Francesco Zaghini, Jacopo Fiorini, Philip Moons, Alessandro Sili
Aims: This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.
Methods and results: The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.
Conclusion: Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.
Registration: PROSPERO: CRD42022355669.
目的:本系统综述评估了在心血管环境中工作的护士的组织幸福感,并确定了影响组织幸福感的环境变量:研究遵循乔安娜-布里格斯研究所(Joanna Briggs Institute)的方法和系统综述与元分析首选报告项目(PRISMA)指南。从数据库建立之初到 2022 年 12 月 1 日(含 2022 年 12 月 1 日),在 Medline(通过 PubMed)、Cumulative Index of Nursing and Allied Health、Cochrane Library 和 Scopus 上进行了检索。使用标准化工具进行了严格评估和数据提取。共纳入六篇高质量文章。这些文章大多是在不同背景下进行的横断面研究,突出了心血管护理环境的特殊性。研究确定了三个主题领域:心血管护理环境的压力因素;压力因素对护士的影响;心血管护理人员应对这些压力因素的策略。确定的压力因素包括缺乏自主权、职业角色与家庭角色之间的冲突、高工作量以及与患者和护理人员之间的紧张关系。这些组织变量可能导致护士产生职业倦怠、抑郁、烦躁和/或睡眠障碍。为了应对这些压力,心血管科护士采用了不同的策略来补偿、回避、逃避或忽视问题,或者在其他情况下变得有些激进:考虑到数据有限,应进一步研究心血管护理人员的应对策略,从而确定预防或限制压力因素的有效途径,并由组织加以应用。在这一护理环境中对压力因素进行监测和干预,可以提高心血管护理人员的组织幸福感,从而改善患者的治疗效果:prospero:CRD42022355669。
{"title":"Cardiovascular nurses and organizational well-being: a systematic review.","authors":"Francesco Zaghini, Jacopo Fiorini, Philip Moons, Alessandro Sili","doi":"10.1093/eurjcn/zvad078","DOIUrl":"10.1093/eurjcn/zvad078","url":null,"abstract":"<p><strong>Aims: </strong>This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.</p><p><strong>Methods and results: </strong>The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.</p><p><strong>Conclusion: </strong>Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.</p><p><strong>Registration: </strong>PROSPERO: CRD42022355669.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"213-220"},"PeriodicalIF":2.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9971349","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}
Meghan Reading Turchioe, Alexander Volodarskiy, Winston Guo, Brittany Taylor, Mollie Hobensack, Jyotishman Pathak, David Slotwiner
Aims: Atrial fibrillation (AF) symptom relief is a primary indication for catheter ablation, but AF symptom resolution is not well characterized. The study objective was to describe AF symptom documentation in electronic health records (EHRs) pre- and post-ablation and identify correlates of post-ablation symptoms.
Methods and results: We conducted a retrospective cohort study using EHRs of patients with AF (n = 1293), undergoing ablation in a large, urban health system from 2010 to 2020. We extracted symptom data from clinical notes using a natural language processing algorithm (F score: 0.81). We used Cochran's Q tests with post-hoc McNemar's tests to determine differences in symptom prevalence pre- and post-ablation. We used logistic regression models to estimate the adjusted odds of symptom resolution by personal or clinical characteristics at 6 and 12 months post-ablation. In fully adjusted models, at 12 months post-ablation patients, patients with heart failure had significantly lower odds of dyspnoea resolution [odds ratio (OR) 0.38, 95% confidence interval (CI) 0.25-0.57], oedema resolution (OR 0.37, 95% CI 0.25-0.56), and fatigue resolution (OR 0.54, 95% CI 0.34-0.85), but higher odds of palpitations resolution (OR 1.90, 95% CI 1.25-2.89) compared with those without heart failure. Age 65 and older, female sex, Black or African American race, smoking history, and antiarrhythmic use were also associated with lower odds of resolution of specific symptoms at 6 and 12 months.
Conclusion: The post-ablation symptom patterns are heterogeneous. Findings warrant confirmation with larger, more representative data sets, which may be informative for patients whose primary goal for undergoing an ablation is symptom relief.
{"title":"Characterizing atrial fibrillation symptom improvement following de novo catheter ablation.","authors":"Meghan Reading Turchioe, Alexander Volodarskiy, Winston Guo, Brittany Taylor, Mollie Hobensack, Jyotishman Pathak, David Slotwiner","doi":"10.1093/eurjcn/zvad068","DOIUrl":"10.1093/eurjcn/zvad068","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) symptom relief is a primary indication for catheter ablation, but AF symptom resolution is not well characterized. The study objective was to describe AF symptom documentation in electronic health records (EHRs) pre- and post-ablation and identify correlates of post-ablation symptoms.</p><p><strong>Methods and results: </strong>We conducted a retrospective cohort study using EHRs of patients with AF (n = 1293), undergoing ablation in a large, urban health system from 2010 to 2020. We extracted symptom data from clinical notes using a natural language processing algorithm (F score: 0.81). We used Cochran's Q tests with post-hoc McNemar's tests to determine differences in symptom prevalence pre- and post-ablation. We used logistic regression models to estimate the adjusted odds of symptom resolution by personal or clinical characteristics at 6 and 12 months post-ablation. In fully adjusted models, at 12 months post-ablation patients, patients with heart failure had significantly lower odds of dyspnoea resolution [odds ratio (OR) 0.38, 95% confidence interval (CI) 0.25-0.57], oedema resolution (OR 0.37, 95% CI 0.25-0.56), and fatigue resolution (OR 0.54, 95% CI 0.34-0.85), but higher odds of palpitations resolution (OR 1.90, 95% CI 1.25-2.89) compared with those without heart failure. Age 65 and older, female sex, Black or African American race, smoking history, and antiarrhythmic use were also associated with lower odds of resolution of specific symptoms at 6 and 12 months.</p><p><strong>Conclusion: </strong>The post-ablation symptom patterns are heterogeneous. Findings warrant confirmation with larger, more representative data sets, which may be informative for patients whose primary goal for undergoing an ablation is symptom relief.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"241-250"},"PeriodicalIF":2.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10007254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jia-Ming Xiong, Jin Su, Qi-Qi Ke, Yao-Xia Li, Ni Gong, Qiao-Hong Yang
Aims: We sought to explore the latent classifications of psychosocial adaptation in young and middle-aged patients with acute myocardial infarction (AMI) and analyse the characteristics of different profiles of AMI patients.
Methods and results: A cross-sectional study was performed in 438 Chinese young and middle-aged patients with AMI. The investigation time was 1 month after discharge. Three different self-report instruments were distributed to the participants, including the Psychosocial Adjustment to Illness Scale, the Perceived Stress Scale, and the Social Support Rating Scale. The seven dimensions of the Psychosocial Adjustment to Illness Scale were then used to perform a latent profile analysis. All participants signed informed consent forms in accordance with the ethical principles of the Declaration of Helsinki. Finally, a total of 411 young and middle-aged AMI patients were enrolled. Three distinct profiles were identified, including the 'well-adapted group' (44.8%), 'highlight in psychological burdens group' (25.5%), and 'poorly adapted group' (29.7%). The influencing factors included stress perception, social support, occupational type, and marital status (P < 0.05).
Conclusion: The psychosocial adaptation of young and middle-aged AMI patients can be divided into three profiles. Clinical nurses can carry out individualized psychological interventions according to the characteristics of patients in different potential profiles to improve the psychosocial adaptation of patients and the prognosis of their disease.
目的:我们试图探索急性心肌梗死(AMI)中青年患者社会心理适应的潜在分类,并分析AMI患者的不同特征:对 438 名中国中青年急性心肌梗死患者进行了横断面研究。调查时间为出院后 1 个月。向参与者发放了三种不同的自我报告工具,包括疾病社会心理适应量表、知觉压力量表和社会支持评分量表。然后利用疾病社会心理适应量表的七个维度进行潜在特征分析。根据《赫尔辛基宣言》的伦理原则,所有参与者都签署了知情同意书。最后,共招募了 411 名中青年 AMI 患者。结果发现了三种不同的情况,包括 "适应良好组"(44.8%)、"心理负担突出组"(25.5%)和 "适应不良组"(29.7%)。影响因素包括压力感、社会支持、职业类型和婚姻状况(P < 0.05):中青年 AMI 患者的社会心理适应可分为三种情况。结论:中青年 AMI 患者的社会心理适应可分为三种类型,临床护士可根据不同潜在类型患者的特点进行个体化心理干预,以改善患者的社会心理适应和疾病预后。
{"title":"Psychosocial adaptation profiles in young and middle-aged patients with acute myocardial infarction: a latent profile analysis.","authors":"Jia-Ming Xiong, Jin Su, Qi-Qi Ke, Yao-Xia Li, Ni Gong, Qiao-Hong Yang","doi":"10.1093/eurjcn/zvad071","DOIUrl":"10.1093/eurjcn/zvad071","url":null,"abstract":"<p><strong>Aims: </strong>We sought to explore the latent classifications of psychosocial adaptation in young and middle-aged patients with acute myocardial infarction (AMI) and analyse the characteristics of different profiles of AMI patients.</p><p><strong>Methods and results: </strong>A cross-sectional study was performed in 438 Chinese young and middle-aged patients with AMI. The investigation time was 1 month after discharge. Three different self-report instruments were distributed to the participants, including the Psychosocial Adjustment to Illness Scale, the Perceived Stress Scale, and the Social Support Rating Scale. The seven dimensions of the Psychosocial Adjustment to Illness Scale were then used to perform a latent profile analysis. All participants signed informed consent forms in accordance with the ethical principles of the Declaration of Helsinki. Finally, a total of 411 young and middle-aged AMI patients were enrolled. Three distinct profiles were identified, including the 'well-adapted group' (44.8%), 'highlight in psychological burdens group' (25.5%), and 'poorly adapted group' (29.7%). The influencing factors included stress perception, social support, occupational type, and marital status (P < 0.05).</p><p><strong>Conclusion: </strong>The psychosocial adaptation of young and middle-aged AMI patients can be divided into three profiles. Clinical nurses can carry out individualized psychological interventions according to the characteristics of patients in different potential profiles to improve the psychosocial adaptation of patients and the prognosis of their disease.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"267-277"},"PeriodicalIF":2.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9874255","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}
Simon Stewart, Sheila K Patel, Terase F Lancefield, Thalys S Rodrigues, Nicholas Doumtsis, Ashleigh Jess, Emily-Rose Vaughan-Fowler, Yih-Kai Chan, Jay Ramchand, Paul A Yates, Jason C Kwong, Christine F McDonald, Louise M Burrell
Aims: We aimed to recruit a representative cohort of women and men with multi-morbid chronic heart disease as part of a trial testing an innovative, nurse-co-ordinated, multi-faceted intervention to lower rehospitalization and death by addressing areas of vulnerability to external challenges to their health.
Methods and results: The prospective, randomized open, blinded end-point RESILIENCE Trial recruited 203 hospital inpatients (mean age 75.7 ± 10.2 years) of whom 51% were women and 94% had combined coronary artery disease, heart failure, and/or atrial fibrillation. Levels of concurrent multi-morbidity were high (mean Charlson Index of Comorbidity Score 6.5 ± 2.7), and 8.9% had at least mild frailty according to the Rockwood Clinical Frailty Scale. Including the index admission, 19-20% of women and men had a pre-existing pattern of seasonally linked hospitalization (seasonality). Detailed phenotyping revealed that 48% of women and 40% of men had ≥3 physiological factors, and 15% of women and 16% of men had ≥3 behavioural factors likely to increase their vulnerability to external provocations to their health. Overall, 61-62% of women and men had ≥4 combined factors indicative of such vulnerability. Additional factors such as reliance on the public health system (63 vs. 49%), lower education (30 vs. 14%), and living alone (48 vs. 29%) were more prevalent in women.
Conclusion: We successfully recruited women and men with multi-morbid chronic heart disease and bio-behavioural indicators of vulnerability to external provocations to their health. Once completed, the RESILIENCE TRIAL will provide important insights on the impact of addressing such vulnerability (promoting resilience) on subsequent health outcomes.
{"title":"Vulnerability to environmental and climatic health provocations among women and men hospitalized with chronic heart disease: insights from the RESILIENCE TRIAL cohort.","authors":"Simon Stewart, Sheila K Patel, Terase F Lancefield, Thalys S Rodrigues, Nicholas Doumtsis, Ashleigh Jess, Emily-Rose Vaughan-Fowler, Yih-Kai Chan, Jay Ramchand, Paul A Yates, Jason C Kwong, Christine F McDonald, Louise M Burrell","doi":"10.1093/eurjcn/zvad076","DOIUrl":"10.1093/eurjcn/zvad076","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to recruit a representative cohort of women and men with multi-morbid chronic heart disease as part of a trial testing an innovative, nurse-co-ordinated, multi-faceted intervention to lower rehospitalization and death by addressing areas of vulnerability to external challenges to their health.</p><p><strong>Methods and results: </strong>The prospective, randomized open, blinded end-point RESILIENCE Trial recruited 203 hospital inpatients (mean age 75.7 ± 10.2 years) of whom 51% were women and 94% had combined coronary artery disease, heart failure, and/or atrial fibrillation. Levels of concurrent multi-morbidity were high (mean Charlson Index of Comorbidity Score 6.5 ± 2.7), and 8.9% had at least mild frailty according to the Rockwood Clinical Frailty Scale. Including the index admission, 19-20% of women and men had a pre-existing pattern of seasonally linked hospitalization (seasonality). Detailed phenotyping revealed that 48% of women and 40% of men had ≥3 physiological factors, and 15% of women and 16% of men had ≥3 behavioural factors likely to increase their vulnerability to external provocations to their health. Overall, 61-62% of women and men had ≥4 combined factors indicative of such vulnerability. Additional factors such as reliance on the public health system (63 vs. 49%), lower education (30 vs. 14%), and living alone (48 vs. 29%) were more prevalent in women.</p><p><strong>Conclusion: </strong>We successfully recruited women and men with multi-morbid chronic heart disease and bio-behavioural indicators of vulnerability to external provocations to their health. Once completed, the RESILIENCE TRIAL will provide important insights on the impact of addressing such vulnerability (promoting resilience) on subsequent health outcomes.</p><p><strong>Registration: </strong>ClinicalTrials.org: NCT04614428.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"278-286"},"PeriodicalIF":2.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10072776","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}
Erin Salahshurian, Bunny J Pozehl, Scott W Lundgren, Sara Bills, Ambarish Pandey, Salvatore Carbone, Windy W Alonso
Aims Adults with heart failure with preserved ejection fraction (HFpEF) responded more favorably to an exercise intervention compared to those with reduced ejection fraction. This study explores factors that contributed to this response focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention. Methods and results This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18-months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise. We included participants with at least 2 interviews. Interviews were examined across and within participants and time points using thematic analysis. Analyses included 67 interviews from 21 adults with HFpEF enrolled in the intervention arm. The sample was 52% (11/21) male and over 47% (10/21) non-White. Mean age at enrollment was 63.7 ± 9.9 years. We identified 4 major themes: 1. Overcoming negative attitudes, barriers, and injury, 2. Motivations to exercise, 3. Exercise - the panacea for HFpEF symptoms and quality of life, and 4. Advice for others with HFpEF. Conclusions Our findings suggest that for many adults with HFpEF, initial hesitancy, fear, and negative attitudes about exercise can be overcome. Exercise coaching using social cognitive constructs, medical fitness center memberships, and heart rate self-monitoring are successful strategies of engaging adults with HFpEF in long-term unsupervised exercise training. Registration This study is registered at ClinicalTrials.gov, NCT01658670
{"title":"“Working me to life” – Longitudinal Perceptions from Adults with Heart Failure with Preserved Ejection Fraction Enrolled in an Exercise Training Clinical Trial","authors":"Erin Salahshurian, Bunny J Pozehl, Scott W Lundgren, Sara Bills, Ambarish Pandey, Salvatore Carbone, Windy W Alonso","doi":"10.1093/eurjcn/zvae049","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae049","url":null,"abstract":"Aims Adults with heart failure with preserved ejection fraction (HFpEF) responded more favorably to an exercise intervention compared to those with reduced ejection fraction. This study explores factors that contributed to this response focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention. Methods and results This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18-months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise. We included participants with at least 2 interviews. Interviews were examined across and within participants and time points using thematic analysis. Analyses included 67 interviews from 21 adults with HFpEF enrolled in the intervention arm. The sample was 52% (11/21) male and over 47% (10/21) non-White. Mean age at enrollment was 63.7 ± 9.9 years. We identified 4 major themes: 1. Overcoming negative attitudes, barriers, and injury, 2. Motivations to exercise, 3. Exercise - the panacea for HFpEF symptoms and quality of life, and 4. Advice for others with HFpEF. Conclusions Our findings suggest that for many adults with HFpEF, initial hesitancy, fear, and negative attitudes about exercise can be overcome. Exercise coaching using social cognitive constructs, medical fitness center memberships, and heart rate self-monitoring are successful strategies of engaging adults with HFpEF in long-term unsupervised exercise training. Registration This study is registered at ClinicalTrials.gov, NCT01658670","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"7 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140565009","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}
Aims This study aims to investigate the demographic, clinical and service level factors determining change in walking fitness in cardiac rehabilitation (CR) patients with a history of depression following the CR programme. Methods and results National Audit of Cardiac Rehabilitation (NACR) clinical data were used to identify 1476 patients with a history of depression who had their pre and post incremental shuttle walk test (ISWT) recorded between 1st Jan 2016 and 31st Jan 2020. A multiple linear regression was conducted to examine the determinants of change in walking fitness (m) following CR. Mean age was 61 (SD 10.45) and mean ISWT distance at baseline and outcome were 352.06m (SD 169.48) and 463.43m (SD 197.65), respectively. Multivariate analysis revealed that change in walking distance reduced by 1.6m for each year increase in age at baseline (P < 0.001). Females and unemployed patients had less improvement in walking fitness (23.1m and 21.5m, respectively). Having a body mass index >30 was associated with lower improvement (24.2m, p < 0.001), while physically active patients had 14.6m higher change. Higher baseline ISWT quintiles were associated with less improvement, and increased waiting time to start CR was associated with reduced change in walking fitness following CR. Conclusion Older age, female gender, unemployment, higher baseline BMI, longer waiting time, and lower physical activity were associated with reduced walking fitness improvement in patients with a history of depression. Targeted intervention and prompt access to CR can optimize outcomes.
{"title":"What are the determinants of change in walking fitness in patients with a history of depression following cardiac rehabilitation?","authors":"Serdar Sever, Alexander Harrison, Patrick Doherty","doi":"10.1093/eurjcn/zvae047","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae047","url":null,"abstract":"Aims This study aims to investigate the demographic, clinical and service level factors determining change in walking fitness in cardiac rehabilitation (CR) patients with a history of depression following the CR programme. Methods and results National Audit of Cardiac Rehabilitation (NACR) clinical data were used to identify 1476 patients with a history of depression who had their pre and post incremental shuttle walk test (ISWT) recorded between 1st Jan 2016 and 31st Jan 2020. A multiple linear regression was conducted to examine the determinants of change in walking fitness (m) following CR. Mean age was 61 (SD 10.45) and mean ISWT distance at baseline and outcome were 352.06m (SD 169.48) and 463.43m (SD 197.65), respectively. Multivariate analysis revealed that change in walking distance reduced by 1.6m for each year increase in age at baseline (P &lt; 0.001). Females and unemployed patients had less improvement in walking fitness (23.1m and 21.5m, respectively). Having a body mass index &gt;30 was associated with lower improvement (24.2m, p &lt; 0.001), while physically active patients had 14.6m higher change. Higher baseline ISWT quintiles were associated with less improvement, and increased waiting time to start CR was associated with reduced change in walking fitness following CR. Conclusion Older age, female gender, unemployment, higher baseline BMI, longer waiting time, and lower physical activity were associated with reduced walking fitness improvement in patients with a history of depression. Targeted intervention and prompt access to CR can optimize outcomes.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"36 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140596534","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}
Sabine M Allida, Maree L Hackett, Richard Lindley, Kelvin Hill, Caleb Ferguson
Living evidence involves continuous evidence surveillance to incorporate new relevant evidence into systematic reviews and clinical practice guideline recommendations as soon as it becomes available. Thus, living evidence may improve the timeliness of recommendation updates and reduce the knowledge-to-practice gap. When considering a living evidence model, several processes and practical aspects need to be explored. Some of these include identifying the need for a living evidence model, funding, governance structure, time, team skills and capabilities, frequency of updates, approval and endorsement and publication and dissemination.
{"title":"A practical guide to living evidence: Reducing the knowledge-to-practice gap","authors":"Sabine M Allida, Maree L Hackett, Richard Lindley, Kelvin Hill, Caleb Ferguson","doi":"10.1093/eurjcn/zvae048","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae048","url":null,"abstract":"Living evidence involves continuous evidence surveillance to incorporate new relevant evidence into systematic reviews and clinical practice guideline recommendations as soon as it becomes available. Thus, living evidence may improve the timeliness of recommendation updates and reduce the knowledge-to-practice gap. When considering a living evidence model, several processes and practical aspects need to be explored. Some of these include identifying the need for a living evidence model, funding, governance structure, time, team skills and capabilities, frequency of updates, approval and endorsement and publication and dissemination.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"68 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140596012","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}
Stacey Matthews, Samantha Cook, Tim Clayton, Sarah Murray, Rochelle Wynne, Julie Sanders
Aims: Women are underrepresented in cardiovascular trials. We sought to explore the proportional representation of women in contemporary cardiovascular research and the factors (barriers and enablers) that affect their participation in cardiovascular studies.
Methods and results: Multiple electronic databases were searched between January 2011 and September 2021 to identify papers that defined underrepresentation of women in cardiovascular research and/or reported sex-based differences in participating in cardiovascular research and/or barriers for women to participate in cardiovascular research. Data extraction was undertaken independently by two authors using a standardised data collection form. Results were summarised using descriptive statistics and narrative synthesis as appropriate.From 548 identified papers, 10 papers were included. Of those, four were conducted prospectively and six were retrospective studies. Five of the retrospective studies involved secondary analysis of trial data including over 780 trials in over 1.1 million participants. Overall, women were reported to be underrepresented in heart failure, coronary disease, myocardial infarction, and arrhythmia trials, compared to men. Barriers to participation included lack of information and understanding of the research, trial-related procedures, the perceived health status of the participant, and patient-specific factors including travel, childcare availability, and cost. A significantly higher likelihood of research participation was reported by women following a patient educational intervention.
Conclusion: This review has highlighted the underrepresentation of women in a range of cardiovascular trials. Several barriers to women's participation in cardiovascular studies were identified. Researchers could mitigate against these in future trial planning and delivery to increase women's participation in cardiovascular research.
Registration: The protocol was published on the public Open Science Framework platform on 13th August 2021 (no registration reference provided) and can be accessed at https://osf.io/ny4fd/.
{"title":"Factors affecting women's participation in cardiovascular research: a scoping review.","authors":"Stacey Matthews, Samantha Cook, Tim Clayton, Sarah Murray, Rochelle Wynne, Julie Sanders","doi":"10.1093/eurjcn/zvad048","DOIUrl":"10.1093/eurjcn/zvad048","url":null,"abstract":"<p><strong>Aims: </strong>Women are underrepresented in cardiovascular trials. We sought to explore the proportional representation of women in contemporary cardiovascular research and the factors (barriers and enablers) that affect their participation in cardiovascular studies.</p><p><strong>Methods and results: </strong>Multiple electronic databases were searched between January 2011 and September 2021 to identify papers that defined underrepresentation of women in cardiovascular research and/or reported sex-based differences in participating in cardiovascular research and/or barriers for women to participate in cardiovascular research. Data extraction was undertaken independently by two authors using a standardised data collection form. Results were summarised using descriptive statistics and narrative synthesis as appropriate.From 548 identified papers, 10 papers were included. Of those, four were conducted prospectively and six were retrospective studies. Five of the retrospective studies involved secondary analysis of trial data including over 780 trials in over 1.1 million participants. Overall, women were reported to be underrepresented in heart failure, coronary disease, myocardial infarction, and arrhythmia trials, compared to men. Barriers to participation included lack of information and understanding of the research, trial-related procedures, the perceived health status of the participant, and patient-specific factors including travel, childcare availability, and cost. A significantly higher likelihood of research participation was reported by women following a patient educational intervention.</p><p><strong>Conclusion: </strong>This review has highlighted the underrepresentation of women in a range of cardiovascular trials. Several barriers to women's participation in cardiovascular studies were identified. Researchers could mitigate against these in future trial planning and delivery to increase women's participation in cardiovascular research.</p><p><strong>Registration: </strong>The protocol was published on the public Open Science Framework platform on 13th August 2021 (no registration reference provided) and can be accessed at https://osf.io/ny4fd/.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"107-114"},"PeriodicalIF":2.9,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492276","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}
Aims: The aims of this study were to: (i) test if there are clusters of stroke survivors who experience distinct trajectories of quality of life (QOL) from hospital rehabilitation discharge to 12-month follow-up; (ii) test if any sociodemographic or clinical variables predict this class membership; and (iii) examine the associations between the clusters of stroke survivors' and their caregivers' trajectories of anxiety, depression, and burden over time.
Methods and results: A total of 415 stroke survivors and their caregivers were recruited in Italy for this 1-year, longitudinal, multicentre prospective study, filling out a survey at five time points. We found two distinct trajectories of change in stroke survivors' psychological QOL (i.e. Memory, Communication, Emotion, and Participation). The first trajectory (86% of the survivors) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, while the second trajectory (14% of the survivors) comprised those who started with lower overall levels of psychological QOL and experienced a worsening or no changes at all in these dimensions up to 12-month follow-up. Very few clinical and sociodemographic variables at baseline predicted class membership. Finally, caregivers of those patients who experienced no change or a worsening in psychological QOL reported greater distress and burden over time.
Conclusion: Our results highlight the need for more tailored interventions to improve patients' psychological QOL and consequently their caregivers' well-being. This requires a shift from a stroke survivor-centred approach to a stroke survivor- and caregiver-centred one.
目的:本研究旨在(i) 检验从康复出院到 12 个月随访期间是否存在经历不同生活质量(QOL)轨迹的中风幸存者群组;(ii) 检验是否有任何社会人口学或临床变量可预测该群组成员;(iii) 检验中风幸存者群组及其照顾者的焦虑、抑郁和负担轨迹随时间变化的关联:这项为期 1 年的纵向多中心前瞻性研究在意大利共招募了 415 名中风幸存者及其照护者,他们在五个时间点填写了调查问卷。我们发现中风幸存者的心理 QOL(即记忆、沟通、情感和参与)有两种不同的变化轨迹。第一种轨迹(86% 的幸存者)包括那些开始时心理 QOL 水平较高,并且在所有心理领域都有轻微到明显改善的幸存者,而第二种轨迹(14% 的幸存者)包括那些开始时心理 QOL 总体水平较低,并且在 12 个月的随访中这些方面的情况有所恶化或没有任何变化的幸存者。基线时的临床和社会人口学变量很少能预测患者的类别。最后,随着时间的推移,那些心理 QOL 无变化或恶化的患者的护理人员报告了更大的痛苦和负担:我们的研究结果突出表明,有必要采取更有针对性的干预措施来改善患者的心理 QOL,进而改善其照护者的福祉。这需要从以中风幸存者为中心的方法转变为以中风幸存者和照护者为中心的方法。
{"title":"Stroke disease-specific quality of life trajectories and their associations with caregivers' anxiety, depression, and burden in stroke population: a longitudinal, multicentre study.","authors":"Davide Bartoli, Agostino Brugnera, Andrea Grego, Rosaria Alvaro, Ercole Vellone, Gianluca Pucciarelli","doi":"10.1093/eurjcn/zvad054","DOIUrl":"10.1093/eurjcn/zvad054","url":null,"abstract":"<p><strong>Aims: </strong>The aims of this study were to: (i) test if there are clusters of stroke survivors who experience distinct trajectories of quality of life (QOL) from hospital rehabilitation discharge to 12-month follow-up; (ii) test if any sociodemographic or clinical variables predict this class membership; and (iii) examine the associations between the clusters of stroke survivors' and their caregivers' trajectories of anxiety, depression, and burden over time.</p><p><strong>Methods and results: </strong>A total of 415 stroke survivors and their caregivers were recruited in Italy for this 1-year, longitudinal, multicentre prospective study, filling out a survey at five time points. We found two distinct trajectories of change in stroke survivors' psychological QOL (i.e. Memory, Communication, Emotion, and Participation). The first trajectory (86% of the survivors) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, while the second trajectory (14% of the survivors) comprised those who started with lower overall levels of psychological QOL and experienced a worsening or no changes at all in these dimensions up to 12-month follow-up. Very few clinical and sociodemographic variables at baseline predicted class membership. Finally, caregivers of those patients who experienced no change or a worsening in psychological QOL reported greater distress and burden over time.</p><p><strong>Conclusion: </strong>Our results highlight the need for more tailored interventions to improve patients' psychological QOL and consequently their caregivers' well-being. This requires a shift from a stroke survivor-centred approach to a stroke survivor- and caregiver-centred one.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"160-168"},"PeriodicalIF":2.9,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9540294","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}