bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning Health Care Network Heart Failure: towards a better Heart Failure care in Belgium
Authors: Baldewijns K , Smeets M , Vandenhoudt H 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Koning Boudewijn Stichting, Fonds Dr. Daniel De Konick
Background
The best HF-care is provided in a seamless system that includes both community- and hospital care to avoid hospital readmission. Essential elements to included in such a system are a.o. discharge planning, follow-up, multidisciplinary patient education, teamwork incl. shared professional education, medication optimisation and implementation of care pathways across settings.
Purpose
To facilitate seamless HF-care in Belgium trough capacity building in primary care and improved communication between primary and specialist care.
Methods
HeartsConnect, a Learning Health care Network Heart Failure (LHCN-HF) was established and unites eight regional integrated care projects in Flanders, the Flemish speaking region of Belgium. This LHCN-HF organizes regular symposia on relevant topics for their members. Furthermore, materials to facilitate professional and patient education are being developed. To scale-up integrated care the LHCN-HF works together with several stakeholders. In addition, the process and results of the participating projects will be evaluated.
Results
Four symposia have taken place since the start of the LHCN. The discussed topics were project evaluation and data collection, the roles in a multidisciplinary team, data sharing and best practises. Narrated PowerPoints considering HF-management for GP’s, pharmacists and physiotherapists are being developed in collaboration with their professional associations. To scale-up integrated HF-care, the LHCN-HF works in close collaboration with the Belgian Working Group on Heart Failure and the Flemish Hospital Network. Together with national organizations the LHCN strives for the recognition of HF-nurses, standardized discharge planning, reimbursement of NT-pro-BNP and HF-education and the training of primary care nurses (PCN) in terms of HF-education, aligned with the existing initiatives of HF-nurse education.
Conclusion
At this moment a seamless system of HF-care is not yet in place in Belgium. However, the LHCN-HF together with several HF-stakeholders aims to bridge existing gaps between primary- and specialist HF-care.
Development and effectiveness of advance care planning protocol for heart failure outpatients
Authors: Higashitsuji AH , Okada SO , Fujisawa YF , Sano MS , Taguchi NT , Majima TM , Kobayashi YK 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Heart failure has a poor prognosis, and the number of patients continues to increase. Moreover, since it is a disease that causes various sufferings, substantial end-of-life care is needed. Advanced care planning (ACP) is a part of end-of-life care for patients with heart failure. ACP provides patient decision-making opportunities, documenting end-of-life preferences, and increasing end-of-life conversation. However, the ACP intervention for patients with heart failure is not integrated, and studies are insufficient. In addition, Japan follows a non-Western culture, in which participation in the medical decision-making is reluctant and considered to be less prepared for ACP. Clarifying the effects of systematic ACP on patients with heart failure in Japan can be used to determine effective interventions in Japan and may provide effective ACP intervention for patients who have no preparedness worldwide.

Purpose
This study aimed to identify the effect of protocol-based intervention on the outcomes of ACP in Japanese outpatients with heart failure.

Methods
This is a single-center retrospective observational study. Data on patient attributes, conversation records, and document information from medical records of patients who have undergone intervention using the predeveloped ACP protocol were collected. Numerical data were statistically analyzed. ACP results were evaluated by performing deductive content analysis on the basis of existing frameworks. A subgroup analysis was performed on differences in ACP outcomes based on patient attributes.

Results
Data were collected from 13 patients who underwent ACP intervention. The median age was 69 years. Moreover, 76% were male, 84% were married, 76% were living with family, and 46% were receiving home-visit nursing care. New York Heart Association functional classification II was the most common in the severity classification of heart failure, and ischemic cardiomyopathy was the most common etiology. Documenting patient’s wishes, recording patient’s wishes in medical record, and identifying what brings value to patient"s life were achieved in 76% of the participants. Deciding surrogate decision makers, discussing values and care preferences with the surrogate, and discussing values and care preferences with health care professionals were achieved in 69% of the participants. Differences in patient attributes, such as age and presence or absence of home-visit nursing, did not affect ACP outcomes.

Conclusion
Protocol-based ACP allows patients with heart failure to determine surrogate decision makers and discuss care preferences with healthcare professionals, identify what they value, and record their wishes. The protocol-based ACP had a positive impact on ACP outcomes, without being restricted by patient attributes.
The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review
Authors: Farquharson B , Dixon D , Williams B 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Chief Scientist Office, Scottish Government

OnBehalf
BICeP Study Group
Background
Prompt, effective CPR greatly increases the chances of survival in out-of-hospital cardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified.
Objective
To identify the psychological and behavioural factors associated with CPR initiation amongst lay-people.
Methods

Data sources
Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar.

Study eligibility criteria
Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 15th January 2020).

Study appraisal and synthesis methods
Potential studies were screened and quality assessed independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively.
Results
Ninety studies (132,429 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence is limited by a preponderance of atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of posited ‘predictors’.
Conclusions
We will present the psychological and behavioural factors that are likely useful foci for future interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs which make greater use of theory.
Co-design of cardiac rehabilitation delivery in the aftermath of COVID-19, putting the patient view back in the picture
Authors: Caughers G , Bradley J , Donnelly P , Fitzsimons D 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Research and Development PhD Fellowship

Background
Poor uptake and adherence to Cardiac Rehabilitation (CR) is a longstanding problem exacerbated by the Covid-19 pandemic. Since lockdown, several alternative formats have been utilised to adapt to social distancing requirements, but evaluation of these is needed1.

Purpose
This study uses Experience Based Co-Design to identify novel approaches to delivering CR in a post COVID-19 era.

Methods
Using a co-design approach 58 participants were recruited, these included staff, patients who attended, dropped out or did not attend CR. Interviews and focus groups were recorded, transcribed, and analysed using template analysis. The results will be depicted through video at a co-design workshop where innovative approaches will be discussed and prioritised by the study participants.

Results
The main themes developed from interview and focus group include 1. Staff & hospital treatment, 2. Patient characteristics, 3. Emotional state, 4. What Cardiac Rehabilitation is, 5. Time, location and delivery, 6. Self-Care and finally, 7. Technology. These themes are conveyed through a 15-minute trigger video along with quotations to stimulate discussion. Anticipated outcome will be 4-5 approaches which can be adapted for implementation.

Conclusion
The forthcoming co-design workshop will present findings to patients and staff in a virtual setting allowing valuable co-ownership of the outcomes. This presentation will describe an innovative process that has redesigned CR using the perspective of all stakeholders and sought to maximise choice and flexibility for a post-COVID climate.
The impact of the cardiac rehabilitation program in patients with mid-range heart failure (40-50%) in improving cardio respiratory predictors
Authors: Rodrigues HR , Ferreira V , Alves L , Sousa D , Pinto J , Pinto A , Rio P , Ferreira R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Universitário Lisboa Central

Methods
We studied 30 patients (P) with ejection fraction (EF) 40-50%, in a number of 198 P that participated in cardiac rehabilitation program (CRP). Of these P, 24 (80%) male and 6 (20%) female, 20 P were diagnosed myocardial infarction with ST-segment elevation, 2 P myocardial infarction non ST and 8 P with myocardial hypertrophy non ischemic. Of these P 30% were diabetics, 56% hypertension, 70% dyslipidemia, 36% smokers previous to CRP and body mass index 26,3 medium.
All P were submitted to previous echocardiogram, cardiopulmonary exercise testing (CET) and a rehabilitation program minimum 4 sessions and maximum 52 sessions. At the end of the total sessions the echocardiogram and CET were repeated.

Results
Of the 30 P that participated in CRP only 20 completed the program, while the other 10 P dropped out because of social and economic problems. Of the P that completed the CRP, 70% got better on EF, 80% improved VE/VCO2 slope &lt; 33 therefore are classified VC-II in ventilatory classification (VC), 5% VE/VCO2 slope &gt; 40 VC-III classification, and 15% maintained the initial classification. 50% of the P increased at least one level metabolic equivalent of task (MET) from the first CET. Only 3 of the 20 patients came, once, to the hospital after the CRP with heart failure, and one died but did not fulfill the program.

Conclusion
Patients with mid-range heart failure submitted to a CRP can improve cardiorespiratory predictors, leading to a better quality of life. However, it is important to find solutions to minimize the causes that make patients to give up CRP.
Patient & public involvement for inherited cardiac conditions
Authors: Bueser T , Patch C , Rowland E , Coles L , Metcalfe A 
Published: July 2021

Abstract

Funding Acknowledgements
National Institute for Health Research

OnBehalf
King"s Health Partners Patient & Public Involvement for Inherited Cardiac Conditions (PPIICC) group

Background
Inherited Cardiac Conditions (ICCs) affect up to 1:200 of the population and is the leading cause of sudden death in the under 40s. Research into developing interventions to support patients as they adjust to their diagnosis and genetic carrier status is underway; an example of which is the Psychoeducational Intervention Supporting patients with an ICC (PISICC) study. To ensure the appropriateness, acceptability and applicability of the intervention, patients and the public were involved in the development of PISICC intervention.

Purpose
To ensure the relevance and improve the quality of the PISICC study, Patient & Public Involvement for Inherited Cardiac Conditions (PPIICC) group was organised to guide the research project as this progressed through the three phases of the Medical Research Council framework for developing complex interventions.

Methods
Utilising INVOLVE guidelines, the PPIICC group was initiated by the researcher by inviting patients and families attending a local ICC clinic, members of the patient support group, Cardiomyopathy UK; and members of the existing PPI group of the local biomedical research centre. Ground rules, terms of engagement and provisions for meetings such as rooms, reimbursements for transport costs, childcare and compensation for time was established. The PPIICC group met up to three times per year within a three-year period with electronic exchanges in between. Members gave individual feedback to draft study materials and their views shaped the final versions. A modified Delphi study was used for the development of the PISICC intervention model. Figure 1 illustrates the activities undertaken by the group.

Results
The involvement of the PPIICC group throughout the development of the PISICC intervention model has contributed to the successful recruitment of 32 participants and completion of the qualitative study in Phase 1. In Phase 2 the group had a crucial role in ensuring that the education component of the PISICC intervention included advice on medication and physical activity; and for the group component of the intervention to include a mixed age group to enable sharing of varied experiences. In planning for Phase 3, the PPIICC group helped ensure that the trial processes for the planned feasibility study were not burdensome to participants which supported its full ethical approval by the UK Health Research Authority.

Conclusions
Patients and their families played an important role in designing the PISICC study. So far, their involvement has resulted in reaching recruitment targets for Phase 1 of the study, the development of a patient-informed psychoeducational intervention model and feasibility study protocol.
Caring for patients with a congenital heart defect: a national survey of the educational needs of nurses
Authors: Griffiths L , Seaton S , Lotto R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Around 1 in every 130 babies are born with a structural heart defect. Over the past half century, advances in treatment have resulted in increasing numbers surviving with complex disease. Currently, around 90% survive into adult life. In order for these patients to receive a high standard of care throughout their lifespan, it is imperative that nurses are educated appropriately. This is supported by the NHS England Standards (2016), which provides recommendations on minimum staffing levels, but also demands that staff are competent to deliver that care. Aims: The aim of this study was to explore the educational needs of nurses who may encounter this group of patients. Methods: A national online survey was undertaken between 4/06/2020 to 06/07/2020. Results: A total of 513 individual survey responses were received from both paediatric and adult nurses and AHPs (representative of an all age service), working in all levels of care. Regardless of where the nurse worked, band 5 nurses reported a higher level of anxiety about caring for patients with congenital heart disease (CHD) in comparison to the whole cohort (18% versus 12%). In the previous two years, 30% of the band 5 staff had received no training. Of the band 5s who had received no training, 71% were based in non-CHD settings. Both band 5 nurses and staff of all grades working in non-CHD centres identified managing emergencies (band 5: 77% and non-CHD: 76%), caring for a patient with CHD (band 5: 71% and non-CHD: 72%) and a simple understanding of CHD (band 5: 61% and non-CHD: 67%) as priority topics. Whilst the majority of band 5, and non-CHD centre nurses who had received recent education had undergone a local study day (band 5: 33% and non-CHD: 34%) or self-directed learning (band 5: 38% and non-CHD: 31%), formal or accredited courses were rated most desirable (band 5: 93 and non-CHD: 84%). Conclusion Whilst education within specialist level 1 and 2 centres appears to be well developed and embedded, junior nurses (band 5) and particularly those working in non-cardiac units, appear to be being left behind. Easy access information pertaining to emergency care, alongside simple descriptions of care requirements would benefit those nurses who rarely encounter CHD patients. Digital and other innovative approaches may work well as memory aids and provide a solution alongside formal training. Consideration to including fundamentals of care within the nursing curriculum would potentially provide a base from which nurses can develop. Preferences for accredited, formal study sessions support the need for further development of post graduate education.
Evaluation and Cardiac Rehabilitation on a patient with a congenital heart disease
Authors: Felix A 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Severe congenital heart disease (CHD) requiring surgical intervention occurs in 6 of 1000 live-born infants. Substantial improvements in surgical treatment and perioperative care have led to excellent long-term cardiac outcomes for most of these patients and, consequentially, to a significant increase in survival rates.
Formal evaluations of preschool, school-aged children and adolescents born with complex CHD demonstrate a pattern of neurodevelopmental sequelae, which may appear alone, or in combination.

Purpose
F. is a 21 years-old patient with repaired complex transposition of the great arteries with ventricular septal defect, who have already undergone three surgeries: a) an initial palliative surgery (pulmonary artery banding and ductus arteriosus ligation) at the neonatal period; b) a corrective surgery (arterial switch and VSD closure) at the end of the first year of life and c) Pulmonary artery plasty for residual pulmonary stenosis at the age of 16 years-old. Now, he was admitted to our department for urgent wide-complex tachycardia treatment. His initial assessment documented a subjectively impaired motor development, and subsequently, a formal assessment was performed.

Methods
The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) is an individually administrated test that resorts to a series of engaging, goal-directed activities to measure a wide array of motor skills in individuals ages 4 through 21. The BOT-2 uses a subtest and composite structure that highlights motor performance in the broad functional areas of stability, mobility, strength, coordination, and object manipulation.

Results
Patient"s performance in the four main motor skill areas will be report, namely: Fine Manual Control, Manual Coordination, Body Coordination, and Strength and Agility. Because Fabio completed all four parts of the BOT-2, a comprehensive score from all four areas, the Total Motor Composite, will also be reported. Fabio"s scores were compared to the ones of a control group of age and gender-matched individuals.
This Patient started sessions of Cardiac Rehabilitation. The rehabilitation sessions are conducting for 1 hour three times a week for 1 year. This program still in progress, but we speculate that the will improve his motor abilities and developmental skills.
Conclusion
The risk of a poor developmental outcome varies according to the specific cardiac effect. In addition, there is significant interindividual variation in developmental outcome even among children with the same cardiac defect. Other factors may contribute to neurologic dysfunctions. These factors can be divided into three main categories and time-frames: prenatal, perioperative and post-discharge.
Awareness on the coronary heart disease patient - a case series
Authors: Teixeira Rodrigues D , Ferreira G 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Each year cardiovascular disease (CVD) causes 3.9 million deaths in Europe, accounting for 45% of all deaths. CVD are especially relevant not only due to the high mortality rate related to them, but also due to the disability associated with them. In Portugal, one of the specific skills of the medical-surgical nurse is to take care of the person and family / caregivers experiencing complex medical processes (such as acute coronary syndrome - ACS), resulting from chronic disease (such as coronary heart disease - CHD). The medium-range theory of transitions, by Meleis and collaborators, helps to frame the theoretical aspects in nursing practice. Nursing approaches to the person with CHD, are often focused on transmitting knowledge and teaching abilities, regardless of the perception the person may have of the need to pursue changes in his/her life.

Purpose
This study aimed at gathering information on how a person perceives, has knowledge, and recognises an acute coronary event as a moment of transition. It is intended to evaluate the level of awareness the person has of his/her situation in this health-illness transition, as to incorporate an approach based upon the transition’s theory.

Methods
The study was conducted on a Cardiology ward and Intensive Care Unit of a tertiary hospital in Northern Portugal, on the second half of September 2020. All patients admitted with an ACS were eligible. A qualitative research framework was adopted, using the semi-structured interview. When phrasing some questions, the phenomenological approach was adopted.

Results
Four patients were included. Their interviews showed a wide variability of knowledge about the motive for admission or what caused it; there was an uneven perception of the severity of the event; in general, they did not recognize the need to make changes in their lives or externalized the responsibilities for it. This study was limited by a reduced number of interviews conducted, limiting the generalization of the findings and conclusions, though it was not the purpose of this exercise. Also, the interviews were performed in different moments after admission, so some of the patients had already been approached by the nursing staff in moments of health education, which may lead to information bias.

Conclusions
The traditional health education approach based on teaching the patients a set number of items needed to achieve a healthier lifestyle after an ACS, seem to produce very variable effects on how the person recognizes, perceives, and knows about his/her condition. The transition theory framework may be useful to engage patients in the process and, considering the reduced length of stay in the hospital, it is necessary the transition of care to the community. Awareness is a central concept in the patient"s adaptive process and, therefore, a major theme for nursing practice. Considering the apparent scarcity of evidence about it, it reveals to be an area of future investment.