European journal of cardiovascular nursing最新文献

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.

Aims: Physical, psychological, and social distress experienced by patients undergoing cardiac surgery has long-term effects on quality of life. Therefore, patient-centred, continuous, and comprehensive transitional care is required. We aimed to develop a Self-Assessment Tool for Transition to Daily Life (SAT-TDL) and to examine its reliability and validity.

Methods and results: A draft SAT-TDL was developed and validated by experts. A modified version was then developed through patient interviews and acceptability assessment, and its reliability and validity were evaluated through exploratory and confirmatory factor analyses. Construct validity was tested using the standard version of the 12-item Short Form Health Survey (SF-12v2). The initial 56-item SAT-TDL draft was modified into a 28-item pilot version and then into a 27-item version based on feedback from seven patients who had undergone cardiac surgery. From 340 valid responses, the 27-item SAT-TDL yielded four domains through item and factor (exploratory and confirmatory) analyses. Cronbach's alpha coefficient for the entire tool was 0.95. Hypothesis testing revealed significant correlations between the psychological aspects of the SF-12v2 and 'psychological transitions' domain of the SAT-TDL, and between the social aspects of the SF-12v2 and 'continuation of self-management' and 'meeting care needs' domains of the SAT-TDL. The final model fit was generally good (CMIN/DF = 3.3285, GFI = 0.809, AGFI = 0.771, CFI = 0.883, and RMSEA = 0.083).

Conclusion: The SAT-TDL is a reliable and valid self-assessment tool. Sharing information on patients' post-discharge transitions and care needs with medical staff may support smoother recovery and improve the quality of life after cardiac surgery.

Aims: The purpose of this study was to construct a symptom network for identifying core symptoms of frailty in physical, cognitive, and social domains in patients with chronic heart failure (CHF).

Methods and results: A total of 269 hospitalized patients with CHF was included in the study. The FRAIL scale, the Montreal Cognitive Assessment (MoCA), and the Help, Participation, Loneliness, Financial, Talk scale (The HALFT scale) were used to assess the frailty in physical, cognitive, and social domains. The construction of symptom networks for frailty in physical, cognitive, and social domains in patients with CHF was conducted by R software. The symptom network analysis indicated that the three symptoms with the highest centrality of strength were 'attention' (rs = 4.178), 'visuospatial/executive function' (rs = 3.940), and 'language' (rs = 3.843). The three symptoms with the highest centrality of betweenness were 'language' (rb = 32.000), 'loneliness' (rb = 28.000), and 'decreased endurance' (rb = 26.000). The three symptoms with the highest centrality of closeness were 'attention' (rc = 0.011621), 'visuospatial/executive function' (rc = 0.011620), and 'language' (rc = 0.011568). The three symptoms with the highest centrality of bridge were 'decreased walking ability' (rbs = 7.608), 'decreased endurance' (rbs = 7.373), and 'inability to help others' (rbs = 4.990).

Conclusion: The core symptoms of frailty in the physical, cognitive, and social domains among patients with CHF are attention, visuospatial/executive function, and language function. Therefore, prioritizing interventions for core symptoms should be implemented to address frailty in the physical, cognitive, and social domains of patients with CHF in clinical practice.

Aims: The transition from hospital to home is a critical phase for stroke survivors and their caregivers, often marked by complex and unmet needs due to fragmented care. Understanding how dyads experience this phase is essential to ensure continuity and quality of post-stroke care. Although various educational programmes have been studied, few have examined the lived experiences of dyads participating in an integrated teletraining and telesupport programme during transitional care. This qualitative study explores these experiences in the first month after discharge to inform improvements in transitional care and the development of tailored telehealth programmes.

Methods and results: A phenomenological study was conducted using Cohen's methodology. Dyads received predischarge training through videos and nursing support. Open-ended interviews were conducted between October 2023 and June 2024. Data triangulation enhanced analytical rigour. Fourteen dyads were enrolled (mean age 62 years; 46% men, 54% women), including spouses, cohabiting partners, siblings, and adult children. Two overarching themes emerged: Transitional Care Impact on Dyads (three subthemes) and Meeting the Holistic Needs of the Dyad (five subthemes).

Conclusion: Findings suggest that teletraining and telesupport programmes may support post-stroke transitional care, fostering dyadic well-being and reducing anxiety and isolation. Given the qualitative design and small sample size, transferability is limited. Further research across diverse settings is needed to validate and extend these insights.

Aims: Heart failure is a complex syndrome marked by the heart's insufficient pumping ability, and it is frequently complicated by prevalent sleep problems such as initiating and maintaining sleep. Aromatherapy via inhalation is a safe, non-pharmacological therapy that may improve sleep. Lavender oil, a type of essential oil, is reputed for its calming and sedative properties, but evidence of its effectiveness in patients with chronic heart failure remains limited. This study aimed to assess the efficacy and safety of lavender essential oil inhalation in improving sleep quality and reducing fatigue levels among patients with chronic heart failure.

Methods and results: An open-label, parallel randomised controlled trial was conducted between March and August 2023. A total of 80 participants were randomised 1:1 to receive either lavender essential oil or fractionated coconut oil (placebo) inhalation for 8 hours nightly over 4 weeks, in addition to standard care. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and fatigue using the Fatigue Assessment Scale (FAS), at baseline, Day 3, Week 1, Week 2, and Week 4 (immediate post-intervention). Patient satisfaction and adverse events were assessed. Of 80 participants, 68 completed the study. The experimental group demonstrated significantly greater improvement in sleep quality versus control group at all time points. Participants who had lavender essential oil inhalation therapy also exhibited significantly lower FAS scores at Week 2 (β = -3.825, 95% CI: -4.955 to -2.695, p<0.001) and 4 (β = -7.900, 95% CI: -9.725 to -6.075, p<0.001). Patient satisfaction was higher in the experimental group (9.06±1.24 vs. 6.03±1.10, p<0.001). No adverse events were reported.

Conclusion: Lavender essential oil inhalation is a safe and well-accepted intervention for improving sleep quality and reducing fatigue in patients with chronic HF. Larger multicentre trials with objective sleep measurements and longer follow-up are warranted.

Registration: The trial was registered at www.clinicaltrials.gov (number NCT05862350) on October 24, 2022.

Aims: Healthcare is a significant contributor to environmental degradation, with cardiac catheterization laboratories (cath labs) recognized as high-resource clinical environments. The aim of this study was to identify modifiable drivers of clinical waste and co-develop practical, locally relevant strategies to improve environmental sustainability within a cath lab setting.

Methods and results: A qualitative co-design workshop was conducted at a metropolitan tertiary hospital in Australia. Ten participants, including clinical staff, hospital administrators, support services personnel, and community members, engaged in structured discussions using a World Café model. Data were collected through field notes, participant-generated materials, and member checking, and were analysed thematically using an inductive approach. Six interrelated themes emerged: (i) excessive packaging and procurement practices, (ii) underutilization and disposability of clinical stock, (iii) behavioural norms and change readiness, (iv) infrastructure and feasibility constraints, (v) community and patient engagement, and (vi) measurement, leadership, and accountability. Participants expressed motivation to reduce waste but identified systemic and organizational barriers that limited the adoption of sustainable practices.

Conclusion: Sustainability in the cath lab is shaped by modifiable factors beyond individual clinician behaviour, including procurement policies, stock management, and leadership structures. Embedding sustainability within organizational processes and engaging patients and communities are essential to achieving meaningful, lasting reductions in healthcare waste.

Aim: Heart failure (HF) is characterized by high morbidity and frequent hospital readmissions, highlighting the need for scalable out-of-hospital monitoring to support post-discharge nursing care. We aimed to: (1) develop a HF-tailored, user-friendly voice task set suitable for remote monitoring; (2) identify HF-related acoustic markers and build explainable voice-based models; and (3) evaluate the accuracy of smartphone recordings for clinical monitoring.

Methods and results: In this multicentre observational study, patients hospitalised with AHF were recruited at four centres. Voice recordings were obtained with professional devices and common smartphones (Apple, Huawei, Vivo). Eleven speech tasks were evaluated, and eleven acoustic feature categories were extracted (e.g., MFCCs, chroma, spectral, glottal features). Two XGBoost models were trained to classify clinical status from admission to discharge and from mid-hospitalization to discharge; models were interpreted with SHAP. Four tasks were selected for the final model. The admission-to-discharge model achieved 0.76 accuracy, 0.86 sensitivity, 0.65 specificity, and an AUC of 0.77. The mid-hospitalization-to-discharge model showed 0.81 accuracy, 0.89 sensitivity, 0.71 specificity, and an AUC of 0.80. SHAP analysis revealed vocal improvements corresponding to clinical recovery, characterized by transitions from unstable, noisy voice patterns to more stable, harmonic-rich, brighter, and stronger vocal expressions. Cross-device comparison demonstrated high consistency among recordings across different smartphone brands, supporting the feasibility of mobile-based voice data collection.

Conclusions: We developed an explainable, high-performing voice-based HF monitoring model deployable via smartphones. The approach is non-invasive, low-burden and feasible for integration into nurse-coordinated post-discharge monitoring and remote triage.

Public and Patient Involvement (PPI) is widely recognised and increasingly required in health and nursing research, yet many research teams struggle to operationalise PPI meaningfully, especially in the early stages of PPI. Existing guidance tends to be in text format (checklists and principles) rather than a visual, co-creative planning tool. In this paper, we discuss how to initiate PPI in Nursing science and suggest a new tool, the PPI Project Design Canvas; an integrative tool to support planning and enacting PPI in health and nursing research.