Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires最新文献

The objective of the clinical project was to plan and deploy a knowledge translation approach to prevent falls among elderly patients hospitalized in a unit of cardiovascular medicine. A combination of education strategies built around interactive workshops enabled the implementation of a screening tool and of an up-to-date preventive intervention guide. Twenty-four workshops were conducted in all three work shifts and an implementation follow-up was made. The participation rate was 93% of the unit's active staff The increased use of prevention tools and of an intervention guide to prevent falls suggests an increased level of awareness as a result of the project. The staff expressed their satisfaction on having been consulted and involved early in the implementation process. Moreover, the flexible schedule and focus on a bilateral sharing of knowledge through brief interactive workshops were appreciated.

Qualitative nurse researchers are required to make deliberate and sometimes complex methodological decisions about their work. Methodology in qualitative research is a comprehensive approach in which theory (ideas) and method (doing) are brought into close alignment. It can be difficult, at times, to understand the concept of methodology. The purpose of this research column is to: (1) define qualitative methodology; (2) illuminate the relationship between epistemology, ontology and methodology; (3) explicate the connection between theory and method in qualitative research design; and 4) highlight relevant examples of methodological decisions made within cardiovascular nursing research. Although there is no "one set way" to do qualitative research, all qualitative researchers should account for the choices they make throughout the research process and articulate their methodological decision-making along the way.

Background: One fifth of Canadians are smokers despite the availability of community-based smoking cessation programs. It was hypothesized that offering a post-discharge smoking cessation program to cardiac patients would decrease smoking rates at six months.

Method: This pilot randomized study explored the feasibility, acceptability and preliminary efficacy of a smoking cessation intervention delivered by a smoking cessation nurse specialist (SCNS) to cardiac patients after hospital discharge.

Sample: Participants (N=40) were randomized to either a postdischarge telephone intervention delivered weekly for the first month and then monthly until the third month (experimental group [EG]), or referral to usual community care (control group [CG]).

Findings: The researchers confirmed the feasibility of recruitment and acceptability of the intervention, but dfficulty with follow-up. The intention-to-treat analysis showed similar smoking cessation rates in both groups at six months (25% EG versus 30% CG; p = 0.72).

Conclusion: An intensifed follow-up protocol, or a more intensive, comprehensive and multidisciplinary intervention might be required, given the characteristics of the smokers.

Background: Measurement of health status (HS) and social support are becoming increasingly accepted as tools to guide clinical decision-making and patient-centred practice.

Purpose: To assess self-reported HS, cardiac-health related quality of life and social support in subjects with a diagnosis of acute coronary syndrome (ACS).

Design: The study used a quantitative descriptive design.

Sample: 36 subjects with a diagnosis of ACS were selected from patients admitted to medical units at a teaching hospital in Toronto, Ontario.

Methods: One-time, semi-structured interviews were conducted using valid and reliable cardiac-specific HS and social support measures.

Results: Analysis indicated that subjects with higher perceived social support and patients with higher income reported greater treatment satisfaction and C-HROL. Subjects with severe angina reported a higher perceived level of social support than those with more moderate physical limitation due to angina.

Conclusion: Patients' social environment and HS significantly impact their satisfaction with treatment. Patient-centred measures assist in clinical decision-making, patient-centred care planning and patient involvement in their care.

Background: Adherence to diet and exercise regimens significantly limits morbidity and mortality for cardiac patients. Research at six and 12 months post CR program indicates that healthy behaviours learned in CR are not sustained. However, little is known about the extent of adherence in the immediate program completion period.

Purpose: To determine CR participants' knowledge of their diet and exercise prescription and the degree of adherence two months after completing CR, and to examine demographic and clinical variables to identify relationships to adherence behaviours.

Methods: Participants (n = 174) were recruited from Phase II CR over a one-year period. The Diet Habit Survey (DHS) and Duke Activity Status Index (DASI) scores were administered at admission, discharge, and two months post discharge. Structured telephone interviews were conducted to evaluate adherence behaviours. Spearman correlation was used to determine relationships between demographic and clinical variables and adherence behaviours.

Results: Repeated measures ANOVA showed DHS and DASI scores were significantly higher at discharge (p < 0.001) without significant drift at two months post program (p < 0.09). These scores were in contrast with low self-report of knowledge of dietary and exercise recommendations and adherence to dietary and exercise instructions. Lower knowledge about diet and exercise were correlated with employment (diet, p < 0.001; exercise, p < 0.025). Decreased dietary adherence was correlated with BMI (p < 0.005). Exercise adherence was correlated with gender (p < 0.021) and marital status (p < 0.042).

Conclusion: Although CR participants gain and retain knowledge about necessary dietary changes and improve their exercise activity tolerance during CR, most fail to translate the information into health promoting behaviour changes beginning in the immediate discharge period. Research to identify methods that transform knowledge into lasting behaviour change post CR is needed.

Although conference presentations are central to the dissemination of new nursing knowledge, public speaking can be a daunting prospect. The purpose of this article is to provide nurses with the essential tools to deliver a successful conference presentation. Accordingly, the all-too-familiar steps of assessment, planning, implementation, and evaluation provide an organizational framework for a practical guide to developing and executing a relatively stress-free, effective presentation.

Amiodarone remains one of the most commonly prescribed antiarrhythmics effectively treating atrial fibrillation and ventricular arrhythmias. Diligent monitoring for potentially serious side effects especially in the elderly is paramount.

Background: Family presence (FP) during cardiopulmonary resuscitation (CPR) is becoming an increasing practice. Within current literature, the attitudes and beliefs towards FP of cardiac health care professionals in Canada are limited.

Purpose: The purpose of this project was to examine the perceptions of cardiac health care professionals (n=368) concerning FP during CPR.

Method: A survey was conducted to explore the attitudes and beliefs of cardiac health care professionals towards family presence during CPR within five Edmonton and surrounding area hospitals.

Results: The response rate was 46%, with the greatest response from nurses and physicians. Of the respondents, 44.3% believed that family should have the option to be present, and 40.9% believed that family should be allowed at the bedside during CPR. Less than half of the respondents had experience with FP during CPR. The barriers identified towards FP were lack of support for families, the experience would be too traumatic for families, families would not understand the procedures, fear of families physically interfering with procedures, FP would increase stress levels among staff, and tradition and politics excludes FP.

Conclusion: Despite less than half the respondents supporting FP the majority endorsed development of policy and procedures to overcome barriers to FP during CPR.