Progress in cardiovascular nursing最新文献

Although the use of support groups for patients with an implantable cardioverter defibrillator (ICD) is recommended, little information concerning support and anxiety exists in relation to group attendance. Using a comparative descriptive design, this study sought to examine differences in demographics, ICD indicators, anxiety, and social support between the ICD recipients who attended a support group and those who did not. Characteristics of 150 ICD patients (77 nonattendees, 73 attendees) were evaluated using Sarason's 6-item Social Support Questionnaire and the State-Trait Anxiety Inventory. Results show that those who attended a support group had higher trait anxiety (P=.05) and were less satisfied with their social support (P=.03) compared with nonattendees. Among all participants, trait anxiety was higher in those diagnosed with tachycardia (P=.046). Finally, higher satisfaction with support was associated with less anxiety (P=.000) and a larger social network (P=.02). Thus, support group attendees were not less anxious, nor did they experience more support than nonattendees, indicating that support groups may serve a vital role for ICD recipients who are characteristically anxious and lack supportive resources. This study recommends evaluating patient support and anxiety to improve support group efficacy.

Heart failure (HF) is the leading cause of rehospitalization in older adults. The purpose of this pilot study was to examine whether telemonitoring by an advanced practice nurse reduced subsequent hospital readmissions, emergency department visits, costs, and risk of hospital readmission for patients with HF. One hundred two patient/caregiver dyads were randomized into 2 groups postdischarge; 84 dyads completed the study. Hospital readmissions, emergency department visits, costs, and days to readmission were abstracted from medical records. Participants were interviewed soon after discharge and 3 months later about effects of telemonitoring on depressive symptoms, quality of life, and caregiver mastery. There were no significant differences due to telemonitoring for any outcomes. Caregiver mastery, informal social support, and electronic home monitoring were not significant predictors for risk of hospital readmission. Further studies should address the interaction between the advanced practice nurse and follow-up intervention with telemonitoring of patients with HF to better target those who are most likely to benefit.

Heart failure (HF) is well recognized as a condition resulting from chronic neurohormonal activation. Sleep-disordered breathing (SDB) as a neurohormonal disorder is less recognized. In SDB, whether obstructive or central in nature, nightly repetitive cycles of hypoxia-reoxygenation produce intense sympathetic activation and deprive the body of much needed sleep. Both HF and SDB are associated with fatigue, cognitive impairment, and challenges for adherence to prescribed therapies. Together, the combination of HF and SDB can have particularly ominous consequences for cognitive functioning, decision making, adherence and, ultimately, outcomes. The suboptimal adherence seen in patients with both HF and SDB may result from a neurohormonal synergism that exists between the 2 conditions.

Increasing evidence suggests that there are sex/gender differences in the presentation and prodromal symptoms of acute coronary syndrome (ACS). The purpose of this pilot study was to identify sex differences in the prodromal symptoms of ACS using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS). Telephone surveys using the MAPMISS were conducted between 4 and 6 months after the ACS event. Seventy-six patients (24 women) participated in the study. The women generally reported higher prodromal scores. Moreover, scores demonstrated differences in prodromal symptoms based on menopausal status. The premenopausal and perimenopausal women reported a greater number and higher frequency of symptoms compared with the men and menopausal women. The results of this study suggest that both men and women report nontraditional prodromal symptoms of ACS. In addition, there appears to be a difference in the frequency and number of symptoms reported based on menopausal status.