Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 7 Articles
Background: Cardiac misconceptions are common among healthcare professionals. The development of\nprofessional knowledge is considered an essential component of nursing education. Nurses, regardless of their\ngrade, skills, and experience, should be updated with information so as to be able to rectify their misconceptions,\nas these could affect patient health outcomes. As the literature evaluating the cardiac knowledge and\nmisconceptions of nursing students is sparse, a study of the subject seems warranted.\nMethods: A cross-sectional sample survey was used to study the cardiac knowledge and cardiac misconceptions of\nnursing students in Hong Kong. The study sample included 385 senior nursing students from three universities.\nTheir level of knowledge of cardiac disease was assessed using the modified Coronary Heart Disease Knowledge\nTest. The York Cardiac Beliefs Questionnaire (YCBQv1) was used to examine cardiac misconceptions.\nResults: The scores for the nursing studentsââ?¬â?¢ level of knowledge were diverse. Their mean score in the Cardiac\nKnowledge Test was 12.27 out of 18 (SD 2.38), with a range of 2ââ?¬â??17. For cardiac misconceptions, their mean score\nin the YCBQv1 was 6.98 out of 20 (SD 2.84), with a range of 0ââ?¬â??14. A negative correlation, r = âË?â??0.33 was found\namong students with more knowledge and fewer misconceptions. (p < 0.001). The Chi-square tests found some\nassociations between the studentsââ?¬â?¢ experiences of caring for cardiac patients and misconceptions about stress and\nphysiology.\nConclusions: The results of our analyses indicate a diversity in levels of knowledge among the nursing students.\nStudents with higher scores in cardiac knowledge did not necessarily have fewer misconceptions. There were\nassociations between the studentsââ?¬â?¢ misbeliefs and their caregiving experiences with cardiac patients. This study\npresents a framework for designing the contents of cardiac nursing programmes and is a starting point for\npromoting research on misconceptions held by undergraduate nursing students. A new paradigm of teaching\nshould include inputs from both perspectives to help students to make critical use of theoretical knowledge to\nrectify their misconceptions and pursue excellence in the working world....
Background: Although mechanical dyssynchrony parameters derived by speckle tracking echocardiography (STE)\nmay predict response to cardiac resynchronization therapy (CRT), comparability of parameters derived with different\nSTE vendors is unknown.\nMethods: In the MARC study, echocardiographic images of heart failure patients obtained before CRT implantation\nwere prospectively analysed with vendor specific STE software (GE EchoPac and Philips QLAB) and vendor-independent\nsoftware (TomTec 2DCPA). Response was defined as change in left ventricular (LV) end-systolic volume between\nexamination before and six-months after CRT implantation. Basic longitudinal strain and mechanical dyssynchrony\nparameters (septal to lateral wall delay (SL-delay), septal systolic rebound stretch (SRSsept), and systolic stretch index\n(SSI)) were obtained from either separate septal and lateral walls, or total LV apical four chamber. Septal strain patterns\nwere categorized in three types. The coefficient of variation and intra-class correlation coefficient (ICC) were analysed.\nDyssynchrony parameters were associated with CRT response using univariate regression analysis and C-statistics.\nResults: Two-hundred eleven patients were analysed. GE-cohort (n = 123): age 68 years (interquartile range (IQR): 61ââ?¬â??73),\n67%male, QRS-duration 177ms (IQR: 160ââ?¬â??192), LV ejection fraction: 26 Ã?± 7%. Philips-cohort (n = 88): age 67 years (IQR:\n59ââ?¬â??74), 60% male, QRS-duration: 179 ms (IQR: 166ââ?¬â??193), LV ejection fraction: 27 Ã?± 8. LV derived peak strain\nwas comparable in the GE- (GE: -7.3 Ã?± 3.1%, TomTec: âË?â??6.4 Ã?± 2.8%, ICC: 0.723) and Philips-cohort (Philips: âË?â??7.7 Ã?± 2.7%,\nTomTec: âË?â??7.7 Ã?± 3.3%, ICC: 0.749). SL-delay showed low ICC values (GE vs. TomTec: 0.078 and Philips vs. TomTec: 0.025).\nICCââ?¬â?¢s of SRSsept and SSI were higher but only weak (GE vs. TomTec: SRSsept: 0.470, SSI: 0.467) (Philips vs. QLAB: SRSsept:\n0.419, SSI: 0.421). Comparability of septal strain patterns was low (Cohenââ?¬â?¢s kappa, GE vs. TomTec: 0.221 and Philips vs.\nTomTec: 0.279). Septal strain patterns, SRSsept and SSI were associated with changes in LV end-systolic volume for all\nvendors. SRSsept and SSI had relative varying C-statistic values (range: 0.530ââ?¬â??0.705) and different cut-off values\nbetween vendors.\nConclusions: Although global longitudinal strain analysis showed fair comparability, assessment of dyssynchrony\nparameters was vendor specific and not applicable outside the context of the implemented platform. While the\nstandardization taskforce took an important step for global peak strain, further standardization of STE is still warranted....
Background: the National Heart, Lung, and blood Institute estimate that each year approximately 785,000 Americans will have a new\ncoronary attack and approximately 470,000 will have a recurrent attack. Chest pain is one of the most common symptoms of coronary\nartery disease or acute coronary syndrome. Objectives: this study aims to compare between routine nursing care of chest pain and chest\npain guidelines in patients with acute coronary syndrome and assess health outcome after application of chest pain guidelines in acute\ncoronary syndrome patients. Method: Quasi experimental research design was used in the current study. The study was conducted at the\ncoronary care unit of Suez canal University Hospital. Sample; consecutive of 70 patients was included in the study. Four tools were used\nfor study data collection that named the chest pain guidelines evidence based nursing care in patients with angina pectoris, visual analog\nscale to assess chest pain, dyspnea scale to assess breathing pattern and fourth one was lab investigation to assess patient health prognosis.\nResults: The study results revealed an improvement of patients� health outcome represented in a significant reduction in complain of\nchest pain, blood pressure and insufficient sleeping with P-value of 0.000 after applying guidelines of care regarding chest pain. Additionally,\nthe respiratory pattern and respiratory rate improved significantly with P-value of 0.000. Moreover, lab investigation showed\nsignificantly decrease in LHD level with P-value of 0.000. Conclusion: The current study concluded that application of chest pain guidelines\nintervention could be improved patients health outcomes....
Background: Evidence suggests that elective cardiac patients are at risk of functional and psychological deterioration\nin the time preceding surgery. This poses a risk to successful post-operative rehabilitation. This prospective one-group\npre-test, post-test evaluation was designed to assess a clinical Pre-operative Rehabilitation (PREHAB) home-based\nexercise programme, to optimise pre-operative physical function and frailty in patients awaiting elective Coronary\nArtery By-Pass Graft (CABG) or Valve Surgery.\nMethod: Consenting patients awaiting cardiac surgery, with wait time ââ?°Â¥ 6 weeks were referred to a Senior Physiotherapist\nfor baseline assessment. Patients were offered PREHAB in the form of functional home-based exercise that was prescribed\nfrom baseline physical outcomes. All patients were followed up via telephone to ensure progression of exercise and any\nproblems associated with it. This continued weekly until the patient attended Surgical Pre-assessment clinic, where all\noutcome measures were re-assessed.\nResults: Twenty two patients, out of a total number of 36 patients seen in the surgical clinic between March 2016 and\nAugust 2016, participated in the prehab clinical evaluation. Twenty patients completed their prescribed exercises on a\nweekly basis prior to surgery. No adverse events or cardiac symptoms were reported as a result of the home exercise\nintervention. Paired t-Test analyses revealed a significant mean difference in clinical frailty score (CFS) of âË?â??0.53 Ã?± 0.51\n(95% CI [âË?â??0.774, âË?â??0.279], P = 0.0003). Significant mean difference in six-minute walk test (6MWT) distance of 42.5 Ã?± 27.\n8 m (95% CI [23.840, 61.251], P = 0.0005), 6MWT walking speed of 0.5 Ã?± 0.4kmh (95% CI, [0.2433, 0.7567],\nP = 0.001), and short physical performance battery (SPPB) total score of 2.2 Ã?± 1.7, (95% CI [3.066, 1.200],\nP = 0.0002) were also observed. The change in 6MWT distance was shown to be significantly associated\nwith hospital length of stay (LOS) (r = 0.7; P = 0.03).\nConclusion: This small exploratory evaluation suggests that providing a home-based PREHAB programme for frail\npatients undergoing CABG or Valve surgery may be able to improve functional ability and reduce hospital length of stay\nfor those patients undergoing cardiac surgery. A frailty score with greater sensitivity may be required to elucidate the\ninfluence frailty could have in reducing length of stay. A large randomised controlled study is required to reveal the\npotential beneficial effects of PREHAB in this patient population....
Introduction: Hypertensive cardiopathy exhibits a high\nmorbidity and mortality worldwide. The complexity for its\nprevention depends on the number of risk factors involved.\nObjective: To design and validate a hypertensive\ncardiopathy predictive index based on risk factors which\npermit to predict the development of hypertensive cardiopathy\nin patients who suffer from arterial hypertension.\nMethod: An analytical study was carried out in which case\nand control hypertensive patients were paired off by sex and\nfollowed up by the Arterial Hypertensive Outpatient Department\nat ââ?¬Å?Carlos Manuel de CÃ?©spedesââ?¬Â General University Hospital\nof Bayamo, Granma, Cuba from January 1st, 2004 to December\n31st, 2009. The sample consisted of 1200 individuals. An index\nwas constructed based on independent risk factors and internal\nand external validation was carried out.\nResults: The logistic regression model showed that\nthe factor with greater importance was C-reactive protein\n(OR=10, 98; CI 95%=6.350-19,002; p=0,000) followed by\nglycemia greater than 5, 4 mmol/L (OR=5, 01); both the index\ndiscriminative capacity (area under the curve was 0,957; IC\n95%=0,934-0,980; p=0,000) and the calibration were adequate\n(Hosmer and Lemeshow; p=0,783). The validation process was\nsatisfactory.\nConclusion: Both indexes obtained and validated permit to\npredict accurately and reliably the development of hypertensive\ncardiopathy, so its introduction in clinical practice can improve\nthe evaluation of hypertensive patients....
Purpose: Lay consultations can facilitate or impede healthcare.\nHowever, little is known about how lay consultations for symptom\nevaluation affect treatment decision-making. The purpose of this study\nwas to explore the role of lay consultations in symptom evaluation\nprior to hospitalization among patients with heart failure.\nMethods: Semi-structured interviews were conducted with 60\npatients hospitalized for acute decompensated heart failure. Chisquare\nand Fisher�s exact tests, along with logistic regression were\nused to characterize lay consultations in this sample.\nResults: A large proportion of patients engaged in lay\nconsultations for symptom evaluation and decision-making before\nhospitalization. Lay consultants provided attributions and advice\nand helped make the decision to seek medical care. Men consulted\nmore often with their spouse than women, while women more often\nconsulted with adult children.\nConclusions: Findings have implications for optimizing heart\nfailure self-management interventions, improving outcomes, and\nreducing hospital readmissions....
Background: This study examined the long-term effects of nurse-led, individualized education on self-efficacy, selfcare\ncompliance, and health-related quality of life (HRQoL) in middle-aged patients with new-onset acute coronary\nsyndrome.\nMethods: A quasi-experimental pretest-posttest design was used in the study. A cardiovascular nurse provided\nindividualized education to the intervention group (n = 32), and self-efficacy, self-care compliance, and HRQoL at\nbaseline and 3 and 12 months after discharge were compared to those of a control group (n = 30). Patients were\nrecruited from a cardiovascular care unit at a university hospital between 2012 and 2013. Repeated measures\nanalysis of variance was used to compare time-related changes.\nResults: There was no significant difference in self-efficacy between the 2 groups over a fixed period (F = 3.47,\np = 0.067) and showed no interaction between the 2 groups (F = 0.45, p = 0.636). However, significant differences\nwere found in the main and interaction effects between the 2 groups and changes in self-care compliance over the\nfollow-up period differed significantly between the 2 groups (F = 28.72, p < 0.001). Changes in mental HRQoL over\nthe follow-up period differed significantly between the 2 groups (F = 33.34, p < 0.001) and significant interaction\neffect (F = 4.40, p = 0.040).\nConclusions: Structured nurse-led education should be provided to middle-aged patients with new-onset acute\ncoronary syndrome, as part of routine predischarge education, to increase self-care compliance and mental HRQoL and\nprevent secondary adverse events....
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