bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-care recommended by clinicians in patients with heart failure or type 2 diabetes: a Delphi study
Authors: Westland H , Van Rijn M M , Page S , Wiebe D J , Freedland K E , Lee C , Vellone E , Aryal S , Stromberg A , Jaarsma T , Riegel B 
Published: July 2022

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

Funding Acknowledgements
Type of funding sources: None.

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

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

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

Results
Participants (n=20) were aged mean 75±7 years and had lived in Australia for mean 16 ± 8 years. The majority were female (65%), and had poor English language proficiency (95%), poor self-reported health (90%).
Two main themes generated from interviews were related to culture and language influence in terms of accessing and interpreting health information. Other themes were primarily related to deficits, in heart disease-related knowledge, understanding of the healthcare system, and health information resources.

Conclusions
Immigrants with heart disease in this study have multiple health information and education needs related to personal and system factors inadequately addressed by healthcare services. Culturally and linguistic appropriate health information and support services are recommended to improve disease knowledge and appropriate use of healthcare services.
Improving the quality of life an empowerment of our patients with ischemic heart disease
Authors: Gonzalez Batista B , Marti Bertomeu F , Clemente Prat A , Corzan Melgosa P , Esclusa Serra M , Santaularia Capdevila N , Pintado Pallares L , Vazquez Oliva G 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundació Althaia
It is proved that nursing interventions in chronic coronary heart illnesses decrease mortality and risk of a new coronary event. This is achieved through the development and performance of a personalized educational plan, focused on health promotion, aimed at modifying or enhancing a heart-healthy lifestyle and facilitating strategies to promote patient's empowerment, helping them assume certain responsibility in their own heart-healthy. Always based on humanized and empathetic care. This individual attention is reinforced with a "Health School" which is a group of talks addressed to patients and their close family members. Since 2019 we organizer two to healthy walks a year. Once the program is completed are referred to the Primary Care nursing.

Objectives
Improving the knowledge's level of patients with regards to their illness and its treatment. The keys consist in designing easy strategies for an optimum self-control of the illness. Evaluate the acquired knowledge and recording level of satisfaction with the program.
Methodology
A descriptive and retrospective study of patients with ischemic heart disease the for 5 years, from 2015 to 2020. After the hospital discharge, an outpatient nursing follow-up is performed on a 1, 3 and 6 months basis finalizing whit a group talk a kind of "School of health", carried out 3 times a year in 3 educational sessions.

Results
Among 960 patients monitored: 852 who successfully completed, 97 abandoned the program before having completed it and 11 who unfortunately died.
The variables studied in the educational plan are: Identifies cardiovascular risk factors and knows how to act tochange them (82.5%) Recognizes signs and symptoms of chest pain and how to act (90.9%) Recognizes their responsibility for monitoring of the prescribed treatment (91.2%).
In relation to the "School of health" 334 patients attended 156 companions, of the topics covered: the most important was the psychological / emotional aspect followed by control of risk factors and exercise, the information on the pathology and finally diet and sexuality.
Innovative contribution to policy, practice and/or research
The nursing interventions carried out with Educational Program hare proved on patients knowledge improvement and a higher adherence to treatment as well as a major self control of risk factors. Patients and their families report a high level of satisfaction with the program. Under our opinion all this will have a positive impact in the future an impact in the future improving the quality of life of patients and their closest families, reducing the possibilities of new coronary events decreasing as well health care costs for the society. It will more over guaranties a good continuity between specialized and primary care nursing.
The prevalence of negative attitudes towards nurses and depressive symptoms in nurses working in cardiology departments in Malopolska region, preliminary results.
Authors: Wolfshaut-Wolak R , Nowacka A , Micek A , Wadas T , Gniadek A 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
A significant increase in negative attitudes towards nurses accompanied by exacerbation of depressive symptoms in nurses working in cardiology departments have been observed.

Objective
The assessment of the intensity of negative attitudes towards nurses and depressive symptoms experienced by nurses working in cardiology departments in Malopolska region.

Methods
A cross-sectional study was conducted between 2020 and 2022. It was carried out in a group of 130 nurses working in conservative cardiology departments and 72 nurses working in interventional cardiology departments. The nurses were randomly selected from the register of hospital employed nurses of Malopolska Regional Chamber of Nurses and Midwives. The incidence and intensity of negative experiences at work were determined based on NAQ (The Negative Acts Questionnaire) and the incidence and intensity of depressive symptoms were measured by means of Beck’s depression scale.

Results
Among all the nurses surveyed 58% of them experienced some negative attitudes and the exacerbation of mild, moderate and severe depressive symptoms was observed in 37.1%, 18.3% and 4.5% of respondents respectively; no significant differences were found between conservative cardiology departments and interventional cardiology departments. A positive correlation was observed between the exacerbation of depressive symptoms and negative attitudes towards nurses r=0.335, p&lt;0.001, and this correlation was stronger in interventional cardiology departments r=0.397, p&lt;0.001. The risk of developing depressive symptoms was 3.4 times higher in nurses exposed to negative attitudes than in those who did not experience such behaviours (95% CI: 1.61-7.62).

Conclusions
The results of this study show that nurses working in cardiology departments in Malopolska region are exposed to negative attitudes and suffer from exacerbated depressive symptoms, which might affect the quality of the patient care they provide.
First CARMAT implantation in Italy: A Nurse's Experience
Authors: Pettillo V 
Published: July 2022

Abstract

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

Introduction
CARMAT is a new fully implantable device that simulates heart function. CARMAT has three characteristics that allow a physiological simulation that is at the top of biomedical engineering: it is blood-compatible for the use of bovine pericardium; it is pulsatile because it has hydraulic pumps that mimic systole and diastole; it is capable of self-regulating with the physiological needs of the patient. CARMAT has four biological valves that allow the intake of acetylsalicylic acid avoiding the use of warfarin and continuous blood draw. CARMAT also has two hybrid membranes with an internal part formed by bovine pericardium and an external polyurethane membrane; CARMAT has self-regulation sensors that adapt the system to the patient's efforts. The operation is relatively simple because the rollers placed inside move the silicondressingstely and so it pushes the walls creating systole and diastole not synchronously as it normally happens but asynchronously, one ventricle at a time.

Objectives
Evaluation of the patient's hemodynamics, monitoring of vital parameters, dressings of the drive-line and psychological state.

Materials and methods
Training in the field by the manufacturer due to the absence of material in literature.

Outcome and Discussion
Since it was the first CARMAT implantation in Italy , we tried to combine experience with the clinical practice of other artificial hearts. The patient was weaned from anesthesia early and extubated; the patient did not show neurological damage. Psychologically, the artificial heart was accepted without any problems by the patient, the drive line had no infections and the patient was discharged quickly.

Conclusions
The Carmat system appears to be the one that best simulates the physiology of the heart because it involves fewer complications than other artificial hearts. This device is used as a brige to transplant, but research and continuous studies tend to transform it as a therapy to end for patients who leave the transplant list and therefore the possibility of having a heart transplant.
Remote genetic counselling provision for heart failure patients at a UK transplant centre
Authors: Quinn E M , Mason S , Halliday B 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiomyopathy has been highlighted as one of the key drivers of heart failure, particularly dilated cardiomyopathy (DCM) (5,1). Finding the correct diagnosis for patients is not only important to their health, but to that of their family members (2).
European guidelines recommend genetic counselling and testing for all patients with a cardiomyopathy diagnosis (3). Genetic counselling involves communicating complex information and providing support to patients and families with inherited conditions. It is recommended that patients undergo genetic counselling alongside genetic testing (6).

Purpose
historically, the heart failure team had no formal pathway in place for genetic testing. We set to establish a remote provision for genetic counselling and testing. We hoped to increase access to genetic services, without additional trips to the hospital in this already burdened patient group.

Methods
A genetic counsellor (GC) attended the weekly team meeting to raise awareness of the genetic service and help identify eligible patients. Eligibility was determined using criteria from the national genomic test directory (4).
Eligible patients had appointments via video or phone call. Outpatients who consented to genetic testing had blood samples arranged locally or at an upcoming hospital appointment. Inpatients had blood samples taken during their hospital stay.
Forty-one eligible patients were identified, the majority had DCM (n=40) and one had arrhythmogenic right ventricular cardiomyopathy (ARVC). Genetic testing was performed using a diagnostic DCM or ARVC panel. Results were classified as positive, i.e. pathogenic or likely pathogenic variant identified; negative, i.e. no pathogenic variant identified; or inconclusive, i.e. variant of unknown significance identified. Results were fed back to patients by virtual genetic counselling appointment. GCs facilitated screening of family members as appropriate.

Results
In the period, July 2020 to January 2022, 41 patients attended virtual genetic counselling appointments and consented to genetic testing. Of these, 19 received a positive genetic result, 4 an inconclusive result, and 18 a negative result. The majority of positive results were identified in the TTN gene (n=9) (see Figure 1).
To date, six family members have been identified as gene positive and requiring ongoing screening, whilst six have now been discharged on the basis of a gene negative result. These are preliminary figures and expected to grow as more family members are able to access genetic counselling

Conclusion
Heart failure patients represent an underserved population who may benefit from genetic testing alongside genetic counselling. Remote genetic counselling is an effective service delivery model. A significant proportion of patients (46.3%) received a positive genetic result. This has potential benefits, not only to the patient but to family members.
Nutritional Status among patients with Heart Failure and Thyroid Diseases - Result of Nutritional Status Heart Study (NSHS)
Authors: Czapla M , Juarez-Vela R , Lokiec K , Karniej P , Smereka J , Wleklik M 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Wroclaw Medical University

Background
Nutritional status is related to the prognosis and the length of hospitalization of individuals with heart failure. The effects of thyroid dysfunction in patients with pre-existing heart failure and nutritional status have not been adequately studied.

Purpose
This study aims to assess how nutritional status affects thyroid disease in patients with heart failure.

Methods
We performed a retrospective study and analysis of medical records of 1056 patients admitted to the cardiology department of our University Clinical Hospital between September 2017 and September 2020 due to acute heart failure (HF) (ICD10: I50). We analyzed all the patients who met the inclusion criteria (diagnosis of HF, age ≥18 years old). A final group of 1056 patients’ medical records was analyzed. The analysis included data such as age, gender, patients’ body mass index (BMI), and laboratory results such as total data on past and comorbid disease units and assessment of the nutritional status of the patient via the NRS-2002. Our study was approved by the independent Bioethics Committee of the Wroclaw Medical University (decision no. KB–590/2020). Statistical analysis was performed using Statistica 13.1 (StatSoft, Inc., Tulsa, OK, USA). The results were considered statistically significant at p&lt;0.05

Results
A total of 1056 individuals were included in the analysis. It included more men than women (66,7%) Due to a lack of data for some parameters, those numbers are smaller and are provided for each variable. More than 76% of participants were overweight or obese. 4.3% of patients were in risk of malnutrition. Thyroid disease registered in 15.1% of patients (Hyperthyroidism – 5.3% and Hypothyroidism 9.8%)
Based on BMI, four groups were distinguished: &lt;18.5, 18.5–24.9, 25.0–29.9, and ≥30 The occurrence of Hyperthyroidism was more frequently observed in the group of overweight patients (p=0,02) (table 1).
Based on NRS2002, two groups were distinguished: &lt;3 and ≥3. In the group with risk of malnutrition (NRS ≥3) patients had a mean statistically significant higher FT4 (&lt;0.001) than the group with no risk of malnutrition (NRS &lt;3) ( x̅ : 2,02 ng/dl vs x̅ : 1.35 ng/dl, p&lt;0.001). Additionally, lower scores of FT3 were observed in the group NRS ≥3 (x̅ : 1.91 ng/dl, p&lt;0.001) (table2).

Conclusion
This study shows that patients with thyroid disease and heart failure were often overweight and obese. The risk of malnutrition status correlates with a lower result of FT3 and the highest FT4. Undoubtedly, those phenomena require further research.