bluuebunny/crossref_metadata_2025_split huggingface dataset:
Race matters: cardiovascular disease risk in male US prisoners
Authors: Miller J , Williams L , Alhurani A , Saleh Z , Bailey A , Connell A , Hammash M , Chung M , Moser D 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH/National Institute of Nursing Research, 1RC2NR011948

Introduction
Approximately 10% of the 2.2 million prisoners in the US have a diagnosis of cardiovascular disease (CVD) and in 2016, 28% of all deaths in custody were attributable to CVD. Black race, inadequate health literacy, and poor perceived control are predictors of increased cardiovascular disease (CVD) risk, which are prevalent in prisoners. However, little is known about the relationships among race, health literacy, and perceived control in CVD risk for male prisoners.

Objective
The purpose of this study was to explore the relationships among race, health literacy, perceived control, and CVD risk while controlling for well-known risk factors (education, partner status, and body mass index) in male prisoners.

Methods
We used baseline data from 349 male prisoners in a biobehavioral CVD risk reduction intervention. Health literacy was measured using the Newest Vital Sign and perceived control by the Control Attitudes Scale- Revised. CVD risk was quantified with the Framingham Risk Score (FRS). Three indirect effects of race on CVD risk were examined using serial mediation model with two sequential mediators (i.e., health literacy and perceived control) and 95% confidence intervals from 5000 bootstrap samples.

Results
Of the participants (mean age = 36 + 10 years), 64.2% were white and 35.8% were black. Mean education level was 12 years and most (85.8%) were not married or partnered. Mean BMI was 28.3 + 5.0. Mean FRS was 6.63 + 4.90, indicating risk percentages of 2.3 to 13.3% over the next ten years. Black prisoners were younger (35 + 9 versus 37 + 10, p = .047) and had lower levels of health literacy (3.84 + 1.90 versus 4.69 + 1.63, p &lt; .001) than white prisoners. No statistically significant differences in perceived control, education, partner status, or body mass index were noted between races. All three indirect effects of race on CVD were significant while the direct effect of race was not. Compared to white prisoners, black prisoners had higher levels of CVD risk through health literacy (a1b1 = .3571, 95% CI [.0948, .7162]) and lower levels of CVD risk through perceived control (a2b2 = -.1855, 95% CI [-.4388, -.0077]). Black prisoners had higher levels of CVD risk through health literacy influenced by perceived control (a1b2d21 = .0627, 95% CI [.0028, .1409]) indicating that despite the protective effect of higher levels of perceived control in black prisoners, CVD risk remained higher compared to their white counterparts.

Conclusion
Future CVD risk reduction interventions in prisoners of all races, but specifically black male prisoners, should include goals of improving health literacy and perceived control in addition to the traditional modifiable risk factors often included in biobehavioral interventions.
Human connection: a valuable element for health-related quality of life outcomes in cardiac rehabilitation during COVID-19
Authors: Candelaria D , Gallagher R , Ladak L , Glinatsis H , Randall S 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background The COVID-19 pandemic restrictions have pivoted in-person cardiac rehabilitation (CR) to remote delivery via telehealth. Patient perceptions on their CR participation in these models can guide CR coordinators improve program elements.
Purpose To qualitatively explore patient perceptions and experiences on how CR influenced their health-related quality of life (HRQL).
Methods A purposive sample of 16 patients were recruited, ensuring representation from four participating CR sites, gender, age, and mode of CR delivery. Semi-structured telephone or video interviews were conducted at six months following CR completion. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke’s six-step thematic analysis.
Results Perceptions and experiences of patients were positive overall and similar between the two models. Three main themes were identified: value of human connection, benefits of exercise and need for more individualised approaches, and importance of telehealth as an adjunct to in-person CR. Patients have expressed the value of interacting with health care professionals and socialising with peers in similar circumstances; and the absence of these interactions was palpable to those who attended telehealth. Exercises were beneficial but needed to be tailored to individual capabilities and preferences. Telehealth offered convenience and was generally accepted. However, telehealth should be complementary and not a replacement to in-person CR.
Conclusions Meaningful personal interactions with health care providers and other CR participants are most appreciated by patients in both in-person and telehealth models. Exercises are perceived to be more beneficial when individualised. Long-term outcomes from alternative CR delivery models should be evaluated.
How the COVID pandemic affected utilisation of cardiac rehabilitation in rural Australia?
Authors: Beleigoli A , Champion S , Tirimacco R , Govin K , Tideman P , Clark RA 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Caring Futures Institute

Background
Provision of cardiac rehabilitation (CR) was disrupted in 31% of the 155 countries according to the World Health Organisation during the early months of the COVID pandemic. This might have been associated with worsening clinical outcomes and is of particular concern to patients living in rural and remote areas. In Australia, these patients have a higher prevalence of cardiovascular diseases, higher rates of adverse outcomes due to acute myocardial infarction and limited availability to regional services.

Purpose
We aimed to investigate how the COVID affected the delivery of CR services in rural and remote South Australia (SA) during the first wave of the COVID pandemic.

Methods
CR attendance, completion and waiting times in the pre-COVID period (February-July 2019) was compared to data during the first wave of COVID (February-July 2020) using data from CR services across six regional local health networks recorded in the Country Access to Cardiac Health (CATCH) database.

Results
There were 922 patients (32.2% females; mean age 69.2 years; 36.6% living in areas with high socio-economic disadvantage) referred to CR in the pre-COVID period, and 1032 patients (30.7% females; mean age 68.1 years; 35.7% living in areas with high socio-economic disadvantage) in the COVID period across the six regional areas in South Australia. Acute coronary syndrome was the main reason for referral both pre (251; 27.2%) and during COVID (273; 26.5%). The proportion of CR attendance was higher in the pre (522; 56.6%) compared to the COVID period (431, 41.8%; p &lt; 0.001). Completion was higher pre (413, 79.1%) compared to during COVID period (205,47.6%) completed CR during the COVID period (p &lt; 0.001). The waiting time was 35 (SD 27) days pre-COVID and 34 (SD 25) days in the COVID period (p = 0.37).

Conclusion
Our data show that attendance and completion of CR programs were significantly reduced during the COVID period in rural and remote Australia. Limited service access during the pandemic and fear to physically attend health services during the period of social and physical restrictions might have contributed to this. Telehealth-delivered CR can provide opportunities to continuity of cardiovascular care and secondary prevention during pandemic restrictions.
Factors influencing adherence to medication in patients using anticoagulant drug
Authors: Arslan G , Tokem Y 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None. Main funding source(s): Researcher

Introduction
Anticoagulant drugs are quite narrow in their therapeutic range, which should be closely monitored throughout the treatment. In addition to monitoring the responses to the drug in patients who are taking anticoagulant medication, informing the patient and his family is one of the important responsibilities of the nurse within the scope of the counseling and training roles.

Aim
The aim of this comparative study is to investigate the factors affecting drug compliance in young adult (18-65 years) and elderly (over 65 years) patients who using anticoagulant drugs.

Method
This research was carried out descriptively and cross-sectionally in a public hospital between October 1 and December 31, 2018, and was conducted with 100 patients in Cardiovascular Surgery and Cardiology outpatient clinics and clinics. Research data was obtained by; Patient Information Form (55 questions) and Morisky Medication Adherence Scale (9 questions).

Results
56% of the patients were female and 44% were male, the mean age of the patients was 63.3 ± 14.67 years. The mean scale score of young adult patients was 5.41 ± 2.44 (compatible) and the mean scale score of elderly patients was found to be 8.95 ± 2.21 (incompatible). 48.2% of the female patients and 54.5% of the male patients were found to be compatible with the treatment. When the relationship between the knowledge level of anticoagulant drugs and their compliance with the treatment according to age group is evaluated; patients in all age groups who expressed their own level of knowledge inadequately, were found to be incompatible with treatment. 46.2% of young adult patients who stated that they had hospitalization due to the drug and 64.3% of young adult patients who stated that they applied to the emergency department, were highly compatible; 93.8% of elderly patients who stated that they had hospitalized and 88.6% of the elderly patients who stated that they applied to the emergency department, had a low compliance. (p ˂0,05)
Conclusions and Recommendations: Many factors such as age, education, other people who they live together, level of knowledge about anticoagulant medication, forgetting to use the drug, thinking the treatment damages themselves or not wanting the treatment, carrying information about medication beside themselves and using other medications without asking a doctor were found as many cases which affect the compliance with the treatment. It was found that compliance with treatment in older patients was found to be more incompatible with treatment compared to young adult patients. It is recommended that healthcare professionals in healthcare environments in our country specialize in anticoagulant therapy management and establish certification programs. It is suggested to provide effective continuity of these programs by planning trainings for patients receiving anticoagulant therapy by specialized healthcare professionals.
Knowledge of heart failure patients about the disease
Authors: Catarino PAULA , Vaz Alexandre , Paiva SILVIA 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Despite all the technological advances that have made it possible to increase the life expectancy of patients with Heart Failure (HF), this continues to be a disease with an important socioeconomic impact and high hospital mortality. Education to understand HF and the development of capacities for selfcare are considered keys to improve adherence, avoid decompensation crises and maintain the clinical stability.
Purpose
Evaluate the knowledge of patients with HF about the disease, treatment, symptoms and its recognition.
Methods
Was developed a quantitative, cross-sectional, descriptive and correlational study. The questionnaire incorporated Dutch Heart Failure Knowledge Scale (DHFKS). Sampling was consecutive non-probability of patients followed in outpatient visit and hospitalized in the ward at a university hospital.
Results
All elements of the sample answered that "it is important that I take my HF medication regularly". It is important to understand that adherence to therapy is not just taking medications, but also complying with the diet and modification habits or lifestyles. The item that followed with the highest correct rate (97%) was the one that questions what the meaning of HF is. The patient should be tried to understand the cause of the HF, the symptoms and the course of the disease and based on that, make realistic decisions, including decisions about treatment at the end of life.
When asked about the best thing to do in case of increased dyspnea or edema, 90.7% know that early contact with the doctor or nurse is important. The patient must be able to monitor and recognize changes in signs and symptoms so that understands when and how to contact a health professional. The nursing intervention should focus on educating patients and their families for the early recognition of these signs and symptoms, avoiding episodes of decompensation.
One of the items with the worst correct rate was "How often should patients with severe HF be weighed?" (37.2%). Daily weight have an important role in identifying signs of hypervolaemia. The other item with the worst correct rate was "Why should a patient with HF follow a low-salt diet" (34.9%). The knowledge of the patients in our sample needs to be probed about the area of food, particularly with the salt restriction and daily weight control. However, they recognize the importance of taking the medication and what to do in case of worsening symptoms.
Conclusions
We can conclude that about knowledge, patients recognize the importance of taking their medication on a regular basis, they know what "HF" means, what to do in case of dyspnea or edema and what diuretics are for. Instead, they have difficulty understanding the need to weigh themselves daily and the importance of reducing salt in them diet. With this study, it is concluded that it is important to invest in the education of patients and their families so that they adopt healthy lifestyles that can increase their life quality.
Self-perceived heart disease risk assessment in patients with hypertension
Authors: Negesa L , Magarey J , Rasmussen R , Hendriks J 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): The University of Adelaide supported fieldwork

Introduction
Heart disease is the leading cause of morbidity and mortality worldwide. The risk of heart disease is significantly high among patients with hypertension. However, patients’ poor understanding of their risk even further intensifies the risk of heart disease. Therefore it is crucial to improve patients’ understanding of their lifetime risk and applying a healthy lifestyle, to reduce the risk of heart disease.

Purpose
The aim of this study was to explore self-perceived heart disease risk and knowledge of heart disease risk factors in patients with hypertension.

Methods
A cross-sectional study was conducted in patients with a confirmed diagnosis of hypertension who attended follow up care clinics at two referral hospitals in eastern Ethiopia. Data were collected through face-to-face interviews using two validated instruments (ABCD risk questionnaire for assessment of self-perceived risk and heart disease fact questionnaire for assessment of knowledge of cardiovascular risk factors). Data analysis was conducted using SPSS version 25, and descriptive and correlation analysis were conducted.

Results
A total of 203 patients were included in the study, 60% of them were females, and the mean age was 50 ± 9 years. The majority 143 (70.4%) perceived their future heart disease risk as low, however 60 (29.6%) perceived their future chance of developing heart disease as moderate. The mean heart disease risk factors knowledge score was 72.3 + 13.7, and more than half (57%) had optimal knowledge of heart disease risk factors (scored ≥70%), whereas, the remaining 43% had sub-optimal knowledge. Moreover, there is a statistically significant positive association between self-perceived heart disease risk and knowledge of heart disease risk factors (r = 0.28, p= 0.00).

Conclusion
Despite being at high risk, many patients with hypertension underestimate the chance of developing heart disease in their lifetime. Implementation of interventions to promote healthy lifestyle behaviour is crucial to prevent heart disease risk as well as to improve patient’s understanding of these risks.
Factors related to the quality of life in patients with pulmonary arterial hypertension
Authors: Sarzynska K , Polanski J , Kopec G , Mroczek E , Jankowska-Polanska B 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Pulmonary arterial hypertension (PAH) is a rare disease, with an incidence of 15–50 cases per million annually. The disease is associated with further progress and worsening of symptoms despite pharmacotherapy. The severity of PAH symptoms and their effects reduce the patients" quality of life (QoL). Numerous studies show that the quality of life is related to the therapeutic effect of the treatment. Available studies demonstrate that patients QoL deteriorates as the condition progresses. Consequently, the goals of PAH therapy have expanded from increasing survival to improving health-related quality of life. The aim of the study was to determine the clinical and sociodemographic factors influencing the quality of life in PAH patients.

Methods
The study involved 55 patients with PAH who were examined using the Polish version of the PAH-SYMPACT quality of life questionnaire. The PAH-SYMPACT questionnaire results were correlated with several variables.

Results
It was shown that the quality of life correlates significantly (p˂0,05) with WHO Functional Class, NT-pro BNP (N-terminal prohormone of brain natriuretic peptide) value, elderly age (the higher the value, the worse the QoL). On the other hand, the lower the 6MWT (6 minuts walk test) result, the worse the QoL. Moreover, the intensity of the accompanying PAH symptoms, such as chest pain, dyspnoea, arrhythmias, fatigue and weakness were associated with a lower quality of life in patients (p &lt; 0,05).

Conclusion
Patients" quality of life correlates with many variables, both clinical and sociodemographic. In addition, there is a correlation between the quality of life of patients with PAH and the severity of several symptoms associated with this condition. Determination of factors affecting the quality of life of patients with PAH enables the selection of a more comprehensive therapy.
Education in daily life activities as fundamental care in heart surgery rehabilitation: a multifactorial approach to the patient and caregiver
Authors: Acqualagna R , Mazzariol E , Bernardi P , Feltrin C 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

INTRODUCTION
Education represents Fundamental Nursing Care that responds to a psycho-social need of the patient. Acute Coronary Syndrome and cardiac surgery have a strong impact from a psycho-emotional point of view and in the approach to daily activities after discharge: nursing care in this phase aims to obtain not only the full physical recovery of the person but above all to restore awareness of what will be the repercussions in everyday life. Therefore, it is necessary to develop a path that actively involves the client and the caregiver and that aims to recognize and analyse his potential and finally satisfy his educational needs to guarantee a person"s return home that is consistent with his expectations.

PURPOSE
identify the best nursing strategies in managing the educational need of the cardiac surgery patient in the rehabilitation phase involving the caregiver, and describe what aspects to be considered as priorities in personalizing care.

METHODS
a narrative literature review.

RESULTS
23 articles were included in the analysis. The literature has shown that the educational need in cardiac surgery patients in the rehabilitation phase can be detected through semi-structured interviews or self-report questionnaires and should be continued even after discharge. Once shared objectives were set with the client, the care process proved to be more effective with the active involvement of the caregiver, who also has educational and information needs that ensure a return to daily life activities and early recognition of any relapses. Furthermore, both for the client and for the caregiver, the literature emphasizes how the consideration of socio-economic, cultural and gender aspects are important in structuring the educational plan: if not considered, feelings of discomfort and frustration can emerge in the people involved and lead to further emotional problems that can compromise the complete recovery of the person. At the base of the path, however, relational competence is essential for the achievement of health objectives, in a continuum of care between hospital and territory.

CONCLUSION
The educational path of the person after cardiac surgery represents a central point of fundamental nursing care, even after discharge. Given the need to monitor the achievement of the objectives set, the use of nursing taxonomies could prove useful for this purpose in guaranteeing a timely verification of the educational path both before and after discharge: through the declination of objectives and diversified interventions for patient and caregiver, nurses can share the progress made in the care team and facilitate the transfer of care information between professionals in different settings.
How a pandemic changed advanced nurse practitioner (ANP) chest pain assessment from face-to-face to virtual: The impact on clinical workload, diagnosis & patient safety
Authors: Ingram S 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Chest pain presentations to the Emergency Dept. (ED) account for 8% of ED cases annually. In response to the pandemic the usual care pathway of nurse-led assessment in ED and discharge to a chest pain clinic (Ingram 2017) ceased, as face-to-face clinics and diagnostics were curtailed, and staff redeployed. A virtual chest pain clinic was created by one ANP. Telehealth is defined as ‘the entire spectrum of activities used to deliver care remotely, without direct physical contact with the patient’ (Wosik 2020)

Purpose
This analysis aims to compare the outcomes of the Covid-19 virtual chest pain clinic in 2020 to the same face-to- face clinic period in 2019 with a focus on i. Clinic workload, ii. Patient Outcomes iii. Patient Safety,

Methods
The ANP performed a telephone consultation and referred for limited diagnostic testing or discharged to primary care. The patient management system (iPIMS) was used as a clinical and audit tool. This service evaluation was registered as quality improvement project.

Results
From 1/4/20 to 21/7/2020, 130 e-referrals were received compared to 154 face-to-face consults in the same period of 2019. The overall number of clinic episodes was 17% greater during the pandemic period (Fig.1), carried out by 1/3 of the 2019 staff quota. Access to exercise stress testing (EST) was reduced by 88%. CHD was diagnosed in 26%. Virtual assessment in this high risk group in the absence of timely diagnostics is a risk however 30 day mortality was 0%.

Discussion
The pandemic of covid-19 required a rapid redesign of the chest pain service in the midst of staff redeployment. Whilst the total number of referrals is less that the same timeframe in 2019 the ‘virtual’ nature of the service created additional episodes of care with the need for the return clinic in person or by telephone.

Conclusion
In response to the pandemic the change to a virtual clinic was enabled by ANP experience and permitted continued safe discharge of chest pain patients from the ED. The virtual service does add to the ANP clinical workload with potential risk. As it requires more office time, it prevents the ANP presence in the ED. It is hoped in time to return to the original model of care as this will be more efficient for the service and the patient.