Pub Date : 2024-07-17DOI: 10.1093/eurjcn/zvae098.063
B Banaszak-Zak, K Mizia-Stec, M Mizia-Szubryt, A Mlynarska
Introduction The cardiovascular risk factors determine the development of early atheriosclerotic lesions, and the susceptibility to their proartheriosclerotic action is programmed by external factors and also those present during fetal development. The occurrence of atherosclerotic risk factors depends on an age. In population of children and young adults it seems reasonable to assess the classical risk factors for atherosclerosis in the connection with such additional given as family history being an indirect surrogate of genetic factors, and a low birth weight. Aim of the study was to categorize the study group into two groups - those who exhibit a low-risk and those who exhibit a high-risk of cardiovascular disease, and to determine the factors characteristic for each risk group. Materials and Methods The study was done on 512 volunteers, students in the following Faculties: Health Care Faculty: Nursing Course (178 / 34,7%), Physiotherapy Course (109 / 21,3%), Obstetrics Course (49 / 9,5%), Faculty of Medicine (176 / 34,3%). The questionnaire on cardiovascular risk factors was constructed. According to the results of its assessment the following groups were divided: the group of high risk (10% of investigated with the highest awarding of points) and the group of low risk (10% of investigated with the lowest awarding of points). Results Significant quantitative and qualitative differences were found between the low-risk and high-risk groups. Groups of the high and low risk did not differ in respect of sexes investigated and in respect of the direction of studies. One ascertained essential differences in variable qualitative and quantitative between the group of the low and high risk. Family history of diabetes, arterial hypertension, cardiovascular diseases, lipid disturbances, stroke were indeed greater in the group of high risk. The low birth weight was significantly lower in the group of high risk (p=0,02). The current and chronic stress status grading according to the punctual scale (0-10) was significantly higher in the group of high risk as compared to the low risk group (p=0,01, p=0,03, respectively). The systolic pressure was significantly higher in the high risk group in comparison to the low risk subjects (p=0,01). Conclusions High cardiovascular risk in subgroup of young adults results from high smoking status, low physical activity, diet and family history of cardiovascular disorders. The numerous cardiovascular risk factors that occur in some students are associated with low birth weight and a positive family medical history. The above observations show the influence of genetic and fetal factors on the development of atherosclerosis. Young adults with high cardiovascular risk are characterized by higher subjective stress level. Quantitative differences in high risk Medical family history
{"title":"Factors influencing high cardiovascular risk in subpopulation of young adults","authors":"B Banaszak-Zak, K Mizia-Stec, M Mizia-Szubryt, A Mlynarska","doi":"10.1093/eurjcn/zvae098.063","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.063","url":null,"abstract":"Introduction The cardiovascular risk factors determine the development of early atheriosclerotic lesions, and the susceptibility to their proartheriosclerotic action is programmed by external factors and also those present during fetal development. The occurrence of atherosclerotic risk factors depends on an age. In population of children and young adults it seems reasonable to assess the classical risk factors for atherosclerosis in the connection with such additional given as family history being an indirect surrogate of genetic factors, and a low birth weight. Aim of the study was to categorize the study group into two groups - those who exhibit a low-risk and those who exhibit a high-risk of cardiovascular disease, and to determine the factors characteristic for each risk group. Materials and Methods The study was done on 512 volunteers, students in the following Faculties: Health Care Faculty: Nursing Course (178 / 34,7%), Physiotherapy Course (109 / 21,3%), Obstetrics Course (49 / 9,5%), Faculty of Medicine (176 / 34,3%). The questionnaire on cardiovascular risk factors was constructed. According to the results of its assessment the following groups were divided: the group of high risk (10% of investigated with the highest awarding of points) and the group of low risk (10% of investigated with the lowest awarding of points). Results Significant quantitative and qualitative differences were found between the low-risk and high-risk groups. Groups of the high and low risk did not differ in respect of sexes investigated and in respect of the direction of studies. One ascertained essential differences in variable qualitative and quantitative between the group of the low and high risk. Family history of diabetes, arterial hypertension, cardiovascular diseases, lipid disturbances, stroke were indeed greater in the group of high risk. The low birth weight was significantly lower in the group of high risk (p=0,02). The current and chronic stress status grading according to the punctual scale (0-10) was significantly higher in the group of high risk as compared to the low risk group (p=0,01, p=0,03, respectively). The systolic pressure was significantly higher in the high risk group in comparison to the low risk subjects (p=0,01). Conclusions High cardiovascular risk in subgroup of young adults results from high smoking status, low physical activity, diet and family history of cardiovascular disorders. The numerous cardiovascular risk factors that occur in some students are associated with low birth weight and a positive family medical history. The above observations show the influence of genetic and fetal factors on the development of atherosclerosis. Young adults with high cardiovascular risk are characterized by higher subjective stress level. Quantitative differences in high risk Medical family history","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744979","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/zvae098.004
K A Wood, Y A Ko, F Han, W Wharton
Background Atrial fibrillation (AF) is associated with cognitive decline and dementia. Use of oral anticoagulant (OAC) medications has been reported to offer a lower risk of dementia, but whether differences exist in risk of cognitive decline between types of OAC agents is unclear. Purpose We explored whether the progression from normal cognition to mild cognitive impairment (MCI) or MCI to dementia differs between adults with AF on warfarin versus non-Vitamin K inhibitors (NOACs) in the National Alzheimer’s Coordinating Center (NACC) clinical case series. Methods Data freeze/extraction of NACC data (N= 48,605) took place June 2023. The presence of AF was derived using both clinician-reported health information and self-reported medical history. Subjects with AF who reported use of OACs, had normal cognition and no history of stroke at baseline, and had at least one follow-up visit were included. OAC usage was calculated based on follow-up time and reported OAC use in previous visits. Continuation ratio models (with subject-specific random intercepts) were used to examine the association between OAC type and cognitive diagnosis controlling for cognitive diagnosis from previous visit. Interactions with sex were examined in all models. Results Among 1,475 eligible participants, 478 reported taking OACs including either warfarin (N=396) or NOACs (N=82) at baseline (mean age 79 years, 51% females, 84% White). Individuals on NOACs were either on dabigatran (N=24, 29%) or rivaroxaban (N=58, 71%). The median follow-up time was 4 (interquartile range 2-7) years. About 63% continued using either warfarin or NOACs, 44% switched from warfarin to NOACs, and 2% switched from NOACs to warfarin. After adjusting for age, sex, education, race, hypertension, diabetes, hyperlipidemia, smoking history, and depression in the past two years, no significant association was found between OAC type and cognitive decline (p=0.14). Conclusions In this study of older patients with AF on OACs, we found similar risks of cognitive decline between those on NOACs or warfarin. Future studies should consider effects of patient age, provider prescribing practices, and OAC adherence on this risk.
{"title":"Oral anticoagulants and cognitive disease progression in atrial fibrillation","authors":"K A Wood, Y A Ko, F Han, W Wharton","doi":"10.1093/eurjcn/zvae098.004","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.004","url":null,"abstract":"Background Atrial fibrillation (AF) is associated with cognitive decline and dementia. Use of oral anticoagulant (OAC) medications has been reported to offer a lower risk of dementia, but whether differences exist in risk of cognitive decline between types of OAC agents is unclear. Purpose We explored whether the progression from normal cognition to mild cognitive impairment (MCI) or MCI to dementia differs between adults with AF on warfarin versus non-Vitamin K inhibitors (NOACs) in the National Alzheimer’s Coordinating Center (NACC) clinical case series. Methods Data freeze/extraction of NACC data (N= 48,605) took place June 2023. The presence of AF was derived using both clinician-reported health information and self-reported medical history. Subjects with AF who reported use of OACs, had normal cognition and no history of stroke at baseline, and had at least one follow-up visit were included. OAC usage was calculated based on follow-up time and reported OAC use in previous visits. Continuation ratio models (with subject-specific random intercepts) were used to examine the association between OAC type and cognitive diagnosis controlling for cognitive diagnosis from previous visit. Interactions with sex were examined in all models. Results Among 1,475 eligible participants, 478 reported taking OACs including either warfarin (N=396) or NOACs (N=82) at baseline (mean age 79 years, 51% females, 84% White). Individuals on NOACs were either on dabigatran (N=24, 29%) or rivaroxaban (N=58, 71%). The median follow-up time was 4 (interquartile range 2-7) years. About 63% continued using either warfarin or NOACs, 44% switched from warfarin to NOACs, and 2% switched from NOACs to warfarin. After adjusting for age, sex, education, race, hypertension, diabetes, hyperlipidemia, smoking history, and depression in the past two years, no significant association was found between OAC type and cognitive decline (p=0.14). Conclusions In this study of older patients with AF on OACs, we found similar risks of cognitive decline between those on NOACs or warfarin. Future studies should consider effects of patient age, provider prescribing practices, and OAC adherence on this risk.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744981","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/zvae098.071
A Rzepka-Cholasinska, J Ratajczak, A Nowaczyk, K Grzelakowska, A Kubica
Introduction Dance movement engages global muscle sequences of the human body, improves physical performance, and helps reduce stress and excessive muscle tension. Dance exercises allow you to better control your movement and muscles. Zorba Greek dancing as a form of physical activity brings benefits in the form of improved mental health, well-being and quality of life. Rehabilitation may contribute to improving cardiorespiratory fitness and mental condition in the group of patients after myocardial infarction. Aim of the study The aim of the study was to evaluate a rehabilitation program based on Zorba dance on selected clinical parameters in patients after myocardial infarction. Materials and methods The study included 99 patients after myocardial infarction who were rehabilitated for 5 weeks. Patients were enrolled into two groups. Group I (50 patients) performed cycle ergometer training and the Greek dance Zorba. Group II (49 patients) performed cycle ergometer training and rehabilitation exercises. At the beginning and after rehabilitation, patients' BMI, balance (scales: Tinetti, Berg, 30CST), gait (6MWT), psychophysical status (SF-36, WHO-5, FCIS), and breathlessness (mMRC scale) were assessed. Results After undergoing rehabilitation, there was a reduction in BMI (I vs. II p<0.01), improvement in balance on the Tinetti (I vs. II p<0.01) and Berg scale (I vs. II p<0.01), improvement in the 30CS test score (I vs. II p= 0.018), improvement in WHO-5 (I vs. II p< 0.01), and reduction in dyspnea (mMRC) (I vs. II p< 0.01) in the Zorba group. Conclusions Both methods of rehabilitation improve functional efficiency; However, rehabilitation with the use of Zorba dance additionally improves balance in patients after myocardial infarction.
导言 舞蹈动作能调动人体的整体肌肉序列，提高身体表现力，并有助于减轻压力和过度的肌肉紧张。舞蹈练习能让你更好地控制自己的动作和肌肉。希腊左巴舞作为一种体育活动形式，能带来改善心理健康、幸福感和生活质量的益处。康复训练有助于改善心肌梗塞患者的心肺功能和精神状况。研究目的 研究目的是评估基于佐尔巴舞蹈的康复计划对心肌梗塞患者选定临床参数的影响。材料和方法 该研究包括 99 名接受 5 周康复治疗的心肌梗死患者。患者分为两组。第一组（50 名患者）进行自行车测力计训练和希腊舞蹈 Zorba。第二组（49 名患者）进行自行车测力计训练和康复锻炼。在康复训练开始时和结束后，对患者的体重指数、平衡能力（量表：Tinetti、Berg、30CST）、步态（6MWT）、心理生理状态（SF-36、WHO-5、FCIS）和呼吸困难（mMRC 量表）进行评估。结果 接受康复治疗后，患者的体重指数有所下降（I vs. II p<0.01），Tinetti（I vs. II p<0.01）和 Berg（I vs. II p<0.01），佐巴组的 30CS 测试评分有所改善（I vs. II p=0.018），WHO-5 有所改善（I vs. II p<0.01），呼吸困难（mMRC）有所减轻（I vs. II p<0.01）。结论 两种康复方法都能提高功能效率；不过，使用佐巴舞进行康复还能改善心肌梗死患者的平衡能力。
{"title":"Comprehensive assessment of the results of zorba dance-based rehabilitation in patients after myocardial infarction","authors":"A Rzepka-Cholasinska, J Ratajczak, A Nowaczyk, K Grzelakowska, A Kubica","doi":"10.1093/eurjcn/zvae098.071","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.071","url":null,"abstract":"Introduction Dance movement engages global muscle sequences of the human body, improves physical performance, and helps reduce stress and excessive muscle tension. Dance exercises allow you to better control your movement and muscles. Zorba Greek dancing as a form of physical activity brings benefits in the form of improved mental health, well-being and quality of life. Rehabilitation may contribute to improving cardiorespiratory fitness and mental condition in the group of patients after myocardial infarction. Aim of the study The aim of the study was to evaluate a rehabilitation program based on Zorba dance on selected clinical parameters in patients after myocardial infarction. Materials and methods The study included 99 patients after myocardial infarction who were rehabilitated for 5 weeks. Patients were enrolled into two groups. Group I (50 patients) performed cycle ergometer training and the Greek dance Zorba. Group II (49 patients) performed cycle ergometer training and rehabilitation exercises. At the beginning and after rehabilitation, patients' BMI, balance (scales: Tinetti, Berg, 30CST), gait (6MWT), psychophysical status (SF-36, WHO-5, FCIS), and breathlessness (mMRC scale) were assessed. Results After undergoing rehabilitation, there was a reduction in BMI (I vs. II p&lt;0.01), improvement in balance on the Tinetti (I vs. II p&lt;0.01) and Berg scale (I vs. II p&lt;0.01), improvement in the 30CS test score (I vs. II p= 0.018), improvement in WHO-5 (I vs. II p&lt; 0.01), and reduction in dyspnea (mMRC) (I vs. II p&lt; 0.01) in the Zorba group. Conclusions Both methods of rehabilitation improve functional efficiency; However, rehabilitation with the use of Zorba dance additionally improves balance in patients after myocardial infarction.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745085","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/zvae098.013
J Shogaki, A Fukuda, M Imai, S Yasuno, S M Park, M Asai, M Umezawa, N Nakayama, M Watanabe, I Miyawaki
Background Patient-centred multidisciplinary teams must facilitate self-care while addressing the patient’s concerns. Because the concerns of heart failure patients admitted to the hospital for the first time do not always coincide with the principles of self-care for heart failure, providers need to carefully understand their patients’ particular concerns. However, little research has been conducted on the specific concerns of such patients and their providers. Purpose This study sought to clarify the concerns of patients with first-time heart failure and their multidisciplinary team of providers during first-time hospitalization and at the first outpatient visit. Methods Individual and focus group interviews about self-care for heart failure were conducted with 10 patients hospitalized with heart failure for the first time and their multidisciplinary team of providers (eight physicians, nine nurses, seven physical therapists, two pharmacists, and two dieticians). Patients were interviewed during hospitalization and at the first outpatient visit, while the healthcare providers were interviewed either during hospitalization or at the first outpatient visit. Mayring's qualitative content analysis was used to analyse the interviews. Results The analysis identified eight themes. Those extracted from interviews with patients were ‘meaning of symptoms experienced’, ‘continuation of daily life before hospitalization’, ‘healthy living’, and ‘relapse of painful symptoms’. Meanwhile, those extracted from interviews with healthcare providers were ‘improving clinical heart failure status’, ‘health literacy for heart failure self-care’, and ‘post-discharge environment for continued self-care’. The theme ‘self-care to prevent heart failure from worsening’ was extracted from patients and providers. ‘Self-care to prevent heart failure from worsening’ was also more frequently reported during the initial outpatient discharge than during inpatient hospitalization. Conclusion This study revealed that the concerns of patients hospitalized with heart failure for the first time generally differ from those of the healthcare providers comprising their multidisciplinary treatment team. Furthermore, the findings showed that patients were more interested in self-care for heart failure during their first outpatient visit than their hospital stay. Ultimately, the study highlights that healthcare providers working in multidisciplinary teams to support first-time inpatients with heart failure should understand patient concerns, which notably include but are not limited to self-care, and work to support their patients’ self-care by remaining attentive and responsive to their patients’ changing concerns, placing them at the centre of treatment.
{"title":"Differences and changes: a qualitative study of concerns about self-care among heart failure patients hospitalized for the first time and their multidisciplinary providers","authors":"J Shogaki, A Fukuda, M Imai, S Yasuno, S M Park, M Asai, M Umezawa, N Nakayama, M Watanabe, I Miyawaki","doi":"10.1093/eurjcn/zvae098.013","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.013","url":null,"abstract":"Background Patient-centred multidisciplinary teams must facilitate self-care while addressing the patient’s concerns. Because the concerns of heart failure patients admitted to the hospital for the first time do not always coincide with the principles of self-care for heart failure, providers need to carefully understand their patients’ particular concerns. However, little research has been conducted on the specific concerns of such patients and their providers. Purpose This study sought to clarify the concerns of patients with first-time heart failure and their multidisciplinary team of providers during first-time hospitalization and at the first outpatient visit. Methods Individual and focus group interviews about self-care for heart failure were conducted with 10 patients hospitalized with heart failure for the first time and their multidisciplinary team of providers (eight physicians, nine nurses, seven physical therapists, two pharmacists, and two dieticians). Patients were interviewed during hospitalization and at the first outpatient visit, while the healthcare providers were interviewed either during hospitalization or at the first outpatient visit. Mayring's qualitative content analysis was used to analyse the interviews. Results The analysis identified eight themes. Those extracted from interviews with patients were ‘meaning of symptoms experienced’, ‘continuation of daily life before hospitalization’, ‘healthy living’, and ‘relapse of painful symptoms’. Meanwhile, those extracted from interviews with healthcare providers were ‘improving clinical heart failure status’, ‘health literacy for heart failure self-care’, and ‘post-discharge environment for continued self-care’. The theme ‘self-care to prevent heart failure from worsening’ was extracted from patients and providers. ‘Self-care to prevent heart failure from worsening’ was also more frequently reported during the initial outpatient discharge than during inpatient hospitalization. Conclusion This study revealed that the concerns of patients hospitalized with heart failure for the first time generally differ from those of the healthcare providers comprising their multidisciplinary treatment team. Furthermore, the findings showed that patients were more interested in self-care for heart failure during their first outpatient visit than their hospital stay. Ultimately, the study highlights that healthcare providers working in multidisciplinary teams to support first-time inpatients with heart failure should understand patient concerns, which notably include but are not limited to self-care, and work to support their patients’ self-care by remaining attentive and responsive to their patients’ changing concerns, placing them at the centre of treatment.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745087","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/zvae098.120
M Sloma Krzeslak, O Kowalski
Introduction In response to the increasing demand for personalization in cardiac dietetics, tools based on artificial intelligence (AI) are gaining popularity. We assess the compliance of AI-generated nutritional advice and diet plans with current dietary standards. Objective The study aims to evaluate whether nutritional advice and diet plans created by AI for heart disease patients align with the recommended caloric intake and macronutrient ratios, based on current dietary guidelines. Methods Using selected AI tools, nutritional advice and diet plans were generated for defined dietary scenarios corresponding to specific cardiac diagnoses. The analysis included assessing the caloric content and macronutrient composition (protein, fat, carbohydrates) compared to current guidelines. Results The analysis showed that the majority of the AI-generated diet plans and nutritional advice were compliant with dietary recommendations, with an >75% compliance rate for caloric content and macronutrient ratios. However, instances of non-compliance were discovered, suggesting a need for further adjustment of AI algorithms. Conclusions AI tools demonstrate potential in creating personalized diet plans for cardiac patients but require optimization to fully meet current dietary guidelines. The study highlights the importance of integrating dietary knowledge into the design process of AI tools, which is crucial for providing high-quality nutritional support.
{"title":"Evaluation of the compliance of diet plans and nutritional advice generated by artificial intelligence with guidelines for cardiac patients","authors":"M Sloma Krzeslak, O Kowalski","doi":"10.1093/eurjcn/zvae098.120","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.120","url":null,"abstract":"Introduction In response to the increasing demand for personalization in cardiac dietetics, tools based on artificial intelligence (AI) are gaining popularity. We assess the compliance of AI-generated nutritional advice and diet plans with current dietary standards. Objective The study aims to evaluate whether nutritional advice and diet plans created by AI for heart disease patients align with the recommended caloric intake and macronutrient ratios, based on current dietary guidelines. Methods Using selected AI tools, nutritional advice and diet plans were generated for defined dietary scenarios corresponding to specific cardiac diagnoses. The analysis included assessing the caloric content and macronutrient composition (protein, fat, carbohydrates) compared to current guidelines. Results The analysis showed that the majority of the AI-generated diet plans and nutritional advice were compliant with dietary recommendations, with an &gt;75% compliance rate for caloric content and macronutrient ratios. However, instances of non-compliance were discovered, suggesting a need for further adjustment of AI algorithms. Conclusions AI tools demonstrate potential in creating personalized diet plans for cardiac patients but require optimization to fully meet current dietary guidelines. The study highlights the importance of integrating dietary knowledge into the design process of AI tools, which is crucial for providing high-quality nutritional support.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745147","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/zvae098.087
P I Paolo Iovino, H D Hamilton Dollaku, P G Gianluca Pucciarelli, L R Laura Rasero, I U Izabella Uchmanowicz, R A Rosaria Alvaro, E V Ercole Vellone
Background Despite medical advances, patients with heart failure continue to suffer from poor quality of life due to worsening symptoms and functional limitations. Therefore, it is important to understand the multidimensional facets of quality of life in these patients. The Kansas City Cardiomyopathy Questionnaire is a commonly used quality of life assessment tool worldwide. However, However, there is still a lack of knowledge about its psychometric properties. Purpose The aim of this study was to investigate the psychometric properties of the KCCQ-12 and its measurement invariance in a cohort of European patients with heart failure. Methods Participants (n=510, median age=72, IQR=18, 58% males) completed the KCCQ-12 alongside measures of clinical psychosocial severity. A confirmatory factor analysis was used to establish factorial validity; internal consistency was determined using the Omega coefficient and the model-based internal consistency coefficient. Zero-order correlations between the KCCQ-12 scores and clinical and psychosocial measures were performed to test convergent validity. Multigroup confirmatory factor analysis was conducted to test measurement invariance across patients with preserved vs reduced ejection fraction. Results Confirmatory factor analysis confirmed a four-factor solution, with the domains of physical limitations, symptom frequency, quality of life, and social interference. Internal consistency was excellent (Omega coefficients ranging from 0.83 and 0.90, and internal consistency index of 0.94). The KCCQ-12 scores significantly correlated with ejection fraction, New York Heart Association class, quality of life, anxiety, depression, symptom burden, and the KCCQ-23 Overall Summary score, which adequately supported the convergent validity of the KCCQ-12. Measurement invariance was confirmed at the partial scalar and strict level. Conclusions These findings support the validity and reliability of the KCCQ-12, both in patients with reduced and preserved ejection fraction. Hence, this version can be confidently used both in research and clinical practice to measure quality of life of heart failure patients.
{"title":"Psychometric properties of the KCCQ-12 in an european cohort of patients with heart failure","authors":"P I Paolo Iovino, H D Hamilton Dollaku, P G Gianluca Pucciarelli, L R Laura Rasero, I U Izabella Uchmanowicz, R A Rosaria Alvaro, E V Ercole Vellone","doi":"10.1093/eurjcn/zvae098.087","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.087","url":null,"abstract":"Background Despite medical advances, patients with heart failure continue to suffer from poor quality of life due to worsening symptoms and functional limitations. Therefore, it is important to understand the multidimensional facets of quality of life in these patients. The Kansas City Cardiomyopathy Questionnaire is a commonly used quality of life assessment tool worldwide. However, However, there is still a lack of knowledge about its psychometric properties. Purpose The aim of this study was to investigate the psychometric properties of the KCCQ-12 and its measurement invariance in a cohort of European patients with heart failure. Methods Participants (n=510, median age=72, IQR=18, 58% males) completed the KCCQ-12 alongside measures of clinical psychosocial severity. A confirmatory factor analysis was used to establish factorial validity; internal consistency was determined using the Omega coefficient and the model-based internal consistency coefficient. Zero-order correlations between the KCCQ-12 scores and clinical and psychosocial measures were performed to test convergent validity. Multigroup confirmatory factor analysis was conducted to test measurement invariance across patients with preserved vs reduced ejection fraction. Results Confirmatory factor analysis confirmed a four-factor solution, with the domains of physical limitations, symptom frequency, quality of life, and social interference. Internal consistency was excellent (Omega coefficients ranging from 0.83 and 0.90, and internal consistency index of 0.94). The KCCQ-12 scores significantly correlated with ejection fraction, New York Heart Association class, quality of life, anxiety, depression, symptom burden, and the KCCQ-23 Overall Summary score, which adequately supported the convergent validity of the KCCQ-12. Measurement invariance was confirmed at the partial scalar and strict level. Conclusions These findings support the validity and reliability of the KCCQ-12, both in patients with reduced and preserved ejection fraction. Hence, this version can be confidently used both in research and clinical practice to measure quality of life of heart failure patients.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744895","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/zvae098.129
S Rosenstroem
Objective This study aims to investigate the facilitators and barriers perceived by nurses in utilizing video-consultations supported by home-monitoring for patients with cardiac disease. Methodology A systematic search was conducted in PubMed, CINAHL, Scopus, and Web of Science for qualitative data published in English, Norwegian, Swedish, or Danish between 2013-2023. Ten studies were included in the qualitative synthesis using Braun and Clarke's methodology. Findings From the qualitative meta-synthesis, a main theme emerged: Nurses’ uncertainty toward telemedicine is a risk toward the use of video-consultations and home-monitoring The findings spans from nurses' positive encounters to their frustrations with the implementation process and the inadequate technical support for both clinicians and patients. Nurses frequently experienced frustration and uncertainty regarding the quality of care delivered through virtual consultations. Conclusion The successful implementation of video-consultations and home-monitoring necessitates a focus on the specific context in which they are applied, considering the perspectives of both patients and nurses. Additionally, active involvement of nurses, leveraging their clinical expertise, is crucial for the effective integration of these technologies.
目的 本研究旨在调查护士在为心脏病患者提供家庭监护支持的视频会诊过程中感受到的促进因素和障碍。方法 在 PubMed、CINAHL、Scopus 和 Web of Science 中对 2013-2023 年间以英语、挪威语、瑞典语或丹麦语发表的定性数据进行了系统检索。采用布劳恩和克拉克的方法，将十项研究纳入定性综述。研究结果 从定性元综合中，我们发现了一个主要的主题：从护士的积极态度到她们对实施过程的挫折感，以及对临床医生和患者的技术支持不足。护士们经常对通过虚拟会诊提供的护理质量感到沮丧和不确定。结论 视频会诊和家庭监护的成功实施需要关注其应用的具体环境，考虑患者和护士的观点。此外，护士的积极参与，利用其临床专业知识，对于这些技术的有效整合至关重要。
{"title":"Nurses' perceptions of virtual consultations and home-monitoring in patients with cardiac disease: a qualitative meta-synthesis","authors":"S Rosenstroem","doi":"10.1093/eurjcn/zvae098.129","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.129","url":null,"abstract":"Objective This study aims to investigate the facilitators and barriers perceived by nurses in utilizing video-consultations supported by home-monitoring for patients with cardiac disease. Methodology A systematic search was conducted in PubMed, CINAHL, Scopus, and Web of Science for qualitative data published in English, Norwegian, Swedish, or Danish between 2013-2023. Ten studies were included in the qualitative synthesis using Braun and Clarke's methodology. Findings From the qualitative meta-synthesis, a main theme emerged: Nurses’ uncertainty toward telemedicine is a risk toward the use of video-consultations and home-monitoring The findings spans from nurses' positive encounters to their frustrations with the implementation process and the inadequate technical support for both clinicians and patients. Nurses frequently experienced frustration and uncertainty regarding the quality of care delivered through virtual consultations. Conclusion The successful implementation of video-consultations and home-monitoring necessitates a focus on the specific context in which they are applied, considering the perspectives of both patients and nurses. Additionally, active involvement of nurses, leveraging their clinical expertise, is crucial for the effective integration of these technologies.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745171","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/zvae098.027
S Rosenstroem, A S Anette Sjoel
Background Aortic dissection, characterized by a sudden rupture in the carotid artery allowing blood to enter the aortic wall. The mortality rate is 1% per hour, and half of the patients die within 48 hours. Following surgery, patients are advised to limit arm lifting to 2 kg, maintain strict blood pressure control for life, and engage in physical activities that do not strain the aorta. Despite the limited evidence on optimal rehabilitation, our University Hospital in Denmark has established a team that secure patients with aortic dissection a structured post operative rehabilitation program. Aim This study aims to explore the experiences and importance of a specialized rehabilitation program for individuals post-surgery for aortic dissection. Method A qualitative interview study, analyzed using content analysis inspired by Graneheim & Lundman. Interview participants were recruited through the physiotherapist at the hospital either at the end or shortly after their rehabilitation program. Interviews were conducted over the phone or in a private room at the hospital. Results Based on interviews with eight patients (three women and five men aged 43-73), an overarching theme emerged; "Finding peace in a new version of oneself." This theme encapsulates the journey of adapting to a new identity with a changed body that has limitations, combined with a sense of gratitude for being alive. Three subthemes describe the period from surgery to the end of the rehabilitation course: 1) Surviving the operation - the initial miracle and the subsequent uncertainties, 2) The rehabilitation course enhance a sense of security and well-being, and 3) Reclaiming wholeness. Conclusion A specialized rehabilitation program proves to be a crucial support in helping individuals with aortic dissection find peace in their altered selves after facing a life-threatening trauma. These patients require comprehensive physical and psychological support through cardiac rehabilitation provided by cardiac nurses, along with prompt initiation of specialized rehabilitation led by physiotherapists with expertise in aortic dissection.
{"title":"Finding peace in a new version of oneself- a qualitative study of post operative patients after aorta dissection and their experiences of cardiac rehabilitation","authors":"S Rosenstroem, A S Anette Sjoel","doi":"10.1093/eurjcn/zvae098.027","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.027","url":null,"abstract":"Background Aortic dissection, characterized by a sudden rupture in the carotid artery allowing blood to enter the aortic wall. The mortality rate is 1% per hour, and half of the patients die within 48 hours. Following surgery, patients are advised to limit arm lifting to 2 kg, maintain strict blood pressure control for life, and engage in physical activities that do not strain the aorta. Despite the limited evidence on optimal rehabilitation, our University Hospital in Denmark has established a team that secure patients with aortic dissection a structured post operative rehabilitation program. Aim This study aims to explore the experiences and importance of a specialized rehabilitation program for individuals post-surgery for aortic dissection. Method A qualitative interview study, analyzed using content analysis inspired by Graneheim & Lundman. Interview participants were recruited through the physiotherapist at the hospital either at the end or shortly after their rehabilitation program. Interviews were conducted over the phone or in a private room at the hospital. Results Based on interviews with eight patients (three women and five men aged 43-73), an overarching theme emerged; \"Finding peace in a new version of oneself.\" This theme encapsulates the journey of adapting to a new identity with a changed body that has limitations, combined with a sense of gratitude for being alive. Three subthemes describe the period from surgery to the end of the rehabilitation course: 1) Surviving the operation - the initial miracle and the subsequent uncertainties, 2) The rehabilitation course enhance a sense of security and well-being, and 3) Reclaiming wholeness. Conclusion A specialized rehabilitation program proves to be a crucial support in helping individuals with aortic dissection find peace in their altered selves after facing a life-threatening trauma. These patients require comprehensive physical and psychological support through cardiac rehabilitation provided by cardiac nurses, along with prompt initiation of specialized rehabilitation led by physiotherapists with expertise in aortic dissection.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744894","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/zvae098.111
K Aleksandrowicz
Background Time-appropriate return to a resting heart rate (HR) after cessation of exercise is a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement in patients with severe aortic stenosis after percutaneous aortic valve implantation (TAVI). Methods 6 min walk test (6MWT) was performed in 93 individuals before TAVI and in 3 months follow up. The change in walking distance was measured. We analyzed also the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd and 3rd minute of recovery. Results After 3 months the distance of 6MWT in TAVI patients improved by 39±63 m and reached a total of 322±117 m. The differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up in multiple linear regression model. Conclusions Our study showes that changes of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvement in exercise capacity after TAVI. This simple method can also help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.Demographics
{"title":"Early heart rate recovery after a 6-min walking test in patients after percutaneous aortic valve implantation coresponds with clinical benefits","authors":"K Aleksandrowicz","doi":"10.1093/eurjcn/zvae098.111","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.111","url":null,"abstract":"Background Time-appropriate return to a resting heart rate (HR) after cessation of exercise is a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement in patients with severe aortic stenosis after percutaneous aortic valve implantation (TAVI). Methods 6 min walk test (6MWT) was performed in 93 individuals before TAVI and in 3 months follow up. The change in walking distance was measured. We analyzed also the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd and 3rd minute of recovery. Results After 3 months the distance of 6MWT in TAVI patients improved by 39±63 m and reached a total of 322±117 m. The differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up in multiple linear regression model. Conclusions Our study showes that changes of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvement in exercise capacity after TAVI. This simple method can also help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.Demographics","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745084","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/zvae098.080
J C Quijano-Campos, N Sekhri, M Thillai, E Blower, H Clarke, E Murphy, L Othen-Price, J Whight, J Sanders
Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments was combined with the consensus-based standards for the selection of health measurement instruments (COSMIN) recommendations, involving three steps: item selection, item scaling and item reduction. The item-generation process used simultaneous triangulation (QUAN+qual) method, connecting quantitative data (theory, research findings and systematic review) with complementary qualitative components (interviews, clinical observations and experts’ opinion). The formatting of items was guided by patient and public involvement (PPI). The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care". Conclusions This study used a robust methodology and active PPI involvement to develop the first disease-specific HRQoL tool for CS. The engagement and contributions of the PPI group in each step of the framework enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.
{"title":"The development of a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of cardiac sarcoidosis on health-related quality of life","authors":"J C Quijano-Campos, N Sekhri, M Thillai, E Blower, H Clarke, E Murphy, L Othen-Price, J Whight, J Sanders","doi":"10.1093/eurjcn/zvae098.080","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.080","url":null,"abstract":"Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments was combined with the consensus-based standards for the selection of health measurement instruments (COSMIN) recommendations, involving three steps: item selection, item scaling and item reduction. The item-generation process used simultaneous triangulation (QUAN+qual) method, connecting quantitative data (theory, research findings and systematic review) with complementary qualitative components (interviews, clinical observations and experts’ opinion). The formatting of items was guided by patient and public involvement (PPI). The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: \"functioning\", \"social, leisure and occupation\", \"emotional\", psychological\", \"physical\" and \"healthcare/self-care\". Conclusions This study used a robust methodology and active PPI involvement to develop the first disease-specific HRQoL tool for CS. The engagement and contributions of the PPI group in each step of the framework enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745329","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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