European Journal of Cardiovascular Nursing最新文献

{"title":"Cardiology intensive care unit nurse in italy: definition of advanced competences. IN-CORE study","authors":"F Cruciani, M Barisone, L Cacciavillani, G D'alessandro, S Valente, M Rosati, G Marenzi, M Mazza, N Gasparetto, C Casonato, P Bernardo, C Piccinini, S Luchetti, M Marini","doi":"10.1093/eurjcn/zvae098.036","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.036","url":null,"abstract":"Background/Introduction Since the establishment of the Cardiology Intensive Care Units to date, there have been many scientific and technological progresses that have involved not only the pathways of diagnosis and treatment of patients in this specialist area, but also the specialist competencies that nurses must acquire in order to work in these settings. The epidemiological picture and incidence of comorbidities suggest the care of patients requiring intensive and specialised care, with the use of high technology and circulatory support systems, changing the usual setting of a cardiology intensive care unit to a high-intensity cardiology intensive care unit. To date, a few studies have been described in the literature that have mapped the competences of the cardiology intensive care unit nurse, but the heterogeneity of training education at a European level has not yet made a reference framework for this specialist area generalisable. (Endacott R., et al. 2022). In Italy, there are no specific postgraduate courses focused on specialist cardiac intensive care skills development for nurses. To develop such courses, content incorporating appropriate competencies is required and this study was designed to meet this. Purpose To identify the core competencies of nurses working in High-intensity cardiology intensive care units (ICUs) in Italy to develop national competence framework. Methods A three-round e-Delphi study was conducted with a group of 30 experienced cardiac intensive care unit nurses; 28 completed all three rounds. The first round asked each participant to write down five competences, which they were asked to prioritize in the second round. In the third round, they were asked to prioritize again, considering the scores made in the second round. The final list of competencies was the one that achieved a greater than 70% agreement among the participants. Results We identified 12 core competencies that include a few competence areas, including high-tech care, emergency management, teamwork, and critical decision-making. Only slight differences emerged among the panel of experts regarding the priority given to certain core competencies, such as ECG reading, emergency management and technical and practical skills in the intensive care area. Conclusions This is the first study in Italy to identify the core and advanced competencies of nurses working in high level cardiac intensive care units. This study provides an important basis for the development of postgraduate educational programme and a framework for the definition of national standards to be implemented in clinical practice.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of key stakeholder communication in the implementation of an in-hospital digital medical translation application for heart surgery patients: a qualitative study","authors":"I Lie, S Rokeness, K Skredsvig, N Johannsen, K E Lindsjorn, C H Hasle, L S Nes","doi":"10.1093/eurjcn/zvae098.099","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.099","url":null,"abstract":"Background/Introduction The scientific and clinical communities are inundated with health applications designed for testing and/or implementation to support and enhance clinical practice. However, there is a deficiency in studies concentrating on vital factors such as stakeholder involvement to ensure the successful implementation of such applications. Purpose The purpose of this study was to investigate the experiences of key stakeholders involved in the process leading to the implementation of a digital medical translation tool designed for in-hospital use with heart surgery patients who speak minority languages. Methods In-depth interviews were conducted using a semi-structured interview guide through digital (i.e., Zoom) interviews in June 2023. The data collected was analyzed using NVivo software, following Braun and Clarke´s six-step thematic analysis process. Results Five stakeholders participated in the interviews, including representatives from the Regional Health Authorities Information Technology partner and the project leader, and representatives from the company responsible for the digital medical translation tool. All with major stakes in such an in-hospital application implementation process. Four main themes with corresponding quotations emerged from the analysis, pointing to the need for: i) Qualified stakeholders: Stakeholders who possessed the knowledge of \"what to do and when\" played a crucial role in the process. ii) Communication between stakeholders: Effective communication between stakeholders was deemed essential for optimizing the process at the required pace, with an emphasis on collaborative efforts by \"working as partners to enhance services for minority-speaking patients\". iii) Requirement specification for procurement: The importance of \"detailed and clear quality requirements in the procurement process to select the best clinical translation tool\", was highlighted. iv) Clinical practice foundation: \"Expert nurses from the hospital setting and medical doctor from the company adjusted the translation tool\" was pointed to as necessary to suit clinical practice needs. Conclusions Key stakeholders involved in the implementation of a medical translation tool for minority-speaking patients within a hospital setting pointed to four vital aspects for successfully implementing a digital medical translation tool in-hospital care. Effective communication among stakeholders was seen to inspire and improve the working process. Having qualified stakeholders was vital for ensuring quality requirements and establishing a solid clinical foundation during the application implementation.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric analysis of the kansas city cardiomiopathy questionnaire-23 in a european population","authors":"H D Hamilton Dollaku, P I Paolo Iovino, P G Gianluca Pucciarelli, L R Laura Rasero, I U Izabella Uchmanowicz, R A Rosaria Alvaro, E V Ercole Vellone","doi":"10.1093/eurjcn/zvae098.088","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.088","url":null,"abstract":"Background People affected by heart failure (HF) often exhibit poor quality of life, which places a great deal of burden on the healthcare systems. The Kansas City Cardiomyopathy Questionnaire (KCCQ)-23 is one of the most widespread instruments to measure quality of life in this population. So far, its psychometric properties have been investigated by a broad array of research, but the overall findings reveal inconsistency of the factorial structure and lack of rigorous psychometric testing. Objective The aim of this study was to evaluate the psychometric properties of the KCCQ-23 in a European cohort of HF patients. Methods The data used for this study were collected for the MOTIVATE-HF study, which was a three-arm, multicenter, randomized controlled trial to evaluate the effect of motivational interviewing for improving self-care in HF. A group of 510 patients (median age 74 years, IQR=18, 58% males) completed the KCCQ-23 along with clinical and psychosocial measures. Factorial validity was established with confirmatory factor analysis (CFA); omega and model-based internal consistency indexes were computed to examine the internal consistency of the scale. Convergent validity was established by correlating the KCCQ-23 scores with several clinical and psychosocial measures. Measurement invariance testing was conducted within a multigroup framework across patients with preserved vs those with reduced ejection fraction. Results Two CFA solutions were tested, which confirmed the theoretical and empirical models postulated by the original author. The internal consistency coefficients for the latent dimensions were adequate (Omega range =0.77-0.93; internal consistency coefficient =0.89-96)- KCCQ-23 scores were found to be correlated with ejection fraction, NYHA levels, quality of life, self-care confidence, anxiety and depression, and symptom burden, supporting its convergent validity. Finally, the KCCQ-23 was invariant across ejection fraction levels, both in the theoretical and empirical factor solution. Conclusion Overall, this study provides for the first time evidence that the KCCQ-23 has satisfactory psychometric properties, promoting its use in clinical settings and research to investigate the quality of life in patients with HF.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the waiting list to the transplanted heart: a qualitative approach to emotions, feelings, and coping strategies","authors":"R Medeiros Bussi Teixeira, N Malaman Galhardi, R Batista Dos Santos Pedrosa","doi":"10.1093/eurjcn/zvae098.084","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.084","url":null,"abstract":"Introduction Living with a complex disease such as heart failure (HF) can influence the functional and emotional capacity of individuals, compromising their quality of life. Furthermore, it is a progressive disease that can result in the final route of treatment, which is heart transplantation (HT), and the patient suffers an impactful change in health and disease status that can generate different emotions and feelings. A stressful factor can interfere with the way an individual deals with situations and this can result in negative behavior that harms themselves, their quality and meaning in life. Understanding emotions, and feelings and being able to deal with emotions are fundamental practices for coping with the disease and maintaining quality of life. Objective To identify the emotions, feelings, and coping strategies of patients who are on the waiting list for an HT and those who have already received the graft. Method Qualitative and exploratory research was conducted with 3 patients on the waiting list and 3 HT patients undergoing outpatient follow-up in a Brazilian public hospital. The Symbolic Interactionism was used as a theoretical framework. Data collection was carried out through a semi-structured interview with the following triggering questions: \"How do you feel when you think about Heart Transplantation?\", and \"What do you usually do to deal with these emotions and feelings?\", \"Is the way you deal with these emotions ideal for you?\" The interview was recorded in audio, and transcribed in full and the data was subjected to content analysis consisting of 03 phases: I) Pre-exploration; II) Selection of analysis units; III) Categorization and subcategorization. Results The emotions mentioned by patients on the HT waiting list were fear, anger, and surprise and the feelings were hope, melancholy, and disappointment. The coping strategies of this group were religious belief, support from family and friends, or even introspection and resignation to the disease. Heart transplant patients reported emotions such as joy and sadness, and feelings such as gratitude and loneliness. The beliefs, the presence of family and friends, psychiatric support, and carrying out work activities were reported as ways of dealing with loneliness and sadness. Regarding self-perception of emotional management, both groups reported an adequate approach when they can rely on beliefs/family/friends. Conclusion Patients on the waiting list or who have already undergone an HF experience a duality of emotions and feelings characterized by fear, anger, surprise, joy, sadness, hope, melancholy, disappointment, gratitude, and loneliness, respectively. These findings contribute to the development of new tools that enable specific management of these emotions and feelings that emerge in patients who experience the context of HF.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining what matters most to Marfan syndrome (MFS) patients: a convergent mixed method study of the health-related quality of life and psychosocial effects of MFS aortovascular manifestations","authors":"R Magboo, A Oo, J Cooper, D Gibbs, G Owens, J Sanders","doi":"10.1093/eurjcn/zvae098.044","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.044","url":null,"abstract":"Background Marfan Syndrome (MFS) affects multiple organ systems but the aortovascular manifestations are the most serious and life-threatening. However, there is no available evidence on the effect of the aortovascular manifestations on health-related quality of life (HRQoL) and psychosocial wellbeing of MFS patients. Purpose This study aims to determine the HRQoL and the psychosocial effects of the aortovascular manifestation of MFS. Methods A convergent mixed-method design was used in this single site study. Specifically, the quantitative study (S1) is an observational exploratory study using seven validated questionnaires relating to HRQoL (SF36, EQ-5D-5L) and psychosocial health (depression [CESD], illness perception [IPQ], fatigue [FSS], self-esteem [RSES], stigma [PSQ]), previously used in MFS research. The qualitative study (S2) is an exploratory study using semi-structured interviews. Analysis consisted of descriptive and inferential statistics and Framework method1 for S1 and S2, respectively. Joint display was used for data integration. Results A total of 75 participants completed the questionnaires (S1) and 20 were interviewed (S2). The mean age was 43 years (S1) and 40 years (S2) and the majority (S1: 54 (72%); S2: 17 (85%)) were white British. S1 found the majority of MFS participants experienced depression, anxiety, pain and fatigue. These areas were confirmed in S2. A positive self-esteem was generally reported in S1, but this is not supported by S2, which highlighted patients experience a loss of self-esteem due to perceived body image disturbance. Finally, S2 generated new areas not identified in S1 including health anxiety, loss of personal efficacy, self-stigma and ‘invisible disability’ affecting work and socio-economic condition. Overall, the joint display generated three confirmed, seven expanded and one discordant finding. Conclusion MFS patients with aortovascular manifestations experienced several HRQoL and psychosocial issues related to their condition. Collaborative efforts are needed to develop multifaceted interventions and programs to address their needs and provide a holistic and comprehensive service for MFS patients. Finally, four new areas were identified in S2, which added important new evidence in this body of knowledge.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the information needs of patients implanted with a left ventricular assist device via analysis of social media forums","authors":"N Abdelhadi, S Klein, M Shahar, S Melnikov","doi":"10.1093/eurjcn/zvae098.046","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.046","url":null,"abstract":"Background Left Ventricular Assist Devices (LVADs) serve as a feasible treatment alternative for patients with end-stage heart failure who do not respond sufficiently to maximal medical therapy. An increasing number of individuals with end-stage heart failure, both pre- and post-LVAD implantation, are utilizing social media to find medical information and peer support. Purpose The objective of this study was to identify unmet education and information needs of patients with LVAD through social media interactions. Methods In this research, information was gathered from the forum section of the website MyLVAD.com through an automated extraction technique. We conducted an anonymous collection and analysis of a dataset from MyLVAD.com, which comprised 459 forum threads and 3886 messages across the entire forum, contributed by 945 unique users. To establish a matrix addressing existing information and educational needs, we examined 867 posts and conversations that contained questions and inquiries, ultimately identifying a total of 435 concrete questions. A series of categorization matrices were developed and updated to facilitate the discovery of new categories. Results Numerous information gaps and unanswered questions were discovered in relation to the following areas: clothing, complications/adverse events, LVAD pros and cons, self-care, therapy, and recent LVAD implantation. Among the 435 questions, 216 (49.7%) questions had a primary focus on self-care for patients with LVAD, including subjects such managing the driveline site, understanding equipment functionality, and adapting lifestyle habits to ensure safety and health while living with an LVAD. Two other major question categories emerged: those regarding complications/adverse effects, comprising 80 questions (18.4%), and those discussing the pros and cons of LVAD, with 67 questions, accounting for 15.4%. Conclusion The social media data retrieved from MyLVAD.com is the first to be used to assess the unmet needs and knowledge gaps among patients implanted with LVAD and develop categories to describe LVAD patient knowledge and information needs. Unlike investigator-generated data, social media data reflect the natural and organic conversation between patients, untainted by investigator agendas or biases. Social media data can enhance our understanding of patient information deficiencies. This can lead to the creation of materials specifically aimed at fulfilling unaddressed educational requirements.Unmet LVAD patients information needs","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequality in continuity of care after hospitalization due to cardiac conditions","authors":"E Safstrom, A S Stromberg","doi":"10.1093/eurjcn/zvae098.089","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.089","url":null,"abstract":"Background Cardiac conditions are a common cause of hospitalization worldwide. The need for follow-up within primary care and/or specialized care continues after discharge. Continuity of care is crucial to enable a seamless chain of care after hospitalization. Research regarding inequality in continuity of care after discharge is lacking. Purpose The aim was to investigate how patients’ perceptions of continuity of care vary between age, gender, and diagnosis groups. Methods Patients were consecutively included within six weeks after hospitalization due to a cardiac condition. Data were collected with the short version of the Patient Continuity of Care Questionnaire (PCCQ-12). The independent t-test was used to compare differences between sexes and age groups (< 65 years or ≥ 65 years). Differences between diagnosis groups were evaluated with the one-way analysis of variance (ANOVA) and post-hoc analysis with the least significant difference (LSD) correction. The significance level was set at p <0.05 for all analyses. Results A total of 1,000 patients were included (mean age 72 years (SD 10) 66% male). The patients were hospitalized due to myocardial infarction (36%), atrial fibrillation (26%), angina pectoris (21%) or heart failure (17%). Significant differences between age, gender and diagnosis were found: Patients < 65 years perceived significantly higher levels of continuity of care than patients ≥ 65 years. Men had significantly higher scores than women. Patients hospitalized due to acute myocardial infarction perceived significantly higher levels of continuity of care compared to patients who had been hospitalized due to angina pectoris, atrial fibrillation, or heart failure (Table 1). Significant differences were also found between men and women. Men <65 years perceived significantly higher levels of continuity of care (mean 48.08) compared to men ≥ 65 years (mean 45.51, p= 0.008 ). Men who had been hospitalized due to myocardial infarction had significantly higher scores on the PCCQ-12 (mean 48.82) compared to men who had been hospitalized due to angina (mean 44.48), atrial fibrillation (mean 44.09) and heart failure (mean 45.24) (Figure 1). Women <65 years had significantly higher scores on the PCCQ-12 (mean 45.00) compared to women ≥ 65 years (mean 40.71, p 0.018). Women who had been hospitalized due to myocardial infarction or atrial fibrillation had significantly higher scores on the PCCQ-12 (mean 42.48 and 43.02, respectively) compared to women hospitalized due to heart failure (mean 38.00) (Figure 1). Conclusion Overall, patients hospitalized due to cardiac conditions perceive a rather high level of continuity of care. However, statistically significant differences were found between men and women, between younger and older patients, and between diagnosis groups, indicating that care inequality exists in continuity of care.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How is digital technology used to facilitate shared decision-making between healthcare professionals and patients in cardiovascular care? A scoping review","authors":"D Leysen, E Propst, H Mcgowan, F Pfannerstill, R Crutzen, S Kulnik","doi":"10.1093/eurjcn/zvae098.125","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.125","url":null,"abstract":"Introduction Shared decision-making (SDM) is a patient-centred approach in healthcare that emphasizes patient involvement in the decision-making process. Digital technologies (DTs), like Mobile apps and website tools, are on the rise in cardiovascular care (CVC) and healthcare in general. But DTs can play a role in facilitating SDM, for example, with tools such as decision aids (DAs) for patients and quality check frameworks for Health care professionals (HCPs). The aim of this scoping review (ScR) was to identify the types of DTs used to facilitate SDM within the field of CVC and the analysis of how support for SDM is implemented in these technologies; to examine the conceptualizations of SDM utilized in DTs and determine the theories underlying these conceptualizations within the field of CVC; and to present designs, methods, and outcomes of published evaluation studies concerning DTs for SDM within the field of CVC. Methods For this scoping review (ScR), ten databases were searched: eight biomedical and two technical databases between January 2022 and March 2022. After deduplicating the literature, the screening was conducted by the author and was independently double-screened by one of the four contributors. The selected articles were then analysed by the author on SDM and DT. Results From the initial 5719 search results, finished on the 6th of March 2023. 48 articles were included in this ScR. The PRISMA flow diagram is presented in Figure 1. All 48 articles were included after the screening report on one of the 31 applications selected in this ScR. The characteristics of the DTs of the applications were analysed as presented in Table 1. The SDM was all about treatment options, except only one application was on screening tests. Only one application made a direct reference to an SDM model, all the others hat references to literature Defining and explaining SDM. There is an ambiguous outcome of significance in the reported evaluative studies of these applications. making it important to evaluate which characteristics of DTs are efficacious in the variability of the clinical setting. Conclusion There has been an increase in DTs to facilitate SDM in CVC over the past years. Within the scientific literature, there is recognition of a variety of DT characteristics and outcomes of the evaluative studies. It is important to reflect users' needs to choose the right application. It is valuable for developers to see which characteristics of DTs add value to applications.Table 1.Characteristics of DTs","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications in the postoperative period of heart transplantation: a retrospective cohort","authors":"P Molinari Genari, N Malaman Galhardi, R Batista Dos Santos Pedrosa","doi":"10.1093/eurjcn/zvae098.083","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.083","url":null,"abstract":"Introduction Primary graft dysfunction, graft rejection, renal dysfunction, and infections are frequent complications after heart transplantation (HT), and there is evidence that previous comorbidities and risk factors, such as arterial hypertension, diabetes, dyslipidemia, and smoking can predispose or even aggravate the development and evolution of these disorders. Objectives This study verified the association between previous comorbidities and risk factors in the development of complications after HT. Methods A retrospective cohort study was conducted and included 91 HT patients and followed up to 10 years postoperatively, in a Brazilian hospital between 1988 and 2020. The study was designed according to the recommendations of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Data were collected by retrospective analysis of medical records. The independent variables were the following: Demographic and clinical conditions of the subjects during the preoperative period, such as age, sex, arterial hypertension, diabetes, dyslipidemia, and smoking. The outcome variables were: Acute cellular rejection, infection, renal dysfunction, hemodialysis therapy after the HT, and death. Data were submitted to descriptive, Fisher’s Exact Test and Chi-square analyses, with p < 0.05 as the level of statistical significance. The local Ethics Committee approved the study (CAAE: 53026321.4.0000.5404). Results There was a predominance of women (67.0%), with a mean age of 49.4 (11.1) years. Most of them were diagnosed with hypertension (49.45%), smokers (38.46%), dyslipidemia (18.68%), and diabetes (16.48%). Regarding complications, 73.63% of the sample of this study developed acute cellular rejection, 61.54% had infections, 25.47% developed renal dysfunction, in addition to 24.18% of patients received hemodialysis treatment after HT. More than half of patients died (58.24%). Positive associations of strong magnitude were found between renal dysfunction and hypertension (p=0.0018); of moderate magnitude between acute cellular rejection and smoking (p=0.0386) and between infection and smoking (p=0.0156). Furthermore, it was observed that those who developed renal dysfunction had a high association with hemodialysis (p<0.0001). Conclusion This study demonstrated that hypertension may be associated with the development of renal dysfunction, and smoking may contribute to acute cellular rejection and infection after HT. These findings provide support to health professionals to implement prevention strategies and early detection of complications in the postoperative period.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and mental components after cardiac rehabilitation intervention: a systematic review and meta-analysis","authors":"B R U N O Delgado, P A U L O Boto, J O S E Moreira","doi":"10.1093/eurjcn/zvae098.124","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.124","url":null,"abstract":"Background Cardiovascular disease is a major public health problem associated with high mortality and morbidity, reduced exercise capacity, and Health-related quality of life (HRQol). Interventions in Cardiac Rehabilitation (CR) programmes have gained ground in optimising these indicators, using patient-reported outcome measures (PROMs) to assess the HRQol of patients participating in these programmes, allowing them to show their state of health and make more informed clinical decisions. Purpose To analyse, using PROMs, the effect of CR programmes on the HRQoL of patients after a cardiac event, depending on the time of assessment. Methods The search was carried out in the MEDLINE, CINAHL, CENTRAL and Web of Science databases after registering the protocol in PROSPERO. We included all randomized controlled trials (RCTs) that compared interventions in CR programmes with usual care after a cardiac event and that used PROMs to assess HRQoL over time. The risk of bias was assessed using the Cochrane tool (RoB2) and the quality of evidence using the GRADE system. A meta-analysis was carried out with studies that assessed HRQoL in patients with coronary pathology using the SF-12 PROM at 6 months after a CR programme. Results 17 studies with 4,993 patients participating in CR programmes were included. The PROMs used in these studies to assess HRQoL were SF-12 (n=7), SF-36 (n=2), EQ5D (n=5), KCCQ (n=3), MacNewHRQL (n=3) and HeartQol (n=1). In the 3 RCTs of the meta-analysis, and after applying the SF-12 PROM at 6 months after a CR programme in patients with coronary pathology, the effect of participation was positive on HRQoL only in the physical component (MD 7.02; 95%CI [0.41,13.62]; p=0.04). The results of our meta-analysis indicate a moderate overall quality of evidence, using the GRADE approach, when assessing HRQoL at 6 and 12 month after intervention in a CR program. Conclusions This study develops knowledge on CR by showing the different PROMs applied after a programme, demonstrating a positive effect of CR on HRQoL after evaluation by the same PROM. The importance of time for assessing HRQoL was demonstrated by applying the SF-12 after the CR programme in patients with coronary pathology, with statistically significant results in the physical domain at 6 months. Given the importance of these results in improving HRQoL, it will be important for healthcare organisations to implement PROMs, investing more time and resources in a utilisation strategy.","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}