European journal of cardiovascular nursing最新文献

Aim: Informal caregivers play a crucial role in supporting individuals with cardiovascular disease (CVD) during cardiac rehabilitation (CR), yet their specific educational needs are often overlooked. Understanding these needs is essential for developing targeted interventions that enhance informal caregiver support and improve patient outcomes in CR. This study aimed to explore the educational needs of informal caregivers supporting individuals with CVD attending CR.

Methods and results: A mixed-methods approach was used to explore the educational needs of informal caregivers. Quantitative data were collected through an online cross-sectional survey completed by 86 informal caregivers. The survey assessed sociodemographic characteristics, quality of life (WHOQOL-BREF), and educational needs. Most respondents had not received formal education or training related to caregiving, although their knowledge of CVD was rated as moderate to high. Many reported difficulties accessing reliable information and resources. Qualitative data were gathered through semi-structured interviews with 16 informal caregivers, and four key themes were determined: Helpful Resources, Empowerment, Lived Experience Network, and Psychological Support. Informal caregivers expressed a desire for practical resources, more direct access to healthcare professionals, and both emotional and peer support. They also highlighted the importance of managing stress and balancing their well-being alongside caregiving responsibilities.

Conclusion: The findings suggest that educational interventions for informal caregivers should be comprehensive and flexible, incorporating practical caregiving strategies as well as social and emotional support. Such programs could enhance the effectiveness of CR by better equipping informal caregivers to support patient recovery while maintaining their own health.

Effective recruitment and retention of participants in clinical research studies are critical to be able to draw meaningful and valid conclusions in research studies. However, there are multiple challenges related to communication, generalizability, and logistics. Researchers must address and overcome these challenges to ensure robust research outcomes. Effective strategies include honest and clear communication, awareness of reasons for (non)-participation, incentivization, and reimbursements of expenses as well as co-designing interventions and research protocols. This paper outlines common issues in participant recruitment and retention and provides practical strategies to overcome challenges.

Aims: This study aimed to explore effects of exergaming and medical yoga on exercise capacity, fatigue, shortness of breath, health-related quality of life, depression, and anxiety in patients with heart failure.

Methods and results: A randomized sub-study with a 3-month intervention and outcomes measures at baseline, 3, 6, and 12 months. Participants were recruited from heart failure clinics in Sweden. Treatment effects in change of outcomes were tested in an analysis of mixed-effects models with repeated measures. Change in outcomes was the dependent variable. The independent fixed-effect parameters were treatment group, time, and the interaction between treatment group and time.In total, 104 patients (37% women, mean age 71 ± 12, 48% in New York Heart Association Class II and 42% in III) were randomized to exergaming (n = 35), medical yoga (n = 33), or an active control group (n = 36). No statistically significant differences were found between these three groups on any of the outcome measures. Exergaming significantly improved exercise capacity, fatigue, shortness of breath, and physical health-related quality of life and medical yoga improved symptoms of fatigue and emotional health-related quality of life. The control group did not change on the exercise capacity, symptoms, health-related quality of life, or depressive or anxiety symptoms. The well-being score in patients in the control group significantly decreased at 3 months.

Conclusion: Both exergaming and medical yoga demonstrated positive impacts on outcomes when compared with a control group. Exergaming, characterized by its elevated physical intensity, exerted effects primarily on physical health, while medical yoga, as a mind-body intervention, exhibited influences on emotional well-being.

Registration: ClinicalTrial.gov: NCT01785121.

Aims: Digital counselling has gained paramount importance for coronary artery disease (CAD) patients' treatment in recent years. It has been shown to provide a multitude of benefits, including improved risk factors and enhanced lifestyles. No previous reviews have emphasized the interactiveness of digital counselling. Consequently, the aim of this review is to determine whether interactive two-way digital counselling can provide effective secondary prevention as alternative or adjunct care compared with usual care, where patients visit a cardiac clinic and obtain verbal information and written recommendations of the risk factors without a digital intervention.

Methods and results: Studies that implemented digital interventions in patient counselling among CAD patients were identified by searching 10 electronic databases at the end of August 2022 and updated on 15 December 2023. The Joanna Briggs Institution (JBI) protocol was used for screening, quality assessment, data extraction, and meta-analysis. In total, 15 papers were identified that reported the effect of interactive digital counselling on risk factors and lifestyle changes in CAD patients. The results of the meta-analyses had neutral pre-defined outcomes and did not show any effect on cardiovascular risk factors or lifestyle changes.

Conclusion: There is a need for better descriptions of the content and delivery of interactive digital interventions in studies. In the future, digital interventions should be designed not only to focus on patient, but to incorporate social support, peer groups, and interactive tools on a digital platform. Social support has proved to be important in terms of adherence to treatment.

Registration: PROSPERO CRD42021247315.

The participatory co-design method has received significant attention recently. Experience-based co-design is an approach that enables patients (service users) and healthcare providers (service delivers) to co-design services and care pathways in partnership to improve health outcomes based on their experience. Traditionally, it was used as a quality improvement technique. Yet, it is a valuable participatory research design that can help improve health outcomes and be applied in nursing research. This paper will discuss its application in research among people living with cardiovascular multimorbidity and its practicalities, usability, and impact on cardiovascular and chronic disease research and models of care.

Aims: Pharmacological therapy remains a cornerstone in heart failure (HF) treatment despite the implantation of a cardiac resynchronization therapy (CRT) device. The aim of this study was to investigate the association between (i) drug discontinuation and (ii) long-term adherence to HF pharmacotherapy after CRT implantation and socioeconomic position and multimorbidity.

Methods and results: We conducted a registry-based cohort study including all patients who underwent a first-time CRT implantation at Aarhus University Hospital from 2000 to 2017. Heart failure pharmacotherapy included beta-blockers (BBs), renin-angiotensin system inhibitors [angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB)], and mineralocorticoid receptor antagonists (MRAs). Patients were identified using the Danish Pacemaker and International Classification for Disease Registry, and information about medication and comorbidities was obtained through linkage to the Danish health registries. We identified 2007 patients, of whom 1880 (94%) were eligible for inclusion. The cumulative incidence of drug discontinuation at 10 years was 6% [95% confidence interval (CI) 5-8%] for BB, 10% (95% CI 9-12%) for ACEI/ARB, and 24% (95% CI 20-27%) for MRAs. Living alone was associated with higher BB discontinuation rates [hazard ratio (HR) 1.83, 95% CI 1.20-2.79], whereas patients with multimorbidity were more likely to discontinue ACEI/ARB (HR 1.92, 95% CI 1.33-2.80) and MRA therapy (HR 1.51, 95% CI 1.10-2.09). Income and educational level did not influence drug discontinuation rates, and similar adherence patterns were observed across all strata of socioeconomic position and multimorbidity.

Conclusion: In patients with CRTs, drug discontinuation rates were low, and adherence to HF pharmacotherapy was comparable regardless of socioeconomic position. Living alone and multimorbidity were associated with the discontinuation of specific HF drugs.