Journal of Cardiovascular Nursing最新文献

Background: Despite the increasing recognition of heart failure (HF) as a critical public health issue for both rural populations and women, the intersection of rurality and female sex in HF remains underexplored.

Objective: The objective of this scoping review was to synthesize the evidence on the intersection of rurality with female sex and gender in HF, examining how individual, interpersonal, organizational, or community factors influence the experience, management, and outcomes of HF in women.

Methods: Using the PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature databases, a literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Findings were organized by level of the social-ecological model (SEM).

Results: Among the 1119 articles reviewed, 11 original studies met inclusion criteria, and their results were synthesized. Rural women were found to be at higher risk of developing HF when compared with their male and urban counterparts and tended to have worse outcomes, including higher rates of hospitalizations and mortality. Rural women were also less likely to receive evidence-based care and used healthcare services less.

Conclusions: Findings underscore the intricate interplay between SEM factors that influence HF outcomes in rural women. While highlighting the disparities this demographic group faces, the findings also emphasize the urgency for targeted interventions to address these multifaceted disparities. Future research should further explore the interactions between individual, interpersonal, organizational, and community factors to improve the care and outcomes of rural women living with HF.

Background: Existing literature indicates that benefit finding and social support play protective roles against depressive symptoms. However, there is a lack of understanding regarding the interplay between benefit finding, social support, and depressive symptoms within the dyadic context of stroke survivor-spousal caregiver relationships.

Objective: The objective of this study is to investigate the relationships among benefit finding, social support, and depressive symptoms in young and middle-aged stroke survivors and their spouse caregivers. In addition, the mediating role of social support in the association between benefit finding and depressive symptoms is explored.

Methods: A total of 203 pairs of stroke survivor-spouse caregiver were included in the study. Depressive symptoms, social support, and benefit finding were measured using the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Benefit Finding Scale, and the Caregiver Benefit Finding Scale. The Actor-Partner Interdependence Mediation Model was used to assess direct and indirect effect.

Results: The findings revealed a significant negative association between higher levels of benefit finding and lower depressive symptoms in both stroke survivors (actor effect, -0.126) and spousal caregivers (partner effect, -0.044). Perceived social support emerged as a significant mediator in the relationship between benefit finding and depressive symptoms in spousal caregivers (indirect effect, -0.024). Furthermore, spousal caregivers' perceived social support served as a mediating variable between caregiver benefit finding and depressive symptoms in stroke survivors (indirect effect, -0.023).

Conclusion: The study underscores the interdependence between stroke survivors and spousal caregivers, highlighting the mutual influence they have on each other. Consequently, targeted interventions addressing both members of the dyad, with a focus on enhancing benefit finding and social support, could prove beneficial in ameliorating depressive symptoms in stroke survivor-spousal caregiver.

Background: The symptom network can provide a visual insight into the symptom mechanisms. However, few study authors have explored the multidimensional symptom network of patients with atrial fibrillation (AF).

Objectives: We aimed to identify the core symptom and symptom clusters of patients with AF by generating a symptom network. Furthermore, we wanted to identify multiple characteristics related to symptom clusters.

Methods: This is a cross-sectional study. A total of 384 patients with AF at Tianjin Medical University General Hospital were enrolled. The University of Toronto Atrial Fibrillation Severity Scale was used to assess AF symptoms. Network analysis was used to explore the core symptom and symptom cluster.

Results: Shortness of breath at rest ( rs = 1.189, rc = 0.024), exercise intolerance ( rs = 1.116), shortness of breath during physical activity ( rs = 1.055, rc = 0.022), and fatigue at rest ( rc = 0.020) have the top centrality for strength and closeness. The top 3 symptoms of bridge strength were shortness of breath at rest ( rs = 0.264), dizziness ( rs = 0.208), and palpitations ( rs = 0.207). Atrial fibrillation symptoms could be clustered into the breathless cluster and the cardiac cluster. We have identified multiple factors such as mental health status, left ventricular ejection fraction, heart failure, sex, B-type natriuretic peptide, and chronic obstructive pulmonary disease as significant contributors within the breathless cluster, whereas sex, mental health status, and history of radiofrequency ablation were strongly associated with the cardiac cluster, holding promise in elucidating the underlying mechanisms of these symptoms.

Conclusion: Special attention should be given to shortness of breath at rest as its core and bridging role in patients' symptoms. Furthermore, both the breathless and cardiac clusters are common among patients. Network analysis reveals direct connections between symptoms, symptom clusters, and their influencing factors, providing a foundation for clinicians to effectively manage patients' symptoms.

Background: Social stability has been associated with a reduced risk for cardiovascular diseases. However, less is known about how multiple dimensions of social stability such as residential, marital and financial stability are associated with cardiovascular disease risk, and potential moderating factors of these associations within the African American population.

Objective: This study examined the associations between social stability dimensions such as residential stability, financial stability and marital stability, and cardiovascular disease (CVD)-risk in middle to older (>45 years) African American population.

Methods: The study participants (n = 98 were a subsample of a larger church-based intervention to reduce cardiovascular risks and were assessed at baseline and after 6 months. Data at the baseline were used to test two types of hypotheses: (a) social stability dimensions are differently associated with CVD-risk indicators as measured by blood pressure, total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol, and triglycerides after controlling for age and gender, and (b) age, gender and physical activeness moderate these potential associations.

Results: As expected, we found that stable social conditions are important determinants of health for African Americans. Our regression analysis within the SEM framework revealed that residential, marital, and financial stabilities are uniquely associated with most of the CVD-risk indicators. The study results also revealed contingent effect of physical activeness on these associations. The African Americans who were more physically active appeared to gain more health benefits associated with stable social conditions than did the less physically active African Americans.

Conclusion: The study findings will provide evidence that social stability dimensions such as residential stability, financial stability and marital stability are associated with CVD-risk in middle to older African American population. These findings may inform health promotional interventions and policies that focus on mid-older African Americans.

Background: Patients with acute myocardial infarction (AMI) often experience psychological distress and reduced quality of life after stent implantation. In this study, our aim was to evaluate the effectiveness of a nurse-led peer support intervention on the psychological status and quality of life of patients with AMI post stent implantation.

Methods: In this randomized controlled trial, 200 patients with AMI who underwent stent implantation were randomly assigned to either a nurse-led peer support intervention group (n = 100) or a standard care control group (n = 100). The intervention consisted of weekly 90-minute group sessions facilitated by trained nurses and peer supporters for 12 weeks. Psychological status was assessed using the Hospital Anxiety and Depression Scale and the Perceived Stress Scale. Quality of life was measured using the Short Form-36 (SF-36) questionnaire. Assessments were conducted at baseline and 12 weeks post intervention.

Results: Compared with the control group, individuals in the intervention group showed significantly lower anxiety (mean difference, -2.5; 95% confidence interval [CI], -3.2 to -1.8; P < .001) and depression (mean difference, -2.1; 95% CI, -2.8 to -1.4; P < .001) scores at 12 weeks. Perceived stress levels were also significantly reduced in the intervention group (mean difference, -3.7; 95% CI, -4.5 to -2.9; P < .001). Quality of life scores improved significantly across all domains of the Short Form-36 in the intervention group, with the most notable improvements in emotional well-being (mean difference, 10.2; 95% CI, 7.1-13.3; P < .001) and social functioning (mean difference, 9.8; 95% CI, 6.7-12.9; P < .001). Medication adherence and perceived social support also improved significantly in the intervention group.

Conclusions: Nurse-led peer support interventions significantly improve psychological status and quality of life in patients with AMI after stent implantation. These findings suggest that incorporating such interventions into standard care could enhance postoperative recovery and long-term outcomes for individuals with AMI.

Background: Sleep problems and anorexia problems are common in patients with heart failure (HF). The relationship between sleep quality and anorexia has not been previously investigated among patients with HF.

Objective: In this study, our aim was to determine whether the association of sleep quality with anorexia was mediated by anxiety and depressive symptoms in patients with HF.

Methods: A cross-sectional survey was conducted using a paper-based questionnaire between January 1 and March 30, 2024. Data collection included 3 components: demographic and clinical characteristics, and standardized psychological assessments, including the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, and Functional Assessment of Anorexia/Cachexia Therapy-Anorexia Cachexia Subscale. Partial correlation analysis was performed using SPSS, and mediation analysis was conducted with the PROCESS macro.

Results: The mean PSQI score was 7.69 (±4.13), and the mean scores for anxiety and depressive symptoms were 9.42 (±4.56) and 9.71 (±4.67), respectively. The mean Functional Assessment of Anorexia/Cachexia Therapy-Anorexia Cachexia Subscale score was 24.56 (±5.62), with a significant proportion of participants exhibiting anorexic behaviors. Correlation analysis revealed significant associations between sleep quality, anxiety, depressive symptoms, and anorexia. Mediation analysis demonstrated that anxiety and depressive symptoms significantly mediated the relationship between sleep quality and anorexia, with anxiety accounting for 43.61% of the total indirect effect.

Conclusions: Poor sleep quality is prevalent among patients with HF and is significantly associated with anxiety, depressive symptoms, and anorexia. Anxiety and depressive symptoms mediate the impact of poor sleep quality on anorexia, with anxiety symptoms exerting a stronger effect. Addressing sleep disturbances and psychological distress may help mitigate anorexia and improve clinical outcomes in patients with HF.

Background: The prevalence of depressive symptoms post cardiac surgery remains high even 1 year after the operation. However, the relationship between postsurgery long-term depression and physical activity is not well understood.

Objective: The purpose of our study was to investigate the relationship between depression and physical activity levels in patients during an 18-month follow-up period post cardiac surgery.

Methods: Fifty-seven patients with 82.5% men and an average age of 60.3 years were followed up for 18 months in the study. Depression was assessed using the Center for Epidemiologic Studies Depression scale. Physical activity levels were measured using the International Physical Activity Questionnaire at 18 months.

Results: The most common procedures were cardiac bypass (49.1%) and valve replacement (35.1%). Compared with preoperative levels (14.4 ± 1.5), depression scores were significantly increased immediately post surgery (21.0 ± 1.3, P = .002), decreased at 10 days post discharge (14.4 ± 1.2, P < .001), and increased again at 18 months post discharge (19.0 ± 1.1, P = .01). Physical activity levels, measured using the International Physical Activity Questionnaire, were inversely associated with depression scores. Participation in cardiac rehabilitation did not show a significant relationship with depression scores.

Conclusions: Patients with higher International Physical Activity Questionnaire scores had lower Center for Epidemiologic Studies Depression scores, highlighting the potential benefits of physical activity in managing postoperative depression. These findings underscore the importance of promoting physical activity as a potential intervention to improve mental health in patients who had undergone cardiac surgery.