bluuebunny/crossref_metadata_2025 huggingface dataset:
ManGuard an eHealth intervention to reduce cardiovascular risk in male taxi drivers: a pilot randomised controlled trial protocol
Authors: Ski C F , Mcmahon J , Mcmahon J , Brazil K , Brazil K , Thompson D R , Thompson D R
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy, Northern Ireland

Background

Men are at higher risk then women of developing cardiovascular disease (CVD) and male taxi drivers are a particularly high risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and a sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which had a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more user-friendly and effective.

Purpose

The aim of this study is to assess the feasibility of a randomised controlled trial (RCT) of an eHealth intervention – ManGuard – to reduce CVD risk in male taxi drivers.

Methods

A wait-list controlled trial of 30 male taxi drivers in Belfast, Northern Ireland, will be assigned randomly to an intervention or usual care group. The ManGuard Application comprises seven modules: i) introduction and goal setting, ii) being active iii) eating well, iv) managing stress, v) smoking, vi) alcohol and vii) keep accelerating, the latter to be used as a re-cap module. This trial will establish feasibility, including recruitment, engagement and retention rates, program usability and participant satisfaction, as well as preliminary efficacy of ManGuard in improving key outcomes. Primary outcome is to determine the feasibility of an eHealth intervention for reducing CVD risk in male taxi drivers by assessing the following outcome measures:

o Acceptability, recruitment, retention and engagement rates

o Usability and participant satisfaction, process evaluation and survey

The secondary outcome is to evaluate the preliminary efficacy of ManGuard compared to usual care in improving the following outcomes:

o Clinical indices: CVD biomarkers (cholesterol, glucose), blood pressure, anthropometry (BMI, waist circumference, body fat percentage)

o Physical activity

o Psychosocial status: health related quality of life, self-efficacy, social support

An in-depth qualitative process evaluation to explore acceptability of the intervention will also be conducted.

Trial registration: This trial has been registered prospectively on the ISRCTN registry on 5 January 2022

Conclusion

eHealth interventions have been shown to promote behaviour change and reduce CVD risk in men, but there is a lack of robust evidence for this in male taxi drivers, a high-risk group. This study aims to assess the feasibility of a future RCT assessing the impact of ManGuard on CVD risk in male taxi drivers. This study will inform a fully-powered trial that will provide robust evidence for eHealth interventions for this underserved population.
Cardiovascular risk factors in a healthy population in the Croatian centre for cardiac rehabilitation
Authors: Brajkovic I , Komosar-Cvetkovic M , Kuzet Miokovic I
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

According to the statistics of the WHO, cardiovascular diseases (CVD) are the leading cause of death. The problem of CVD is the fact that they do not give the right symptoms, and often lead to personal or public health problems. The first signs of CVD may be an acute myocardial infarction (AMI) or cerebrovascular insult (CVI) and it is important that the cause of them is a combination of risk factors (RF) that we can influence. High cardiovascular risk, due to the presence of one or more RF, requires early intervention with the aim of timely prevention of possible new complications.

Purpose

The aim of the retrospective study was to determine the prevalence of cardiovascular RF in persons who underwent preventive examinations at our Clinic for Treatment, Prevention and Rehabilitation of CVD.

Methods

The study included 100 respondents aged between 30 and 60y. When collecting and presenting data, the privacy and identity of the respondents are protected. For the purposes of the research, the data of medical documentation were used. The parameters used for the study were age, sex, height, weight, body mass index, abdominal thickness, arterial pressure values, blood sugar, ergometric and spirometry findings. For each respondent, daily life habits such as alcohol and smoking consumption, and levels of physical activity were recorded. Microsoft Excel and Statistics are used for data processing.

Results

According to the analysis of the obtained data, an equal number of men and women participated in the research (average age 47y). Anthropometric testing yielded a mean BMI for men and women which tells us that 44% of respondents are overweight and 21% are obese. Prior to the examination, 20% of respondents were diagnosed with arterial hypertension (AH), arrhythmia, hyperlipoproteinemia and diabetes. Only 2% of the subjects had elevated blood glucose values. Spirometric findings in all subjects were correct, while ergometric testing showed a decrease in values in as many as 75% of subjects. The control of daily living habits determined the enjoyment of tobacco products in 32% and alcohol in 10% of respondents. A worrying fact is that only 5% of respondents engage in some physical activity. In addition, new diagnoses are hyperlipoproteinemia IIa (40%), hyperlipoproteinemia IIb (16%), AH (13%), hyperlipidemia (6%), arrhythmia (4%), diabetes (2%), triglyceridemia (2%), ischemic heart disease (1%), carotid artery stenosis (1%).

Conclusions

The study found an increased incidence of cardiovascular RF in people who are not older. New diagnoses suggest a change in life habits towards eliminating the present cardiovascular RF in order to prevent possible cardiovascular incidents. It is through this organized, systematic and regular prevention that cardiovascular diseases are reduced to a significant level.
Assessing the quality of cardiac rehabilitation programs by measuring adherence to the Australian quality indicators.
Authors: Astley C , Beleigoli A , Tavella R , Hendriks J , Gallagher C , Tirimacco R , Wilson G , Barry T , Clark R A
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Australian National Health and Medical Research Council (NHMRC)

Background

Cardiac rehabilitation (CR) prevents recurrent cardiac events and supports patients’ return to an active and fulfilling lifestyle. Evidence on the efficacy of CR programs is well established, but variability of quality across programs may compromise patient outcomes. Core components, quality indicators (QIs) and accreditation of programs have been introduced internationally to increase program standardisation, quality and outcomes. (1) The Australian Cardiovascular Health and Rehabilitation Association (ACRA) and National Heart Foundation (NHF) recently published 10 QIs for CR, comprising process and outcome indicators that can guide delivery of evidence-based service content (Figure 1). (2)

Purpose

The aim was to assess the performance of CR programs in Australia through their adherence to the measurement of the Australian QIs.

Methods

A cross-sectional survey design with face validity testing was used to formulate questions to evaluate CR program performance based on adherence to 9 of the 10 Australian QIs. Between October 2020- December 2021, all 23 CR programs across country and metropolitan areas of South Australia (SA) participated. In addition, each QI was weighted by an expert group of clinician researchers and a service performance score was calculated out of 16. According to the score quartiles, programs could be categorised across 4 performance levels: Poor (0-4.5), Low (5-8.5), Medium (9-12.5) or High (13-16).

Results

Among the 23 participating CR programs, median wait time from discharge to enrolment (QI-2) was 27 days, (interquartile range 19.0-46.0) and completions of enrolled were 66% (n=1316 /1972). All QIs were measured, but not by all programs. Pre-program QI adherence was higher than post program for depression, medication adherence, health-related quality of life and comprehensive re-assessment (Figure 1). Health-related quality of life (HRQOL) was poorly measured pre and post program (21.7% versus 17.3%). For functional exercise capacity assessment, the six-minute walk test was used by 69.5% of programs. Mean performance score was 11.4 /16 (SD ±0.79). Most (74%) programs were ranked at a medium level of performance, whereas 13% were ranked at low and high levels and none as poor.

Conclusions

A survey of 23 CR programs showed gaps in adherence to measurement of the ACRA/NHF Quality indicators in SA, including re-assessment (QI9), HRQOL (QI-8), medication adherence (QI-6) and exercise capacity (QI-7). Service performance scores were lower than an Australian national audit for each category, with United Kingdom data showing more services in the high and less in the medium category than SA. These data give us a baseline from which to improve CR service quality and outcomes.
Using co-design to create user-friendly material promoting cardiac rehabilitation
Authors: Caughers G , Wilson A , Donnelly P , Bradley J , Fitzsimons D
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Public Health Agency Northern Ireland, Research and Development PhD Fellowship

Background

Cardiac Rehabilitation (CR) participation rates remain stagnant across Europe at around 40%(1) , with similar low uptake in Northern Ireland. Patients in our Steering Group confirmed that misconceptions about CR and lack of clear explanations negatively influence their decision to attend. Patients can feel overwhelmed by the experience of a cardiac event and the importance of CR is easily overlooked. Co-production of a short information film could better inform patients, family and the public.

Methods

Focus groups and interviews with N=58. Patients and carers informed 2 co-design workshops identifying the need for an information film to be available to cardiac patients and their families. Between July and November 2021, virtual multidisciplinary staff and patient groups developed the film with all members contributing to the script, voice content and film footage. A professional film company produced the 90 second infomercial with direction from patients and CR professionals.

Results

The information film portrays the experiences of a male and female patient. Elements of CR that were perceived as attractive components by patients in the codesign workshops are portrayed including; one to one interactions between staff and patients, the diversity of CR teams, and comradery between patients. The film is designed to be viewed on multiple devices, in hospital and at home following discharge.

Conclusion

Providing information about CR through the media of film may help to dispel misconceptions of CR and promote its attractiveness to patients. The effectiveness of this film awaits evaluation following dissemination to staff and patients this year.
Let’s get active: patients with a recent coronary event are highly motivated to lose weight and increase physical activity levels
Authors: Van Trier T , Jorstad H T , Peters R J G , Somsen G A , Sunamura M , Ter Hoeve N , Scholte Op Reimer W J M , Snaterse M
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NWO-grant

Title (Dutch): Het centraal stellen van behandelvoorkeuren van de individuele patiënt met een chronische hartziekte.

Subtitle: Persoonsgerichte zorg voor hartpatiënten

Introduction

Motivated patients are more likely to successfully improve unhealthy lifestyles. How patients perceive their risk factors and their willingness to improve is an integral part of this motivation. However, such preferences, and how they align with clinicians’ risk perception are seldom systematically assessed in patients with coronary artery disease (CAD).

Purpose

We aimed to investigate preferences in risk factor treatment in patients with CAD, and to compare this with clinicians’ perception of patients’ risks.

Methods

We administered a 10-item questionnaire on patients’ preferences on risk factor treatment in secondary prevention which was developed in consultation with end-users. We sent the questionnaire to approximately 450 patients who were referred to cardiac rehabilitation after recent (<3 months) admission to an acute coronary unit between Feb 2020 and Apr 2021. We demonstrate the results of 6 questions that covered the following subjects relevant to secondary prevention: Q1: risk factor perception, Q2: priority setting, Q3: wanting help, Q4: willingness to change, Q5: motivation to change, Q6: confidence to successfully change. We compared patients risk factor perception with clinicians’ report in the medical record.

Results

A total of 296 patients completed the survey (66% of eligible respondents) at mean (SD) age 64 (10) years on median (IQR) 38 (25-53) days after discharge. Physical activity was much more frequently reported as risk factor by patients (P 55%) compared to clinicians (C 31%), followed by other disparities such as for high cholesterol (P 48% vs. C 36%) and overweight (P 46% vs. C 59%) (Figure 1). Patients were asked which of their perceived risk factors on Q1 was most important to improve (Q2) and for which they wanted help (Q3). Top-3 risk factors chosen for improvement were overweight (87%), physical inactivity (81%), and stress (79%), for which 75% required help with any risk factor, again most frequently with increasing physical activity (64%), overweight (59%) and stress (51%) (Figure 2). Motivation and confidence for improvement of risk factors were high: 87% were willing to adapt their lifestyles, with motivation rates of median (IQR) 8 (7-9) out of 10, and estimated chance for successful improvement of median (IQR) 7 (6-8) out of 10.

Conclusion(s)

Patients who recently suffered from coronary event are highly motivated to lose weight and increase physical inactivity. The use of these patient preferences by the clinician will enable compliance and outcomes with respect to weight loss and improved physical activity.
Development of a core outcome set for cardio-oncology (COS-CO) to assess and monitor cancer patients at risk of or with cardiovascular diseases
Authors: Van Den Bussche K , Von Kemp B , Manderlier B , Beeckman K , Cosyns B
Published: July 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): King Baudouin Foundation

UZ Brussel Foundation

Background

Experts predict a cardio-oncological epidemic in the coming years due to the growing population of cancer survivors, the increasing number of elderly people with chronic cancer therapy, and the high number of cardiovascular diseases resulting from these treatments. Cardio-oncology clinics should provide multidisciplinary, specialised evaluation, and long-term follow-up. Although a number of (inter)national registries for cardio-oncology have been created, international standards for clinical assessment and outcome measurement is lacking. Moreover, patient-reported outcomes tend to be neglected.

Purpose

To develop a standard and pragmatic patient-centered outcome set to assess and monitor patients at risk of or with cardiovascular diseases before, during and after oncological treatment.

Methods

A list of outcomes and measurement instruments was generated through review of existing registries. The project team reviewed and refined the outcomes prior to starting a Delphi procedure. The panelists, including healthcare providers and researchers were invited to rate the importance of the outcome domains.

Results

The set is designed to include all patients within the cardio-oncology clinic, whether before, during or after oncological treatment. We extracted >500 outcomes and after refinement 93 outcomes were rated by the panelists. The set encompass baseline cancer and cardiovascular health status (e.g. risk assessment), treatment variables, and functional, psychosocial, and survival outcomes. Data will be collected through administrative and clinical records, and validated patient-reported outcome measurement instruments.

Conclusions

A major component of this set’s development was surveying existing registries to establish what measurement efforts are currently being undertaken by health care and research teams. The focus and structure of existing (inter)national cardio-oncology registries limit the extent to which longitudinal patient-centered outcomes can be measured and compared. Due to the underrepresentation of patient-reported outcomes, patients will be interviewed to encompass the patient’s perspective. This set aims to facilitate (inter)national comparison in cardio-oncology care, using standardised parameters and meaningful patient-centered outcomes for research and quality of care assessments.
Assessing The Utility of D-Dimer Driven Anticoagulation Strategies In Severely Obese Patients With COVID-19
Authors: You J , Bae S , Bae E
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Many studies to date have documented significant inflammatory vascular sequelae in association with COVID-19. Current guidelines suggest an initial strategy of therapeutic-dose anticoagulation to non-critically ill, hospitalized patients requiring low-flow oxygen and a concurrent D-dimer level above the upper limit of normal. However, the utility of D-dimer values in predicting thrombosis in severely obese patients are equivocal to poor, with prior evidence suggesting falsely elevated levels with greater BMI. Given the weight-based dosing of heparin, these patients may also be inadvertently at elevated risk for major bleeds.

Purpose

To examine the utility of D-dimer levels in risk stratification and anticoagulation therapy in non-critically ill COVID-19 patients with severe obesity.

Methods

In this single-center, retrospective study, 32 severely obese patients (defined as BMI > 40) hospitalized with COVID-19 and requiring low flow oxygen delivery, without ICU level of care were analyzed. Clinical outcomes were compared between groups receiving therapeutic versus prophylactic doses of anticoagulation. All were treated with low molecular weight heparin (LMWH) per hospital protocol. The following data points were examined: length of hospitalization, mortality, anticoagulation therapy, initial d-dimer levels, thrombotic events, minor/major bleeds, and oxygen modality.

Results

In total, 78% of patients initially presented with a D-dimer level above the upper limit of normal, with 53% of patients meeting criteria for therapeutic anticoagulation. However, there were no significant differences in incidence of thrombotic events, mean length of hospitalization or overall mortality. Furthermore, despite utilization of appropriate therapeutic anticoagulation, it did not reduce the overall use of oxygen support requirements, including high flow oxygen or non-invasive ventilation, when compared to individuals receiving prophylactic dosing.

Conclusion

The clinical utility of D-dimer levels for guiding anticoagulation therapy in severely obese patients with COVID-19 may be limited. Here, we demonstrate that therapeutic dose approaches have nonsignificant differences in clinical outcomes when compared to prophylactic doses in this distinct population.
Drive line infection rate reduction by developing a fixation kit
Authors: Mostafa S , Ellithy A , Kheder H , Elaagamy A , Fawzy N , Ibrahim O
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Continuous-flow left ventricular assist device (LVAD) therapy has become a standard therapy for patients suffering from end-stage heart failure. One of the serious adverse events during LVAD support is infection. Infections can trigger thromboembolic events, haemorrhagic cerebrovascular accidents , and are the second most common cause of death. Moreover, LVAD-related infection is the leading cause of re-admission and increases the cost of LVAD therapy considerably. Patients with an infection during LVAD support need a significantly prolonged hospital stay.

Background

Left ventricular assist device implantation is one of the operations that patients need special and distinctive health care, and therefore a specialized medical team has been appointed to examine these patients, but from the time the device is installed, these patients suffer from frequent infections at the drive line exit site, and therefore the responsible team faces a great challenge in combating this infection and reducing the infection rate and complications. One of the biggest problems is that we cannot find the exact type of dressing that is used to care for the exit, With the increase in the number of patients who have an infection in the drive line exit site, the team started to identify the reasons that lead to this, and it was found that failure to the fixation of the drive line is one of the biggest causes of infection, and patients reported that the movement of the drive line causes them severe pain and inflammation, which leads to many difficulties in their mobility and daily activities.

Aim

Reaching the best practice and reducing drive line infection rate by managing drive line fixation while increasing the number of the implanted devices.

Process: The LVAD nursing team started in collecting data related to the drive line infection and some modifications were implemented according to the available resources to be used in the drive line modified fixation technique:

Step 1: Our available adhesive dressings were used, and two small holes were made in the middle of it. Figure 1

Step 2: A small gauze strip was passed through the two holes to be fixed around the drive line. Figure 2

Step 3: Then a surgical blade used to make a whistling hole in the adhesive dressing to exit the drive line from it. Figure 3

Results

Based on:

Auditing charts and data collection it shows significant decrease in infection rates and re-admission related to drive line infection.

Recommendation

Develop new material for education

Videos in Arabic, Follow-up handbook and Posters.

Updating AHC staff with the latest driveline wound care protocol

Training sessions, Case study and Simulation lab.
Nursing e-learning solution staff experience
Authors: Eltayyeb M , Elkhatib M , Helmy I , Farag I
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

An online education management solution (EMS) has established for the purpose of building staff interest and motivating nurses to establish professional development portfolio and becoming lifelong learners.

Background

In 2013 some clinical skills were collected in an e-book with a search bar to fit as a clinical procedure reference. Then in 2017, an internal website that contains more than 65 courses which the staff can access, self-enrolled and become automatically certified. This site contains hospital orientation guide, education resources and an education calendar. Education resources contain 147 clinical skills, 69 self-enrolled courses, 12 instructor-led courses.

Aim

To assess the nursing staff experience response and feedback to the internal EMS.

Process

A survey was sent to nursing staff for data collection for 5 days.

The survey covers the following points:

Is it the first time to visit the website?

Did you find what you need?

How easy do you find information on the site?

How frequently do you surf the web?

What is your overall impression of the site?

Data Analysis

Most of the nurses visit the internal website with a percentage of 85% as illustrated in chart 1.

99% from the staff found the information they are searching for, 35% found all the topics and 64% found some of the topics.

How easy to find information? staff answered as 46% easy to find the information they are looking for, as 48% were in the middle side and only 6% replied as they face difficulty to find the information on the website.

As mentioned before 85% from the nursing staff responded to survey visit the website, farther analysis that show that 17% visit the EMS every day to 3 times per week, 44.2% of the staff visit the site once a week to 3 time per month, 28.5% surf the site once or less per month and 10.5% are not sure how frequent they surf the EMS.

Staff replay with satisfaction response regarding to site professional, informative and visual pleasing.

Conclusion

Having a Learning management system (LMS) takes the team training to the next level, as self-learners, but E-Learning can take it even further with accepted EMS.

Staff feedback regarding the EMS will help in editing and adding the required learning recourses.

Free web resources such as (google site, forms, and drive – certify me) (a customized EMS) can be established in healthcare facilities.
Modifying the health teaching process to increase the patient awareness
Authors: Hossam M , El-Khatib M , Samir M , Naeem M , Arafat A
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Health teaching is an essential part of the patient journey at any healthcare facility.

Internal audit was carried out in one of the renowned healthcare institutions in the middle east , specifically in the outpatient department. The audit revealed the existence of some issues regarding patients’ familiarity with some aspects of knowledge about their conditions, medications, healthy diets, etc.…. Therefore, it was necessary to assess the patient’s understanding and to re-evaluate the introduced instructions regarding these topics. Nursing leaders in the aforementioned institution were inspired to conduct a quality improvement project that enhanced the patients outcome by assessing patient understanding concerning inpatient health teaching.

Aim

A quality improvement project aimed at assessing patients’ understanding regarding health teaching after open-heart surgeries during their hospital stay.

Process

A survey was conducted to assess the patient understanding regarding healthy diet , wound care after surgery, taking the medications, understanding diagnosis, daily activities, follow-up visits and deal with an emergency. Nurse leaders formed a group of internship nursing students to conduct the survey immediately after a health teaching process.

Data was collected and analyzed. Some interventions were implemented to fill the gap of health teaching process and improve the patients outcome.

Interventions

There were no leaflets or other health teaching materials that could be offered to the patient. 15 health education leaflets were developed to fill in this gap. The health teaching process took place at the time of discharge and the decision was to proceed the patient education from the time of admission. We validated and reinforced the health teaching content with the patient and family before discharge.All patients agreed that their relatives should attend the health teaching sessions and these interventions affected positively the results of survey.

Data Analysis

A group of 100 patients were involved in this survey and results revealed the following. It was found that there was a significant impact of the intervention, as shown in ( Figure 1). 69% of patients were only aware about their healthy diet compared with 92% after intervention. Regarding wound care, there was a 14% increase of patient awareness after the intervention. There was a significant difference in terms of the patient understanding about their own diagnosis after the process intervention that reached 27%. The survey showed satisfying numbers before and after the teaching process of follow up date and emergency contact.

Recommendations

Patient teaching is a continuous process starts from the day of admission.Each patient has a suitable way to cope with the provided information in terms of many aspects such as the education level, availability of relative.
Training assessment of clinical knowledge and skills in the use of negative pressure wound dressings in cardiac patients
Authors: Suvarna S S , Hayes M , Hennessy M
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Objective

An assessment was conducted to analyse the level of improvement impact one can have on clinical knowledge and skills in the use of a novel negative pressure wound dressings in high-risk cardiac patients along with their years of experience following a training program conducted among our cardiac staff.

Methods

In a prospective study involving twenty cardiac nursing staff from December 2020 to June 2021 who voluntarily participated in the study. Their pre and post training assessment of clinical knowledge and skills were assessed using twenty questionnaires. The pre and post training educational knowledge and skills scores were analysed along with their years of clinical experience.

Results

In the six-month period n=20 (100 %) were compliant to the training despite the covid-19 pandemic.

The study group showed an average pre-training score of 10.5% (Knowledge 5.25% and Skills 5.25%)

The average post-training score of84.75% (Knowledge 42.25% and Skills 42.25%)

While comparing the years of clinical experience against the pre and post training scoresSeventeen (n=17/20, 85%) had five to ten years experience compared to three (n-3/20, 15%) with more than 20 years of experience.

Conclusion

Both clinical knowledge and skills can be augmented through regular training members with more than ten years of clinical experience might have an added benefit and their experience could be important to train younger staff members with less clinical experience.
Co-production of a CArdiac Brief INtervention (CABIN) for patients prior to discharge following acute myocardial infarction (AMI)
Authors: Caughers G , Wilson A , Donnelly P , Bradley J , Fitzsimons D
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Public Health Agency Northern Ireland, Research and Development PhD Fellowship

Background

Recovery from AMI can be challenging for patients without adequate psychosocial support to overcome anxiety, address misconceptions and initiate lifestyle change (1,2). Reduced length of stay has minimised the opportunity for nurses to evaluate patients’ holistic needs and initiate effective in-hospital interventions (3). Patients and nurses discussed these challenges openly and worked together in this co-design study to develop a brief intervention for the pre-discharge period.

Method

A multi-site, co-design project was conducted with an exploratory phase of interviewing and focus groups with patients and staff involved in CR. The data from this exploratory phase informed a series of working-group meetings during which this intervention was developed.

Results

The CABIN (CArdiac Brief INtervention) offers brief, reassuring and compassionate discussions alongside educational content. CABIN consists of 8 components as seen in figure 1. It is designed to be used by nursing staff in the acute setting with patients following their AMI. Staff delivering the intervention must have full understanding of the local CR programme to offer practical advice if necessary.

Conclusion

CABIN provides a tangible means to emotionally support patients in the acute phase of recovery following AMI. It is envisaged that CABIN will empower acute clinical nursing staff to address the emotional needs of patients in a way which will encourage attendance at CR and subsequent recovery.
The Polish version of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q)
Authors: Swiatoniowska-Lonc N , Koltuniuk A , Jankowska-Polanska B
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Treatment satisfaction seems to be related to patient adherence and is a quality indicator that can be used to improve healthcare and that influences patient preferences. Information about treatment satisfaction can contribute to predicting treatment adherence and help decision-making by clinicians. Therefore, measuring this parameter is one of the health outcomes that must be observed in daily clinical practice. Unfortunately, there are still few publications assessing the treatment satisfaction, and there are no Polish versions of tools to facilitate standard, regular evaluation of the process.

The aim of the study was to develop a Polish version of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) to assess the patient satisfaction with the treatment received.

Material and methods

This study included 197 patients (64.73±13.27 years) with hypertension (n=55), type 2 diabetes (n=42) and heart failure (n=100). The Polish version of the SATMED-Q was used in the study. Scores on each subscale of SATMED-Q and the total score are expressed on a 0-100 scale, where a higher score indicates greater satisfaction. Socio-clinical data were obtained from medical records of patients.

Results

Cronbach’s alpha for the total score of SATMED-Q is 0.847 and does not require the exclusion of any items to increase its value. Cronbach's alpha for individual domains was: undesirable side effects - 0.985, treatment effectiveness – 0.864, convenience of use - 0.917, impact on daily activities - 0.886, medical care – 0.899, global satisfaction – 0.885. The loadings of the individual items ranged from 0.76 do 0.986. A satisfactory values of the fit indices RMSEA (<0.001), CFI (>0.999), TLI (>0.999) and SRMR (0.067) were obtained. Patients obtained the highest scores in the domain of undesirable side effects (85.32±28.62) and the lowest in the domains of satisfaction with medical care (61.61±28.36) and impact of treatment on daily activities (66.54±26.90). The correlation analysis showed that the SATMED-Q total score and subscale scores of convenience of use (81.06±25.18 vs. 73.33±17.85; p=0.003) and impact on daily activities (72.27±30.26 vs. 62.17±25.14; p=0.011) were significantly higher in the hypertension group than in the heart failure group. In the domain undesirable side effects the mean score was significantly higher in the heart failure group than in the diabetes group (90.33±25.12 vs. 74.6±33.08; p=0.008) and the treatment effectiveness subscale score was significantly higher in the hypertension and diabetes groups than in the heart failure group (74.8±28.0 vs. 63.08±20.56; p=0.002).

Conclusions

The SATMED-Q is a very good tool for assessing patient’s satisfaction with the treatment in Polish-speaking settings and can be recommended for use in everyday practice.
Treatment satisfaction and pharmacological adherence in patients with chronic diseases
Authors: Swiatoniowska-Lonc N , Tanski W , Polanski J , Jankowska-Polanska B
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

There are many factors that influence patient adherence to treatment, including complexity and frequency of dosing, convenience and treatment satisfaction. Patient satisfaction with the results of treatment is a strong motivation for systematic continuation of treatment. Lack of satisfaction with treatment may negatively affect the level of adherence. This relationship is often suggested in articles, but there is still a lack of evidence on the relationship between treatment satisfaction and treatment adherence in chronically ill patients.

The aim of the study was to assess the treatment satisfaction and evaluate the relationship between treatment satisfaction and pharmacological adherence in patients with hypertension, type 2 diabetes and heart failure.

Material and methods

The study included 197 inpatients (110 male, mean age 61.23±14.34) with hypertension (n=55), type 2 diabetes (n=42) and heart failure (n=100). The following instruments were used: the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) to assess the patient satisfaction with the treatment received and the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence. Socio-demographic and clinical data were obtained from patients’ medical records.

Results

In the comparative analysis, patients with heart failure were older (67.59±11.93 vs. 62.51±14.62 vs. 60.83±13.23), were male (68.0% vs. 47.27% vs. 30.95%), had 2 or more additional diseases (55. 0% vs. 23.64% vs. 47.62%), more frequently took 5 or more tablets daily (71.0% vs. 50.91% vs. 54.76%), were more frequently hospitalized (61.0% vs. 14.55% vs. 40.48%) compared to the other groups. Patients obtained the highest scores in the domain of undesirable side effects (85.32±28.62) and the lowest in the domains of satisfaction with medical care (61.61±28.36) and impact of treatment on daily activities (66.54±26.90). However, there were no statistically significant differences in adherence of patients differing by chronic disease (HTN: 17.56±5.21 vs. DM: 18.21±5.34 vs. HF: 17.23±4.36; p=0.791). In correlation analysis, all ARMS subscales correlated significantly and negatively with all SATMED-Q subscales, so the higher the adherence level (lower ARMS score) the lower the treatment satisfaction. Linear regression analysis showed that adherence to pharmacological recommendations measured by the ARMS questionnaire was an independent determinant of treatment satisfaction in all study groups, and a higher ARMS score (lower adherence level) decreased treatment satisfaction (HTN: -2.088 vs. DM: -1.879 vs. HF: -0.942).

Conclusions

Treatment satisfaction has a significant impact on pharmacological adherence in patients with hypertension, type 2 diabetes and heart failure. The more satisfied the patient is with the treatment, the better their pharmacological adherence.
Self-care recommended by clinicians in patients with heart failure or type 2 diabetes: a Delphi study
Authors: Westland H , Van Rijn M M , Page S , Wiebe D J , Freedland K E , Lee C , Vellone E , Aryal S , Stromberg A , Jaarsma T , Riegel B
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Australian Catholic University, Australia

Background

Patients with heart failure or type 2 diabetes often experience bothersome symptoms (e.g., swelling, dizziness) and need clinical support with symptom management to reduce the impact of these symptoms. Knowledge about recommended self-care management behaviors by experienced clinicians can help to guide the development of more effective self-care interventions.

Purpose

To develop a list of common bothersome symptoms of heart failure and type 2 diabetes and of self-care management behaviors that clinicians recommend to patients to reduce the impact of these symptoms.

Methods

A two-round Delphi study among a panel of 37 nurses and physicians (heart failure only n=14; type 2 diabetes only n=11 and both heart failure and type 2 diabetes n=12) from Italy, the Netherlands, Sweden and the US was performed. Online surveys were used to identify common and bothersome symptoms and related self-care management behaviors that they recommend to patients with heart failure or type 2 diabetes. Self-care management behaviors that received at least 75% agreement were retained and similar self-care management behaviors were discussed and merged to reduce redundancy.

Results

For heart failure, the final list included 12 common bothersome symptoms (e.g., fatigue/tiredness, shortness of breath) and 51 related self-care management behaviors (e.g., balance rest & activity, check body weight & swelling). For type 2 diabetes, 11 common bothersome symptoms (e.g., hypo- and hyperglycemia symptom clusters, foot wounds) and 25 related self-care management behaviors (e.g., check blood sugar, take insulin, contact podiatrist) were included in the final list. Consensus was reached on the vast majority (70%) of recommended behaviors.

Conclusion

The lists of common bothersome symptoms and self-care management behaviors reflect consensus but also discrepancies between clinicians’ recommendations and current guidelines. Efforts to enhance and align the use of proven effective self-care management behaviors to reduce symptom impact in routine care by clinicians should be considered.
Intervention tool for general registered nurses providing palliative care in the cardiovascular ward
Authors: Higashitsuji A , Majima T
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by JST SPRING.

Background

Palliative care for patients with heart failure (HF) has benefits such as reducing physical and mental distress and decreasing medical costs. Nevertheless, the palliative care provision rate for patients with HF is merely 0.7%–4%. Palliative care by healthcare professionals in cardiology is recommended for patients with HF, particularly in inpatient wards. To promote palliative care, general registered nurses (GRNs) should be encouraged to practice it, although 99% of them do not have professional qualifications in this field. However, there is no intervention tool for GRNs that provides specific guidelines on palliative care. Therefore, appropriate intervention tools for GRNs are needed to promote palliative care. This study reports a nursing practice model and intervention tool developed before an intervention study in which GRNs practiced palliative care in a cardiovascular ward.

Purpose

To develop a practice model and intervention tool for GRNs providing palliative care to patients with HF in the cardiovascular ward.

Methods

This study reports the development of nursing practice models and intervention tools using a comprehensive development approach for nursing intervention development as the methodology and Corbin's (1998) disease trajectory model as the theoretical basis. We conducted a literature review on the needs of and limitations to HF palliative care. We staged the timing of hospitalized patients with HF. A nursing practice model showing suitable nursing support for each stage was constructed. We then created an intervention tool based on the nursing practice model.

Results

The intervention tools included a pocketbook, an HF palliative care practice material that could be used as a checklist, and an information-sharing notebook that allowed patients to review and record their symptom screening results and end-of-life decisions. The uniqueness of the intervention tool was that it classified hospitalized patients with HF into three stages: symptom-focused stage, cognitive recovery stage, and behavioral recovery stage; each stage included seven nursing support practices. In addition, the intervention tool clarified the criteria for referral to specialized palliative care that could be used before the end-of-life stage and described specific measures for end-of-life decision support that general nurses could implement.

Conclusion

This study created a pocketbook, an HF palliative care practice material, and a patient notebook as intervention tools. We started the intervention studies in December 2021, and we will report the results later.
A cluster analysis of psychological and physical symptoms in patients with heart failure
Authors: Iovino P , Giulia Locatelli L G , Giulia Locatelli L G , Alvaro Rosaria R A , Alvaro Rosaria R A , Barbara Riegel B R , Barbara Riegel B R , Corinne Jurgens C J , Corinne Jurgens C J , Ercole Vellone E V , Ercole Vellone E V
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): CECRI (Center of Excellence for Nursing Scholarship) Rome

Background

The experience of psychological and physical symptoms of heart failure can be burdensome for patients. Identification of profiles of symptom burden may lead to greater understanding of the mechanism underlying this experience and improve symptom-centered care.

Purpose

The aim of this analysis was to identify profiles of psychological and physical symptoms in heart failure patients and compare the sociodemographic and clinical characteristics of patients in each cluster.

Methods

This was a secondary analysis of baseline data from the MOTIVATE-HF trial, that enrolled 510 patients across Italy. Cluster analysis was used to identify profiles of patients based on the two scores of the Hospital Anxiety and Depression scale and the total score of the Heart Failure Somatic Perception Scale. Each profile was described in terms of sociodemographic characteristics (e.g., age, gender, severity of disease), self-care maintenance and management behaviors, and self-efficacy (Self-care of Heart Failure Index), generic quality of life (12-item Short Form Survey), health-related quality of life (Kansas City Cardiomyopathy Questionnaire), and cognitive status (Montreal Cognitive Assessment Scale). Comparisons between the characteristics of each profile were performed by analysis of variance (ANOVA) and chi square test.

Results

Patients (n = 510) were 72.37 years old on average (SD = 12.28), with a slightly higher prevalence of men (58%). Sixty per cent of the sample were symptomatic: New York Heart Association (NYHA) class 2, 31.4% in NYHA class III, and 6.5% in NYHA class IV. Three profiles were identified: (1) low distress, characterized by the youngest patients (69.76, SD = 12.17), mostly in NYHA class II, and with the highest score on self-care self-efficacy and self-care maintenance behaviors; (2) average distress, characterized by the oldest patients (74.45, SD = 11.99), who were mostly retired, with the highest level of education, and poorest (physical) health-related quality of life and low self-care behaviors; (3) high distress, characterized by an average age of 73.08 (SD = 12.29), with the lowest hemoglobin level, the worst cognitive status, and the worst generic and health-related quality of life.

Conclusions

The profiles identified in this study and their characteristics provide new insights into the burden of psychological and physical symptoms experienced by heart failure patients. This represents the first step in promoting symptom-centered care in the future.
I really want to know what is wrong with my heart and what should I do a qualitative study of information needs among Chinese immigrants
Authors: Zhang L , Koo F K , Gallagher R
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The health information needs of immigrants who have heart disease are poorly understood, despite the important role of patient knowledge in improving symptom recognition and control, prevention, and health-rated outcomes.

Purpose

This study explored disease-related information needs among Chinese immigrants with heart disease.

Methods

The study followed an exploratory qualitative design. Immigrants with heart disease from Chinese community associations in Sydney, Australia were recruited to participate in the interviews. Data were analysed using thematic analysis.

Results

Participants (n=20) were aged mean 75±7 years and had lived in Australia for mean 16 ± 8 years. The majority were female (65%), and had poor English language proficiency (95%), poor self-reported health (90%).

Two main themes generated from interviews were related to culture and language influence in terms of accessing and interpreting health information. Other themes were primarily related to deficits, in heart disease-related knowledge, understanding of the healthcare system, and health information resources.

Conclusions

Immigrants with heart disease in this study have multiple health information and education needs related to personal and system factors inadequately addressed by healthcare services. Culturally and linguistic appropriate health information and support services are recommended to improve disease knowledge and appropriate use of healthcare services.