bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular disease patient reported experiences with a web-based, interactive, clinically integrated cardiac rehabilitation program
Authors: Nesbitt K A T I E , Gebremichael L G , Champion S , Bulamu N , Clark R A , Beleigoli A 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/introduction
Patient reported experience measures (PREMS) encompasses a person’s interactions within the healthcare system. Understanding the patient experience is key to quality patient-centered care, and evaluating these experiences is essential to improving clinical outcomes and health care quality. Cardiac rehabilitation (CR) programs contribute to redressing cardiovascular disease (CVD) morbidity and mortality by slowing the progression of CVD and restoring quality of life. There is consensus that CR suboptimal attendance and completion is multifactorial, and that different causes are involved. Thus, evaluating patient experience to improve CR program attendance and completion and reduce the burden of CVD is essential.

Method
A retrospective descriptive survey design was used for patients ≥18 years, who were enrolled and active with the interactive, and clinically integrated web-based program for their CR between July 2021 to December 2022. The primary outcome was patient experience, and the aim was to evaluate this experience.

Results
Of the 54 enrolled patients, 16 met the inclusion criteria and received an online survey link. Of these 9 (56.3%) responded. Most respondents were aged between 60-70 years (55.6%) and male (77.8%). Seven (77.8%) did a web-based program only, and hybrid (combined web-based and centre CR) were two, (22.2%). The main reasons for choosing this mode of delivery were restrictions relating to the COVID-19 pandemic (66.7 %), and/or geographical isolation and work commitments (33.3%). Most stated that they participated in their goal setting (89%), and 77.8% achieved these goals. Program completion was reported by 77.5% of patients, with 7.89 (SD 4.12) mean weeks completed. Information delivered in the education sessions was clear and easy to understand, contributing to positive lifestyle changes as reported by 77.7% of patients. All patients reported increased confidence across the CR health domains and being treated with respect and dignity. Regarding Phase 3 CR, extended ongoing outpatient attendance and exercise programs, 77.9% reported working with their GP and practice nurse to maintain lifestyle changes. Overall patients reported a positive experience from the web-based CR program stating, "I found this program to be very beneficial and would strongly recommend it to people having heart ops. Pity about covid stopping me attending face to face sessions. The phone and internet support was top notch".

Conclusions
Patients reported a high level of satisfaction with the education received and respect and dignity shown via a web-based CR program. This is fundamental to engagement with the program, behavior change and improved clinical outcomes in particular for patients with no access to center-based CR due to pandemics, work commitments and geographical isolation.
How the dyads of heart failure patients and their informal caregivers cope with the disease process: a qualitative synthesis
Authors: Xiong C , Li P W C , Yu D S F , Wong C W Y 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Heart failure (HF) is a debilitating and progressive condition requiring consistent self-care by patients and their caregivers. Understanding the dyadic coping experience is crucial to inform the development of effective self-care interventions. Existing reviews focused on coping experience of patients or informal caregivers separately, without considering dynamic interaction between patients and caregivers.

Purpose
This review aimed to synthesize the qualitative studies to understand how patients and their caregivers interact and jointly cope with HF.

Methods
A systematic literature searching was conducted in nine electronic databases from inception to 11 June 2022. Manual searching of the reference list of relevant articles was also conducted. Articles were eligible if they focused on exploring the dyadic coping experience of HF patient-caregiver dyads aged 18 years or older. The Critical Appraisal Skills Programme tool for qualitative studies was used to assess the methodological quality of included articles. Thematic synthesis was adopted to synthesize the findings.

Results
Thirty articles were included in the review. Eleven articles were rated as high quality and nineteen as moderate quality. Three analytical themes emerged from the findings: (1) challenges in their changing and shared life experience, (2) conditions shaping dyadic coping experience, and (3) evolving dyadic coping strategies from the illness experience (Figure 1). Patients’ progressive and debilitating disease conditions disrupted the shared lives of the dyads, consequently causing a series of stressors for both to cope with. Dyadic coping of HF is influenced by the interpersonal context (i.e., congruence of illness perception, dyadic relationship and interaction, dyadic coping capabilities) and social context (i.e., professional and informal input). During the coping process, HF dyads utilized constructive or destructive methods of adjusting relationship boundaries, transforming patterns of dyadic coping and regulating emotion in a dyadic context. Besides, the strategies of amplifying positive changes and seeking meaning were critical for dyads to normalize HF in their lives.

Conclusion
HF imposed multiple stressors on the shared life of the dyads. Under the influence of interpersonal and social context, patients and caregivers co-regulated dyadic coping strategies to respond to dyadic stress, either adaptively or maladaptively. A relationship-focused dyadic approach is needed to optimize the synergy in the dyadic coping process and support dyads to cope with HF.
Co-design of an atrial fibrillation mHealth intervention to increase medication adherence
Authors: Pearsons A , Hanson C L , Gallagher R , Clark R , O'carroll R , Hanley J , Strachan F , Mills N , Quinn T , Mckinstry B , Neubeck L 
Published: July 2023

Abstract

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

Background
Atrial fibrillation (AF) related stroke risk can be reduced with oral anticoagulants (OACs). OACs need to be taken once or twice a day to maintain effectiveness but non-adherence remains a challenge mHealth applications are one way to support patients to take medication.

Purpose
We aimed to co-design an mHealth intervention to increase medication adherence to OACs in patients with AF.

Methods
We recruited individuals with AF via British Heart Foundation social media advertisement and using established contacts from the Scottish AF survey to take part in a series of remote and in-person workshops. These were 1) an initial patient experience session, gathering personal stories to contextualise the intervention 2) an interactive session, using existing mHealth AF applications identified via scoping review, and 3) a pilot session of the co-designed mobile app prototype. Data were collected using flipchart, post-it notes and researcher field notes, with emphasis placed on the use of direct quotations and storytelling. Development work was overseen by a steering group including clinicians, digital health experts, and four AF patient representatives.

Results
Eleven patients (7 males) aged 35-80 years took part. Six participants were diagnosed with AF within the last five years and eight had one or more co-morbidities. Number of daily medications ranged from 0-12, with 8/11 (72%) of participants taking OACs. Experience with smartphone use varied and only two reported using a smartphone to manage their own health. We developed a prototype mHealth app, MyAFNurse. The talking avatar-based app increases accessibility regardless of user health literacy level. It incorporates behaviour change techniques including a medication tracker and reminders, information about AF, advice on when and where to seek help, and a quiz to test knowledge.

Conclusions
A robust co-design process developed an avatar-based mHealth app that incorporates behaviour change techniques which will be evaluated in a feasibility trial.
Essesment of short-term clinical outcomes in coronary artery disease patients after PCI on the background of low glycemic diet
Authors: Payziev D , Alyavi B A , Uzokov J K , Orziev D Z 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Accumulated data suggest that low glycemic index diet (LGID) improved several clinical and biochemical parameters in patients with atherosclerotic coronary artery disease (ASCAD) after percutaneous coronary interventions (PCI) [1]. Aim of the present study was to evaluate the influence of LGID on short-term clinical outcomes in patients with ASCAD.

Material and Methods
The prospective, open label randomized study included 160 ASCAD patients collected within 2016-2019 years (Aged 38-76 years, mean age 58.2±12.0 years, male=48%). Patients were divided into 2 groups by 80 and assigned either LGID or routine recommended diet (RD). Patients were followed-up to three years after the PCI followed by stenting (medium 18.22±6.54 months) for the assessment of major adverse cardiac events (MACE). All data analyzed using STATA software.

Results
At the follow up period mortality rate was higher in RD groups than LGID group (RR1.34, CI 95%, 1.025-1.85, P&lt;0.05). MACE were significantly higher in Group II than Group I patients (RR 1.28, CI 95%, 1.018-1.76, P&lt;0.05). During the follow up 7% of patients occurred ACS whereas 11% patients in RD group occurred ACS (P&lt;0.05). Regarding the stent thrombosis, there were not observed statistically significant changes between groups (P&gt;0.05). Target vessel revascularization were performed in 2.5% LGID group patients whilst 6.25% in RD group patients (P&lt;0.05). Besides, target lesion revascularization was performed in 1.25% LGID patients whilst 3.75% RD group patients (P&lt;0.05). When we analyzed clinical outcomes by gender there were not observed any statistically significant changed between men and women (P&gt;0.05).

Conclusion
Low glycemic index diet had lesser risk of MACE than routine diet in the short-term period in patients with atherosclerotic coronary artery disease after PCI. Further studies are required with large amount of patients.
How patients affected by heart failure and other chronic conditions perform general and specific self-care behaviors
Authors: Erba I , Ferro F , Saurini M , Ausili D , Matarese M , Vellone E , De Maria M 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Centre of Excellence for Nursing Scholarship (CECRI), Rome, Italy.

Background
Older adults affected by chronic conditions (i.e., heart failure or any other chronic condition) need to perform self-care. It includes behaviors to maintain a healthy lifestyle (self-care maintenance), monitor signs and symptoms of chronic diseases (self-care monitoring), and manage them (self-care management). Performing self-care, allows patients to improve their quality of life, reduce hospital admission rates, and mortality. In patients affected by Heart Failure (HF) and other chronic conditions, also specific self-care behaviors are needed. To date, no prior studies have investigated general and specific self-care behaviors in patients with HF and other chronic conditions.

Purpose
Investigate how patients affected by HF and other chronic conditions perform general and specific self-care.

Methods
Cross-sectional study. We collected data from April 2017 to October 2021 in Italy. Patients with HF and other chronic conditions with more than 65 y/o were enrolled in community and outpatient settings. The Self-Care of Chronic Illness Inventory (SC-CII) and The Self-Care of Heart Failure Index (SCHFI) were used to measure generic and specific self-care behaviors, respectively. Values ≥70 indicate adequate self-care behaviors. Paired t-test was performed to identify differences between SC-CII and SCHFI scores.

Results
A sample of 369 patients with HF was enrolled. 53.3% was female with a mean age of 78.91(±7.41) years, and a median of 3 chronic conditions. The two chronic conditions most frequently associated with HF were Hypertension (75%) and Diabetes Mellitus (70%). Results showed inadequate general self-care maintenance (66.11±14.7) and management (57.77±20.1). Instead, general self-care monitoring was adequate (76.26±20.4). Specific HF self-care maintenance, monitoring and management were inadequate and equal to 57.54 (±17.24), 53.41 (±25.32) and 54.48 (±20.02), respectively. Specific self-care in HF is significantly lower than general self-care behaviors (p&lt;0.001).

Conclusion
Patients showed more difficulties performing general self-care maintenance and management respect self-care monitoring. Regarding specific HF self-care, patients perform inadequate self-care behaviors in all dimensions. Knowing the lower self-care behaviors is important for clinicians to develop tailored interventions. In particular, patients with HF and other chronic conditions need to be supported in specific self-care behaviors.
Clinical use of voice measurement in patients with heart failure: study protocol
Authors: Erba I , Matarese M , Ausili D , Vellone E 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Chronic conditions are the main causes of morbidity and mortality worldwide. Heart failure (HF) has a prevalence between 0.5% and 2% in the western population and the number is destined to increase from 25% in 2012 to 46% in 2030. Older adults affected by HF have difficulties to recognize signs and symptoms of the disease, bringing to a reduction of life expectancy. The voice is a complex coordination mechanism between systems and subsystems (i.e. glottis, lung, nose,..). Changes in voice parameters, measuring by algorisms of artificial intelligence, could be useful markers of HF exacerbation. To date, no prior studies have investigated the changing of voice parameters in HF patients and the relationships between voice parameter changes and the clinical course of HF.

Aims
Explore voice parameter differences between HF patients and healthy subjects; to investigate the relationships between voice parameter changes and the clinical course of the disease.

Methods
Observational study. Patients with HF and healthy subjects between 60 to 80 y/o will be enrolled in inpatient and outpatient settings. Patients and healthy participants will record voices by microphones and smartphones. Voice data will be analyzed with algorithms of artificial intelligence.

Results
This study will identify differences in voice parameters between HF patients and healthy participants, and the associations between the voice parameters and the clinical changes of HF patients.

Conclusion
Monitoring of voice parameters allows to clinicians to early identify, via voice changes, signs and symptoms of HF exacerbations, and to monitor patients at home.
Is balance a marker of health status in patients with reduced left ventricular ejection fraction
Authors: Rebelo C , Jose Bastos J B , Vera Afreixo V A , Ana Abreu A A 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
A significant percentage of patients hospitalized for the coronary disease have a decrease in left ventricular ejection fraction (LVEF), limiting their ability to perform their daily activities and increasing their dependence. Mobility is one of the most affected factors, namely postural balance, walking, transfers, hygiene care, among others. This fact can hinder the resolution of the underlying pathology, delay its resolution, facilitate the appearance of comorbidities, and cause prolonged hospitalization, causing a greater state of fragility. The implementation of measures that improve this dependence and fragility will hypothetically have effects on quality of life and prognosis. Exercise inertia is a well-defined cardiovascular (CV) risk factor, that causes greater physical dependence, greater frailty, and less responsiveness to disease. The authors consider that any improvement in this aspect will lead to a better CV prognosis.

Purpose
To assess the physical fitness of patients undergoing a phase I rehabilitation program to improve their cardiac condition

Methods
Longitudinal, prospective, and experimental study hospitalized for coronary disease.
Physical fitness was evaluated: 1) dynamic balance and mobility (Fullerton test battery that already includes the 6-minute walk test and body composition), 2) upper body strength (handgrip strength test), 3) cardiorespiratory fitness, and 4) body composition. Morisky Medication Adherence Scale and STOP-Bang scale (Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) were also applied. The descriptive and inferential analysis was performed using the R version 4.2.2 program, all test results with p&lt;0.05 are considered statistically significant.

Results
65 patients were evaluated, with a median age of 63 and interquartile range (57, 72), of which 23% had LVEF≤40%; 86% had high blood pressure, 80% have dyslipidemia, 73% drank alcohol daily and only 23% practice regular physical exercise. When applying the Fullerton balance test, we found that: 74% cannot safely turn 360º, needing four or more steps in both directions; 92% cannot walk independently and without interruptions on a straight line on the ground; 74% cannot balance on one leg autonomously and maintain the position for 20 seconds. We also found that 68% had a high risk of sleep apnea (STOP-Bang scale).
LVEF data were divided into classes (LVEF ≤40; LVEF 41-50; LVEF &gt;50) and the association was evaluated using Fisher's exact test and Kruskal-Wallis test, and it was verified that there is a positive association between balance and LVEF (p-value = 0.2) and 6mTM and LVEF (p-value = 0.07).

Conclusion
The positive associations found between balance and mobility limitations in this sample suggest that specific programs may improve balance and, consequently, the patient's general state of health.
Feasibility a mobile exergame intervention for patients with heart failure
Authors: Andreassen M , Klompstra L , Stromberg A , Jaarsma T 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swedish National Science Council (2020-01109)
The Swedish Heart and Lung Foundation (20200190)

Introduction
People with heart failure often perceive difficulties performing physical activities due to their symptoms. However, physical activity is beneficial and recommended. Therefore, it is a need for interventions supporting patients to increase their physical activity in everyday life.

Purpose
This study aims to investigate the feasibility of a mobile exergame intervention for patients with heart failure.

Methods
Nine Swedish patients with heart failure, seven male and two female, median age 73 years (range 63-81) participated. Patients downloaded the exergaming application "Heart Farming" on their private smartphones. Patients were advised to increase daily walking based on their physical condition. Patients received introduction and telephone conversations on a predetermined schedule. Feasibility areas of Acceptability, Demand, Implementation, and Practicality were examined by interviews and data downloaded from the application.

Results
Patients used Heart farming for one month, their goal of daily walks was in mean 704 meters (range 417-900 meters). Patients increased daily walks and experienced improved health. The individual conversations were perceived supportive and encouraging. Heart farming was perceived easy to learn, use and adjustable to individual needs.

Conclusions
The study confirmed the impact of encouragement, and importance of tailoring the intervention to patients' personal situation, to achieve regularly daily walks.
Improving cognitive function after cardiac surgery: home-based computerised cognitive training (FACCT study)
Authors: Bowden T , Aitken L M , Hurt C S , Sanders J 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Barts Charity Nurse / Allied Healthcare Professional Clinical Research Fellowship (MRC0229, Improving cognitive health after cardiac surgery)

Background
Postoperative cognitive dysfunction (POCD) occurs in up to 50% of patients after cardiac surgery. Despite extensive research, the underlying causes and pathophysiology are poorly understood. Further, definitive treatments for POCD are lacking. The focus of this doctoral work was to identify predictors of POCD, examine the effectiveness of existing cognitive interventions on improving cognitive function, and use the findings of both of these systematic reviews to design and develop a cognitive training programme in postoperative cardiac surgery patients.

Objectives
The aim of this study was to evaluate the feasibility and acceptability of a home-based computerised cognitive training programme in postoperative cardiac surgery patients.

Methods
This is a single-arm, non-blinded, feasibility and acceptability study involving adult (&gt;18 years of age) patients admitted for first time elective cardiac surgery. Participants were required to complete an 8-week cognitive training programme (40 sessions [20 minutes/day, 5 days/week]), commencing one week postoperatively, and administered using their own computers or tablets. The Montreal Cognitive Assessment (MoCA), a brief test of global cognition, was administered preoperatively and after the training programme. Feasibility outcomes included recruitment and retention rates and adherence to the programme. Acceptability was assessed by the Theoretical Framework of Acceptability Questionnaire (TFA-Q) which was administered post-programme.

Results
In total, 95 patients were screened, 51 (53.7%) were eligible and approached, and 31 (60.8%) consented to participate. Of these, 29 participants enrolled in the cognitive training programme, 7 (24.1%) were female, 20 (69.0%) were white British, and the mean baseline MoCA was 26.9 (out of 30). Data collection is complete, final analysis will be complete for presentation prior to ACNAP 2023. Interim results suggest that home-based computerised cognitive training (CCT) is feasible in terms of recruitment rate (60.8%, exceeding the target of 50%) and acceptable (with 94.1% of those who completed the TFA-Q identifying CCT as acceptable). Other feasibility indicators measured include retention (58.6%) and adherence (31.0%).

Conclusions
A trial examining home-based computerised cognitive training appears feasible and acceptable to patients, although strategies to improve retention and adherence will need to be strengthened. If found to be beneficial, such a programme could offer an inexpensive and safe method of improving postoperative cognitive function.