Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.105
P Manthou, K Alexandrou, E Sigala, G Lioliousis, N Koumallos, P Sarafis
Introduction Coronary Artery Bypass Grafting (CABG) surgery is the preferred method in Coronary Artery Disease, particularly in patients with multi-vessel disease and impaired left ventricular function. Besides the success of surgical intervention, achieving a good level of Health-Related Quality of Life (HRQoL) is the primary goal of the entire process. Objective The aim of our study is to evaluate HRQoL before and after CABG surgery and to assess the adherence to pharmacotherapy and the frequency of arrhythmias postoperatively during a 6- month follow-up period. Methods The study design involves a descriptive longitudinal study. The study was conducted in one public hospital and two private hospitals of Cyprus. The follow-up period for participants was determined at 6 months post-CABG surgery. HRQoL assessment was conducted using the MacNew questionnaire, and the evaluation of arrhythmias and other clinical data was performed using a Clinical Data Evaluation Form created for the study purposes. Results Our study included 103 people who had undergone CABG surgery. HRQoL decreased at 3 months post-CABG surgery compared to the preoperative period (Mean: 5.03, SD: ±1.02 vs Mean: 4.75, SD: ±1.00) but improved at 6 months post-surgery (Mean: 6.19, SD: ±0.67). Among the total of patients, 21 (20.6%) developed Atrial Fibrillation (AF) postoperatively. All patients with AF received immediate treatment, and sinus rhythm was restored. Additionally, 6 patients developed other types of arrhythmias, among whom 1 patient experienced cardiac arrest with an initial asystole rhythm and eventually passed away. Conclusion CABG significantly affects HRQoL, showing a temporary decline postoperatively followed by improvement. Arrhythmias and compliance with pharmacotherapy are crucial aspects of postoperative care.
{"title":"Health-related quality of life and arrhythmia frequency following coronary artery bypass grafting surgery: a descriptive study","authors":"P Manthou, K Alexandrou, E Sigala, G Lioliousis, N Koumallos, P Sarafis","doi":"10.1093/eurjcn/zvae098.105","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.105","url":null,"abstract":"Introduction Coronary Artery Bypass Grafting (CABG) surgery is the preferred method in Coronary Artery Disease, particularly in patients with multi-vessel disease and impaired left ventricular function. Besides the success of surgical intervention, achieving a good level of Health-Related Quality of Life (HRQoL) is the primary goal of the entire process. Objective The aim of our study is to evaluate HRQoL before and after CABG surgery and to assess the adherence to pharmacotherapy and the frequency of arrhythmias postoperatively during a 6- month follow-up period. Methods The study design involves a descriptive longitudinal study. The study was conducted in one public hospital and two private hospitals of Cyprus. The follow-up period for participants was determined at 6 months post-CABG surgery. HRQoL assessment was conducted using the MacNew questionnaire, and the evaluation of arrhythmias and other clinical data was performed using a Clinical Data Evaluation Form created for the study purposes. Results Our study included 103 people who had undergone CABG surgery. HRQoL decreased at 3 months post-CABG surgery compared to the preoperative period (Mean: 5.03, SD: ±1.02 vs Mean: 4.75, SD: ±1.00) but improved at 6 months post-surgery (Mean: 6.19, SD: ±0.67). Among the total of patients, 21 (20.6%) developed Atrial Fibrillation (AF) postoperatively. All patients with AF received immediate treatment, and sinus rhythm was restored. Additionally, 6 patients developed other types of arrhythmias, among whom 1 patient experienced cardiac arrest with an initial asystole rhythm and eventually passed away. Conclusion CABG significantly affects HRQoL, showing a temporary decline postoperatively followed by improvement. Arrhythmias and compliance with pharmacotherapy are crucial aspects of postoperative care.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"18 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.064
M Krysa
In Poland, cardiac prevention programs minimize the nurse's role in health education related the patient's lifestyle change. Following the experience of Swedish primary health care, the Health Department of the City Hall in Wrocław was the first local government to launch a long-term, ten-year preventive cardiology program in 1998. Aim of the study To present the participation of family nurses in the implementation of population intervention program in cardiological prevention among the inhabitants of Wrocław. Material and method The general practitioners from Wrocław and a group of 100 family nurses participated in the preventative program. The overall goal of the program was to assess risk factors for cardiovascular disease. Each patient was provided with education by the nurse. To conduct the nursing visit, a procedure was used that took into account the structure criteria and the a unified procedure criteria. The nurses analyzed the norms of laboratory test results, blood pressure, heart rate, weight, height, fiber and fat intake, and calculated BMI and WHR. The nurses used a health profile. If a patient was considered a person from a higher risk group, they provided referred the patient to a general practitioner. Conclusions In local prevention program, residents were motivated to modify health behaviors through nursing diagnosis and assessment. The close place of residence and direct contact with the patient made it possible to provide health education focused on first-degree prevention. However, patient health education requires organization, time and communication skills, which is why it is so important to prepare staff to implement preventive programs and finance them from local funds. The new role of a health educator becomes an opportunity to change the perception of the traditional role of nursing.
{"title":"The importance of family nurses' participation in the local program of cardiological prevention in Wroclaw","authors":"M Krysa","doi":"10.1093/eurjcn/zvae098.064","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.064","url":null,"abstract":"In Poland, cardiac prevention programs minimize the nurse's role in health education related the patient's lifestyle change. Following the experience of Swedish primary health care, the Health Department of the City Hall in Wrocław was the first local government to launch a long-term, ten-year preventive cardiology program in 1998. Aim of the study To present the participation of family nurses in the implementation of population intervention program in cardiological prevention among the inhabitants of Wrocław. Material and method The general practitioners from Wrocław and a group of 100 family nurses participated in the preventative program. The overall goal of the program was to assess risk factors for cardiovascular disease. Each patient was provided with education by the nurse. To conduct the nursing visit, a procedure was used that took into account the structure criteria and the a unified procedure criteria. The nurses analyzed the norms of laboratory test results, blood pressure, heart rate, weight, height, fiber and fat intake, and calculated BMI and WHR. The nurses used a health profile. If a patient was considered a person from a higher risk group, they provided referred the patient to a general practitioner. Conclusions In local prevention program, residents were motivated to modify health behaviors through nursing diagnosis and assessment. The close place of residence and direct contact with the patient made it possible to provide health education focused on first-degree prevention. However, patient health education requires organization, time and communication skills, which is why it is so important to prepare staff to implement preventive programs and finance them from local funds. The new role of a health educator becomes an opportunity to change the perception of the traditional role of nursing.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"6 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.020
M Georgieva, M R Rushid, Y T Yotov
Background The follow-up of patients with chronic heart failure by a nurse in an outpatient clinic showed to be as effective as physician management for clinical and prognostic improvement of patients with chronic heart failure (CHF). The role of nurses is important and would improve the general condition of patients. Aim To determine the effect of nurse-lead ambulatory follow-up of patients with heart failure –when compared with physician-guided management of patients with CHF. Participants and methods Overall, 72 patients with HF were included in a structured ambulatory program after hospital discharge following the OptimizeHF Care Program protocol, with the active participation of a nurse in it. The patients were divided into two groups – group A – mostly managed by a trained nurse, and group B – predominantly led by a cardiologist with the helpof the nurse. Advice on diet and physical activity for all patients was provided by the nurse according to an established protocol and in accordance with current recommendations for non-pharmacology behavior in heart failure at the beginning of follow-up and at each visit.We use self-reported readiness of patients to comply with dietary and physical activity guidelines to measure adherence to the program at the end of the follow-up period. Results The patients in group A (21) were insignificantly more often females, with slightly higher ejection fraction, and a little bit older tjhn group B (61). After a 6-month follow-up, 61 finished the program. There was no significant difference in the outcomes – death or hospitalizations, between the groups . In group A, the improvement in the NT-pro BNP levels was more pronounced –94.7% vs 74.4% in group B (p=0.024). Numerically, nurse-lead patients had more often improvement in their functional capacity with 1 NYHA class – 95% vs 84% (p=0.23). Both groups had similar improvement in the 6-minute walking test and there was no difference in hemodynamic measurements and laboratory tests. The majority of the patients followed the advice for diet and physical activity – 81.7%. There was no significant difference in this indicator between the group managed by the nurse and that by the physician. The same similarity was recorded in the drug therapy at the end of the follow–up. Conclusions Our results confirm that the nurse-lead program for ambulatory management of patients with CHF is effective and safe compared to physician management and can be applied in various health systems. This will increase the importance of the health care professionals in the HF team.
背景 由门诊护士对慢性心力衰竭患者进行随访，结果显示，在改善慢性心力衰竭（CHF）患者的临床和预后方面，其效果不亚于医生的管理。护士的作用非常重要，可改善患者的总体状况。目的 确定由护士领导的对心衰患者的非住院随访与由医生指导的对 CHF 患者的管理相比效果如何。参与者和方法 72 名心力衰竭患者出院后，在护士的积极参与下，按照 "优化心力衰竭护理计划 "的方案，参加了一项有组织的流动计划。患者被分为两组--A 组主要由训练有素的护士管理，B 组主要由心脏病专家在护士的帮助下管理。所有患者的饮食和体育锻炼建议均由护士按照既定方案提供，并在随访开始时和每次就诊时根据心力衰竭非药物治疗行为的当前建议提供。结果 A 组患者（21 人）中，女性患者明显较多，射血分数略高，年龄略大于 B 组（61 人）。经过 6 个月的随访，61 人完成了计划。两组在死亡或住院等结果上没有明显差异。在 A 组中，NT-pro BNP 水平的改善更为明显，为 94.7%，而 B 组为 74.4%（P=0.024）。从数字上看，护士指导的患者的功能能力改善更多，NYHA分级为1级--95%对84%（P=0.23）。两组患者在 6 分钟步行测试中的改善情况相似，在血液动力学测量和实验室测试中也没有差异。大多数患者遵循了饮食和体育锻炼建议--81.7%。护士管理组和医生管理组在这一指标上没有明显差异。在随访结束后的药物治疗方面也有相同的记录。结论 我们的研究结果证实，与医生管理相比，护士领导的慢性阻塞性肺病患者门诊管理计划既有效又安全，可以在各种医疗系统中应用。这将提高医护人员在高血压团队中的重要性。
{"title":"Nurse-lead ambulatory follow-up of patients with heart failure compared to physician-guided management - experience of a single academic center","authors":"M Georgieva, M R Rushid, Y T Yotov","doi":"10.1093/eurjcn/zvae098.020","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.020","url":null,"abstract":"Background The follow-up of patients with chronic heart failure by a nurse in an outpatient clinic showed to be as effective as physician management for clinical and prognostic improvement of patients with chronic heart failure (CHF). The role of nurses is important and would improve the general condition of patients. Aim To determine the effect of nurse-lead ambulatory follow-up of patients with heart failure –when compared with physician-guided management of patients with CHF. Participants and methods Overall, 72 patients with HF were included in a structured ambulatory program after hospital discharge following the OptimizeHF Care Program protocol, with the active participation of a nurse in it. The patients were divided into two groups – group A – mostly managed by a trained nurse, and group B – predominantly led by a cardiologist with the helpof the nurse. Advice on diet and physical activity for all patients was provided by the nurse according to an established protocol and in accordance with current recommendations for non-pharmacology behavior in heart failure at the beginning of follow-up and at each visit.We use self-reported readiness of patients to comply with dietary and physical activity guidelines to measure adherence to the program at the end of the follow-up period. Results The patients in group A (21) were insignificantly more often females, with slightly higher ejection fraction, and a little bit older tjhn group B (61). After a 6-month follow-up, 61 finished the program. There was no significant difference in the outcomes – death or hospitalizations, between the groups . In group A, the improvement in the NT-pro BNP levels was more pronounced –94.7% vs 74.4% in group B (p=0.024). Numerically, nurse-lead patients had more often improvement in their functional capacity with 1 NYHA class – 95% vs 84% (p=0.23). Both groups had similar improvement in the 6-minute walking test and there was no difference in hemodynamic measurements and laboratory tests. The majority of the patients followed the advice for diet and physical activity – 81.7%. There was no significant difference in this indicator between the group managed by the nurse and that by the physician. The same similarity was recorded in the drug therapy at the end of the follow–up. Conclusions Our results confirm that the nurse-lead program for ambulatory management of patients with CHF is effective and safe compared to physician management and can be applied in various health systems. This will increase the importance of the health care professionals in the HF team.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"10 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.003
C Panagiotou, E Marinopoulos, S Linardos
Introduction Hypertrophic cardiomyopathy is the most prevalent inherited cardiomyopathy characterized by left ventricular hypertrophy and manifests with atrial fibrillation in 25% of patients, correlating with heightened morbidity and mortality rates. Purpose To investigate the clinical and echocardiographic parameters associated with the occurrence and progression of atrial fibrillation in patients diagnosed with hypertrophic cardiomyopathy. Material and Methods The study sample consisted of 72 patients with hypertrophic cardiomyopathy attending the Hereditary Heart Disease Unit at a tertiary cardiac surgery center. Thorough examination of patients' medical records was conducted. Results Myocardial fibrosis was observed in 68.1% of the patients. Analysis of the data revealed that atrial fibrillation (AF) episodes were more prevalent in older individuals (p=0.035) with a lower ejection fraction (p=0.003). Additionally, a larger left atrial diameter of 49.8mm (p<0.001), functional stage according to NYHA III (p=0.015), a history of syncope/pre-syncope events (p=0.018), patients with an implanted pacemaker/defibrillator (p=0.003), and those with known coronary artery disease factors (p=0.032), particularly dyslipidemia (p=0.049) and diabetes mellitus (p=0.027), were associated with higher AF incidence. Conclusions . This study underscores the importance of recognizing clinical and echocardiographic factors that contribute to atrial fibrillation risk in hypertrophic cardiomyopathy, enabling early identification of high-risk individuals and implementation of preventive strategies to reduce the frequency of atrial fibrillation episodes and associated complications.
{"title":"Clinical and echographic parameters as risk factors for atrial fibrilation in patients with hypertophic cardiomyopathy","authors":"C Panagiotou, E Marinopoulos, S Linardos","doi":"10.1093/eurjcn/zvae098.003","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.003","url":null,"abstract":"Introduction Hypertrophic cardiomyopathy is the most prevalent inherited cardiomyopathy characterized by left ventricular hypertrophy and manifests with atrial fibrillation in 25% of patients, correlating with heightened morbidity and mortality rates. Purpose To investigate the clinical and echocardiographic parameters associated with the occurrence and progression of atrial fibrillation in patients diagnosed with hypertrophic cardiomyopathy. Material and Methods The study sample consisted of 72 patients with hypertrophic cardiomyopathy attending the Hereditary Heart Disease Unit at a tertiary cardiac surgery center. Thorough examination of patients' medical records was conducted. Results Myocardial fibrosis was observed in 68.1% of the patients. Analysis of the data revealed that atrial fibrillation (AF) episodes were more prevalent in older individuals (p=0.035) with a lower ejection fraction (p=0.003). Additionally, a larger left atrial diameter of 49.8mm (p&lt;0.001), functional stage according to NYHA III (p=0.015), a history of syncope/pre-syncope events (p=0.018), patients with an implanted pacemaker/defibrillator (p=0.003), and those with known coronary artery disease factors (p=0.032), particularly dyslipidemia (p=0.049) and diabetes mellitus (p=0.027), were associated with higher AF incidence. Conclusions . This study underscores the importance of recognizing clinical and echocardiographic factors that contribute to atrial fibrillation risk in hypertrophic cardiomyopathy, enabling early identification of high-risk individuals and implementation of preventive strategies to reduce the frequency of atrial fibrillation episodes and associated complications.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"2 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.096
M Kinjo, A Higashitsuji, M Sano, S Okada, T Majima
Background Self-management in patients with heart failure is important in terms of their prognosis and quality of life. The use of mobile applications in the self-management of patients with heart failure has been suggested to improve their knowledge of the disease and quality of life. However, there are limited data on the experiences of patients with heart failure when mobile applications are integrated into their routine as a self-management intervention. Purpose We aimed to determine the experiences of patients with heart failure who incorporated the use of mobile applications as a self-management intervention. Methods In this qualitative cross-sectional study, participants were purposive-sampled at a university hospital, and semi-structured interviews were conducted with both male and female patients, aged 40–70 years, with a diagnosis of chronic heart failure (ACCF/AHA stage C). Data were collected between December 2022 and April 2023. All interviews were audio-recorded and transcribed verbatim, followed by content analyses. The mobile application used in this study recorded and managed patients’ subjective symptoms and daily life as cloud data and allowed healthcare professionals to access the data using a dedicated terminal. Results Four themes were identified from the data: 1) patients used the mobile application in their own way through trial and error; 2) the support of healthcare professionals through the mobile application increased patients’ sense of self-efficacy; 3) using the mobile application made them feel secure as they always felt connected; and 4) some patients struggled to incorporate new technology into their self-management. Most participants in this study had a positive experience of using the mobile application for self-management in their own way with the support of healthcare professionals, including gaining a sense of self-efficacy and security. On the other hand, some patients had a negative experience, such as not looking at the mobile application for a while or discontinuing self-management because they felt burdened by the introduction of this new self-management method. Conclusions Both positive and negative aspects of the experiences of patients with heart failure with adopting a mobile application for self-management were identified. Psychological support is essential when patients incorporate mobile applications into their routine as a self-management intervention.
{"title":"Experience of integrating mobile applications in the self-management of patients with heart failure","authors":"M Kinjo, A Higashitsuji, M Sano, S Okada, T Majima","doi":"10.1093/eurjcn/zvae098.096","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.096","url":null,"abstract":"Background Self-management in patients with heart failure is important in terms of their prognosis and quality of life. The use of mobile applications in the self-management of patients with heart failure has been suggested to improve their knowledge of the disease and quality of life. However, there are limited data on the experiences of patients with heart failure when mobile applications are integrated into their routine as a self-management intervention. Purpose We aimed to determine the experiences of patients with heart failure who incorporated the use of mobile applications as a self-management intervention. Methods In this qualitative cross-sectional study, participants were purposive-sampled at a university hospital, and semi-structured interviews were conducted with both male and female patients, aged 40–70 years, with a diagnosis of chronic heart failure (ACCF/AHA stage C). Data were collected between December 2022 and April 2023. All interviews were audio-recorded and transcribed verbatim, followed by content analyses. The mobile application used in this study recorded and managed patients’ subjective symptoms and daily life as cloud data and allowed healthcare professionals to access the data using a dedicated terminal. Results Four themes were identified from the data: 1) patients used the mobile application in their own way through trial and error; 2) the support of healthcare professionals through the mobile application increased patients’ sense of self-efficacy; 3) using the mobile application made them feel secure as they always felt connected; and 4) some patients struggled to incorporate new technology into their self-management. Most participants in this study had a positive experience of using the mobile application for self-management in their own way with the support of healthcare professionals, including gaining a sense of self-efficacy and security. On the other hand, some patients had a negative experience, such as not looking at the mobile application for a while or discontinuing self-management because they felt burdened by the introduction of this new self-management method. Conclusions Both positive and negative aspects of the experiences of patients with heart failure with adopting a mobile application for self-management were identified. Psychological support is essential when patients incorporate mobile applications into their routine as a self-management intervention.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"64 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.045
L Pina Astete, M L Buelga Suarez, M I Munoz Gomez, P Rodriguez Sanchez, A Tur Sainz, N Penaranda Romero, J Garcia Montalvo, A Rebolleda Sanchez, G L Alonso Salinas
Background Heart failure (HF), with an incidence of approximately 3/1000 person-years, often progresses to advanced stages where symptoms persist despite treatment. In such cases, mechanical circulatory assist devices, particularly left ventricular assist devices (LVADs) in ambulatory patients, enhance survival and quality of life. These LVADs generate electromagnetic interference, resulting in noise artefacts in conventional electrocardiograms (ECGs). The conventional ECG should be configured with a low-pass filter of 150 Hz and a high-pass filter of 0.05 Hz, as recommended by the American Heart Association/American College of Cardiology/Heart Rhythm Society. LVADs, such as the HeartMate 3 (Abbott®), typically operate at a rotational speed of 5000 to 6000 rpm, corresponding to oscillatory frequencies of 83.3 to 100 Hz. Objective To assess the impact of various surface electrode placement strategies and modifications to the low-pass filter on the electromagnetic interference produced by LVADs. Methods We conducted an observational study involving seven patients with HeartMate 3 adjusted to various rotational speeds (refer to Table 1). Three distinct electrode placement schemes (AHA, Mason Likar, and modified Torso) were employed for the frontal plane leads. The horizontal plane leads remained unmodified. Each patient underwent a total of 6 ECGs, corresponding to each of the aforementioned schemes. ECG recordings were performed using a high-pass filter set at 0.05 Hz and a low-pass filter set at 150 Hz. Additionally, a set of ECGs was obtained by modifying the low-pass filter to 40 Hz for further analysis. Results Figure 1 displays ECGs obtained from a male with a HeartMate 3 operating at 4600 rpm or 76.6 Hz. This device employs an algorithm to generate an "artificial pulse" by cyclically accelerating and decelerating the pump speed by 2000 rpm every 2 seconds, resulting in rotational speeds of 2600 rpm and 6600 rpm (43.3 Hz and 110 Hz, respectively). No specific placement scheme demonstrated consistent noise reduction across all cases, likely due to inter-individual variability resulting from factors such as the final position of the LVAD the rpm in each case, and the thoracic impedance of each patient. However, the modification of the low-pass filter to 40 Hz yielded a noteworthy improvement in noise reduction across all cases. In our limited sample, this adjustment did not pose issues for ECG interpretation. Nevertheless, it is essential to acknowledge that excessively low filter settings may not only eliminate noise but also potentially discard clinically relevant high-frequency signals (e.g., pacemaker spikes, large amplitude Rs, QRS notches). Conclusions Individualizing the electrode placement scheme is crucial for minimizing noise generated by LVADs. The adjustment of the low-pass filter to 40 Hz could generally prove beneficial in reducing artifact generation, despite the clinical limitations it may entail.
{"title":"Influence of different electrode placement patterns on electromagnetic interference generated by Left Ventricular Assist Devices (LVADs) during electrocardiogram performance","authors":"L Pina Astete, M L Buelga Suarez, M I Munoz Gomez, P Rodriguez Sanchez, A Tur Sainz, N Penaranda Romero, J Garcia Montalvo, A Rebolleda Sanchez, G L Alonso Salinas","doi":"10.1093/eurjcn/zvae098.045","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.045","url":null,"abstract":"Background Heart failure (HF), with an incidence of approximately 3/1000 person-years, often progresses to advanced stages where symptoms persist despite treatment. In such cases, mechanical circulatory assist devices, particularly left ventricular assist devices (LVADs) in ambulatory patients, enhance survival and quality of life. These LVADs generate electromagnetic interference, resulting in noise artefacts in conventional electrocardiograms (ECGs). The conventional ECG should be configured with a low-pass filter of 150 Hz and a high-pass filter of 0.05 Hz, as recommended by the American Heart Association/American College of Cardiology/Heart Rhythm Society. LVADs, such as the HeartMate 3 (Abbott®), typically operate at a rotational speed of 5000 to 6000 rpm, corresponding to oscillatory frequencies of 83.3 to 100 Hz. Objective To assess the impact of various surface electrode placement strategies and modifications to the low-pass filter on the electromagnetic interference produced by LVADs. Methods We conducted an observational study involving seven patients with HeartMate 3 adjusted to various rotational speeds (refer to Table 1). Three distinct electrode placement schemes (AHA, Mason Likar, and modified Torso) were employed for the frontal plane leads. The horizontal plane leads remained unmodified. Each patient underwent a total of 6 ECGs, corresponding to each of the aforementioned schemes. ECG recordings were performed using a high-pass filter set at 0.05 Hz and a low-pass filter set at 150 Hz. Additionally, a set of ECGs was obtained by modifying the low-pass filter to 40 Hz for further analysis. Results Figure 1 displays ECGs obtained from a male with a HeartMate 3 operating at 4600 rpm or 76.6 Hz. This device employs an algorithm to generate an \"artificial pulse\" by cyclically accelerating and decelerating the pump speed by 2000 rpm every 2 seconds, resulting in rotational speeds of 2600 rpm and 6600 rpm (43.3 Hz and 110 Hz, respectively). No specific placement scheme demonstrated consistent noise reduction across all cases, likely due to inter-individual variability resulting from factors such as the final position of the LVAD the rpm in each case, and the thoracic impedance of each patient. However, the modification of the low-pass filter to 40 Hz yielded a noteworthy improvement in noise reduction across all cases. In our limited sample, this adjustment did not pose issues for ECG interpretation. Nevertheless, it is essential to acknowledge that excessively low filter settings may not only eliminate noise but also potentially discard clinically relevant high-frequency signals (e.g., pacemaker spikes, large amplitude Rs, QRS notches). Conclusions Individualizing the electrode placement scheme is crucial for minimizing noise generated by LVADs. The adjustment of the low-pass filter to 40 Hz could generally prove beneficial in reducing artifact generation, despite the clinical limitations it may entail.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"18 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.031
B Kobson, R Paterson, J Hanley, A Mair, A Dima, N Rea
Background Medication optimisation is a global issue with up to 50% of people not taking medicines as prescribed. Numerous interventions have been developed to address this, many of them including feedback on behaviour and outcomes. Understanding patients’ views on such interventions is essential for successful adoption and use. Purpose The purpose of this systematic review is to: (1) Understand patients’ perspectives and experiences of medication adherence feedback interventions and (2) Identify barriers and facilitators which influence their implementation within practice. Methods CINAHL, MEDLINE, EMBASE, PubMED, PsycINFO and Google Scholar were systematically searched to identify relevant studies. The inclusion criteria included; studies with qualitative or mixed method designs describing patients’ perspectives on medication adherence feedback interventions, primary studies with adult participants on long-term medications and studies involving interventions suitable for self-management in primary or community care. Quality assessment was completed using the Mixed Methods Appraisal Tool. The review was reported using the PRISMA and conducted using ENTREQ guidelines. Data were extracted and analysed using thematic synthesis (NVivo 20). Findings were presented narratively. Results From the 1,031 records screened, ten studies were included. Five studies were conducted in the United States, two in the United Kingdom, and one in the Netherlands, Canada, and Tanzania, respectively. Medication adherence interventions included the use of therapeutic drug monitoring methods and digital adherence technologies such as mHealth and eHealth for people living with asthma, HIV, coronary heart disease, hypertension, and type 2 diabetes. Patients found interventions acceptable if they were simple to use, allowed control over data sharing options, incorporated audio visual cues, and provided emotional and motivational support. Building trust between patients and healthcare providers and the resulting benefit of shared decision-making were also considered key factors for intervention success. However, developing interventions without user input was identified as a potential barrier to intervention implementation. Patients expressed an overall desire to have interventions tailored to meet their personal needs and preferences, highlighting the importance of placing user needs at the centre of intervention development. Conclusion Placing user needs at the centre of adherence intervention development is crucial for successful implementation. Further research which facilitates user involvement in co-designing interventions to compliment patients’ characteristics and preferences would be key for intervention implementation.
{"title":"Patients' perspectives on feedback interventions to support adherence to long-term medication: a systematic review with thematic synthesis of qualitative evidence","authors":"B Kobson, R Paterson, J Hanley, A Mair, A Dima, N Rea","doi":"10.1093/eurjcn/zvae098.031","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.031","url":null,"abstract":"Background Medication optimisation is a global issue with up to 50% of people not taking medicines as prescribed. Numerous interventions have been developed to address this, many of them including feedback on behaviour and outcomes. Understanding patients’ views on such interventions is essential for successful adoption and use. Purpose The purpose of this systematic review is to: (1) Understand patients’ perspectives and experiences of medication adherence feedback interventions and (2) Identify barriers and facilitators which influence their implementation within practice. Methods CINAHL, MEDLINE, EMBASE, PubMED, PsycINFO and Google Scholar were systematically searched to identify relevant studies. The inclusion criteria included; studies with qualitative or mixed method designs describing patients’ perspectives on medication adherence feedback interventions, primary studies with adult participants on long-term medications and studies involving interventions suitable for self-management in primary or community care. Quality assessment was completed using the Mixed Methods Appraisal Tool. The review was reported using the PRISMA and conducted using ENTREQ guidelines. Data were extracted and analysed using thematic synthesis (NVivo 20). Findings were presented narratively. Results From the 1,031 records screened, ten studies were included. Five studies were conducted in the United States, two in the United Kingdom, and one in the Netherlands, Canada, and Tanzania, respectively. Medication adherence interventions included the use of therapeutic drug monitoring methods and digital adherence technologies such as mHealth and eHealth for people living with asthma, HIV, coronary heart disease, hypertension, and type 2 diabetes. Patients found interventions acceptable if they were simple to use, allowed control over data sharing options, incorporated audio visual cues, and provided emotional and motivational support. Building trust between patients and healthcare providers and the resulting benefit of shared decision-making were also considered key factors for intervention success. However, developing interventions without user input was identified as a potential barrier to intervention implementation. Patients expressed an overall desire to have interventions tailored to meet their personal needs and preferences, highlighting the importance of placing user needs at the centre of intervention development. Conclusion Placing user needs at the centre of adherence intervention development is crucial for successful implementation. Further research which facilitates user involvement in co-designing interventions to compliment patients’ characteristics and preferences would be key for intervention implementation.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"50 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.094
M Hamre, T R Pettersen, I Valaker, T Wentzel-Larsen, T M Norekvaal
Background Better and more efficient treatment have led to decreased mortality rates and shorter hospital stays in patients with coronary artery disease (CAD). Nevertheless, fatigue is a prominent and distressing symptom in patients with CAD more frequently reported in women. Therefore, further investigation through follow-up studies focusing on women and fatigue in the context of CAD is imperative to address this knowledge gap and enhance clinical outcomes. Purpose To investigate fatigue in women with CAD at baseline, 2, 6 and 12 months after percutaneous coronary intervention (PCI), and to determine whether self-reported health, and clinical and sociodemographic characteristics are associated with fatigue after PCI. Methods CONCARDPCI is a multicentre, prospective cohort study including 3417 consecutive patients after PCI. Of these, 22% (n=746) were women and included in this analysis. Clinical data were collected from patients’ medical records and national registries. Sociodemographic characteristics were self-reported at baseline registration. Self-reported health was assessed with RAND-12 Item Short Form Health Survey (RAND-12) and the Myocardial Infarction Dimensional Assessment Scale (MIDAS). Fatigue was measured with a Visual Analogue Fatigue scale providing scores from 0-10 with higher scores indicating higher levels of fatigue. Patient-reported outcomes measures were completed at baseline and 2-, 6- and 12 months after hospital discharge. Results A substantial proportion was living alone (39%), retired (55%) or had three or more comorbidities (67%). Meanage was 68 years (SD 10). Age was significantly associated with fatigue at baseline (p<0.001), 6 months (p=0.002) and 12 months (p<0.001) in the RAND-12 model and at 2 months (p=0.018) and 12 months (p= 0.003) in the MIDAS model. Cohabitation status was significantly associated with fatigue at baseline (p=0.001), 2 months (p=0.033) and 12 months (p=0.016) in the RAND-12 model and at 2 months (p=0.032) in the MIDAS model. The degree of fatigue was at the highest level at baseline (5.2, SD 2.7) but was still present after one year (4.4, SD 2.6) (p≤0.004 for all comparisons). In RAND-12, self-reported physical health was associated with fatigue (p <0.001 for all comparisons). Furthermore, mental health was associated with fatigue at all meassuring time points (p<0.001- p=0.006). In MIDAS, physical health was associated with fatigue (p<0.001 for all comparisons). Conclusion A substantial proportion of women reported challenges with fatigue long after hospital discharge. Therefore, healthcare providers must identify the most vulnerable patients and tailor interventions accordingly. Person-centered treatment strategies may be developed by identifying factors associated with fatigue, such as age, cohabitation status, and self-reported physical and mental health.
{"title":"Fatigue in women after percutaneous coronary intervention - results from CONCARDPCI","authors":"M Hamre, T R Pettersen, I Valaker, T Wentzel-Larsen, T M Norekvaal","doi":"10.1093/eurjcn/zvae098.094","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.094","url":null,"abstract":"Background Better and more efficient treatment have led to decreased mortality rates and shorter hospital stays in patients with coronary artery disease (CAD). Nevertheless, fatigue is a prominent and distressing symptom in patients with CAD more frequently reported in women. Therefore, further investigation through follow-up studies focusing on women and fatigue in the context of CAD is imperative to address this knowledge gap and enhance clinical outcomes. Purpose To investigate fatigue in women with CAD at baseline, 2, 6 and 12 months after percutaneous coronary intervention (PCI), and to determine whether self-reported health, and clinical and sociodemographic characteristics are associated with fatigue after PCI. Methods CONCARDPCI is a multicentre, prospective cohort study including 3417 consecutive patients after PCI. Of these, 22% (n=746) were women and included in this analysis. Clinical data were collected from patients’ medical records and national registries. Sociodemographic characteristics were self-reported at baseline registration. Self-reported health was assessed with RAND-12 Item Short Form Health Survey (RAND-12) and the Myocardial Infarction Dimensional Assessment Scale (MIDAS). Fatigue was measured with a Visual Analogue Fatigue scale providing scores from 0-10 with higher scores indicating higher levels of fatigue. Patient-reported outcomes measures were completed at baseline and 2-, 6- and 12 months after hospital discharge. Results A substantial proportion was living alone (39%), retired (55%) or had three or more comorbidities (67%). Meanage was 68 years (SD 10). Age was significantly associated with fatigue at baseline (p&lt;0.001), 6 months (p=0.002) and 12 months (p&lt;0.001) in the RAND-12 model and at 2 months (p=0.018) and 12 months (p= 0.003) in the MIDAS model. Cohabitation status was significantly associated with fatigue at baseline (p=0.001), 2 months (p=0.033) and 12 months (p=0.016) in the RAND-12 model and at 2 months (p=0.032) in the MIDAS model. The degree of fatigue was at the highest level at baseline (5.2, SD 2.7) but was still present after one year (4.4, SD 2.6) (p≤0.004 for all comparisons). In RAND-12, self-reported physical health was associated with fatigue (p &lt;0.001 for all comparisons). Furthermore, mental health was associated with fatigue at all meassuring time points (p&lt;0.001- p=0.006). In MIDAS, physical health was associated with fatigue (p&lt;0.001 for all comparisons). Conclusion A substantial proportion of women reported challenges with fatigue long after hospital discharge. Therefore, healthcare providers must identify the most vulnerable patients and tailor interventions accordingly. Person-centered treatment strategies may be developed by identifying factors associated with fatigue, such as age, cohabitation status, and self-reported physical and mental health.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"64 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.051
N C Cedrone, M L Lommi, I G Gangemi, P I Iovino, E V Vellone
Background Pulmonary arterial hypertension (PAH) is a rare, complex and chronic disease, characterised by a mean pulmonary arterial pressure at rest above 20 mmHg, determined through right heart catheterisation. As the disease progresses, symptoms (e.g., chest pain, syncope, respiratory distress) occur, which negatively impact quality of life. Moreover, symptoms of PAH can impair activities of daily living and social functions, leading to social isolation and loneliness. So far the experience of social isolation and loneliness in PAH patients. Purpose To explore the lived experience of social isolation and loneliness in patients with PAH. Methods A multicentre descriptive phenomenological study was conducted with semi-structured interviews driven by the Middle Range Theory of Social Isolation. This study followed the COREQ guidelines, and data analysis was conducted using the Elo and Kyngäs method. Results Seventeen patients (mean age 55,3 years; range 21-83 years; n=3 male) recruited from specialized clinics or patient associations across different Italian regions, participated in the interviews. The results show that patients with a marked symptomatology experience daily moments of loneliness and social isolation that inevitably impact the quality of life. While, patients with a mild symptomatology or with drug support can lead a life similar to that before diagnosis. Three main categories emerged. First, within the main category of loneliness emerged generic categories including emotions associated with loneliness (anger, depression, frustration, guilt, fear)as well as the influence of loneliness on the disease and the various strategies to limit it. Second, for the main category of social isolation were also identified other generic categories including networks of support of the person with PAH (family, social and work), emotions related to social isolation (dismissal and pretend to be well) and the influence of social isolation on the path of illness. Finally, generic categories related to well-being, autonomy, health, self-care activity or health promotion performed by the patient emerged for the main quality of life category. Conclusion The findings of this study contribute to a more in depth understanding of the factors influencing the quality of life of patients with PAH and enlighten the design of interventions aimed at improving their condition. Integration of these results with quantitative data regarding the extent of the influence of loneliness and social isolation is warranted.
背景肺动脉高压（PAH）是一种罕见、复杂的慢性疾病，其特征是通过右心导管检查确定静息时平均肺动脉压高于 20 mmHg。随着病情的发展，患者会出现各种症状（如胸痛、晕厥、呼吸困难），对生活质量造成负面影响。此外，PAH 的症状会影响日常生活和社交功能，导致社交孤立和孤独。到目前为止，PAH 患者的社会隔离和孤独体验尚不清楚。目的 探讨 PAH 患者社交孤立和孤独的生活体验。方法 根据社会隔离的中程理论（Middle Range Theory of Social Isolation）进行半结构式访谈，开展一项多中心描述性现象学研究。该研究遵循了 COREQ 指南，并使用 Elo 和 Kyngäs 方法进行了数据分析。结果 从意大利不同地区的专科诊所或患者协会招募的 17 名患者（平均年龄 55.3 岁；年龄范围 21-83 岁；男性 3 人）参加了访谈。结果显示，症状明显的患者每天都会经历孤独和社会隔离的时刻，这不可避免地影响了他们的生活质量。而症状轻微或有药物支持的患者则可以过上与诊断前相似的生活。研究结果主要分为三类。首先，在 "孤独 "这一主要类别中，出现了一些通用类别，包括与孤独有关的情绪（愤怒、抑郁、沮丧、内疚、恐惧）以及孤独对疾病的影响和限制孤独的各种策略。其次，对于社会隔离这一主要类别，还确定了其他通用类别，包括 PAH 患者的支持网络（家庭、社会和工作）、与社会隔离有关的情绪（被解雇和假装健康）以及社会隔离对疾病的影响。最后，在主要的生活质量类别中，出现了与患者的幸福感、自主性、健康、自我护理活动或健康促进有关的通用类别。结论 本研究的结果有助于更深入地了解影响 PAH 患者生活质量的因素，并对设计旨在改善患者病情的干预措施有所启发。有必要将这些结果与有关孤独和社会隔离影响程度的定量数据相结合。
{"title":"The lived experience of loneliness and social isolation in patients with pulmonary arterial hypertension: A phenomenological study","authors":"N C Cedrone, M L Lommi, I G Gangemi, P I Iovino, E V Vellone","doi":"10.1093/eurjcn/zvae098.051","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.051","url":null,"abstract":"Background Pulmonary arterial hypertension (PAH) is a rare, complex and chronic disease, characterised by a mean pulmonary arterial pressure at rest above 20 mmHg, determined through right heart catheterisation. As the disease progresses, symptoms (e.g., chest pain, syncope, respiratory distress) occur, which negatively impact quality of life. Moreover, symptoms of PAH can impair activities of daily living and social functions, leading to social isolation and loneliness. So far the experience of social isolation and loneliness in PAH patients. Purpose To explore the lived experience of social isolation and loneliness in patients with PAH. Methods A multicentre descriptive phenomenological study was conducted with semi-structured interviews driven by the Middle Range Theory of Social Isolation. This study followed the COREQ guidelines, and data analysis was conducted using the Elo and Kyngäs method. Results Seventeen patients (mean age 55,3 years; range 21-83 years; n=3 male) recruited from specialized clinics or patient associations across different Italian regions, participated in the interviews. The results show that patients with a marked symptomatology experience daily moments of loneliness and social isolation that inevitably impact the quality of life. While, patients with a mild symptomatology or with drug support can lead a life similar to that before diagnosis. Three main categories emerged. First, within the main category of loneliness emerged generic categories including emotions associated with loneliness (anger, depression, frustration, guilt, fear)as well as the influence of loneliness on the disease and the various strategies to limit it. Second, for the main category of social isolation were also identified other generic categories including networks of support of the person with PAH (family, social and work), emotions related to social isolation (dismissal and pretend to be well) and the influence of social isolation on the path of illness. Finally, generic categories related to well-being, autonomy, health, self-care activity or health promotion performed by the patient emerged for the main quality of life category. Conclusion The findings of this study contribute to a more in depth understanding of the factors influencing the quality of life of patients with PAH and enlighten the design of interventions aimed at improving their condition. Integration of these results with quantitative data regarding the extent of the influence of loneliness and social isolation is warranted.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"39 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.130
A M C Karner Kohler, C Hyback, C Andreae, C Lans, M Back, M Wijkman, P Johansson, G Mourad
Background Fear of movement (kinesiophobia) is common among patients after a myocardial infarction or atrial fibrillation. The kinesiophobia is developed due to the patients’ beliefs that physical activity may cause re-injury. This negatively affects their ability to perform physical activity which is stated as the first line treatment in present guidelines. Purpose To explore how patients with myocardial infarction and/or atrial fibrillation experience participation in a digital group education targeting kinesiophobia and physical activity. Methods Seven women (55-81 years) with myocardial infarction and/or atrial fibrillation that had occurred at least 6 months earlier, and kinesiophobia, i.e., score of ≥ 37 on the Tampa Scale of Kinesiophobia Swedish Version for the Heart, were included. They took part in a digital program that was based on problem-based learning and cognitive behavioural therapy and delivered via a video conferencing platform over 8 weeks and supervised by a nurse or physiotherapist. The program covered topics such as myocardial infarction, atrial fibrillation, kinesiophobia, physical activity, and exposure. A digital platform with two-factor authentication for login was developed to provide educational materials, including tutorial group scenarios, streamed lectures, factual texts, and homework assignments. Individual semi-structured interviews were conducted with the women via a video conferencing platform after the 8-week program and transcripts were analysed using conventional qualitative content analysis. Preliminary results The women felt empowered after the digital encounters and joyful discussions with the group members. The educational materials and their own search for information, which was discussed in the group made them feel enlightened. The kinesiophobia was relieved or gone according to their experiences. This promoted the women to be physically active based on their own preferences. Initially, experiences of stress due to technical problems were felt. The tutor was attentive and enabling in guiding the women during the meetings on the video conferencing platform. Conclusions A digital group education targeting kinesiophobia after myocardial infarction and/or atrial fibrillation was experienced as feasible, enlightening, and empowering in a small group of women. The kinesiophobia was relieved or gone. This promoted them to perform physical activity as they preferred, and which is important for their recovery. More and larger studies are needed to show if a digital group educational program via a video conferencing platform can reduce kinesiophobia and promote physical activity after myocardial infarction or atrial fibrillation.
{"title":"Patients' experiences of a digital group education targeting kinesiophobia after myocardial infarction or atrial fibrillation - a qualitative pilot study","authors":"A M C Karner Kohler, C Hyback, C Andreae, C Lans, M Back, M Wijkman, P Johansson, G Mourad","doi":"10.1093/eurjcn/zvae098.130","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.130","url":null,"abstract":"Background Fear of movement (kinesiophobia) is common among patients after a myocardial infarction or atrial fibrillation. The kinesiophobia is developed due to the patients’ beliefs that physical activity may cause re-injury. This negatively affects their ability to perform physical activity which is stated as the first line treatment in present guidelines. Purpose To explore how patients with myocardial infarction and/or atrial fibrillation experience participation in a digital group education targeting kinesiophobia and physical activity. Methods Seven women (55-81 years) with myocardial infarction and/or atrial fibrillation that had occurred at least 6 months earlier, and kinesiophobia, i.e., score of ≥ 37 on the Tampa Scale of Kinesiophobia Swedish Version for the Heart, were included. They took part in a digital program that was based on problem-based learning and cognitive behavioural therapy and delivered via a video conferencing platform over 8 weeks and supervised by a nurse or physiotherapist. The program covered topics such as myocardial infarction, atrial fibrillation, kinesiophobia, physical activity, and exposure. A digital platform with two-factor authentication for login was developed to provide educational materials, including tutorial group scenarios, streamed lectures, factual texts, and homework assignments. Individual semi-structured interviews were conducted with the women via a video conferencing platform after the 8-week program and transcripts were analysed using conventional qualitative content analysis. Preliminary results The women felt empowered after the digital encounters and joyful discussions with the group members. The educational materials and their own search for information, which was discussed in the group made them feel enlightened. The kinesiophobia was relieved or gone according to their experiences. This promoted the women to be physically active based on their own preferences. Initially, experiences of stress due to technical problems were felt. The tutor was attentive and enabling in guiding the women during the meetings on the video conferencing platform. Conclusions A digital group education targeting kinesiophobia after myocardial infarction and/or atrial fibrillation was experienced as feasible, enlightening, and empowering in a small group of women. The kinesiophobia was relieved or gone. This promoted them to perform physical activity as they preferred, and which is important for their recovery. More and larger studies are needed to show if a digital group educational program via a video conferencing platform can reduce kinesiophobia and promote physical activity after myocardial infarction or atrial fibrillation.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"19 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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