Current Issue : October - December Volume : 2015 Issue Number : 4 Articles : 6 Articles
Providing clinical nursing care to a patient with a heart disease requires the application of the knowledge of disease process which informs the nursing intervention. This paper presents a discussion on some priority aspects of clinical care for the patient with heart failure from the perspective of nursing care as summarized in the figure below. A brief summative overview of the disease process and the central concept in heart failure as fundamental to the conceptualization of clinical care needs for a patient with heart failure was presented. Application of the framework of the nursing process in providing clinical nursing care for a patient with a heart disease and the application of ethical principles were discussed. Thus, competent and therefore safe clinical care for a patient with heart failure requires comprehensive nursing care which embraces both the scientific approach and ethics of care....
Background: Cardiovascular disease is common among old people and many undergo cardiac surgery. Scientific\nknowledge is available on cardiac surgery from several perspectives. However, we found few studies focusing on\nolder patients� experiences of cardiac surgery. The aim of this study was to illuminate experiences of undergoing\ncardiac surgery among older people diagnosed with postoperative delirium, a one year follow-up.\nMethods: Qualitative interviews were conducted with 49 participants (aged ?70 years) diagnosed with delirium\nafter cardiac surgery. Data were collected in Sweden during 2010 through individual, semi-structured interviews in\nparticipants� homes one year after surgery. The interviews were analyzed using qualitative content analysis.\nResults: Four themes with sub-themes were formulated: Feeling drained of viability includes having a body under\nattack, losing strength and being close to death. Feeling trapped in a weird world describes participants having\nhallucinations, being in a nightmare and being remorseful for their behavior. Being met with disrespect includes\nfeeling disappointed, being forced, and feeling like cargo. On the other hand, Feeling safe, including being in\nsupportive hands and feeling grateful, points to participants� experiences of good care and the gift of getting a\nsecond chance in life.\nConclusions: Even one year after cardiac surgery, participants described in detail feelings of extreme vulnerability\nand frailty. They also had felt completely in the hands of the health care professionals. Participants described\nexperiences of hallucinations and nightmares during hospitalization. Cardiac surgery was a unique, fearful, traumatic\nand unpleasant experience yet could also include pleasant or rewarding aspects. It seems that health care\nprofessionals need deeper knowledge on postoperative delirium in order to prevent, detect and treat delirium to\navoid and relieve the suffering these experiences might cause....
To advance knowledge about ways to promote physical activity in Filipino Americans, this feasibility study evaluated whether\nthey enjoyed ballroom dancing and at the same time tested the validity of the Physical Activity Enjoyment Scale (PACES) for\nassessing enjoyment in this population. This study consisted of a single group of healthy Filipino Americans (N = 41) aged\nbetween 35 and 65 years residing in southern Nevada. Participants danced 45 min per week for 12 weeks and completed\nthe PACES questionnaire to measure enjoyment at two time points (Week 4 and Week 12). Four participants dropped out\nduring Weeks 2 to 5. Thirty-seven participants completed the 12 consecutive dance sessions. Descriptive statistics, pairedsample\nt test, Pearson correlation, and a mixed-model ANCOVA were used for data analysis. Principal components analysis\nassessed the construct validity of the PACES. The mean age of the sample was 50.7 years. On average, the participants�\nPACES score significantly improved from Week 4 to Week 12. Age was negatively correlated with perceived enjoyment of\ndancing. In terms of the validity and reliability of the PACES, high construct validity and internal consistency of the PACES\nwere noted. This study described the effectiveness of ballroom dance as a form of physical activity among first-generation\nFilipino Americans and confirmed the appropriateness of the PACES for assessing enjoyment in this population. Ballroom\ndance has the potential to promote physical activity and improve the cardiovascular outcomes of Filipino Americans and\nother populations who are at risk of heart disease....
Background: Ankle exercise has been proven to be an effective intervention to increase venous velocity. However,\nthe efficacy of ankle exercise for improving cerebral circulation has not been determined. We hypothesized that\nankle exercise in the supine position would be able to increase oxyhemoglobin levels measured at the forehead.\nMethods: Seventeen community-dwelling elderly women participated in this study. We recorded blood pressure,\nheart rate (HR), and oxyhemoglobin (OxyHb) levels from the participants in the supine position. Participants repeated\nankle plantar flexion and dorsiflexion movements for 1 min. Two types of exercise were used: active movement and\npassive movement. We used two-way analysis of variance to assess the differences in mean arterial blood pressure\n(MAP), HR, and OxyHb between different exercises (active and passive) and times (before and after exercise).\nResults: The HR and MAP increased during active exercise but not during passive exercise. On the other hand, the\nlevels of OxyHb measured at the forehead were elevated during both active and passive exercises. This increase lasted\nat least 1 min after exercise. There was no significant difference between active and passive exercise with regard to\nOxyHb; however, a significant difference was observed between before and after exercise (p < 0.05, ?2\nG = 0.153).\nConclusions: The physiological response of OxyHb to ankle exercise was different from that of the other cardiovascular\nfunctions. Both active and passive ankle exercises were able to increase cerebral blood oxygenation, whereas the other\ncardiovascular functions did not respond to passive exercise....
Objective: Sleeping problems are among the issues most mentioned by patients after cardiothoracic\nsurgery. These problems can have a negative effect on duration of the hospital stay and recovery.\nIn the ward of our cardiothoracic surgery department, a study was initiated to assess the\nquality of sleep after cardiothoracic surgery. The primary objective was to investigate the effect of\ncardiothoracic surgery on the quality of sleep. The secondary objective was to investigate the\nquality of sleep. Correlations with perioperative factors and related issues such as the type of surgery\nand medication were sought. Methods: A consecutive prospective cohort study was initiated\n(N = 72). The study used validated questionnaires to assess sleep: the Pittsburgh Sleep Quality Index\n(PSQI), the Epworth Sleepiness Scale (ESS), the Verran Snyder-Halpern Sleep Scale (VSH) and\nthe Factors Influencing Sleep Quality (FISQ). Results: The PSQI showed that the quality of sleep one\nmonth after surgery was inferior to the quality of sleep before surgery (p-value: 0.03). The efficiency\nof sleep (time spent in bed) was higher after surgery then before surgery (p-value: 0.01).\nThe VSH showed increased impaired sleep on the third night after surgery. The most disruptive\nfactors were not being comfortable in a hospital bed, pain and the noise of medical devices. Conclusions:\nThe quality of sleep after cardiothoracic surgery is worse when compared with the preoperative\nsituation. The chief influencing factors are discomfort in bed, pain and disturbance from\nmedical devices. The use of pain medication does not improve the quality of sleep....
Surviving a myocardial infarction (MI) can be a stressful event entailing challenges in daily life\nduring the recovery period. Experiencing fatigue symptoms post-MI has been described as bothersome\nand occurs in nearly half of patients four months and two years after MI. The aetiology of\nfatigue disorder is unclear, but research has shown that fatigue plays an important role in the relationship\nbetween stress and perceived poor health. Previous findings indicate that having access\nto an easily administered stress measurement is worthwhile both in the clinic and in research.\nThe single-item measure of stress symptoms has not been validated in persons treated for MI. The\naim was to validate the single-item measure of stress symptoms and to explore its association with\nfatigue in a sample of persons treated for MI. Methods: 142 respondents completed the questionnaires\nof the Multidimensional Fatigue Inventory-20, the single-item measure of stress symptoms\nand the Perceived Stress Scale-10 (PPS-10) two months post-MI. Correlation analysis and t-tests\nwere used to validate the single-item stress measure and its association with post-MI fatigue. Results:\nThe convergent validity of the single-item measure of stress symptoms was confirmed. In\nanalyses of relations between stress and fatigue, it was found that the single-item stress measure\nwas strongly associated with both the global fatigue score and all four fatigue dimension scores\n(general, physical and mental fatigue as well as reduced activity). Conclusion: The single-item\nmeasure of stress symptoms was found to be a valid measure of post-MI stress. Also, the measure\nwas useful in assessing associations between stress and fatigue and could therefore indicate that post-MI fatigue experiences should be further explored in full using multidimensional fatigue assessment....
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