European journal of cardiovascular nursing最新文献

Aims: Nurse-led clinics can potentially provide effective secondary prevention for coronary heart disease (CHD). This study updated an existing systematic review to determine the effectiveness of nurse-led clinics for patients with CHD on mortality, morbidity and other clinical and patient outcomes.

Methods and results: This review of randomized controlled trials used Joanna Briggs Institute methodology, RoB 2 for critical appraisal, RevMan software for synthesis, GRADE for certainty of evidence, and PRISMA for reporting. Twenty-nine trials of nurse-led clinics compared with usual care by another healthcare professional for adults with existing or newly diagnosed CHD (e.g. angina pectoris and myocardial infarction) were included. Nurse-led clinics probably result in little to no difference in mortality (RR 0.91, 95% CI 0.59-1.40; P = 0.67; I2 = 43%; six studies, 3921 participants; moderate certainty evidence) and a slight reduction in CHD exacerbations (RR 0.87, 95% CI 0.76-0.99; P = 0.03; I2 = 40%; five studies, 2848 participants; moderate certainty evidence). Risk factors including systolic and diastolic blood pressure (low certainty) and total cholesterol (moderate certainty) were probably slightly decreased in NLCs although there was no difference in high density lipoprotein (low certainty) between the groups. Low-moderate certainty evidence for behavioural outcomes (exercise and smoking), adherence to medications (Beta blockers, ACE inhibitors, statins and antiplatelets), health-related quality of life (both physical and mental health) and depression and anxiety indicates that patient outcomes are better than, or at least no worse than, usual care.

Conclusion: Treatment in nurse-led clinics for secondary prevention of CHD is supported by the best available evidence.

Registration: PROSPERO (CRD42020205270).

Aim: Oral anticoagulation reduces stroke risk in atrial fibrillation, yet up to 30% of patients do not take their anticoagulation as prescribed. Mobile health applications incorporating behaviour change techniques may improve adherence. This study aimed to co-design a mobile health application to increase adherence to oral anticoagulation for atrial fibrillation.

Methods and results: The Person-Based Approach informed by Leventhal's Common Sense Self-Regulatory Model was used to involve participants with AF as co-designers of a medication adherence mHealth app. Participants recruited via British Heart Foundation existing contacts and social media advertising attended three workshops: 1) a patient storytelling session, 2) an interactive review of existing atrial fibrillation mobile health applications, and 3) pilot testing of the co-designed application. Data were collected using flipchart, post it notes and researcher field notes, with emphasis placed on direct quotations and storytelling. Eleven participants (7 males, aged 35-80 years) took part; and six were diagnosed with atrial fibrillation within the last five years with daily medication counts from 0-12. Eight (72%) participants were taking oral anticoagulants, and only two people used smartphones to manage their own health. The newly develop mobile application, MyAFNurse, featured a talking avatar and behaviour change techniques including a medication tracker, information about AF, advice on when and where to seek help, and a quiz to test knowledge.

Conclusion: The co-design approach to app design empowered AF patients, by incorporating their experiences and preferences. This fostered ownership over self-care and produced a tool grounded in users' real-world needs.

Aims: Adults with implantable cardioverter defibrillators (ICDs) frequently experience psychological distress, characterized as elevated symptoms of anxiety and depression; this significantly compromises their health-related quality of life (HRQoL). This review aims to synthesize the evidence on telemedicine interventions and evaluates their effectiveness on anxiety, depression, and HRQoL among adults with ICDs.

Methods and results: A comprehensive search was conducted across eight databases including Embase, PubMed, Cochrane Library, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and ProQuest Dissertations and Theses. The quality of the studies was assessed using the revised Cochrane risk of bias tool for randomized trials (RoB2). Meta-analyses were performed using the Review Manager Web, employing a random-effects model. Nine studies encompassing a total of 1147 participants were included. Telemedicine interventions included phone calls, web-based platforms, mobile application, and remote monitoring. The meta-analysis results showed no significant differences between telemedicine interventions and standard care in perceived anxiety [standardized mean difference (SMD): -0.21; 95% confidence interval (CI): -0.64, 0.22; P = 0.34, very low certainty], perceived depression (mean difference: -0.40; 95% CI: -2.14, 1.34; P = 0.65, very low certainty), and HRQoL (SMD: 0.01; 95% CI: -0.18, 0.20, P = 0.92, low certainty).

Conclusion: Although no statistically significant differences were observed between telemedicine and standard care interventions in improving anxiety, depression, and HRQoL in adults with ICDs, telemedicine should continue to serve as a valuable complement to existing standard care. Future high-quality randomized controlled trials are needed to establish its effectiveness.

Registration: PROSPERO: CRD42025648188.

This paper discusses whether there is a need to upskill nurses and allied professionals in light of recent developments in ribonucleic acid-based therapeutics (RNA-Tx) for cardiovascular disease (CVD). The paper highlights potential challenges related to knowledge and understanding surrounding RNA-Tx, and provides an overview of the RNA-Tx landscape in CVD to illustrate the expanding and future role these therapies will play in patient management. Finally, it discusses how nurses and allied professionals may enhance their knowledge of RNA-Tx, how they can keep up to date with rapid advances, and how they might support patients to augment their own genomic literacy.