Heart & Lung最新文献

{"title":"Non-pharmacological interventions to reduce thirst in patients with heart failure or hemodialysis: A systematic review and meta-analysis","authors":"Franziska Wefer M.Sc., RN ,&nbsp;Lars Krüger M.Sc., RN ,&nbsp;Nana Waldréus PhD, RN ,&nbsp;Sascha Köpke PhD, RN","doi":"10.1016/j.hrtlng.2024.04.012","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.012","url":null,"abstract":"<div><h3>Background</h3><p>Thirst is a frequent and burdening symptom in many patients, especially in patients with chronic heart failure (CHF) and/or receiving hemodialysis (HD). As drug therapies are not feasible, non-pharmacological strategies are needed to reduce thirst and thirst-related burden.</p></div><div><h3>Objectives</h3><p>To identify non-pharmacological interventions aiming to reduce thirst in patients with CHF and/ or HD, to describe intervention components, and to evaluate the effectiveness of these interventions.</p></div><div><h3>Methods</h3><p>In February 2024, we completed a systematic search in MEDLINE via PubMed, Livivo, CINAHL, Cochrane Library and Web of Science. Two reviewers independently screened titles, abstracts, and full texts, performed critical appraisal and data extraction. We checked risk of bias with the checklists of the Joanna Briggs Institute and the Cochrane Risk of Bias tool and calculated meta-analyses for sufficiently homogeneous studies using fixed-effects models.</p></div><div><h3>Results</h3><p>We included 15 intervention studies applying non-pharmacological interventions including chewing gum (<em>n</em> = 8), low-sodium diet (<em>n</em> = 2), acupressure (<em>n</em> = 1), frozen strawberries (<em>n</em> = 1), fluid timetables (<em>n</em> = 1), ice cubes and mouthwash (<em>n</em> = 1), and a psychological intervention (<em>n</em> = 1). Sample sizes varied between 11 and 88 participants. Eleven intervention studies showed a reduction of thirst as intervention effect. Meta-analyses for chewing gum showed no significant effect on thirst using a visual analogue scale (IV: -2,32 [-10.37,5.73]; <em>p</em> = 0.57) or the dialysis thirst inventory (IV: -0.26 [- 1.83, 1.30]; <em>p</em> = 0.74). Quality of studies was moderate to low.</p></div><div><h3>Conclusion</h3><p>Results indicate that various non-pharmacological interventions could be helpful to reduce thirst in patients with CHF or HD, but important uncertainty remains.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324000669/pdfft?md5=48ba1ad2a1024beba381c52aa50f7ac4&pid=1-s2.0-S0147956324000669-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140631204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of \"CENTR(AR)\" walking trails: Different field criteria do not lead to different physical activity intensities in people with COPD","authors":"Nicola S. Diciolla PT, M.Sc. ,&nbsp;Patrícia Rebelo PT, M.Sc. ,&nbsp;Guilherme Rodrigues PT, M.Sc. ,&nbsp;Ana Sofia Grave PT, M.Sc. ,&nbsp;Cíntia Dias PT, M.Sc. ,&nbsp;Maria Gomes PT, M.Sc. ,&nbsp;E. Samuel Santos PT, M.Sc. ,&nbsp;Zulmira Pereira Eng, M.Sc. ,&nbsp;Luísa Pereira Eng, Ph.D. ,&nbsp;Alda Marques PT, Ph.D., Prof.","doi":"10.1016/j.hrtlng.2024.04.014","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.014","url":null,"abstract":"<div><h3>Background</h3><p>Validating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD.</p></div><div><h3>Objectives</h3><p>We aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD.</p></div><div><h3>Methods</h3><p>This cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity.</p></div><div><h3>Results</h3><p>Twenty people with COPD [71(7) years, 80 % male, FEV₁%predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), <em>p</em> = 0.01], but not vigorous (3.5[2.5–4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (<em>p</em> &gt; 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (<em>p</em> &lt; 0.01). Walking trails were categorised as moderate intensity in most participants.</p></div><div><h3>Conclusion</h3><p>Walking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324000682/pdfft?md5=7794639e1def1bd3df689db6f80e73df&pid=1-s2.0-S0147956324000682-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of pulmonary artery catheters in reducing mortality in acute heart failure cardiogenic shock: A systematic review","authors":"Brianna Wagaman ACNPC-AG, RN, BSN, CCRN","doi":"10.1016/j.hrtlng.2024.02.012","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.02.012","url":null,"abstract":"<div><h3>Background</h3><p>Cardiogenic shock (CS), a complex and life-threatening medical condition, has an astounding hospital mortality rate spanning from 40 % to 59 %. Frequently, CS requires the use of pulmonary artery catheters (PACs) for management.</p></div><div><h3>Objective</h3><p>This literature review aims to investigate the relationship between PAC utilization in CS patients and in-hospital 30-day mortality rates compared to noninvasive vital sign monitoring alone.</p></div><div><h3>Methods</h3><p>An integrative literature search was conducted from January 1, 2003, until August 1, 2023. The review focused on patients with acute decompensated heart failure CS. It compared PAC and non-PAC hemodynamic monitoring with 30-day mortality outcomes. Five articles met the inclusion criteria and underwent quality assessment using CONSORT, STROBE, and STARD guidelines.</p></div><div><h3>Results</h3><p>Five articles totaled 332,794 patients. Patients with a PAC showed lower 30-day in-hospital mortality rates (22.2 % to 55 %) than patients without a PAC (29.8–78 %). One study, however, indicated that PAC use did not significantly affect mortality rates (<em>p</em> = 0.66). Notably, the lowest mortality rates (25 %) were linked to complete hemodynamic profiling with a PAC.</p><p>The mortality rates showed greater significance when PAC initiation occurred early, resulting in a further reduction of the mortality rate to 17.3 %. Conversely, mortality rates increased to 27.7 % with delayed PAC initiation, 40 % with incomplete hemodynamic profiling, and 35 % with no PAC use.</p></div><div><h3>Conclusions</h3><p>PAC utilization reduces in-hospital mortality for the CS patient population, as suggested by the analyzed studies. Further research via randomized controlled trials (RCTs) with standardized treatment protocols and adequate follow-up are required to validate the findings.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationship between chronic obstructive pulmonary disease and heart failure: A Mendelian randomization study","authors":"Rui Jiang,&nbsp;Chang Sun,&nbsp;Ying Yang,&nbsp;Qi Sun,&nbsp;Xiuping Bai","doi":"10.1016/j.hrtlng.2024.04.007","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.007","url":null,"abstract":"<div><h3>Background</h3><p>Causal association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) has been controversial. This study used Mendelian Randomization (MR) analysis to clarify the potential causal connection between these two conditions.</p></div><div><h3>Objectives</h3><p>The purpose of the study was to investigate the causal relationship between COPD and HF based on the hypothesis that the genetic predisposition to COPD could lead to an increased risk of developing HF</p></div><div><h3>Methods</h3><p>A two-sample MR analysis of genetic data was performed for COPD and HF. This study was based on genome-wide association study (GWAS) data, including 6,915 patients with confirmed COPD and 186,723 controls. The odds ratios (ORs) and their 95 % confidence intervals (95 %CIs) were estimated using a fixed effects inverse variance weighting (IVW) method. Several supplementary statistical methods, including MR-Egger, weighted median, maximum likelihood, penalized weighted median, and random effects IVW, were applied to enhance the robustness of findings. Moreover, MR-PRESSO was employed as an alternative method for statistical detection.</p></div><div><h3>Results</h3><p>Pooled data for HF were obtained from different GWASs, including 4,7309 confirmed HF patients and 930,014 controls. The MR analysis, based on the IVW model, revealed that COPD was significantly associated with an increased risk of HF. Specifically, the obtained findings showed that COPD patients had a higher risk of developing HF (Model 1: OR = 1.068, 95 %CI: 1.006–1.134, <em>p</em> = 0.031; Model 2: OR = 1.038, 95 %CI: 1.006–1.071, <em>p</em> = 0.020), indicating a causal relationship between COPD and HF. No evidence was found to suggest a reverse causal effect of HF on COPD incidence.</p></div><div><h3>Conclusion</h3><p>The MR analysis substantiates a causal link between COPD and HF, with no evidence supporting a reverse causation from HF to COPD. These findings underscore the importance of proactive COPD management as a potential strategy to prevent the development of HF, highlighting the need for targeted interventions in patients with COPD to mitigate their risk of HF.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014795632400061X/pdfft?md5=892193ef4de1109deab8182f450a1cf8&pid=1-s2.0-S014795632400061X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140555270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial readiness assessment for heart transplant candidates","authors":"Audrey C. Kleet DNP, MBA, ACNP-BC ,&nbsp;Mathew Regan MSN, RN, CCTC ,&nbsp;Birgit A. Siceloff DNP, ANP-BC ,&nbsp;Carmen Alvarez PhD, CRNP, CNM, FAAN ,&nbsp;Maryjane Farr MD, MSc","doi":"10.1016/j.hrtlng.2024.04.013","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.013","url":null,"abstract":"<div><h3>Background</h3><p>Psychosocial evaluation for transplant suitability is required by the Centers for Medicare and Medicaid Services (CMS) as a condition of participation for transplant programs. There are no regulations regarding follow-up reassessment for transplant readiness after waitlisting.</p></div><div><h3>Objectives</h3><p>An evidence-based pilot project was developed and implemented to evaluate the feasibility of psychosocial readiness assessments for waitlisted heart transplantation candidates. The primary aim was to test the feasibility of these assessments in practice from a patient and programmatic perspective.</p></div><div><h3>Methods</h3><p>During a 12-week period, waitlisted outpatients underwent one assessment each. Socioeconomic elements of caregiver support, housing, transportation, and insurance coverage status were assessed by simple using “yes/no” questions. To assess mental health needs, the General Anxiety Disorder-7 questionnaire (GAD-7) and the Patient Health Questionnaire-8 (PHQ-8) tools were utilized. Rescheduled readiness visits and no-show rates were measured. A post-implementation Qualtrics survey was administered to measure team member perceptions of feasibility.</p></div><div><h3>Results</h3><p>A total of 57 patients were assessed during the 12-week period. The primary aim of feasibility was achieved with 93 % of visits performed with freedom from rescheduling or patient no-show to the visit. Additionally, 75 % of team members reported the readiness assessments were feasible to complete in practice.</p></div><div><h3>Conclusions</h3><p>Addressing the non-medical and mental health needs of waitlisted heart transplant patients allows transplant programs to maintain candidates with necessary resources and care. The readiness assessments are feasible in practice and may serve to reduce untoward outcomes in the post-transplant phase by providing targeted care prior to the time of transplant.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324000670/pdfft?md5=3a7ee11ef7f9e8743299676dcff47037&pid=1-s2.0-S0147956324000670-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140555271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles of work ability and associated factors in young and middle-aged acute myocardial infarction patients: A latent profile analysis","authors":"Shuqian Qiao ,&nbsp;Wei Wang ,&nbsp;Xinyi Chen ,&nbsp;Xi Cao","doi":"10.1016/j.hrtlng.2024.04.010","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>The incidence of acute myocardial infarction (AMI) is increasing among young and middle-aged people, and such patients need to be reemployed after AMI events from the individual and society perspectives. However, the situation of employment after AMI was not ideal. Early identification of patients vulnerable to decreased work ability and provided targeted intervention may be beneficial.</p></div><div><h3>Objective</h3><p>To identify the profiles and associated factors of work ability in young and middle-aged AMI patients.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted in Guangzhou, China, from September 2022 to October 2023. Work ability, self-efficacy for return-to-work, social support, anxiety, and depression were measured by the Work-ability Support Scale (WSS), Return-To-Work Self-Efficacy Questionnaire, Social Support Rating Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire 9, respectively. We performed latent profile analysis based on three subdomains of the WSS by using Mplus 8.3. Multiple logistic regression was used to identify factors associated with work ability.</p></div><div><h3>Results</h3><p>A total of 155 participants (aged 48.58±7.153 years, 95.5 % male) were included. We identified three latent profiles of work ability: low work ability (28.1 %), moderate work ability (51 %), and high work ability (20.6 %). The per capita monthly household income, NYHA functional class, total cholesterol, length of hospital stay, social support, and self-efficacy for return-to-work were factors associated with work ability.</p></div><div><h3>Conclusion</h3><p>This study demonstrated different profiles and associated factors of work ability in young and middle-aged AMI patients. It is suggested that healthcare providers identify and monitor associated factors to improve work ability among this subpopulation.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140542578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experiences among bereaved family members after a left ventricular assist device (LVAD) deactivation","authors":"Anne Kelemen LICSW, SEP ,&nbsp;Hunter Groninger MD, FAAHPM ,&nbsp;Edilma L. Yearwood PhD, RN, FAAN ,&nbsp;Casey French MS ,&nbsp;Cindy Bither NP ,&nbsp;Anirudh Rao MD ,&nbsp;Kelley M. Anderson PhD, FNP, CHFN","doi":"10.1016/j.hrtlng.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.004","url":null,"abstract":"<div><h3>Background</h3><p>The use of left ventricular assist devices (LVADs) is increasing with an estimated 2500 devices implanted each year. When burdens of the LVAD outweigh benefits, most individuals with LVADs will undergo deactivation in the hospital setting. While the decision to deactivate an LVAD is considered an ethical practice, little is known about the experience and needs of bereaved family members.</p></div><div><h3>Objective</h3><p>To investigate the experiences of bereaved family members of patients who died following LVAD deactivation.</p></div><div><h3>Methods</h3><p>In this qualitative study, 11 family members of patients who underwent LVAD deactivation were interviewed. The semi-structured interviews were conducted until data saturation was reached and relevant themes emerged.</p></div><div><h3>Results</h3><p>This qualitative study was conducted to understand the experience of family members before, during and after the patient underwent LVAD deactivation, including their perceptions of engagement with the healthcare team. Analysis revealed six overarching themes from the experience, including 1) hope for survival, 2) communication, 3) spirituality and faith, 4) absence of physical suffering, 5) positive relationships with staff, 6) post-death care needs.</p></div><div><h3>Conclusion</h3><p>Bereaved family members of patients undergoing LVAD deactivation have unique lived experiences and concerns. This study highlights the importance of effective communication not only near end-of-life but throughout the LVAD experience. While the positive relationships with staff and the absence of physical suffering were strengths identified by bereaved caregivers, there is an opportunity for improvement, particularly during the decision-making and post-death periods.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140542579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ARDS in solid organ transplant recipients hospitalized for COVID-19 based on the 2023 new definition","authors":"Jun Tang ,&nbsp;Yang Zhou ,&nbsp;Linmei Gong ,&nbsp;Jiayi Deng ,&nbsp;Yihao Yuan ,&nbsp;Yanjun Zhong ,&nbsp;Jinxiu Li ,&nbsp;Guyi Wang","doi":"10.1016/j.hrtlng.2024.04.008","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.008","url":null,"abstract":"<div><h3>Background</h3><p>Solid organ transplant recipients (SOTRs) are more likely to suffer complications after being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).</p></div><div><h3>Objectives</h3><p>We aimed to describe the clinical features of SOTRs infected with SARS-CoV-2 and to assess independent risk factors associated with the development of acute respiratory distress syndrome (ARDS) following COVID-19 infection in SOTRs based on the new ARDS definition.</p></div><div><h3>Methods</h3><p>358 SOTRs infected with SARS-CoV-2 were recruited and divided into two groups, patients with ARDS (<em>n</em> = 81) and patients without ARDS (<em>n</em> = 277). Demographic data, initial laboratory findings, therapeutic measures, and outcome indicators were compared between the two groups. The association between the onset of ARDS and related factors was analyzed using a logistic regression model. A nomogram was created to estimate the probability of developing ARDS.</p></div><div><h3>Results</h3><p>Approximately 22.6 % (81/358) of hospitalized SOTRs infected with SARS-CoV-2 developed ARDS. In comparison to patients without ARDS, those with ARDS presented with more underlying conditions, decreased lymphocyte counts and serum albumin levels, but increased levels of leukocytes, serum creatinine, nitrogen urea, uric acid, and inflammatory markers. Cerebrovascular disease, leukocyte counts, albumin levels, and IL-6 levels were independent risk factors for the development of ARDS in this population. Furthermore, a nomogram prediction model was created utilizing the aforementioned factors to facilitate early prediction of ARDS, exhibiting an AUC (area under curve) of 0.81.</p></div><div><h3>Conclusions</h3><p>Cerebrovascular disease, leukocyte counts, albumin levels, and IL-6 levels were independent risk factors for the development of ARDS following COVID-19 infection in SOTRs.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140539456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The findings of a service evaluation on the practice of assessment and treatment of iron deficiency in people admitted to a UK hospital with decompensated Heart Failure","authors":"Rebecca Bone MSc. ,&nbsp;Helen Walthall PhD.","doi":"10.1016/j.hrtlng.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Iron Deficiency (ID) is common in Heart Failure (HF) and associated with poor outcomes. Replacement with intravenous (IV) iron can improve functional status, quality of life and risk of unplanned admission. In 2015/16 a local service evaluation was performed which found that of people admitted with HF, only 27.5 % had assessment of iron status, and when identified, replacement occurred in fewer than half. Education strategies were employed to increase awareness of the importance of assessment and correction.</p></div><div><h3>Objectives</h3><p>To assess if practice had improved following education strategies.</p></div><div><h3>Methods</h3><p>A review of 220 patient records for people admitted with HF in 2020/21 to establish if iron status assessed, presence of ID, and whether if ID identified it was treated, and by which route. Trends in 2020/21 data were explored in sub-groups by age, sex, type of HF, anaemia status, input from HF specialists and type of ID.</p></div><div><h3>Results</h3><p>Compared to 2015/16, more assessments of iron status were performed (45% vs 27.5 %), ID was corrected more frequently (57% vs 46 %) and increased use of the IV route for replacement (83% vs 58 %)</p></div><div><h3>Conclusions</h3><p>Despite the impact of COVID-19 on usual care in 2020/21, improvement was seen in proportion of assessment and treatment of ID following simple education strategies for key stakeholders. There may be scope to improve practice further if the findings remain similar post pandemic. If so, a formal Quality Improvement approach may be helpful.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140540340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating effect of uncertainty in illness between heart failure symptoms and health-related quality of life among rural patients with heart failure: A multi-center cross-sectional study","authors":"Chunhua Ma PhD, RN","doi":"10.1016/j.hrtlng.2024.04.011","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.04.011","url":null,"abstract":"<div><h3>Background</h3><p>The health-related quality of life (HRQoL) of patients with heart failure (HF) in rural settings in China remains unclear. Limited studies explored the mediating effect of uncertainty in illness between heart failure symptoms and HRQoL in this population.</p></div><div><h3>Objectives</h3><p>To explore the status of HRQoL in rural patients with HF; assess the impact of HF symptoms and uncertainty in illness on HRQoL; and examine the mediating effect of uncertainty in illness on the relationship between symptoms and HRQoL in rural patients with HF.</p></div><div><h3>Methods</h3><p>Overall, 298 rural patients with HF were recruited from five township hospitals of Taishan and Jinzhong City in China between November 2021 and August 2022. Three variables, namely HF symptoms, uncertainty in illness, and HRQoL were measured using three validated scales.</p></div><div><h3>Results</h3><p>The average score of HRQoL in rural patients with HF was 43.19. Of the participants, 60.4 %, 35.23 %, and 4.37 % exhibited poor, moderate, and good HRQoL, respectively. The HF symptoms (<em>β</em> = −0.47) and uncertainty in illness (<em>β</em> = −0.34) directly influenced HRQoL. Moreover, the HF symptoms also indirectly affected HRQoL through uncertainty in illness (<em>β</em> = −0.07). The indirect effect accounted for 12.96 % of the total effect of HF symptoms on HRQoL.</p></div><div><h3>Conclusion</h3><p>Rural patients with HF exhibited poor HRQoL. In this population, HF symptoms and uncertainty in illness were negatively associated with HRQoL. Uncertainty in illness mediated the relationship between HF symptoms and HRQoL. Tailored healthcare services should be developed for the rural population to alleviate HF symptoms, reduce uncertainty in illness, and enhance their HRQoL.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140535499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}