bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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 &gt;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

Abstract

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 &gt; 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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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 (&lt;0.001), CFI (&gt;0.999), TLI (&gt;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

Abstract

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.