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The impact of class I compression stockings on the peripheral microperfusion of the lower limb: A prospective pilot study I 级压力袜对下肢外周微灌注的影响:前瞻性试点研究
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.08.003
Andreas Lutz Heinrich Gerken , Michelle Ann Hattemer , Christel Weiß , Martin Sigl , Sebastian Zach , Michael Keese , Kai Nowak , Christoph Reißfelder , Nuh N. Rahbari , Kay Schwenke

Objective

The use of medical compression stockings (MCS) in patients with peripheral arterial disease (PAD) and diabetes is the subject of an ongoing critical debate. While reducing leg edema of various origins by improving venous back flow, there is a concern about additional arterial flow obstruction when compression therapy is applied in pre-existing PAD. The aim of this study is to obtain further information on the use of class I MCS in patients with advanced PAD and to evaluate the framework conditions for a safe application.

Methods

The total collective (n = 55) of this prospective, clinical cohort study consisted of 24 patients with PAD Fontaine stage IIb and higher studied before revascularization, of whom 16 patients were examined again after revascularization, and 15 healthy participants included for reference. The microperfusion of the lower extremity of all participants was examined in a supine, elevated, and sitting position using the oxygen to see (O2C) method.

Results

The results indicate that leg positioning had the strongest influence on microcirculation (SO2 and flow: p = 0.0001), whereas MCS had no significant effect on the perfusion parameters (SO2: p = 0.9936; flow: p = 0.4967) and did not lead to a deterioration of values into critical ranges.

Conclusion

Mild medical compression therapy appears to be feasible even in patients with advanced PAD. Larger studies are warranted to observe any long-term effects, in particular for the treatment of reperfusion edema after revascularization.

目的在患有外周动脉疾病(PAD)和糖尿病的患者中使用医疗压力袜(MCS)一直是争论的焦点。在通过改善静脉回流减轻各种原因引起的腿部水肿的同时,人们也担心在原有的 PAD 患者中使用压力疗法会造成额外的动脉血流阻塞。这项前瞻性临床队列研究的总人数(n = 55)包括在血管再通术前接受研究的 24 名方丹 IIb 期及以上 PAD 患者,其中 16 名患者在血管再通术后接受了再次检查,另外还包括 15 名健康参试者作为参考。结果表明,腿部定位对微循环的影响最大(SO2 和流量:P = 0.0001),而 MCS 对灌注参数无明显影响(SO2:p = 0.9936;血流:p = 0.4967),也不会导致数值恶化至临界范围。结论:即使是晚期 PAD 患者,轻度医疗压力疗法似乎也是可行的。需要进行更大规模的研究,以观察其长期效果,尤其是在治疗血管再通后的再灌注水肿方面。
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引用次数: 0
Predicting factors of patient satisfaction after varicose vein surgery at a university hospital in Nepal 尼泊尔某大学医院静脉曲张手术后患者满意度的预测因素
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.06.007
P. Shrestha MNS, MA , R.M. Karmacharya MS, CTVS , P. Dhakal MBBS , S. Bade MBBS , S. Dahal MBBS , N. Bhandari MBBS , S. Bade MBBS

Introduction

Varicose veins are a common vascular problem with a high prevalence, yet they are often neglected. The main objective of this study was to explore the patient satisfaction after varicose vein surgery, along with its predicting factors. To our knowledge, no similar study has been conducted in Nepal to date.

Methodology

This retrospective cross-sectional study included patients who underwent varicose vein surgery at Dhulikhel Hospital from September 2019 to February 2020. The satisfaction level after the surgery was assessed using a 10-point Likert scale questionnaire during a telephone interview with their verbal consent. Descriptive statistics and linear regression were performed to identify the predicting factors of patient satisfaction.

Results

Among a total of 84 patients interviewed, 53.6% were male. The mean age of the participants was 43.13 ± 13.62 years. The mean patient satisfaction score was 42 ± 5.5, with nursing service, discharge teaching and hospital service being the highest scoring items in terms of patient satisfaction. Linear regression revealed age ≤40 years as a predictor of higher patient satisfaction (β=0.258, p=0.015) while early stage of varicose veins (β=-0.233, p=0.026) and duration of post-operative follow-up (β=-0.25, p=0.021) were negative predictors of patient satisfaction. This means that patients with C2-C3 venous disease and longer duration of postoperative follow-up tended to have lower satisfaction scores.

Conclusion

The overall patient satisfaction following varicose vein surgery was very good, and the major predictors of better satisfaction were age ≤40 years, C4-C6 clinical classification of venous disease and the shorter duration of follow-up after surgery.

导言静脉曲张是一种常见的血管问题,发病率很高,但却常常被忽视。本研究的主要目的是探讨静脉曲张手术后患者的满意度及其预测因素。据我们所知,尼泊尔至今尚未开展过类似的研究。方法这项回顾性横断面研究纳入了 2019 年 9 月至 2020 年 2 月期间在 Dhulikhel 医院接受静脉曲张手术的患者。在征得患者口头同意的情况下,在电话访谈中使用 10 点李克特量表问卷对术后满意度进行评估。结果在受访的 84 名患者中,53.6% 为男性。参与者的平均年龄为 43.13 ± 13.62 岁。患者满意度的平均得分为(42 ± 5.5)分,其中护理服务、出院指导和医院服务是患者满意度得分最高的项目。线性回归结果显示,年龄≤40 岁是患者满意度较高的预测因素(β=0.258,P=0.015),而早期静脉曲张(β=-0.233,P=0.026)和术后随访时间(β=-0.25,P=0.021)是患者满意度的负预测因素。结论 静脉曲张手术后患者的总体满意度非常好,年龄≤40 岁、静脉疾病临床分类为 C4-C6 和术后随访时间较短是患者满意度较高的主要预测因素。
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引用次数: 0
Surgical treatment of nutcracker syndrome results in improved pain and quality of life 手术治疗胡桃钳综合征可改善疼痛和生活质量
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.10.001
Suzanna Fitzpatrick DNP, FAANP, Eleanor Dunlap DNP, Eugene Schweitzer MD, Michael Phelan MD, Khanjan Nagarsheth MD

Background

Left renal vein (LRV) compression, or nutcracker phenomenon, describes the compression of the LRV, most commonly between the aorta and the superior mesenteric artery. The outflow obstruction that occurs from the compression causes venous hypertension leading to the development of pelvic collaterals, lumbar vein engorgement and gonadal vein reflux. The symptoms associated with LRV compression include abdominal pain, left flank pain, back pain, headache, pelvic pain/pressure, and hematuria. Symptomatic LRV compression can cause chronic pain and disability that impedes activities of daily living. Left renal auto transplantation (LR-AT) is one mode of treatment, leading to decreased pain with no significant vascular or urological complications. Herein we present a five patient case series with symptomatic LRV compression who underwent LR-AT with improved pain and quality of life after surgery.

Methods

Five patients underwent LR-AT between June 2020-December 2020 to resolve their symptomatic LRV compression. These patients were given three validated surveys pre- and post- intervention, then again at their three month follow up visit to assess their pain and health-related quality of life.

Results

The five patients were all female with the average age of 36.8 years old (36–41) and underwent LR-AT to treat their symptomatic LRV compression. The average Numeric Rating Scale (NRS) pain score pre intervention was 8.3 (range 6.7 to 10) which improved to pain rating 5.22 (range 2.7 to 6) post intervention, p-value = 0.013. The average pain NRS score at 3 month follow up was 3.86 (range 1.3–6), p-value = 0.006 when compared to pre-intervention pain scores. The average pain intensity pre intervention was 4.5 (4 to 5) and 2.7 (1 to 4.3) post intervention, p-value = 0.024. The average pain intensity score at 3 month follow up was 2.24 (range 1.3–3.3), p-value = 0.002 when compared to pre-intervention. The VascuQoL-6 survey score pre intervention averaged score of 9.6 (range 7–12) which improved to an average score of 20.6 (range 18–24), p-value = 0.001. The average VascuQoL score at 3 month follow up was 22.6 (range 22–24), p-value = < 0.001 when compared to pre intervention QoL scores all showing a statistically significant improvement of health-related quality of life.

Conclusion

The diagnosis of LRV compression can be challenging due to the non-descript symptoms and overall lack of awareness. Understanding venous tributary pathways and drainage can help clarify why patients present with unusual symptoms. Surgical treatment of LRV compression through LR-AT can improve patients’ pain and improve vascular quality of life.

背景左肾静脉(LRV)受压或胡桃钳现象是指左肾静脉受压,最常见的是主动脉和肠系膜上动脉之间的压迫。压迫造成的流出受阻会引起静脉高压,导致骨盆袢、腰静脉充血和性腺静脉回流。LRV 压迫引起的症状包括腹痛、左侧腹痛、背痛、头痛、骨盆疼痛/压迫和血尿。有症状的左肾静脉压迫可导致慢性疼痛和残疾,妨碍日常生活活动。左肾自体移植(LR-AT)是一种治疗模式,可减轻疼痛,且无明显的血管或泌尿系统并发症。方法五名患者在 2020 年 6 月至 2020 年 12 月期间接受了 LR-AT,以解决症状性 LRV 压迫。结果五名患者均为女性,平均年龄为36.8岁(36-41岁),接受了LR-AT治疗其症状性LRV压迫。干预前的平均数字评定量表(NRS)疼痛评分为 8.3(范围为 6.7 至 10),干预后疼痛评分降至 5.22(范围为 2.7 至 6),P 值 = 0.013。与干预前的疼痛评分相比,3 个月随访时的平均疼痛 NRS 评分为 3.86(范围为 1.3-6),p 值 = 0.006。干预前的平均疼痛强度为 4.5(4 至 5),干预后为 2.7(1 至 4.3),p 值 = 0.024。与干预前相比,3 个月随访时的平均疼痛强度评分为 2.24(范围为 1.3-3.3),p 值 = 0.002。干预前的 VascuQoL-6 调查平均得分为 9.6(范围为 7-12),干预后平均得分为 20.6(范围为 18-24),p 值 = 0.001。与干预前的 QoL 得分相比,3 个月随访时的 VascuQoL 平均得分为 22.6(范围为 22-24),p 值 = < 0.001,这表明与健康相关的生活质量在统计学上有显著改善。了解静脉支流路径和引流情况有助于明确患者出现异常症状的原因。通过 LR-AT 对 LRV 压迫进行手术治疗,可以改善患者的疼痛并提高血管生活质量。
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引用次数: 0
Identification of types of wound bed tissue as a percentage and total wound area by planimetry in neuropathic and venous ulcers 通过平面测量法确定神经性和静脉性溃疡中伤口床组织类型的百分比和总伤口面积
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.06.005
Silvia Bottaro Carvalho Alcântara , Juliano Gonçalves de Araújo , Diogo Fernandes Santos , Tathiane Ribeiro da Silva , Isabela Maria Bernardes Goulart , Andrea Mara Bernardes da Silva , Douglas Eulálio Antunes

Background

Neuropathic and venous leg ulcers are chronic wounds associated with devitalized tissue and recurrent infection. Management should be guided by accurate tissue assessment, including the use of planimetry, which provides tissue types as a percentage of the total wound bed surface area.

Objective

This innovative study aimed to assess and identify the wound bed tissues, as a percentage, of neuropathic and venous ulcers using digital planimetry, providing support to nurses optimize the management of necrotic tissues and, consequently, to avoid wound infection.

Methods

This cross-sectional study enrolled 24 patients with chronic wounds who were assessed from January to March 2021 at the Wound Outpatients Clinic. The wound photographs were analyzed using Image J 1.53e and a smartphone with WoundDoc Plus® 2.8.2 via digital planimetry. Statistical analyses were performed using the binomial test, t-test, and Mann-Whitney.

Results

Median wound areas (p=0.3263) did not differ between the group with 2 or 3 risk factors for delayed healing (Md: 31.7) and the group with up to 1 risk factor (Md: 5.3). A low exudate level was associated with the up-to-1-risk-factor-for-delayed-healing group (p=0.0405), while a medium level was associated with the two-or-three-risk-factor group (p=0.0247). A heat map displayed the tissue percentages in the wound bed. In the group with 2 or 3 risk factors for delayed healing, 91.7% (11/12) had less than 70% granulation tissue, which was the primary factor for this group (p<0.0001). Additionally, 66.7% (8/12) of patients with 2 or 3 risk factors for delayed healing exhibited discolored and/or dark red granulation tissue as the primary factor (p=0.0130).

Conclusion

This novel identification of wound area and tissue types as a percentage, using digital planimetry, can play a crucial role in assisting nurses in decision-making related to the appropriate management of devitalized tissues. Furthermore, this measurements may facilitate the conducting of virtual wound consultations and offer valuable support in the development of protocols aimed at preventing infection and biofilm formation in the wound bed.

背景神经性和静脉性腿溃疡是一种慢性伤口,伴有组织坏死和反复感染。这项创新研究旨在使用数字平面测量法评估和识别神经性和静脉性溃疡伤口床组织的百分比,为护士优化坏死组织的管理提供支持,从而避免伤口感染。方法这项横断面研究纳入了 24 名慢性伤口患者,他们于 2021 年 1 月至 3 月在伤口门诊接受了评估。伤口照片使用 Image J 1.53e 和智能手机 WoundDoc Plus® 2.8.2 通过数字平面测量法进行分析。采用二项检验、t 检验和曼-惠特尼法进行统计分析。结果中位数伤口面积(p=0.3263)在有 2 或 3 个延迟愈合风险因素(Md: 31.7)的组别和只有 1 个风险因素(Md: 5.3)的组别之间没有差异。渗出水平低与延迟愈合风险因素多达 1 个的组别相关(p=0.0405),而渗出水平中等与风险因素为 2 或 3 个的组别相关(p=0.0247)。热图显示了伤口床组织的百分比。在有 2 或 3 个延迟愈合风险因素的组别中,91.7%(11/12)的肉芽组织少于 70%,这是该组别的主要因素(p<0.0001)。此外,在有 2 或 3 个延迟愈合风险因素的患者中,66.7%(8/12)的患者表现出肉芽组织变色和/或暗红色,这是主要因素(p=0.0130)。结论这种使用数字平面测量法确定伤口面积和组织类型百分比的新方法可在协助护士做出有关适当管理坏死组织的决策方面发挥重要作用。此外,这种测量方法还有助于进行虚拟伤口会诊,并为制定旨在预防伤口床感染和生物膜形成的方案提供宝贵支持。
{"title":"Identification of types of wound bed tissue as a percentage and total wound area by planimetry in neuropathic and venous ulcers","authors":"Silvia Bottaro Carvalho Alcântara ,&nbsp;Juliano Gonçalves de Araújo ,&nbsp;Diogo Fernandes Santos ,&nbsp;Tathiane Ribeiro da Silva ,&nbsp;Isabela Maria Bernardes Goulart ,&nbsp;Andrea Mara Bernardes da Silva ,&nbsp;Douglas Eulálio Antunes","doi":"10.1016/j.jvn.2023.06.005","DOIUrl":"10.1016/j.jvn.2023.06.005","url":null,"abstract":"<div><h3>Background</h3><p>Neuropathic and venous leg ulcers<span> are chronic wounds associated with devitalized tissue and recurrent infection. Management should be guided by accurate tissue assessment, including the use of planimetry, which provides tissue types as a percentage of the total wound bed surface area.</span></p></div><div><h3>Objective</h3><p>This innovative study aimed to assess and identify the wound bed tissues, as a percentage, of neuropathic and venous ulcers using digital planimetry, providing support to nurses optimize the management of necrotic tissues and, consequently, to avoid wound infection.</p></div><div><h3>Methods</h3><p>This cross-sectional study enrolled 24 patients with chronic wounds who were assessed from January to March 2021 at the Wound Outpatients Clinic. The wound photographs were analyzed using Image J 1.53e and a smartphone with WoundDoc Plus® 2.8.2 via digital planimetry. Statistical analyses were performed using the binomial test, t-test, and Mann-Whitney.</p></div><div><h3>Results</h3><p>Median wound areas (p=0.3263) did not differ between the group with 2 or 3 risk factors for delayed healing (Md: 31.7) and the group with up to 1 risk factor (Md: 5.3). A low exudate level was associated with the up-to-1-risk-factor-for-delayed-healing group (p=0.0405), while a medium level was associated with the two-or-three-risk-factor group (p=0.0247). A heat map displayed the tissue percentages in the wound bed. In the group with 2 or 3 risk factors for delayed healing, 91.7% (11/12) had less than 70% granulation tissue, which was the primary factor for this group (p&lt;0.0001). Additionally, 66.7% (8/12) of patients with 2 or 3 risk factors for delayed healing exhibited discolored and/or dark red granulation tissue as the primary factor (p=0.0130).</p></div><div><h3>Conclusion</h3><p>This novel identification of wound area and tissue types as a percentage, using digital planimetry, can play a crucial role in assisting nurses in decision-making related to the appropriate management of devitalized tissues. Furthermore, this measurements may facilitate the conducting of virtual wound consultations and offer valuable support in the development of protocols aimed at preventing infection and biofilm formation in the wound bed.</p></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46790869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient experiences of closed-incision negative pressure therapy on groin incisions after discharge following peripheral arterial surgery: A qualitative study 外周动脉手术出院后腹股沟切口闭式负压治疗的临床经验:一项定性研究
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.06.006
Camilla Borch Graversen RN, BScN , Malene Missel RN, MScN, PhD , Sally Jakobsen RN, MScN

Background

Closed-incision negative pressure therapy may lower the risk of surgical site infections in patients after peripheral arterial surgery.

Aim

To explore patient experience of negative pressure therapy applied to groin incisions after discharge following peripheral arterial surgery, and to study their perception and attitudes toward the self-care information sheet they received at the vascular department.

Methods

A qualitative study underpinned by Gadamer's philosophical hermeneutics was conducted semi-structured interviews by telephone around day seven after therapy ended with ten participants. All had received self-care information sheet at the discharge and been home with closed-incision negative pressure therapy for 3-6 days. The participants had open peripheral arterial surgery in the groin in form of femoral thromboendarterectomy. Kvale and Brinkmann's research guided the data collection, analysis, and interpretation.

Findings

Patients found themselves coping with an unfamiliar situation after peripheral arterial surgery and the need arose to conceal the pump and tubing that were part of their incision treatment to protect their self-image. Their treatment became a constant companion, with some patients viewing the equipment as an extension of their bodies and others feeling its impact on activities of daily living. Patients perceived the treatment as providing reassurance, albeit with constraints, leading to feelings of manageability and an increasing sense of control. They viewed the written information as informative but with room for improvement.

Conclusions

Patient experiences of closed-incision negative pressure therapy on groin incisions after discharge following peripheral arterial surgery showed that they perceived it as safe and manageable. Patients need support, however, in learning how to hide the treatment and to expand their own involvement and improve self-care. The study found that patient involvement and individually tailored information is essential to facilitating a healthy transition from hospital to self-care at home and that written information must be improved further.

背景闭合切口负压疗法可降低外周动脉手术后患者手术部位感染的风险.目的探讨外周动脉手术后出院后腹股沟切口负压疗法的患者体验,并研究他们对在血管科收到的自我护理信息表的看法和态度.方法以伽达默尔的哲学诠释学为基础,在治疗结束后第 7 天左右通过电话对 10 名参与者进行了半结构化访谈。所有参与者在出院时都收到了自我护理信息表,并在家中接受了 3-6 天的闭合切口负压治疗。参与者都在腹股沟进行过股骨血栓内膜切除术等开放性外周动脉手术。Kvale 和 Brinkmann 的研究为数据收集、分析和解释提供了指导。研究结果患者发现自己在外周动脉手术后要应对一个陌生的环境,为了保护自我形象,他们需要隐藏作为切口治疗一部分的泵和管道。他们的治疗成为了一个永恒的伴侣,一些患者将这些设备视为身体的延伸,而另一些患者则感觉到这些设备对日常生活的影响。患者认为治疗提供了保证,尽管有一些限制,但会让他们感到可以控制,并增强控制感。结论外周动脉手术后出院的患者对腹股沟切口闭合切口负压疗法的体验表明,他们认为这种疗法是安全和可控的。但是,患者在学习如何隐藏治疗、扩大自身参与和改善自我护理方面需要支持。研究发现,患者的参与和个性化信息对于促进从医院到家中自我护理的健康过渡至关重要,书面信息必须进一步改进。
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引用次数: 0
Danish men's experiences of cardiovascular screening and their views on preventive cardiovascular medication: A qualitative explorative nurse study 丹麦男性心血管筛查经历及对心血管预防用药的看法:一项质的探索性护士研究
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.06.009
Ina QVIST RN, MHS, PhD , Bodil RASMUSSEN RN, MEdSt, PhD (Professor) , Lars FROST MD, PhD, DMSc (Associate Professor) , Jes S. LINDHOLT MD, PhD, DMSc (Professor) , Rikke SØGAARD MSc, MPH, PhD (Professor) , Vibeke LORENTZEN RN, PhD (Associate Professor)

Objectives

This study explored Danish men's experience of participating in a screening program for cardiovascular disease (CVD) and their perceptions of preventive medication for CVD before and after participation in the screening program.

Methods

An exploratory phenomenological-hermeneutical study. Fifteen men from a cardiovascular screening program for men aged 65–74 years participated. Semi-structured interviews were conducted before screening and one year later (2015–2017). The interviews were transcribed verbatim and analysed using Kvale and Brinkmann's approach to data analysis.

Results

Two main themes were identified: (i) seeking confirmation and control of health: familiarity with CVD; understanding the screening program; confirmation of health; perception of preventive medication, and (ii) sense of own health and prevention: experiences with the screening program; accept or denial of diagnosis and preventive medication.

Conclusion

A minority of the men understood the nature of the diseases for which they were being examined. The invitation for screening and the outcome of the examinations must be communicated more skilfully. The health providers need to engage early in treatment after the screening and provide an individualised plan that addresses patients concerns and knowledge based on their needs.

本研究探讨了丹麦男性参加心血管疾病(CVD)筛查项目的经历,以及他们在参加筛查项目前后对心血管疾病预防药物的看法。15 名 65-74 岁男性参加了心血管筛查项目。在筛查前和一年后(2015-2017 年)进行了半结构化访谈。访谈内容逐字誊写,并采用 Kvale 和 Brinkmann 的数据分析方法进行分析:(i) 寻求对健康的确认和控制:熟悉心血管疾病;了解筛查计划;确认健康;对预防性药物的认识,以及 (ii) 对自身健康和预防的认识:筛查计划的经验;接受或拒绝接受诊断和预防性药物。必须更巧妙地传达筛查邀请和检查结果。医疗服务提供者需要在筛查后及早参与治疗,并根据患者的需求提供个性化的计划,以解决患者的疑虑和了解相关知识。
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引用次数: 0
Information for authors 作者须知
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/S1062-0303(23)00080-8
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引用次数: 0
Information for readers 读者须知
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/S1062-0303(23)00081-X
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引用次数: 0
Effects of exercise training on heart rate variability in individuals with lower extremity arterial disease and claudication: A systematic review 运动训练对下肢动脉疾病和跛行患者心率变异性的影响:系统综述
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.09.002
Isabela R. Marçal MSc , Raphael M. Abreu PhD , Nils Cornelis PhD , Anthony S. Leicht PhD , Claudia L.M. Forjaz PhD , Gabriel Cucato PhD , Ingrid Brenner PhD , Marko Novakovic PhD , Raphael Ritti-Dias PhD , Emmanuel G. Ciolac PhD , Véronique A. Cornelissen PhD

Purpose

To perform a systematic review of studies assessing the effects of regular exercise on heart rate variability (HRV) in individuals with lower extremity arterial disease (LEAD) and symptoms of claudication.

Methods

A systematic search in the electronic databases MEDLINE, Embase, and Scielo, was conducted and updated on January 21, 2023. Randomized clinical trials investigating patients with LEAD and IC, assessing ≥ 4 wk of exercise interventions, and reporting at least one HRV measure (e.g., time or frequency domains) at baseline and follow-up were included. Two reviewers independently screened studies for inclusion, performed data extraction, and quality assessment of included studies.

Results

Data from 7 trials were included (i.e., 5 walking, 1 resistance, and 1 isometric handgrip training), totaling 327 patients (66% males; range: 61 - 68 yr; ankle brachial index: 0.4 - 0.7). Following exercise training, three studies investigating walking training reported an increase in parasympathetic modulation indices and/or a decrease in sympathetic modulation indices (n = 2) as well as an increase in non-linear indices (n = 1).

Conclusion

The current evidence is weak, and larger randomized controlled trials are needed to confirm the efficacy of exercise training in improving HRV. Additionally, the high divergence in the methodology of studies indicated the need for standard tools to improve the quality of HRV measurements in exercise trials. It is recommended to use standard procedures in future trials investigating HRV.

目的 对评估定期运动对下肢动脉疾病(LEAD)和跛行症状患者的心率变异性(HRV)的影响的研究进行系统性综述。纳入的随机临床试验调查了 LEAD 和 IC 患者,评估了≥ 4 周的运动干预,并报告了基线和随访时至少一种心率变异测量(如时间或频率域)。结果 共纳入了 7 项试验的数据(即 5 项步行试验、1 项阻力试验和 1 项等长手握训练试验),共计 327 名患者(66% 为男性;年龄范围:61 - 68 岁;踝肱指数:0.4 - 0.7)。结论目前的证据不足,需要更大规模的随机对照试验来证实运动训练对改善心率变异的疗效。此外,研究方法的高度差异表明,需要标准工具来提高运动试验中心率变异测量的质量。建议在未来研究心率变异的试验中使用标准程序。
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引用次数: 0
Developing post-stroke psychometric properties for an Adherence to rehabilitation regimen scale: A sequential exploratory mixed-method study 开发脑卒中后康复治疗依从性量表的心理测量特性:顺序探索性混合方法研究
IF 1 Q2 Nursing Pub Date : 2023-12-01 DOI: 10.1016/j.jvn.2023.09.001
Asghar Dalvandi LPN, ADN, BSN, MSN, PhD , Maryam Khoshbakht-Pishkhani BSN, MSN, PhD in nursing , Abbas Ebadi BSN, MSN, PhD , Mohammadali Hosseini BSN, RN, MSN, PhD

Introduction

Adherence to rehabilitation in patients post-stroke plays a significant role in the effectiveness of rehabilitation and patient recovery. This study aimed to design and determine the psychometric properties of a scale for measuring adherence to the rehabilitation regimen in patients post-stroke in the Iranian community.

Methods

The present study used a sequential exploratory mixed method and was conducted in two phases (phase one qualitative and phase two quantitative). Participants in the first phase were patients post-stroke, caregivers, and rehabilitation team members (n=20). The second phase was conducted on patients post-stroke (n=198), and the psychometric steps, including face, content, and construct validity, as well as reliability, were assessed.

Results

The Adherence to Rehabilitation Regimen Scale (ARRS)was designed with 26 items and four factors of participation: 1) physical exercises, 2) following prescribed regimens, 3) performing the activities of daily living, and 4) psychological follow-up. The internal consistency was 0.96 by calculating Cronbach's alpha coefficient. The Interclass Correlation Coefficient was 0.99 with a confidence interval of 0.96-0.99.

Conclusion

The scale measuring adherence to the rehabilitation regimen in patients post-stroke has optimal psychometric properties. Therefore, as the first specific scale to measure the degree of rehabilitation regimen adherence in patients post-stroke, this tool may be beneficial for other rehabilitation programs interested in managing and improving program adherence.

引言 中风后患者康复治疗的依从性对康复治疗的效果和患者的康复起着重要作用。本研究旨在设计并确定一个量表的心理测量特性,用于测量伊朗社区脑卒中后患者康复治疗的依从性。方法本研究采用顺序探索混合法,分两个阶段进行(第一阶段定性,第二阶段定量)。第一阶段的参与者包括中风后患者、护理人员和康复团队成员(20 人)。第二阶段的调查对象为脑卒中后患者(n=198),并对心理测量步骤进行了评估,包括面效度、内容效度、结构效度和信度:1)体育锻炼;2)遵照医嘱;3)日常生活活动;4)心理随访。通过计算 Cronbach's alpha 系数,其内部一致性为 0.96。结论:测量脑卒中后患者康复治疗依从性的量表具有最佳的心理测量特性。因此,作为首个专门测量脑卒中后患者康复治疗依从性的量表,该工具可能会对其他有意管理和改善康复治疗依从性的康复项目有所帮助。
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Journal of Vascular Nursing
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