European journal of cardiovascular nursing最新文献

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of heart attacks, particularly for female patients; however, approximately 10% of cases occur in male patients. While male and female differences pertaining to clinical outcomes and treatment protocols have been addressed in the literature, research is limited on sex differences in secondary prevention programming, such as cardiac rehabilitation. Cardiac rehabilitation is recommended for patients with SCAD to promote physical and mental recovery. This letter highlights sex-specific gaps in existing programming and reports patients' suggestions for enhancing the recovery of this unique patient population.

Aims: Myocardial infarction (MI) can lead to post-traumatic stress disorder (PTSD) which frequently occurs with anxiety and depression, impairing daily functioning and increasing the risk of recurrent cardiovascular events. While psychological interventions have shown promise in reducing anxiety and depression, their effectiveness for PTSD in post-MI patients remains unexplored. This systematic review and meta-analysis aim to evaluate the effectiveness of psychological interventions on PTSD, anxiety, and depression in post-MI patients.

Methods and results: A comprehensive search of databases (Cochrane, CINAHL, PubMed, PsycINFO, Scopus, Embase, Web of Science, CNKI, Wanfang, CBM, ProQuest Dissertations and Theses Global, ClinicalTrials.gov) was conducted until June 2024, identifying randomized controlled trials and quasi-experimental studies assessing psychological interventions in post-MI patients. Study quality was evaluated using the Cochrane Risk of Bias and ROBINS-I tools. Post-traumatic stress disorder outcomes were pooled using meta-analysis in RevMan 5.4. Narrative synthesis was conducted where meta-analysis was not feasible. Nine studies involving 1065 participants were included. Psychological interventions significantly reduced PTSD symptoms {standardized mean difference (SMD) = -0.43 [95% confidence interval (CI): -0.70 to -0.16, P = 0.002]}, anxiety, and depression post-intervention. Subgroup analyses found that intervention components influenced effectiveness, with first-line treatments [eye movement desensitization and reprocessing (EMDR) and cognitive-behavioural therapy (CBT)] demonstrating a medium effect (SMD = -0.40; 95% CI: -0.74 to -0.07; P = 0.02). No significant subgroup differences were found based on the control condition or geographical location of studies.

Conclusion: Psychological interventions, particularly CBT and EMDR, were effective in alleviating PTSD, anxiety, and depression in post-MI patients. Future high-quality research is needed to identify active components and optimize these psychological interventions.

Registration: Prospero CRD42024528138.

Aims: Patients with heart failure (HF) commonly have poor quality of life (QoL), secondary to the persistence and severity of HF symptoms. We aimed to evaluate the prognostic value of QoL measures on all-cause mortality in patients with HF from the Colombian registry of heart failure (RECOLFACA).

Methods and results: We analysed data from patients registered in RECOLFACA during 2017-19. QoL was measured using the EuroQol-5D questionnaire (EQ-5D). From the questionnaire, two independent predictors of mortality were obtained, the visual analogue scale (VAS) and the utility score (US). The primary outcome was all-cause mortality, and secondary variables evaluated were demographic factors, comorbidities, NYHA classification, medications used, and laboratory test results. To analyse survival among patients, the Kaplan-Meier method and the hierarchical Cox proportional hazards regression model were used. This study included 2514 patients from RECOLFACA. Most patients were male (57.6%), and the mean age was 67.8 years. The mean value and standard deviation (SD) of the VAS score was 78.8 ± 20.1 points, while the mean and SD of the US score was 0.81 ± 0.20. As the Kaplan-Meier curve illustrated, patients in the lower quartiles of both VAS and US scores had a significantly higher probability of mortality (log-rank test: P < 0.001 for both scores).

Conclusion: QoL, as calculated by the EQ-5D questionnaire, served as an independent predictor of mortality in patients from RECOLFACA. Further studies may be needed to evaluate whether the provision of optimizing therapies and follow-up care based on patients' perceived QoL reduces short- and long-term mortality rates in this population.

Aims: This study aims to systematically interpret and synthesize the data obtained from qualitative research about the sexual lives of individuals who have experienced myocardial infarction (MI).

Methods and results: A thorough literature review was conducted between November and December 2023 across five electronic databases: PubMed, Web of Science, CINAHL, EBSCO, and Science Direct Embase. This article includes 12 studies published in English since 2000 that have examined the sexual experiences of individuals who have experienced MI. This research adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. We utilized the Critical Appraisal Skills Programme tool for qualitative research to evaluate the quality of all the papers included. To synthesize the data, the deductive and interpretation technique according to Sandelowski and Barroso's approach has been used. The sexual experiences of individuals who have experienced MI were summarized under four main themes: changes in sexual life, barriers to engaging in sexual intercourse, an unmet need: information, and sexuality as a part of routine care.

Conclusion: Patients' expectations from counselling services regarding sexuality after MI are oriented towards these services providing more comprehensive information and incorporating multidisciplinary approaches. This demand clearly indicates the complex and multidimensional changes in sexual life after MI and underscores the necessity for healthcare professionals to play a more active role in this area.

Registration: PROSPERO: CRD42023483112.

Aims: Heart failure (HF) with preserved ejection fraction (HFpEF) is increasing in incidence and is increasingly the most common HF diagnosis. Patients with HFpEF are often excluded from specialist HF services, which has negative impacts on their healthcare experiences and health-related outcomes. As emerging evidence-based treatments are being incorporated into clinical guidelines, it is timely to focus on the management of this phenotype. This review aims to explore literature around care provision for HFpEF in the UK, to characterize and assess HFpEF care pathways against current standards, and to generate evidence to create an optimized framework of care.

Methods and results: A scoping review of the evidence from six databases will be performed, alongside a search of grey literature search and consultation with relevant experts. Given the expected heterogeneity, multiple lines of synthesis are anticipated. Data analysis will follow best practice guidelines for the synthesizing methodologies selected. Patient and public representatives will assist with analysis and in identifying priority components for HFpEF clinical services.

Conclusion: This scoping literature review will enable an in-depth examination of the current health service provision for those with HFpEF in the UK. Synthesis of key components of services and illumination of challenges and barriers will inform current and future practice. There is a long history of specialist HF care in the UK, including seminal work on nurse-led care. Therefore, evidence derived from this review will likely be useful to HF services across Europe. The proposed combination of the search across both peer-reviewed literature and grey literature, combined with patient and public involvement, will identify the key components of a framework of care for those with HFpEF.

Registration: This scoping review protocol was published on the public Open Science Framework platform (no registration reference provided) and can be accessed at: https://osf.io/5gufq/.