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

Background: Physical limitation is a great burden for patients with heart failure, but little is known about how that affects spouses. Beneficial effects of support on the prognosis for the patient with chronic heart failure may come at a psychological and physical cost to the person providing the support.

Purpose: The aim of this study was to explore and describe how spouses conceive the physical limitations in patients with heart failure and the impact these limitations have on the daily life of the spouse.

Design: A qualitative design with a phenomenographic approach was chosen for the study.

Findings: The informants were 15 spouses of heart failure patients. The spouses perceived a variety of aspects pertaining to how they conceive the physical limitations in the loved one with heart failure and the implication this had on their daily life. The referential aspects were: Losing self-containment, Missing communality, Accommodating to the situation and Finding satisfaction in life.

Implications and conclusions: Awareness must be raised among health care professionals about the profound impact heart failure in loved ones has on the spouses and explore how the spouses' needs can be appropriately met. Since spouses have an important role to play in the management of heart failure, it is of great importance that nurses identify and support spouses to manage daily life activities. Taking care of the good days in order to have a rich life and to help spouses see possibilities is necessary since it is difficult to predict the future.

In this clinical column, we discuss the ambiguous distinction between genetic research and clinical genetics, particularly for Mendelian diseases with high recurrence risk, high morbidity and/or mortality and the possible amelioration of such diseases by screening or treatment. We use arrhythmogenic right ventricular cardiomyopathy as an example of a lethal Mendelian disorder, which prompted the discussion contained in this column. Working with such diseases may mean that genetic researchers have some responsibility for both immediate research subjects and their extended families, as they obtain molecular genetic information. For some diseases, therefore, a willingness to accept genetic research results should be an inclusion criterion, and it may be considered unethical for research ethics boards to approve genetic studies unless measures to ensure clinical follow-up have been established. We recommend managing the tensions between genetic research and clinical practice by using disease-based genetic registers, organized within a clinical genetic service.

Background: The demographic profile of the patient receiving coronary artery bypass graft (CABG) surgery in Canada has changed significantly over the past 20 years from mainly white (i.e., English, Irish, Scottish) to non-white (i.e., Indian or Chinese). To support individuals who have recently undergone a CABG procedure, patient education is provided to guide performance of self-care behaviours in the home environment. The relevance of this education, when applied to the current CABG surgery population, is questionable, as it was designed and tested using a white, homogenous sample. Thus, the number and type of self-care behaviours performed by persons of Indian and Chinese origin has not been investigated. These individuals may have varying self-care needs that are not reflected in the current self-care patient education materials.

Purpose: The intent of this study was to examine the difference in the type and number of self-care behaviours performed between white and non-white patients following CABG surgery.

Methods: This study is a sub-study of a descriptive, exploratory design that included a convenience sample. Ninety-nine patients were recruited, representing three cultural groups (White, Indian, and Chinese). Descriptive data were used to describe the sample and identify specific self-care behaviours performed in the home environment.

Findings: Results indicate statistically significant differences between white and non-white individuals related to use of incentive spirometer (p = 0.04), deep breathing and coughing exercises (p = 0.04), and activity modification (p < 0.05) at 1 week following hospital discharge.

Implications: Future research and theoretical exploration are required to assist in the understanding of the underlying mechanisms that contribute to the differences that are noted between white and non-white groups.

Clinical practice guidelines and expert consensus statements are available to guide nursing practice. Research suggests care gaps exist between best practice standards and the clinical reality of day-to-day nursing practice. The purpose of this column is to review the rationale for ST-segment monitoring, indications, preparation and implications for direct patient care.

Background: Educational needs for patients who are hospitalized with cardiovascular health issues are often underestimated by those caring for them. Perceived control is a construct that has been employed to guide understanding these needs.

Purpose: The purpose of this exploratory study was to expose cardiac nurses to the construct of perceived control during an annual cardiac education day in February 2009, and evaluated whether the nurses find perceived control constructive in their current practice. The exploratory study also evaluated whether the nurses planned to alter their approach to patient teaching to incorporate perceived control based on the information contained in the presentation.

Method: Data were collected from registered nurses (n=16) employed in a tertiary cardiac intervention unit, who attended an annual cardiac education day in February 2009. The nurses completed a one-time cross-sectional survey, created de novo, which explored their beliefs around perceived control and patient education.

Findings: The survey revealed that the nurses generally agreed that perceived control had the potential to positively impact patient teaching. This was despite the nurses' lack of previous knowledge about perceived control. Younger nurses tended to find that perceived control had an impact on patient adherence more than older nurses, although this result was not statistically significant. Younger and less experienced nurses were also more open to theory and research underpinning patient education.

Conclusion: Further study is required with a larger sample size and validated measurement tool.

Oualitative research approaches are diverse and provide the opportunity to explore the experiences, behaviours,. contexts and lifestyle choices of individuals with cardiovascular disease. Understanding these complex health and social factors is essential to the delivery of responsive health care services that improve patient satisfaction and health outcomes. In-depth interviewing is a popular and versatile data collection method used in qualitative inquiry. Qualitative research interviews are not as simple as they may first seem and involve complex interactions that employ a range of communication and interpretation skills. Preparation for interview practice can promote rigour and help avoid pitfalls, such as premature interpretation of research data, inadequate depth of questioning, and the identification of researcher presuppositions that may influence data collection and analysis. In this research column, an overview of qualitative interviewing is presented followed by a brief outline of practice techniques to improve the execution and outcomes of this valuable data collection method.