G, Czapla M, Uchmanowicz B, Fehler P, Aleksandrowicz K, Rypicz Ł, Wolska-Zogata I, Uchmanowicz I. Influence of Disease Acceptance on the Quality of Life of Patients with Ankylosing Spondylitis - Single Centre Study. Patient Prefer Adherence 2023; 17:1075-1092. [PMID: 37090183 PMCID: PMC10119491 DOI: 10.2147/ppa.s403437] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Ankylosing spondylitis (AS) is a chronic, progressive disease, often with multiple complications, with periods of exacerbation and remission. The onset of the disease usually affects people under 30 years of age. The disease impairs physical, psychological, and social functioning, leading to disability. Therefore, patients with AS face the challenge of adapting to life with the condition and deteriorating quality of life (QoL). Objective This study aimed to assess the impact of disease acceptance on quality of life in patients with AS. Material and Methods The study was conducted in the Department of Rheumatology and Internal Diseases of the University Hospital in Wrocław among 110 patients (67 men and 43 women) with the diagnosis of AS, aged 20-89 years (M=48.44 years, SD±12.55). The study used the Acceptance of Illness Scale (AIS), the WHOQoL-BREF Quality of Life Scale, and a self-constructed questionnaire of clinical and sociodemographic data. Results Respondents rated the quality of life as good and moderate (M = 3.49 points, SD=±0.84). The mean AIS score was 27.44 (SD=±8.67). AIS scores are positively correlated with all QoL domains and perception of quality of life and health (p<0.001). The strongest correlation was in the physical domain (r=0.71), while the weakest correlation was observed in the social domain (r=0.329). AIS and QoL measures showed significant relationships with selected sociodemographic data (eg, gender, age, education, and occupational activity) and correlated with selected disease data (eg, type of treatment used, duration of disease, or comorbidities). Conclusion AIS in patients with AS condition correlated positively with their QoL in all domains. Both disease acceptance and quality of life are influenced by specific sociodemographic and disease-related data. Prevention of complications and the type of treatment for AS (primarily biological treatment) can be essential in improving patients' quality of life.
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Affiliation(s)
| | - Michał Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, Spain
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Correspondence: Michał Czapla, Department of Emergency Medical Service, Wroclaw Medical University, ul. Parkowa 34, Wroclaw, 51-616, Poland, Email
| | - Bartosz Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Fehler
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | | | - Łukasz Rypicz
- Department of Population Health, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Irena Wolska-Zogata
- Department of Applied Sociology and Social Work, Institute of Sociology, University of Wroclaw, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Czapla M, Uchmanowicz I, Juárez-Vela R, Durante A, Kałużna-Oleksy M, Łokieć K, Baeza-Trinidad R, Smereka J. Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation - a result of the nutritional status heart study. Front Nutr 2022; 9:1086715. [PMID: 36590210 PMCID: PMC9794855 DOI: 10.3389/fnut.2022.1086715] [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: 11/08/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background Nutritional status is related to the prognosis and length of hospital stay (LOHS) of patients with atrial fibrillation (AF). This study aimed to assess how nutritional status affects LOHS for patients with AF. Methods We performed retrospective analysis of the medical records of 1,813 patients admitted urgently with a diagnosis of AF to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland. Results In total, 1,813 patients were included in the analysis. The average LOHS in the entire group was 3.53 ± 3.41 days. The mean BMI was 28.7 kg/m2 (SD: 5.02). Patients who were hospitalized longer were statistically more likely to have a Nutritional Risk Score (NRS) ≥3 (p = 0.028). A higher percentage of longer hospitalized patients with LDL levels below 70 mg/dl (p < 0.001) and those with HDL ≥40 mg/dl (p < 0.001) were observed. Study participants with NRS ≥3 were an older group (M = 76.3 years), with longer mean LOHS (M = 4.44 days). The predictors of LOHS in the univariate model were age (OR = 1.04), LDL (OR = 0.99), HDL (OR = 0.98), TC (OR = 0.996), CRP (OR = 1, 02, p < 0.001), lymphocytes (OR = 0.97, p = 0.008) and in the multivariate model were age, LDL (mg/dl), HDL (mg/dl), Na, and K. Conclusion For nutritional status, factors indicating the risk of prolonged hospitalization in patients with AF are malnutrition, lower serum LDL, HDL, potassium, and sodium levels identified at the time of admission to the cardiology department. Assessment of nutritional status in patients with AF is important both in the context of evaluating obesity and malnutrition status, as both conditions can alter the prognosis of patients. Further studies are needed to determine the exact impact of the above on the risk of prolonged hospitalization.
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Affiliation(s)
- Michał Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland,Institute of Heart Diseases, University Hospital, Wrocław, Poland,Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Izabella Uchmanowicz
- Institute of Heart Diseases, University Hospital, Wrocław, Poland,Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Angela Durante
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain,*Correspondence: Angela Durante,
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, Lodz, Poland
| | | | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland
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Prokopowicz A, Stańczykiewicz B, Uchmanowicz I, Zimmer M. How to Improve the Care of Women after Childbirth in the Rooming-in Unit: A Prospective Observational Study. Int J Environ Res Public Health 2022; 19:16117. [PMID: 36498191 PMCID: PMC9736068 DOI: 10.3390/ijerph192316117] [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: 11/06/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Rooming-in is the WHO-recommended care system for mothers in the puerperium and their babies. This system allows the newborn to stay with the mother in the same room, 24 h a day. We aimed to investigate the need to entrust a newborn (NEN) in the care of maternity rooming-in staff during the COVID-19 pandemic, and its relationship to pain, anxiety, and blood loss after delivery. A prospective study of 200 adult women in the maternity ward operating in the rooming-in system focussed on NEN in the care of maternity rooming-in staff on the first (T1) and the second day of puerperium (T2). Women who declared having NEN were compared with women without NEN for anxiety, pain, and a drop in haemoglobin in the blood after delivery. In T1, 34% and in T2, 27% of women felt NEN in the care of maternity rooming-in staff. The NEN of women after a cesarean section was higher on both days than the NEN of women after vaginal delivery. Women with NEN had higher levels of pain, state anxiety, and higher levels of postpartum anxiety than women without NEN. Further research should be warranted to investigate whether women who give birth in hospitals that satisfy the NEN in the care of maternity rooming-in staff in their rooming-in units experience less pain and anxiety in comparison to those who give birth in hospital units without such a possibility and whether this factor is an important element in reducing anxiety and pain during puerperium.
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Affiliation(s)
- Anna Prokopowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | | | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynaecology and Obstetrics, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Gotlib J, Jaworski M, Cieślak I, Sobierajski T, Wawrzuta D, Małkowski P, Dobrowolska B, Dyk D, Gaworska-Krzemińska A, Grochans E, Kózka M, Lewko J, Uchmanowicz I, Panczyk M. How Psychological Variables Maybe Correlated with Willingness to Get COVID-19 Vaccine: A Nationwide Cross-Sectional Study of Polish Novice Nurses. Int J Environ Res Public Health 2022; 19:15787. [PMID: 36497862 PMCID: PMC9740348 DOI: 10.3390/ijerph192315787] [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] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.
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Affiliation(s)
- Joanna Gotlib
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Mariusz Jaworski
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Ilona Cieślak
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 00-503 Warszawa, Poland
| | - Dominik Wawrzuta
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Małkowski
- Department of Surgical Nursing, Transplantation Nursing and Extracorporeal Therapies, Medical University of Warsaw, 02-007 Warsaw, Poland
| | - Beata Dobrowolska
- Department of Management in Nursing, Medical University of Lublin, 20-081 Lublin, Poland
| | - Danuta Dyk
- Department of Anaesthesiology and Intensive Care Nursing, Poznan University of Medical Sciences, 60-179 Poznan, Poland
| | | | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland
| | - Maria Kózka
- Department of Clinical Nursing, Faculty of Health Sciences, Jagiellonian University Collegium Medicum in Krakow, 31-501 Krakow, Poland
| | - Jolanta Lewko
- Department of Primary Health Care, Faculty of Health Sciences, Medical University in Bialystok, 15-054 Bialystok, Poland
| | | | - Mariusz Panczyk
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
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Wleklik M, Czapla M, Denfeld Q, Przybylski R, Reczuch K, Uchmanowicz I. The how and why of assessing frailty syndrome in cardiac surgery. ADV CLIN EXP MED 2022; 31:1061-1064. [DOI: 10.17219/acem/155306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Orszulak N, Kubiak K, Kowal A, Czapla M, Uchmanowicz I. Nurses' Quality of Life and Healthy Behaviors. Int J Environ Res Public Health 2022; 19:12927. [PMID: 36232229 PMCID: PMC9564667 DOI: 10.3390/ijerph191912927] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined as the actions and attitudes of a person that affect their physical and mental health, is one of many lifestyle components. The nursing community, which is exposed to a range of dangers associated with the job position and responsibilities of the nursing profession, has to contend with several negative impacts. This results in a decreased quality of life among the nursing staff and reduced effectiveness in providing care services to patients. METHODS This study was conducted using an online Google questionnaire, which was completed by 312 nurses nationwide. The questionnaire included questions about the respondents' socio-demographic survey and included the Health Behavior Inventory (HBI) by Juczyński and the WHOQoL-BREF questionnaire. RESULTS The mean QoL reported by respondents was 3.65 points (SD = 0.67), meaning that QoL ranked between good and average results. The respondents' mean rating of their own health was 3.58 points (SD = 0.79), indicating that they rated their health status between satisfactory and average. Low health-behavior prevalence was reported by 139 of the 312 survey participants (44.55%), while 111 respondents (35.58%) had average health-behavior prevalence and 62 (19.87%) had high health-behavior prevalence. Each of the QoL domains correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with the total HBI score and all its subscales. CONCLUSIONS Higher quality of life improves the level of health behavior by nursing staff. Obesity lowers the quality of life in physical, psychological, and social domains. The psychological sphere was the best-rated quality of life domain by nurses. A good material situation for nurses has a positive effect on their quality of life.
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Affiliation(s)
- Natalia Orszulak
- Student Research Group in Nursing, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Klaudia Kubiak
- Student Research Group in Nursing, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Adam Kowal
- Student Research Group in Nursing, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Michał Czapla
- Department of Emergency Medical Service, Faculty of Health Sciences, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Nursing, University of La Rioja, 26006 Logrono, Spain
| | - Izabella Uchmanowicz
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
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Uchmanowicz I, Wleklik M, Foster M, Olchowska-Kotala A, Vellone E, Kaluzna-Oleksy M, Szczepanowski R, Uchmanowicz B, Reczuch K, Jankowska EA. Digital health and modern technologies applied in patients with heart failure: Can we support patients’ psychosocial well-being? Front Psychol 2022; 13:940088. [PMID: 36275212 PMCID: PMC9580561 DOI: 10.3389/fpsyg.2022.940088] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Despite advances in the treatment of heart failure (HF), the physical symptoms and stress of the disease continue to negatively impact patients’ health outcomes. Technology now offers promising ways to integrate personalized support from health care professionals via a variety of platforms. Digital health technology solutions using mobile devices or those that allow remote patient monitoring are potentially more cost effective and may replace in-person interaction. Notably, digital health methods may not only improve clinical outcomes but may also improve the psycho-social status of HF patients. Using digital health to address biopsychosocial variables, including elements of the person and their context is valuable when considering chronic illness and HF in particular, given the multiple, cross-level factors affecting chronic illness clinical management needed for HF self-care.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
| | - Marva Foster
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, Boston, MA, United States
- Department of General Internal Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Agnieszka Olchowska-Kotala
- Department of Medical Humanities and Social Science, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Ercole Vellone
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Marta Kaluzna-Oleksy
- Department of Cardiology, University of Medical Sciences in Poznan, Poznan, Poland
| | - Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Bartosz Uchmanowicz
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- *Correspondence: Bartosz Uchmanowicz,
| | - Krzysztof Reczuch
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa Anita Jankowska
- Institute of Heart Diseases, University Hospital, Wroclaw, Poland
- Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
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Machul M, Dziurka M, Gniadek A, Gotlib J, Gutysz-Wojnicka A, Kotowski M, Kozieł D, Krasucka K, Obuchowska A, Ozdoba P, Panczyk M, Pydyś A, Uchmanowicz I, Dobrowolska B. Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:11308. [PMID: 36141579 PMCID: PMC9517121 DOI: 10.3390/ijerph191811308] [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] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.
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Affiliation(s)
- Michał Machul
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Magdalena Dziurka
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | - Agnieszka Gniadek
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Joanna Gotlib
- Department of Education and Health Sciences Research, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Gutysz-Wojnicka
- Department of Nursing, School of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
| | - Michał Kotowski
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | - Dorota Kozieł
- Collegium Medicum, Jan Kochanowski University of Kielce, 25-369 Kielce, Poland
| | - Kamila Krasucka
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | - Anna Obuchowska
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | - Patrycja Ozdoba
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | - Mariusz Panczyk
- Department of Education and Health Sciences Research, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Pydyś
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, 20-081 Lublin, Poland
| | | | - Beata Dobrowolska
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
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Abstract
Introduction Chronic Heart Failure (CHF) involves a complex regimen of daily self-care behaviors: pharmacological therapy, symptom monitoring and lifestyle modifications. Patients with CHF may have a reduced health related quality of life (HRQoL) due to various physical and emotional symptoms. HRQoL may be improved through the use of self-care interventions. Purpose To assess the level of self-care and quality of life among men with chronic heart failure. Methods The study was conducted among 80 men diagnosed with CHF (mean age 58 years). The study was cross-sectional. A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9 and quality of life was assessed using the World Health Organization Quality of Life Bref. Results The Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52). The mean score regarding perception of QoL was 2.78 points (SD = 0.91), and 40% of patients indicating poor perception of QoL. The mean score for self-rated Analysis of the results of the individual domains of the WHOQoL BREF questionnaire showed that patients rated their QoL best in the environmental domain (M = 13.28; SD = 3.11), then in the social domain (M = 12.81; SD = 2.71), and in the psychological domain (M = 12.8; SD = 3.2). In contrast, QoL in the physical domain was rated the lowest (M = 10.44; SD = 2.85). There was no significant correlation between quality of life and self-care (p > 0.05). Conclusions Men with CHF have unsatisfactory self-care outcomes and low quality of life scores and are dissatisfied with their health. Strategies to improve selfcare and quality of life in this group are indicated.
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Affiliation(s)
- Alicja Wiśnicka
- Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Lomper
- Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland
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Wleklik M, Kaluzna-Oleksy M, Czapla M, Uchmanowicz I. Relationship between multimorbidity and prevalence of frailty syndrome in patients qualified for elective cardiac surgery. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.031] [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: None.
Intorduction
Frailty syndrome (FS) and multimorbidity are closely related but separate constructs that are associated with higher risk of death, higher rehospitalization rates, disability, and reduced quality of life. Identification of multimorbidity and FS in the cardiac surgery patient population appears to be important in terms of the qualification process, incidence of perioperative risk, and optimization of patient status before the cardiac surgery procedure.
Purpose
Analysis of the relationship between multimorbidity and FS in patients qualified for elective cardiac surgery.
Methods
The study included 100 patients ≥ 65 years of age (40 women and 60 men, mean age M±SD =71.69±4). The study included elderly patients qualified for elective cardiac surgery (coronary artery bypass grafting, valvular surgery or combined surgery). In the study group frailty was identified with the use of standardized research tools including those for one-dimensional and multidimensional assessment (FRAIL scale, Frailty Phenotype, 5-meter gaid speed, Tilburg Frailty Indicator, Tilburg Frailty Indicator - TFI). The presence of more than 3 chronic diseases was considered as multimorbidity. A significance level of 0.05 was assumed in the analysis, so all p<0.05 values were interpreted as indicating significant relationships.
Results
Multimorbidity was reported in 88% of patients qualified for cardiac surgery. The prevalence of FS varied according to the screening tool used.Based on FRAIL was reported in 27% of patients, based on Frailty Phenotype in 17% of patients, based on 5-meter gaid speed in 43% of patients, and based on TFI in 63% of patients. In patients with multimorbidity FS was significantly more frequent than in patients without frailty syndrome, which was confirmed by FRAIL (96.3% vs. 60.0%; p-=0.003) and TFI questionnaire (95.2% vs. 75.7%; p=0.008) scores.
Conclusions
1. Most elderly patients qualified for elective cardiac surgery procedures are characterized by multimorbidity. 2 Multimorbidity is associated with a higher prevalence of FS in both unidimensional and multidimensional assessment. 3 This phenomenon requires further study, especially with regard to the occurrence of outcomes in this patient population.
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Affiliation(s)
- M Wleklik
- Wroclaw Medical University, Department of Clinical Nursing , Wroclaw , Poland
| | - M Kaluzna-Oleksy
- Poznan University of Medical Sciences, 1st Department of Cardiology , Poznan , Poland
| | - M Czapla
- Wroclaw Medical University, Department of Emergency Medical Service, Wroclaw , Wroclaw , Poland
| | - I Uchmanowicz
- Wroclaw Medical University, Department of Clinical Nursing , Wroclaw , Poland
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Bujak-Rogala E, Lisiak MH, Uchmanowicz I. Quality of life and frailty: an important issue for elderly patients with an implanted pacemaker. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.121] [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: None.
Background
Quality of life (QoL) and Frailty Syndrome (FS) are increasingly considered in the clinical evaluation after invasive cardiac procedures, such as pacemaker implantation in the elderly.
Purpose
The aim of the study was to report on the baseline to follow-up changes in QoL and FS in patients following pacemaker implantation.
Methods
The population of the study comprised 101 elderly patients (≥65 y/o) who were qualified for pacemaker implantation. The medical record analysis and self-administered questionnaire were used twice: before the implantation (Cardiology Department) and after 6 months (outpatient clinic). The following instruments were used: sociodemographic and clinical data, WHO Quality of Life and the Tilburg Frailty Indicator (TFI).
Results
The mean age of the participants (54 men) was 76.44 ± 6,92. The 6-month analysis showed that QoL scores in all domains were significantly higher than before implantation, respectively (p<0.001): physical domain (SD = 15.72 vs. SD = 21.17; T = 4810.50, z = - 8.154) psychological domain (SD = 27.55 vs. SD = 23.14; T = 4553.50, z = - 8.135), social domain (SD = 12.10 vs. SD = 17.36; T = 2396.50, z = - 6.776), and environmental domain (SD = 13.00 vs. SD = 16.80; T = 4414.00, z = - 7.932). The analysis of the FS showed that all FS components decreased compared to the subjects' score at baseline measurement (p<0.001), respectively: physical component level: SD = 1.42 vs. SD = 1.53; T = 3916, z = -9.381), psychological components (SD = 0.67 vs. SD = 0.94; T = 990, z = - 6.633), social components (SD = 0.83 vs. SD = 0.89; T = 300, z = - 4.899). The additional analysis revealed that age (in all domains) and FS (only in the physical domain) were predictors of better QoL. The results indicate that as age increases by one year, post-implantation QoL decreases by 0.4 points, B = -0.40; β = -0.18 (physical domain), by 0.89 points, B = -0.89; β = -0.22 (psychological domain), by 0.55 points, B = -0.55; β = -0.32 (social domain), and by 0.44 points, B = -0.44; β = -0.25 (environmental domain). In contrast, greater severity of FS symptoms before implantation is a significant predictor of lower QoL after implantation, B = -0.99; β = -0.40.
Conclusion(s)
The assessment of QoL and FS, in addition to the clinical assessment, should be performed in elderly patients qualified for pacemaker implantation. The results indicate that pacemaker implantation is an important factor in improving the QoL and reducing the severity of physical component of FS. Appropriate assessment may be helpful in optimizing the therapeutic management in terms of prognostic assessment and the risk of hospitalization.
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Affiliation(s)
- E Bujak-Rogala
- Klodzko County Hospital, Department of Cardiology , Klodzko , Poland
| | - M H Lisiak
- Wroclaw Medical University, Department of Clinical Nursing , Wroclaw , Poland
| | - I Uchmanowicz
- Wroclaw Medical University, Department of Clinical Nursing , Wroclaw , Poland
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Wisnicka A, Wisnicki K, Lomper K, Uchmanowicz I. Self-care among men with chronic heart failure - need for educational interventions? Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.298] [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: None.
Introduction
Heart failure (HF) is one of the biggest problems in cardiology and public health. The long-term risk of developing HF symptoms in a person aged 55 years is 33% for men. Self-care is a key element of therapeutic process of patients with HF.
Purpose
To assess the level of self-care among men with chronic heart failure.
Methods
The study was conducted among 80 men diagnosed with chronic heart failure (mean age 58 years). A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9.
Results
Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52).
Conclusions
Patients with HF have unsatisfactory self-care outcomes. There is a need to implement interventions based on patient-tailored health education.
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Affiliation(s)
- A Wisnicka
- Wroclaw Medical University, Department of Clinical Nursing, Wroclaw, Poland
| | - K Wisnicki
- Wroclaw Medical University, Wroclaw, Poland
| | - K Lomper
- Wroclaw Medical University, Department of Clinical Nursing, Wroclaw, Poland
| | - I Uchmanowicz
- Wroclaw Medical University, Department of Clinical Nursing, Wroclaw, Poland
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Jędrzejczyk M, Foryś W, Czapla M, Uchmanowicz I. Relationship between Multimorbidity and Disability in Elderly Patients with Coexisting Frailty Syndrome. Int J Environ Res Public Health 2022; 19:ijerph19063461. [PMID: 35329148 PMCID: PMC8950513 DOI: 10.3390/ijerph19063461] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 12/11/2022]
Abstract
Background: Multimorbidity is a common problem worldwide. It carries the risk of reduced quality of life, disability, frequent hospitalizations, and death. The present study was designed to assess the relationships that exist between multimorbidity and disability in elderly patients. Methods: The study included 100 patients and was conducted between October 2020 and January 2021. Inclusion criteria included age >65 years, presence of a minimum of two comorbidities in the subject, and consent to participate in the study. Standardized survey instruments such as Tilburg Frailty Indicator (TFI), Charlson Comorbidities Index (CCI), Assessment of Basic Activities of Daily Living—Katz Scale (ADL), and Assessment of Complex Activities of Daily Living—Lawton Scale (IADL) were used in the study. Results: The majority of the subjects (92) had a frailty syndrome (TFI). A small group of respondents (8%) suffered from severe comorbidities (CCI). Among the subjects surveyed, 71% maintained full function in performing simple activities of daily living (ADL), while 29% demonstrated moderate disability on the scale. Full independence in performing complex activities of daily living (IADL) was present in 33% of the respondents, and 67% were partially independent. Independence in complex activities of daily living (IADL) was significantly higher in patients with fewer comorbidities. The severity of comorbidities (CCI) had a significant effect on the decrease in the level of independence (ADL and IADL). Independence in performing complex activities (IADL) was worse among older patients. Conclusions: An increase in the number of comorbidities contributes to a decrease in the level of performance of complex activities of daily living. The severity of comorbidities significantly reduces the level of independence of the subjects in simple and complex activities of daily living. In patients with a higher level of independence in performing simple and complex activities, the co-occurrence of frailty syndrome was less severe. As the age of the subjects increases, the frequency in which they show moderate dependence on third parties in performing complex activities of daily living increases.
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Affiliation(s)
- Maria Jędrzejczyk
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wrocław, Poland; (M.J.); (I.U.)
| | - Weronika Foryś
- Harvard Division of Continuing Education, Harvard University, Cambridge, MA 02138-3722, USA;
| | - Michał Czapla
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Faculty of Nursing, Group in Research in Care (GRUPAC), University of La Rioja, 26006 Logroño, Spain
- Correspondence:
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wrocław, Poland; (M.J.); (I.U.)
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
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Olchowska-Kotala A, Uchmanowicz I, Szczepanowski R. Verbal Descriptors of the Frequency of Side Effects: Implementation of EMA Recommendations in Patient Information Leaflets in Poland. Int J Qual Health Care 2022; 34:6547612. [DOI: 10.1093/intqhc/mzac013] [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] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 03/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The European Medicines Agency (EMA) recommends a description of drug side effects based on the frequency format and the associated verbal description. Although the recommendations refer to English-speaking countries, in several non-English speaking states, official authorities have accepted the proposed recommendations on how the patient information leaflets should be designed for descriptions of side effect frequencies. The aim of the study was to examine how manufacturers of authorized medicines in Poland implement the EMA recommendations regarding the verbal descriptors of the frequency of side effects.
Methods
A qualitative study. As a first step, we identified which of the 150 pharmaceutical companies operating in Poland had the largest market share. Then, five manufacturers were selected at random from the list of the top fifteen drug manufacturers in Poland by market share of the pharmaceutical sector. Lists of medicinal products authorized for marketing in Poland were downloaded from manufacturers’ websites, and then five products from each manufacturer were selected based on random sampling. The study included only prescription medicines and excluded over-the-counter medicines and dietary supplements from the sample. Subsequently, for each of the 25 drugs relevant patient information leaflets were obtained from the manufacturers’ websites. We evaluated how information on the frequency of side effects was provided in each leaflet, including the use of EU-recommended terms (verbal descriptors such as "very common," "common," "uncommon," "rare," "very rare") and additional notes explaining their meanings.
Results
For all manufacturers, word labels of the frequencies of side effects selected for the study were the same but the additional notes explaining their meanings were different. There were various explanations of how to understand verbal descriptors of the frequency of side effects not only across different manufacturers but also across different medicines from one manufacturer.
Conclusions
There is no single standard in the Polish pharmaceutical industry for implementing the EMA recommendations into the written information about the frequency of side effects. The observed differences for an explanation of how to understand a given verbal term do not favor a uniform interpretation of the verbal frequency labels meaning by patients.
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Affiliation(s)
- Agnieszka Olchowska-Kotala
- Department of Humanities and Social Science, Wroclaw Medical University, ul Mikulicza-Radeckiego 7, 50-368 Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, ul. K. Bartla 5, 51-618 Wroclaw, Poland
| | - Remigiusz Szczepanowski
- Department of Humanities and Social Science, Wroclaw Medical University, ul. K. Bartla 5, 51-618 Wroclaw, Poland
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Zachciał J, Uchmanowicz I, Krajewska M, Banasik M. Adherence to Immunosuppressive Therapies after Kidney Transplantation from a Biopsychosocial Perspective: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11051381. [PMID: 35268471 PMCID: PMC8910970 DOI: 10.3390/jcm11051381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/15/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 12/02/2022] Open
Abstract
Kidney transplantation (KT) is the best method for kidney replacement therapy (KRT) because of patient survival rates and quality of life (QoL). Nowadays, the main cause of graft loss is antibody-mediated rejection. The treatment of humoral injury is difficult with uncertain results and still not firmly established. Therefore, appropriate adherence is crucial to prolong graft and patient survival. This study aims to evaluate the association of transplant patients’ acceptance of illness, symptoms of anxiety and depression, frailty, and QoL with medication adherence in KT recipients. A total of 210 patients after KT completed the surveys. The instruments were distributed during patients’ admission at the clinic by a qualified nurse, who assisted the patients’ in completing the questionnaires. A cross-sectional study of KT recipients 9.45 ± 7.26 years after KT was performed. Patient adherence with medications was assessed using the Adherence to Refills and Medications Scale (ARMS). Explanatory variables were examined with validated instruments, such as the World Health Organization Quality of Life (WHOQoL-BREF) questionnaire, The Mini-Mental State Examination (MMSE), the Acceptance of Illness Scale (AIS), the Hospital Anxiety and Depression Scale (HADS), and the Tilburg Frailty Indicator (TFI) scale, respectively. Simple linear and multiple regression analyses demonstrated the positive correlation between acceptance of illness and adherence to immunosuppressive medications in a patient sample of KT recipients. The other important factor facilitating adherence to medications was linked with physical and environmental dimensions. On the other hand, frail kidney transplant patients were more likely to be non-adherent. In conclusion, identifying contributors to better medication adherence in immunosuppressive therapy is crucial in preventing transplant rejection or graft loss. In the kidney transplant population, the acceptance of illness, selected dimensions of QoL, and demographic variables associated with rural living and vocational education favored adherence behaviors.
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Affiliation(s)
- Justyna Zachciał
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.Z.); (M.K.); (M.B.)
- Department of Clinical Nursing, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Wroclaw Medical University, 51-618 Wroclaw, Poland
- Correspondence: ; Tel.: +48-71-784-18-24
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.Z.); (M.K.); (M.B.)
| | - Mirosław Banasik
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (J.Z.); (M.K.); (M.B.)
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Kolasa J, Frączek-Jucha M, Grabowski M, Jankowska EA, Lelonek M, Pawlak A, Uchmanowicz I, Nessler J. A quasi-experimental study examining a nurse-led educational program to improve disease knowledge and self-care for patients with acute decompensated heart failure with reduced ejection fraction. ADV CLIN EXP MED 2022; 31:267-275. [PMID: 34856078 DOI: 10.17219/acem/143989] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and consequently lead to better patient outcomes. OBJECTIVES To assess the effectiveness of "The Weak Heart" educational model in enhancing the level of disease knowledge and self-care behaviors among patients hospitalized with acute decompensated heart failure with reduced ejection fraction (HFrEF). MATERIAL AND METHODS An evidence-based, standardized educational program was implemented for HF patients in Poland. We compared the initial level of HF knowledge - as rated using a self-developed questionnaire and self-care behaviors, evaluated according to the 9-item European Heart Failure Self-care Behavior Scale (9-EHFScBS) - to the results obtained at the 3-month follow-up period with a sample of patients (n = 231) hospitalized with acute decompensated HF (ADHF). RESULTS The results showed a significant increase in total score of HF knowledge test depending on the time of measurement (χ2 = 356.526, p < 0.001) and in all individual questions on HF. The significant change of the 9-EHFScBS self-care questionnaire was also found in total score (Z = -7.317, p < 0.001), in all domains: autonomous-based adherence (Z = -5.870, p < 0.001); consulting behavior (Z = -7.238, p < 0.001); provider-based adherence (Z = -4.162; p < 0.001) and in relation to all individual statements except statement 7 ("I eat a low salt diet") and statement 9 ("I exercise regularly"). Within 3 months of hospital discharge, 84% (193 out of 231) of participants visited their primary care physician and 79% (183 out of 231) visited a cardiologist in accordance with their individual treatment plan. CONCLUSIONS "The Weak Heart" educational model is effective in enhancing the level of HF knowledge and self-care behaviors among patients with decompensation of HFrEF.
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Affiliation(s)
- Jolanta Kolasa
- Medical Unit Cardiology, Novartis Poland Ltd., Warszawa, Poland
- Mossakowski Medical Research Centre, Polish Academy of Sciences, Department of Applied Physiology, Warszawa, Poland
| | - Magdalena Frączek-Jucha
- Department of Emergency Medical Care, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Marcin Grabowski
- 1st Department of Cardiology, Medical University of Warsaw, Poland
| | - Ewa A Jankowska
- Institute of Heart Diseases, Wroclaw Medical University, Poland
- Institute of Heart Diseases, University Hospital in Wrocław, Poland
| | - Małgorzata Lelonek
- Department of Noninvasive Cardiology, Medical University of Lodz, Poland
| | - Agnieszka Pawlak
- Mossakowski Medical Research Centre, Polish Academy of Sciences, Department of Applied Physiology, Warszawa, Poland
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Jadwiga Nessler
- Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
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Wleklik M, Denfeld Q, Lisiak M, Czapla M, Kałużna-Oleksy M, Uchmanowicz I. Frailty Syndrome in Older Adults with Cardiovascular Diseases-What Do We Know and What Requires Further Research? Int J Environ Res Public Health 2022; 19:ijerph19042234. [PMID: 35206422 PMCID: PMC8872246 DOI: 10.3390/ijerph19042234] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 02/07/2023]
Abstract
Cardiovascular diseases (CVD) affect 60% of people over 60 years of age and are one of the main causes of death in the world. Diagnosed cardiovascular disease also triples the likelihood of Frailty syndrome (FS). FS has become increasingly relevant in cardiology and cardiac surgery and occurs in a significant number of patients with CVD, with prevalence ranging from 25% to 62%. Viewed in a multidimensional, biopsychosocial perspective, FS increases a patient's vulnerability, making them susceptible to several adverse clinical outcomes. Frailty syndrome also is a predictor of mortality in patients with CVD regardless of age, severity of disease, multi-morbidity, and disability. Frailty syndrome potentially can be prevented in patients with CVD and its early identification is important to avoid the development of disability, dependence on others and reduced quality of life. The aim of this paper is to show the relationship between FS and specific CVDs (coronary artery disease, hypertension, atrial fibrillation, heart failure) and cardiac procedures (device implantation, cardiac surgery, and transcatheter aortic valve implantation). Furthermore, we highlight those areas that require further research to fully understand the relationship between FS and CVD and to be able to minimize or prevent its adverse effects.
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Affiliation(s)
- Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland; (M.W.); (M.L.); (I.U.)
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Quin Denfeld
- School of Nursing, Oregon Health and Science University, Portland, OR 97239, USA;
| | - Magdalena Lisiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland; (M.W.); (M.L.); (I.U.)
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Correspondence:
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, University of Medical Sciences in Poznan, 61-848 Poznan, Poland;
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland; (M.W.); (M.L.); (I.U.)
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
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Kubielas G, Diakowska D, Uchmanowicz I. Survival analysis of patients with acute coronary syndrome receiving comprehensive coordinated care after myocardial infarction (KOS-Zawał). Kardiol Pol 2022; 80:415-321. [PMID: 35129204 DOI: 10.33963/kp.a2022.0035] [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] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study aimed to analyze survival rates among patients with acute coronary syndrome (ACS) covered and not covered by the National Comprehensive Care after Myocardial Infarction (KOS-Zawał) program. METHODS A total of 179972 patients after myocardial infarction (MI) were enrolled in KOS-Zawał program between October 2017 and March 2020 and were included in the comparative analysis with survival analysis. A group of 24496 (13.61%) patients received KOS-Zawał services, while a group of 155476 (86.39%) were not covered by the KOS-Zawał program. The time points for observation of the incidence of death were set at 30, 180, and 365 days from the end of the first hospitalization. RESULTS There was a lower incidence of death in favor of the KOS-Zawał group relative to the non-KOS-Zawał group both in hospital and at 30, 180, and 365 days after the end of hospitalization, respectively: 0.19% vs. 6.55%; 0.80% vs. 8.39%; 2.92% vs. 10.74%; and 6.35% vs. 13.40%. Survival analysis revealed a statistically significantly lower (P <0.0001) probability of death in the KOS-Zawał group compared with the non-KOS-Zawał group. Also, logistic regression analysis confirmed that patients in the KOS-Zawał group had a significantly lower risk of death than those in the non-KOS-Zawał group (odds ratio, 0.710; 95% confidence interval, 0.554-0.908; P = 0.007). CONCLUSIONS The KOS-Zawał comprehensive care program reduces the risk of death in the first year after MI by 29%. There are indications of a biased interpretation of the data due to the initial better clinical status of post-MI patients covered by the KOS-Zawał program.
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Affiliation(s)
- Grzegorz Kubielas
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland. .,Department of Health Care Services, Polish National Health Fund, Central Office in Warsaw, Warszawa, Poland.
| | - Dorota Diakowska
- Department of Basic Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland.,Center for Heart Diseases, University Hospital, Wrocław, Poland
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Uchmanowicz I, Pasieczna AH, Wójta-Kempa M, Gobbens RJJ, Młynarska A, Faulkner KM, Czapla M, Szczepanowski R. Physical, Psychological and Social Frailty Are Predictive of Heart Failure: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11030565. [PMID: 35160017 PMCID: PMC8836458 DOI: 10.3390/jcm11030565] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of this study were to study different dimensions of frailty (physical, psychological and social) in patients with HF and the effect of different dimensions of frailty on the incidence of heart failure. Methods: The study used a cross-sectional design and included 965 patients hospitalized for heart failure and 164 healthy controls. HF was defined according to the ESC guidelines. The Tilburg Frailty Indicator (TFI) was used to assess frailty. Probit regression analyses and chi-square statistics were used to examine associations between the occurrence of heart failure and TFI domains of frailty. Results: Patients diagnosed with frailty were 15.3% more likely to develop HF compared to those not diagnosed with frailty (p < 0.001). An increase in physical, psychological and social frailty corresponded to an increased risk of HF of 2.9% (p < 0.001), 4.4% (p < 0.001) and 6.6% (p < 0.001), respectively. Conclusions: We found evidence of the association between different dimensions of frailty and incidence of HF.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wrocław, Poland;
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | | | - Monika Wójta-Kempa
- Department of Health Humanities and Social Science, Wroclaw Medical University, 51-618 Wrocław, Poland;
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands;
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland;
| | | | - Michał Czapla
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Correspondence:
| | - Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Wrocław University of Science and Technology, 50-370 Wrocław, Poland;
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Fredericks S, Ski C, Taylor RS, Uchmanowicz I, Gomes AF, Goossens E, de Stoutz N, Desteghe L, Sanders J. ESC Nursing and Allied Professional Training grants: 10 top tips for enhancing funding success! Eur J Cardiovasc Nurs 2022; 21:92. [PMID: 35019991 DOI: 10.1093/eurjcn/zvab109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/12/2022]
Affiliation(s)
- Suzanne Fredericks
- Daphne Cockwell School of Nursing, Ryerson University, 288 Church Street, Toronto, ON M5B 1Z5, Canada
| | - Chantal Ski
- Integrated Care Academy, University of Suffolk, Ipswich IP4 1QJ, 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 G12 8QQ, UK
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Ana F Gomes
- Centro Hospitalar do Baixo Vouga, Av. Artur Ravara, Aveiro, Portugal.,Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal
| | - Eva Goossens
- Center for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Department of Patient Care, Antwerp University Hospital (UZA), Antwerp, Belgium
| | - Naomi de Stoutz
- ESC Patient Forum Representative, Dorfstrasse 64, 8126 Zumikon, Switzerland
| | - Lien Desteghe
- Faculty of Medicine and Life Sciences, Hasselt University and Heart Center Hasselt, Jessa Hospital, Hasselt, Belgium.,Research Group Cardiovascular Diseases, Cardiology Department, University of Antwerp, Antwerp University Hospital (UZA), Antwerp, Belgium
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
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Kałużna-Oleksy M, Kukfisz A, Migaj J, Dudek M, Krysztofiak H, Sawczak F, Szczechla M, Przytarska K, Straburzyńska-Migaj E, Wleklik M, Uchmanowicz I. A Simple Risk Score Based on Routine Clinical Parameters Can Predict Frailty in Hospitalized Heart Failure Patients. J Clin Med 2021; 10:jcm10245963. [PMID: 34945259 PMCID: PMC8708413 DOI: 10.3390/jcm10245963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/20/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/17/2022] Open
Abstract
Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and specificity of 97%. Awarding 2 points or less ruled out FS in the studied group with negative predictive value 94%. The presented novel, simple score predicts FS in HFrEF patients with routine clinical parameters and has good positive and negative predictive values.
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Affiliation(s)
- Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
- Lord’s Transfiguration Clinical Hospital, Poznań University of Medical Sciences, 61-848 Poznan, Poland
- Correspondence: ; Tel.: +48-502-896-932
| | - Agata Kukfisz
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
| | - Jacek Migaj
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
- Lord’s Transfiguration Clinical Hospital, Poznań University of Medical Sciences, 61-848 Poznan, Poland
| | - Magdalena Dudek
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
- Lord’s Transfiguration Clinical Hospital, Poznań University of Medical Sciences, 61-848 Poznan, Poland
| | - Helena Krysztofiak
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
| | - Filip Sawczak
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
| | - Magdalena Szczechla
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
| | - Katarzyna Przytarska
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
| | - Ewa Straburzyńska-Migaj
- 1st Department of Cardiology, Poznań University of Medical Sciences, 61-848 Poznań, Poland; (A.K.); (J.M.); (M.D.); (H.K.); (F.S.); (M.S.); (K.P.); (E.S.-M.)
- Lord’s Transfiguration Clinical Hospital, Poznań University of Medical Sciences, 61-848 Poznan, Poland
| | - Marta Wleklik
- Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.W.); (I.U.)
| | - Izabella Uchmanowicz
- Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland; (M.W.); (I.U.)
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Zborowska A, Gurowiec PJ, Młynarska A, Uchmanowicz I. Factors Affecting Occupational Burnout Among Nurses Including Job Satisfaction, Life Satisfaction, and Life Orientation: A Cross-Sectional Study. Psychol Res Behav Manag 2021; 14:1761-1777. [PMID: 34744464 PMCID: PMC8566003 DOI: 10.2147/prbm.s325325] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/06/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose Everyday nursing practice under demanding conditions, high mental and physical strain may result in occupational burnout. There is still a need for studies on the comprehensive identification of burnout among nursing staff. This study aimed to evaluate factors affecting occupational burnout among nurses, including job satisfaction, life satisfaction, and dispositional optimism. Methods The study involved 625 survey participants with a mean age of 49.47 years and was conducted between January and December 2018. The inclusion criteria were job experience >1 year, current nurse work activity, and written informed consent to participate in the study. The study used standardized research tools such as Maslach Burnout Inventory (MBI), Life Orientation Test-Revised version (LOT-R), Satisfaction with Life Scale (SWLS), and Satisfaction with Job Scale (SWJS). Also, sociodemographic data were collected using a self-developed questionnaire. The STROBE guidelines were followed. Results Emotional exhaustion (EE) was significantly greater in respondents with medium life satisfaction (SWLS). Also, EE was significantly greater in pessimists and those with a neutral orientation than in optimists (LOT-R). Housing conditions and family-related problems were significant factors differentiating depersonalization (DEP). Reduced personal accomplishment (PA) was more significant in respondents with a bachelor’s degree than in those with a master’s degree. Also, decreased PA was significantly greater in respondents with low life satisfaction than those with medium life satisfaction. Life satisfaction and life orientation were significant factors differentiating job dissatisfaction among the health-related and psychological variables. Conclusion Burnout was found to be related to individual, interpersonal and organizational feelings. There was an interrelationship between personality traits, where a higher level of occupational burnout was found among nurses with a pessimist attitude. Health programs should be implemented to identify and eliminate burnout through mental health support, improved communication skills, optimized teamwork, and evidence-based interventions.
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Affiliation(s)
| | | | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, Medical University of Silesia, Katowice, Poland.,Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland.,Centre for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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Uchmanowicz I, Kubielas G, Serzysko B, Kołcz A, Gurowiec P, Kolarczyk E. Rationing of Nursing Care and Professional Burnout Among Nurses Working in Cardiovascular Settings. Front Psychol 2021; 12:726318. [PMID: 34690885 PMCID: PMC8527187 DOI: 10.3389/fpsyg.2021.726318] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Nursing needs close interpersonal contact with the patient and emotional involvement, therefore can contribute to professional burnout and rationing of nursing care. Aim: Assessing the relationship between the rationing of nursing care and professional burnout in nursing staff. Materials and Methods: The study included a group of 219 nurses working in cardiovascular facilities. This was a cross-sectional study designed to investigate the relationship between factors of the care rationing and professional burnout. The survey data was collected with standardised and research instruments such as the revised Basel Extent of Rationing of Nursing Care questionnaire (BERNCA-R) and the Maslach Burnout Inventory (MBI). Results: The total mean BERNCA-R score was 1.38 (SD = 0.62), while the total MBI score amounted to 38.14 (SD = 22.93). The specific components of professional burnout yielded the values: emotional exhaustion (M = 44.8), job dissatisfaction (M = 40.66), and depersonalisation (M = 28.95). Multiple linear regression showed that independent predictors of BERNCA-R score were emotional exhaustion, depersonalisation, job dissatisfaction, and multi-jobs activity (p < 0.001). Conclusion: The level of rationing of nursing care in cardiovascular facilities increases along with emotional exhaustion, depersonalisation and job dissatisfaction, and multi-jobs activity.
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Affiliation(s)
- Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Grzegorz Kubielas
- Department of Clinical Nursing, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Bogusława Serzysko
- Department of Healthcare, Higher School of Applied Sciences in Ruda Śląska, Ruda Śląska, Poland
| | - Anna Kołcz
- Laboratory of Ergonomics and Biomedical Monitoring, Wrocław Medical University, Wrocław, Poland
| | - Piotr Gurowiec
- Faculty of Health Sciences, University of Opole, Opole, Poland
| | - Ewelina Kolarczyk
- Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences, Medical University of Silesia, Katowice, Poland
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Kołtuniuk A, Witczak I, Młynarska A, Czajor K, Uchmanowicz I. Satisfaction With Life, Satisfaction With Job, and the Level of Care Rationing Among Polish Nurses-A Cross-Sectional Study. Front Psychol 2021; 12:734789. [PMID: 34650492 PMCID: PMC8505674 DOI: 10.3389/fpsyg.2021.734789] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Rationing of nursing care is a serious issue that has been widely discussed throughout recent years in many countries. The level of satisfaction with life and of satisfaction with job as the nurse-related factors may significantly affect the level of care rationing. Aim: To assess the rationing of nursing care among the Polish nurses and the impact of nurse-related variables, i.e., satisfaction with life and satisfaction with job on the level of nursing care rationing. Materials and Methods: A cross-sectional study was conducted among 529 Polish registered nurses employing in two University Hospitals. Three self-report scales in the Polish version were used in this study, namely, Basel Extent of Rationing of Nursing Care-revised version (BERNCA-R), Satisfaction with Life Scale (SWLS), and Satisfaction with Work Scale (SWWS). Results: The respondents indicated that the most frequently rationed activity is studying the situation of individual patients and care plans at the beginning of the shift. The least frequently rationed activity indicated by the respondents was adequate hand hygiene. The patient-to-nurse ratio and the level of satisfaction with job are significant independent factors affecting the level of care rationing. Conclusions: The assessment of the level of satisfaction with life and identification of factors affecting this assessment will enable reducing the occurrence of care rationing.
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Affiliation(s)
- Aleksandra Kołtuniuk
- Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Izabela Witczak
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Karolina Czajor
- Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Prokopowicz A, Stanczykiewicz B, Uchmanowicz I. Validation of the Numerical Anxiety Rating Scale in postpartum females: a prospective observational study. Ginekol Pol 2021; 93:686-694. [DOI: 10.5603/gp.a2021.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022] Open
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Witczak I, Rypicz Ł, Karniej P, Młynarska A, Kubielas G, Uchmanowicz I. Rationing of Nursing Care and Patient Safety. Front Psychol 2021; 12:676970. [PMID: 34566757 PMCID: PMC8458807 DOI: 10.3389/fpsyg.2021.676970] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 03/06/2021] [Accepted: 08/11/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Nursing care has a significant impact on patient safety, which affects clinical outcomes, patients’ satisfaction with the care received and nursing personnel’s satisfaction with the care provided. This study aimed to determine the extent of nursing care rationing and its relationship with patient safety including identification of the specific reasons. Methods: This cross-sectional study involved 245 nurses and was performed between April–June 2019 in four hospitals in Wrocław, Poland. The standardized and relevant research tools such as Hospital Survey on Patient Safety Culture (HSOPSC) and the Perceived Implicit Rationing of Nursing Care (PIRNCA) were used. The data was submitted to hierarchical multiple regression analysis. The study was approved by the Bioethics Committee and was followed with the STROBE guidelines. Results: The PIRNCA scores were negatively correlated with the HSOPSC subscales, which indicates that more frequent rationing of nursing care was associated with lower levels of patient safety parameters. It was shown that the highest level of unfinished nursing care was associated with decreases in patient safety factors linked with supervisor manager expectations actions promoting safety (rs = −0.321, p < 0.001), teamwork within hospital units (rs = −0.377, p < 0.001), feedback and communication about error (rs = −0.271, p < 0.001), teamwork across hospital units (rs = −0.221, p < 0.01), and hospital handoffs transitions (rs = −0.179, p < 0.01). Moreover, the strongest association was observed between the PIRNCA scores with patient safety grade (rs = 0.477, p < 0.001). Also, the PIRNCA scores among the internal unit were significantly higher than in the intensive care and surgical units. Conclusion: Our study indicated the presence of nursing care rationing. Regarding patient safety, we found insufficient numbers of medical personnel and excessive personnel workload for providing safe care to patients, a lack of transparency in handling adverse event reports and analyses, and a lack of cooperation between hospital units regarding patient safety.
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Affiliation(s)
- Izabela Witczak
- Department of Economics and Quality in Health Care, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Łukasz Rypicz
- Department of Economics and Quality in Health Care, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Piotr Karniej
- Department of Organisation and Management, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Agnieszka Młynarska
- Department of Electrocardiology, Upper Silesian Medical Centre, Katowice, Poland.,Department of Gerontology and Geriatric Nursing, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Kubielas
- Department of Clinical Nursing, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
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