Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 6 Articles
Background: Despite considerable efforts to encourage participation, even in some developed countries,\nproportion of patients participating in institution-based cardiac rehabilitation (CR) programs remained sub-optimal.\nThe present study was designed to investigate the acceptability of community health service center (CHSC)-based\nCardiac Rehabilitation (CR), and examine its effectiveness in terms of changes in quality of life (QOL), psychological\nstate and exercise capacity.\nMethods: A consecutive series of eligible patients was recruited from the health registration system of two CHSCs\nin Shijiazhuang, Hebei, China. Patients in intervention site were provided with CR (CR-group) while patients in\nnon-intervention site were offered the usual care (UC-group). Data regarding health-related QOL (HRQoL),\npsychological state and exercise capacity (6-min walk test = 6MWT) were collected and compared at baseline\nand at 6 months post-intervention.\nResults: Among invited patients eligible for CR program, 65.3% participated, while 5.3% of the participants dropped\nout during follow-up. Patients in CR-group showed significant decrease in the scores for anxiety and depression as per\nthe Hospital Anxiety and Depression Scale (HADS), along with marked increases in the Short-Form Health Survey\n(SF-12)-based Physical (PCS) and Mental Component Summary (MCS) scores. Moreover, the measurement of\n6MWT showed a significant increase of 57.42 m walking distance among CR patients in contrast with a slight\nincrease among UC patients.\nConclusions: Given the high participation and low withdrawal along with considerable improvements in HRQoL,\npsychological state and exercise capacity, CHSC was likely to be the optimal setting for implementing CR for\npatients with CHD in China....
Background: Cardiac pain arising from acute coronary syndrome (ACS) is a\nmulti-factorial phenomenon. Historically, episodes of cardiac pain have been\ncaptured using a one-dimensional numeric pain rating scale. Lacking in clinical\npractice are acute pain assessments that employ a comprehensive evaluation of\nan emergent ACS episode. Aim: To examine the sensory-discriminative, motivational-\naffective and cognitive-evaluative dimensions of ACS-related pain. Methods:\nA descriptive-correlational, repeated-measure design was used to collect\ndata on 121 ACS patients of their cardiac pain intensity. The (numeric rating\nscale-NRS 0-10 scale) measured chest pain ââ?¬Å?Nowââ?¬Â and ââ?¬Å?Worst pain in the previous\n2 hours over 8 hoursââ?¬Â and the McGill Pain Questionnaire Short-Form\n(MPQ-SF) measured pain at 4 hours. Results: Mean age was 67.6 Ã?± 13, 50%\nwere male, 60% had unstable angina and 40% had Non-ST-elevation myocardial\ninfarction. Cardiac pain intensity scores remained in the mild range from 1.1 Ã?±\n2.2 to 2.4 Ã?± 2.7. MPQ-SF: 66% described pain as distressing and 26% reported\npain was horrible or excruciating. Participants described ACS pain quality as\nacute injury (nociceptive pain: heavy, cramping, stabbing ), as nerve damage\n(neuropathic: gnawing, hot-burning, shooting) and as a mixture of acute and\nchronic pain qualities (aching, tender and throbbing ). Conclusions: Patients reported\nboth nociceptive and neuropathic cardiac pain. It is unclear if pain perceptions\nare due to: i) pathophysiology of clot formation, ii) occurrence of a\nfirst or repeated ACS episode, or iii) complex co-morbidities. Pain arising from\nACS requires an understanding of the interplay of ischemic, metabolic and neuropathophysiological mechanisms that contribute to complex cardiac pain\nexperiences....
Surgical site infection is postoperative wound infection that occurs after surgery. The complications in the acute\ncare facilities with up to 60% of surgical site infection cases estimated to be preventable by using evidence-based practice. Not\nwith standing the advances in the coronary artery bypass graft, the rising prevalence of surgical site infection has become a\nprimary concern in the infection control practices. The current study amid to evaluate the risk factors associated with the\nsurgical site infections among coronary artery bypass graft patients and, to assess nurses compliance to bundle care to prevent\nsurgical site infection. The study followed a quantitative, retrospective design and was carried out in King Abdulaziz\nUniversity Hospital in Jeddah city. All sample (n= 120) coronary artery by-pass graft patient's record complied between\nJanuary 2011 to December 2013.The study revealed statistically significant results between the preference of surgical site\ninfection and demographic factor e.g. body mass index, patient risk factors such as diabetes type1 and 2, selected pre-operative\nfactors e.g. Methicilin-resistant staphylococcus aurous, postoperative factors e.g. rewiring, dressing, ventilation and low\ncardiac output. This study established that the compliance with the bundle was proven to be effective in reducing risk factors to\nsurgical site infection however nurses adherence to surgical site infection bundle care were incomplete and required more\nenforcement to comply. Based on the finding, the investigator recommended that nurses should be aware of the importance of\nadhering to surgical site infection bundles. Nurses should not only be educated on the importance of the bundles, but on how\neffectives apply the bundles at different stages....
For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge\nto emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs)\nparticipating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247\ncases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical\n(NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (TCS),\nfracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of\n21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended.\nIn NT-O and T-CS cases, the RNs� attendance can notably save the on-scene time with a statistical significance (...
Background: Coronary heart disease (CHD) is the most prevalent type of cardiac disease among adults worldwide,\nincluding those in Singapore. Most of its risk factors, such as smoking, physical inactivity and high blood pressure,\nare preventable. mHealth has improved in the last decade, showing promising results in chronic disease prevention\nand health promotion worldwide. Our aim was to develop and examine the effect of a 4-week Smartphone-Based\nCoronary Heart Disease Prevention (SBCHDP) programme in improving awareness and knowledge of CHD,\nperceived stress as well as cardiac-related lifestyle behaviours in the working population of Singapore.\nMethods: The smartphone app ââ?¬Å?Care4Heartââ?¬Â was developed as the main component of the programme. App\ncontent was reviewed and validated by a panel of experts, including two cardiologists and two experienced\ncardiology-trained nurses. A pilot randomised controlled trial was conducted. Eighty working people were recruited\nand randomised to either the intervention group (n = 40) or the control group (n = 40). The intervention group\nunderwent a 4-week SBCHDP programme, whereas the control group were offered health promotion websites\nonly. The participantsââ?¬â?¢ CHD knowledge, perceived stress and behavioural risk factors were measured at baseline and\non the 4th week using the Heart Disease Fact Questionnaire-2, Perceived Stress Scale, and Behavioural Risk Factor\nSurveillance System.\nResults: After the SBCHDP programme, participants in the intervention group had a better awareness of CHD\nbeing the second leading cause of death in Singapore (X2 = 6.486, p = 0.039), a better overall CHD knowledge level\n(t = 3.171, p = 0.002), and better behaviour concerning blood cholesterol control (X2 = 4.54, p = 0.033) than\nparticipants in the control group.\nConclusion: This pilot study partially confirmed the positive effects of the SBCHDP programme in improving\nawareness and knowledge of CHD among the working population. Due to the small sample size and short followup\nperiod, this study was underpowered to detect significant differences between groups. A full-scale longitudinal\nstudy is required in the future to confirm the effectiveness of the SBCHDP programme....
Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household\nand community level. However, there is lack of information on task shifting the management and control\nof hypertension to community health nurses in low- and middle-income countries including Ghana. The\npurpose of this study was to assess nurses� knowledge and practice of hypertension management and\ncontrol pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH).\nMethods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and\nenrolled nurses (ENs) employed in community health centers and district hospitals before and after the\nTASSH training, followed by semi-structured qualitative interviews that assessed nurses� satisfaction with the\ntraining, resultant changes in practice and barriers and facilitators to optimal hypertension management.\nResults: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training\nassessments showed a marked improvement in nurses� knowledge and practice related to hypertension detection and\ntreatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas\nthis improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also\nmentioned by the nurses as positive outcomes of participation in the intervention.\nConclusions: Findings suggest that if all nurses receive even brief training in the management and control of\nhypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However,\nmore research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that\nhighlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana....
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