European journal of cardiovascular nursing最新文献

Aims: Caregiving processes and outcomes have been increasingly articulated in the cardiovascular literature, particularly in heart failure and coronary artery disease, but there has been no synthesis on caregiving for a patient with atrial fibrillation (AF). This review synthesizes scientific evidence that describes caregiving in the context of AF, with the aim of informing future research priorities for AF caregiving or clinical approaches that may support caregivers.

Methods and results: Informed by PRISMA guidelines, we conducted a mixed-methods systematic review with a data-based convergence design using a thematic synthesis approach. All studies that examined factors related to caregiving for patients with AF, as either a descriptive, predictor, or outcome variable, were included. After the search, data from 13 studies were abstracted; half of the studies (53%) were of low-to-moderate quality. Changes to the family unit and feelings of uncertainty are common post-AF; a subset of caregivers struggle with mental health challenges, particularly those who are unwell themselves or those who provide several hours of care to patients with more advanced symptoms or limitations. Informational support for caregivers appears to be lacking but is desired to better adapt to the changes or consequences incurred from AF.

Conclusion: This review complements findings from previous reviews conducted in other cardiovascular disease subgroups. As there is still limited high-quality research on caregiving in an AF context, additional research is required to adequately inform supportive programming for caregivers of patients with AF, if indicated.

Registration: PROSPERO: CRD4202339778.

Aims: To explore the mediating role of relationship satisfaction between communication patterns and benefit findings in stroke couples using the actor-partner interdependence mediation model.

Methods and results: A cross-sectional study was conducted from October 2022 to April 2023 in China. Based on the actor-partner interdependence mediation model, we used structural equation modelling to explore the mediating role of relationship satisfaction of stroke patients and their spouses in communication patterns and benefit findings. A total of 381 stroke couples (patients, 61.4% male, mean age 54.06; caregivers, mean age 53.58) were included in the data analysis. Actor effects showed that stroke couples' relationship satisfaction mediated each of their own three communication patterns (constructive communication, demand/withdraw communication, and mutual avoidance) and benefit findings. In addition, patients' relationship satisfaction mediated patient demand-spouse withdraw and spouses' benefit findings. Partner effect showed that patients' relationship satisfaction mediated the association between their own three communication patterns and spouses' benefit findings. Patients' relationship satisfaction mediated the association between patient demand-spouse withdraw and patients' benefit findings. Moreover, spouses' relationship satisfaction mediated the association between the two communication avoidance patterns exhibited by patients (spouse demand-patient withdraw and mutual avoidance) and the spouses' benefit findings.

Conclusion: The results have demonstrated a reciprocal influence on benefit findings between stroke patients and their spouses. The communication patterns within these couples have impacted not only their own benefit findings but also those of their spouses, with relationship satisfaction playing a mediating role.

Aims: Patient engagement in decision-making could improve healthcare quality and health outcome, which has been emphasized in atrial fibrillation (AF) management guidelines. However, patients report relatively low level of engagement in decision-making for catheter ablation (CA). Therefore, this study aims to explore the influencing factors of AF patient engagement in decision-making for CA.

Methods and results: A cross-sectional study was conducted. A total of 836 patients were recruited from six tertiary hospitals in Shanghai. Adapted version of the Control Preferences Scale, Chinese version of the All Aspects of Health Literacy Scale, Chinese version of the Facilitation of Patient Involvement Scale, and the Atrial Fibrillation Knowledge Questionnaire were used to measure patient engagement in decision-making, health literacy, perception of physician facilitation, and AF knowledge, respectively. Of the 750 patients who returned valid questionnaires, 20.2% of the patients reported active engagement in decision-making, 39.5% reported collaborative engagement, and 40.3% reported passive engagement. Compared with patients perceiving passive engagement, those with collaborative or active engagement were more likely to be female and have higher income, moderate European Heart Rhythm Association (EHRA) class (II and III), higher perception of physician facilitation, higher health literacy, and higher AF knowledge (P < 0.05 for all). The collaborative engagement group exhibited a shorter AF duration.

Conclusion: The degree of patient engagement in CA decision-making varied, with most perceiving passive engagement. Patient engagement in decision-making was influenced by gender, income, duration of AF, EHRA class, perception of physician facilitation, health literacy, and AF knowledge.

Aims: To investigate associations between body image concerns (BICs) measured by the implantable cardioverter defibrillator body image concerns questionnaire (ICD-BICQ) and other patient-reported outcomes (PROs), in a cohort of patients with an implantable cardioverter defibrillator (ICD).

Methods and results: In a cross-sectional survey, we included patients > 18 years implanted with a first-time ICD (VVI, DDD, and cardiac re-synchronization therapy defibrillator) who had lived with their ICD from 3-24 months. They completed the 39-item ICD-BICQ together with the Generalized Anxiety Disorder scale, Patient Health Questionnaire, Type D Scale, Health Status Questionnaire, and the Florida Patient Acceptance Survey. Data were analysed using linear regression to compare personality constructs between patients with and without BICs. Logistic repression and receiver operating characteristic curves were used to predict patients with BICs based on other PROs. A total of 330 patients completed the survey. Five patients were excluded due to re-operations leaving 325 patients in the analyses. A total of 20% reported BICs at the recommended cut-off at 36 points. Patients with BICs reported higher anxiety and depression levels, lower device acceptance and health status, and had a Type D personality as compared to patients without BICs. Florida Patient Acceptance Survey was moderately able to predict BICs, while other PROs only had limited ability to predict BICs.

Conclusion: Patients with BICs reported poorer PROs. The PRO instruments were not able to predict patients with BICs, indicating that the ICD-BICQ provides independent relevant clinical information. In clinical practice, healthcare professionals can use the ICD-BICQ to identify and obtain information on possible BICs. The ICD-BICQ can also be used to evaluate new operation techniques.