Journal of Cardiovascular Nursing最新文献

Background: Comparatively less research has been done on caregiving for persons with cardiovascular disease (CVD) than in other chronic conditions, leaving gaps in guidance for clinical care and interventions.

Objective: We aimed to describe the care needs of older adults with CVD in the United States and identify determinants of stress and mental health in their care partners.

Methods: This was a cross-sectional analysis using the National Health and Aging Trends Study (n = 1011 persons with CVD) and the National Study of Caregiving (n = 510 CVD care partners). We compared differences in health and care needs of persons with and without CVD and described care partners' caregiving activities. Using multivariate regression, we examined determinants of care partner stress and anxiety/depression.

Results: Persons with CVD had higher comorbid burden, worse health, and more care needs than those without CVD. Most care partners helped with activities of daily living in addition to disease-related care. Worse stress was associated with worse care partner health (β = 0.357; 95% confidence interval [CI], 0.192-0.522), more care activities (β = 0.388; CI, 0.070-0.705), greater care coordination (β = 0.367; CI, 0.012-0.722), more medical/nursing tasks (β = 0.489; CI, 0.145-0.834), and poorer relationship quality with the care recipient (β = -0.269; CI, -0.365 to -0.173). Care partners were more likely to have anxiety/depression if their care recipient had poorer mental health (odds ratio [OR], 1.137; CI, 1.017-1.270), whereas better relationship quality and higher educational attainment appeared protective (OR, 0.837 [CI, 0.719-0.975], and OR, 0.170 [CI, 0.076-0.380], respectively).

Conclusions: Our findings suggest a need for broader examination of caregiving burden in CVD, well beyond CVD-specific aspects.

Background: Health literacy among caregivers of patients with myocardial infarction is a crucial area that is still not fully addressed in research.

Objective: In this study, our aim was to explore the health literacy profiles of caregivers of patients with acute myocardial infarction (AMI).

Methods: A cross-sectional design was used, involving 121 caregivers of patients with AMI recruited through convenience sampling. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire. Hierarchical cluster analysis was performed to determine health literacy profiles based on Health Literacy Questionnaire scores and sociodemographic characteristics.

Results: Six distinct clusters of health literacy profiles emerged from the analysis. Caregivers in cluster 1 exhibited the highest health literacy levels, whereas those in cluster 6 had the lowest health literacy scores with significant difficulties in understanding and using health information. Caregivers' sociodemographic factors such as age, gender, smoking status, and education level played a significant role in determining health literacy profiles.

Conclusion: The study highlights the diverse health literacy profiles among caregivers of patients with AMI, emphasizing the importance of designing tailored interventions to address these differences to improve the health outcomes of caregivers and patients.

Background: The past 2 decades have witnessed a number of studies and reviews reporting on the development, implementation, and evaluation of nurse-based models of cardiovascular disease (CVD) prevention, which are contributing to the growing evidence base of their effectiveness. Teams comprising healthcare professionals with expertise in nursing, dietetics, physical activity, and behavioral skills have shown high levels of success in preventive efforts, particularly in high-risk and vulnerable populations.

Purpose: The purpose of this article is to highlight the research and successful models of nurse-based care in clinical practice including the main outcomes, challenges, and dissemination of these models. Highlights include the role of nurses in CVD prevention and the lessons learned from implementation.

Conclusions: Used appropriately, collaborative, team-based, nurse-led models have the potential to effect positive change in both primary and secondary prevention of CVDs. Technology also has an increasingly important role to play. Considerations regarding the effectiveness of contemporary nurse-based models include their design features and content, and methods of implementation and dissemination, with the aim of organizing and delivering flexible CVD preventive healthcare, including training and administrative oversight, which is responsive to contemporary patient need, choice, and preferences.

Clinical implications: The nurse's role in CVD prevention shows promise for enhancing both primary and secondary prevention of CVD worldwide. The research and dissemination of models shown to be effective in clinical practice will enhance the capability of individuals to ensure that appropriate methods are used to implement and extend these models in numerous settings from primary to tertiary care.

Background: People with heart failure frequently experience dry mouth and thirst. More information is currently needed on the effectiveness of practical interventions in reducing these symptoms.

Objective: This study was conducted to determine the effect of cold-water spray on thirst distress, dry mouth, and fluid intake in patients with heart failure.

Methods: A randomized controlled trial was conducted involving 72 patients with a confirmed diagnosis of heart failure. The patients were randomly assigned to either an intervention group that received a cold-water spray-based program or a control group that received routine department care. The program of spraying cold water was implemented for 3 days. The level of thirst distress, dry mouth, and fluid intake was measured at the beginning and end of the 3-day intervention, and the data were analyzed using SPSS software version 21.

Results: Before the intervention, the 2 groups showed no significant differences in demographic characteristics, such as age and gender (P > .05). The average scores for thirst and dry mouth distress were also identical. However, after the intervention, the group that received the intervention had significantly lower average scores for thirst distress (20.2 ± 6.9 vs 27.1 ± 8.5, P < .001) and dry mouth distress (3.5 ± 1 vs 5.2 ± 1.2, P < .001) compared with the control group. It is worth noting that there was no significant difference in the average fluid intake between the 2 groups.

Conclusion: The study concluded that cold-water spray effectively reduces thirst distress and dry mouth in patients with heart failure.

Background: Accurate assessment of caregivers' roles in self-care for heart failure (HF) is essential for effectively managing the condition. This evaluation helps identify areas needing additional support, allowing healthcare providers to create tailored and effective patient care strategies.

Objective: The objective of this study is to test the validity and reliability of the Arabic version of The Caregiver Contribution to Self-Care of Heart Failure Index Version 2 (CC-SCHFI v2) among the caregivers of patients with HF in Jordan.

Methods: A cross-sectional design was used to test the validity and reliability of the Arabic version of CC-SCHFI v2. A translation process and psychometric evaluation were performed. Three hundred caregivers and 300 patients with HF were statistically analyzed.

Results: Caregivers had a mean age of 42 years (females were dominant), whereas patients had a mean age of 66 years. Statistical analysis showed significant results: content validity showed high content validity index (0.92), construct validity showed that Bartlett test (P < .001) confirmed factorability, and the Kaiser-Meyer-Olkin index was 0.74. Confirmatory factor analysis indicated a good fit (χ2 = 150.23, df = 90, P < .001; comparative fit index = 0.95, TLI = 0.94, root mean square error of approximation = 0.045), revealing a 3-factor solution that accounted for 75% of the total variance, 50% for self-care maintenance, 15% for symptom perception, and 10% for self-care management. Concurrent validity showed a strong correlation (r = 0.68, P < .001) between the CC-SCHFI v2 and SCHFI scales. Reliability was good internal consistency, with Cronbach α between 0.78 and 0.84, and the test-retest showed intraclass correlation coefficients from 0.85 to 0.90.

Conclusion: This study provides valuable evidence supporting the reliability and validity of the Arabic version of the CC-SCHFI v2 among the caregivers of patients with HF in Jordan.

Background: Women with a history of gestational diabetes mellitus (GDM) have an elevated risk for cardiometabolic diseases. Chinese American immigrants are disproportionately affected by GDM, yet their cardiometabolic risk factors are understudied. Little is known about physical activity (PA) of this understudied high-risk minority group.

Objective: The purpose of this study was to describe self-reported PA and the facilitators of and barriers to PA in Chinese American immigrants with a history of GDM.

Methods: We conducted an exploratory multimethod study between 2020 and 2021 among 106 Chinese American immigrant women. PA was self-reported using the International Physical Activity Questionnaire-Long form. Four domains of PA (work, transportation, housework, and leisure time) and daily sitting time were recorded. Open-ended questions were asked about the facilitators of and barriers to PA.

Results: Participants' mean age was 34.3 ± 3.7 years, and body mass index was 21.7 ± 2.6 kg/m 2 . Approximately 25% had low PA. Over half (N = 56, 53%) reported no leisure-time moderate-to-vigorous PA. Walking and housework were the most common types of PA. Barriers to PA included being busy with life, physical health issues (eg, sleep and postpartum health issues), low motivation or not enjoying PA, COVID-related barriers, and an unfavorable environment for PA.

Conclusions: Strategies are needed to increase leisure-time moderate-to-vigorous PA in this population. Modifiable factors include providing convenient PA programs (eg, technology or home-based) and addressing postpartum health issues (eg, sleep). Increasing providers' awareness of barriers to PA and cardiometabolic disease risk in this hard-to-reach, high-risk group may improve assessment and referral for high-risk women. Future research is needed to further explore opportunities for PA that Chinese American immigrant women would be open to at this stage in their life.

Background: The Heart Failure Somatic Perception Scale (HFSPS) is an 18-item scale used to evaluate the severity of common signs and symptoms of heart failure (HF) in patients. To date, psychometric properties of the HFSPS have been tested in samples of Japanese, Spanish, Farsi, Italian, and Arabic speakers.

Objective: In this study, our aim was to determine the validity and reliability of the HFSPS in a Turkish population of patients with HF.

Methods: This study was a cross-cultural adaptation of the HFSPS to evaluate its psychometric properties in a Turkish population diagnosed with HF, in accordance with the methodology and recommendations of the International Commission on Testing.

Results: A total of 228 patients were included. The mean age of patients was 67.08 ± 8.53 years, and the mean duration of disease was 4.3 ± 2.9 years. Confirmatory factor analysis testing of the 4-factor (dyspnea, chest discomfort, early and subtle, edema) structure of the original HFSPS resulted in supportive fit indices. Confirmatory factor analysis findings showed that the factor loadings of the model indicated that the items had strong and significant relationships with relevant factors (P < .001 for all items). Cronbach's α reliability coefficients of the scale were calculated as 0.92. A positive moderate correlation of r = 0.887 (P < .001) was found between the HFSPS and the Minnesota Living With Heart Failure Questionnaire.

Conclusion: The findings of this study indicate that the scale is valid and reliable for use in Turkish patients with HF.

Background: Stroke incidence is rising among younger populations, who often face long-term disabilities. Understanding their care needs, preferences, and coping strategies is essential for recovery.

Objective: The objective of this study -was to explore young stroke survivors' care needs, preferences, and coping strategies within 6 months poststroke.

Methods: A qualitative study involving 25 participants at a Taiwanese medical hospital was conducted, where data were gathered through in-depth, semistructured in-person or telephone interviews from August 2022 to January 2023. Inductive content analysis was performed.

Results: The participants had an average age of 53 years and were primarily married men. Three categories emerged: medical-related, social and economic, and self-reconstruction needs. (1) Medical-related needs included personalized rehabilitation and clear communication about prognosis. When unmet, survivors engaged in self-directed rehabilitation or sought peer advice. (2) Social and economic needs included family or peer support and financial assistance. Survivors preferred family presence during recovery and an early return to work to ease financial burdens. When needs were unmet, they relied on peer support, reducing expenses, or returning to work early despite physical limitations. (3) Self-reconstruction needs involved regaining prestroke abilities and adapting to life changes. Survivors preferred rehabilitation for independence and made lifestyle and work adjustments; they coped by accepting the possibility of partial recovery.

Conclusions: We highlighted the medical, socioeconomic, and self-reconstruction needs of young stroke survivors. Tailored rehabilitation, clear communication with clinicians, and support from family and peers are crucial. However, financial pressures often compel early reintegration into the workforce. Personalized recovery strategies addressing physical, emotional, and financial challenges are vital for improving poststroke recovery.