Subjects -> MEDICAL SCIENCES (Total: 8819 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (225 journals)
    - ANAESTHESIOLOGY (122 journals)
    - CARDIOVASCULAR DISEASES (352 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (233 journals)
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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)

CARDIOVASCULAR DISEASES (352 journals)                  1 2 | Last

Showing 1 - 200 of 352 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal   (Followers: 1)
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 13)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 2)
American Heart Journal     Hybrid Journal   (Followers: 64)
American Journal of Cardiology     Hybrid Journal   (Followers: 74)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 22)
American Journal of Hypertension     Hybrid Journal   (Followers: 31)
American Journal of Preventive Cardiology     Open Access   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 5)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 14)
AORTA     Open Access   (Followers: 1)
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 6)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 4)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 2)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 3)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access  
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 34)
Artery Research     Hybrid Journal   (Followers: 5)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 3)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 25)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 17)
Cardiac Cath Lab Director     Full-text available via subscription   (Followers: 1)
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 3)
Cardiac Failure Review     Open Access   (Followers: 3)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 4)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 9)
Cardiology in the Young     Hybrid Journal   (Followers: 35)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 16)
Cardiology Research and Practice     Open Access   (Followers: 11)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 12)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 2)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 1)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 16)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 2)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 2)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 6)
Cardiovascular Journal     Open Access   (Followers: 7)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 19)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 2)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 8)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
CASE : Cardiovascular Imaging Case Reports     Open Access  
Case Reports in Cardiology     Open Access   (Followers: 8)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 5)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 114)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 292)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 23)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 15)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 17)
Circulation : Heart Failure     Hybrid Journal   (Followers: 33)
Circulation Research     Hybrid Journal   (Followers: 37)
Cirugía Cardiovascular     Open Access  
CJC Open     Open Access   (Followers: 1)
Clínica e Investigación en Arteriosclerosis     Hybrid Journal  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 10)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 7)
Clinical Medicine Reviews in Cardiology     Hybrid Journal   (Followers: 1)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 5)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 7)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 2)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 6)
Current Cardiology Reviews     Hybrid Journal   (Followers: 3)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 13)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 3)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 1)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 5)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 77)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 11)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 3)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal   (Followers: 1)
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 2)
European Heart Journal Supplements     Hybrid Journal   (Followers: 7)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 10)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 15)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 7)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 10)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 4)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 5)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 4)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 53)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 4)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 16)
Heart Rhythm O2     Full-text available via subscription   (Followers: 3)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access   (Followers: 1)
Hearts     Open Access   (Followers: 3)
Hellenic Journal of Cardiology     Open Access   (Followers: 2)
Herz     Hybrid Journal   (Followers: 2)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 3)
Hypertension     Full-text available via subscription   (Followers: 26)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 10)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access   (Followers: 1)
IJC Heart & Vessels     Open Access   (Followers: 2)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access   (Followers: 1)
Indian Journal of Clinical Cardiology     Open Access   (Followers: 1)
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 2)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal  
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 3)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 36)
International Journal of the Cardiovascular Academy     Open Access  

        1 2 | Last

Similar Journals
Journal Cover
European Journal of Cardiovascular Nursing
Journal Prestige (SJR): 0.945
Citation Impact (citeScore): 2
Number of Followers: 5  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1474-5151 - ISSN (Online) 1873-1953
Published by Sage Publications Homepage  [1162 journals]
  • Family Nursing: The family as the unit of research and care

    • Free pre-print version: Loading...

      Authors: Marie Louise Luttik
      Pages: 660 - 662
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 660-662, December 2020.

      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-10-01T08:56:56Z
      DOI: 10.1177/1474515120959877
      Issue No: Vol. 19, No. 8 (2020)
       
  • An integrative review on facilitators and barriers in delivering and
           managing injectable therapies in chronic conditions: A part of the ACNAP
           project ‘injectable medicines among patients with cardiovascular
           conditions’

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      Authors: Ekaterini Lambrinou, Martha Kyriakou, Ioanna Lakatamitou, Neil Angus, Rani Khatib, Ercole Vellone, Abigail Barrowcliff, Tina Birgitte Hansen, Geraldine A Lee
      Pages: 663 - 680
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 663-680, December 2020.
      Introduction:Although preventive health and therapeutics have benefited from advances in drug development and device innovation, translating these evidence-based treatments into real-world practice remains challenging.Aim:The current integrative review aims to identify facilitators and barriers and perceptions in delivering and managing injectable therapies from patient perspectives.Methods:An integrative review was conducted in the databases of PubMed, CINAHL, PsycINFO and Cochrane. Keywords were used “Injectable therapy”, “IV therapy”, “SC therapy”, “long term injectable therapies”, “self-administered injectable therapy”, “patients”, “caregivers”, “family”, “carers”, “facilitators”, “barriers”, “perspectives”, “needs”, “expectations”, “chronic disease”, “cardiovascular disease” linked with the words “OR” and “AND”. The search was limited from January 2000 to July 2019. Inclusion and exclusion criteria were used.Results:Twenty studies were identified from the literature search. Studies followed qualitative, quantitative methodology and mixed methods. Facilitators included: health improvement, prevention of disease complications, taking control of their disease, effectiveness of the medication and convenience in management. Barriers included: fear of needles, insulin will cause harm, poor perception of the benefits of injectable therapies on their quality of life, inconvenience in self-management, social stigma, impact on daily living, financial barriers, lack of education. Perceptions included: ‘treatment of last resort’, ‘life becomes less flexible’, ‘injectables were punishment/restriction’, ‘personal failure of self-management’.Conclusion:Evidence shows how to create effective communication and shared decision-making relationships to provide best possible care to patients who need injectable therapy and support for self-management. Future research might help guide response to the fears and barriers of the patients using patients’ perspectives.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-16T01:31:54Z
      DOI: 10.1177/1474515120939007
      Issue No: Vol. 19, No. 8 (2020)
       
  • A qualitative analysis of psychosocial needs and support impacts in
           families affected by young sudden cardiac death: The role of community and
           peer support

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      Authors: Edith Maria Steffen, Lada Timotijevic, Adrian Coyle
      Pages: 681 - 690
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 681-690, December 2020.
      BackgroundYoung sudden cardiac death (YSCD), often occurring in previously healthy individuals, is a tragic event with devastating impact on affected families, who are at heightened risk of posttraumatic stress and prolonged grief and may themselves be at risk of YSCD. Previous research suggests that surviving family members’ psychosocial support needs are often unmet.PurposeThis study sought to identify how YSCD-affected families experience dedicated community and peer support in light of their psychosocial support needs.MethodsThe study used a qualitative design, employing a thematic analysis of focus group and interview data. Three focus groups and five individual interviews were conducted with affected family members (N = 19). The sample was drawn from a UK-based charity, Cardiac Risk in the Young. Audio-recordings of the focus groups and interviews were transcribed and subjected to thematic analysis.ResultsThree super-ordinate themes were identified: 1. YSCD community support as offering a place of safety, 2. YSCD community support as fostering sense-making, 3. YSCD community support as facilitating finding new meaning.ConclusionsYSCD-affected families can benefit from access to dedicated community and peer support that offers a safe environment, provides affiliation, understanding and normalisation and enables sense-making and the rebuilding of a sense of self. Dedicated community support can facilitate meaningful re-engagement with life through helping prevent YSCD and through memorialisation and legacy-building to maintain a continuing bond with the deceased. Clinicians need to be aware of the need to incorporate available community and peer support into patient pathways.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-06T02:08:41Z
      DOI: 10.1177/1474515120922347
      Issue No: Vol. 19, No. 8 (2020)
       
  • Subjective reports of physical activity levels and sedentary time prior to
           hospital admission can predict utilization of hospital care and all-cause
           mortality among patients with cardiovascular disease

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      Authors: Amanda Ek, Lena V Kallings, Mattias Ekström, Mats Börjesson, Örjan Ekblom
      Pages: 691 - 701
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 691-701, December 2020.
      BackgroundIn prevention, sedentary behaviour and physical activity have been associated with risk of cardiovascular disease and mortality. Less is known about associations with utilization of hospital care.AimTo investigate whether physical activity level and sedentary behaviour prior to cardiac ward admission can predict utilization of hospital care and mortality among patients with cardiovascular disease.MethodsLongitudinal observational study including 1148 patients admitted and treated in cardiac wards in two hospitals. Subjective reports of physical activity levels and sedentary time prior to admission were collected during inpatient care and categorized as low, medium or high. The associations between physical activity level and sedentary time with hospital stay, readmission and mortality were analysed using linear, logistic and Cox regressions.ResultsMedian hospital stay was 2.1 days. One higher step in the physical activity level, or lower sedentary time, was related to an approximately 0.9 days shorter hospital stay. Sixty per cent of patients were readmitted to hospital. The risk of being readmitted was lower for individuals reporting high physical activity and low sedentary time (odds ratios ranging between 0.44 and 0.91). A total of 200 deaths occurred during the study. Mortality was lower among those with high and medium physical activity levels and low sedentary time (hazard ratios ranging between 0.36 and 0.90).ConclusionBoth physical activity level and sedentary time during the period preceding hospitalization for cardiac events were predictors of hospital utilization and mortality. This highlights the prognostic value of assessing patients’ physical activity and sedentary behaviour.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-06T02:09:59Z
      DOI: 10.1177/1474515120921986
      Issue No: Vol. 19, No. 8 (2020)
       
  • Utility of the integrated palliative care outcome scale (IPOS): a
           cross-sectional study in hospitalised patients with heart failure

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      Authors: Carmen Roch, Johanna Palzer, Teresa Zetzl, Stefan Störk, Stefan Frantz, Birgitt van Oorschot
      Pages: 702 - 710
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 702-710, December 2020.
      AimThe aim of this study was to evaluate the suitability and comprehensibility of the integrated palliative care outcome scale for the evaluation of palliative care needs in patients with heart failure.Methods and resultsThis cross-sectional study investigated 100 heart failure patients (40 women, 60 men; median age 79 years) within the first few days of their hospitalisation by applying the integrated palliative care outcome scale (3-day recall period) and two additional self-developed questions about the suitability and comprehensibility of the integrated palliative care outcome scale. Clinically relevant somatic and psycho-emotional symptoms were reported very frequently (approximately 75% each), followed by communicational needs or practical issues. Ninety-five per cent of patients thought the integrated palliative care outcome scale very easy to understand, and 91% judged the integrated palliative care outcome scale suitable to assess palliative care needs.ConclusionThe integrated palliative care outcome scale was well accepted by hospitalised patients with heart failure and identified a high burden of both physical and psycho-emotional symptoms. Screening for palliative care has to consider patients and their relatives alike, and should be part of a comprehensive care concept jointly integrated into clinical routine by primary and specialised palliative care teams.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-06T02:09:18Z
      DOI: 10.1177/1474515120919386
      Issue No: Vol. 19, No. 8 (2020)
       
  • Characteristics for a tool for timely identification of palliative needs
           in heart failure: The views of Dutch patients, their families and
           healthcare professionals

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      Authors: Daisy JA Janssen, Stephanie MC Ament, Josiane Boyne, Jos MGA Schols, Hans-Peter Brunner-La Rocca, José MC Maessen, Marieke HJ van den Beuken-van Everdingen
      Pages: 711 - 720
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 711-720, December 2020.
      BackgroundPalliative care can improve outcomes for patients with advanced chronic heart failure and their families, but timely recognition of palliative care needs remains challenging.AimThe aim of this study was to identify characteristics of a tool to assess palliative care needs in chronic heart failure that are needed for successful implementation, according to patients, their family and healthcare professionals in The Netherlands.MethodsExplorative qualitative study, part of the project ‘Identification of patients with HeARt failure with PC needs’ (I-HARP), focus groups and individual interviews were held with healthcare professionals, patients with chronic heart failure, and family members. Data were analysed using the Consolidated Framework for Implementation Research.ResultsA total of 13 patients, 10 family members and 26 healthcare professionals participated. Direct-content analysis revealed desired tool characteristics for successful implementation in four constructs: relative advantage, adaptability, complexity, and design quality and packaging. Healthcare professionals indicated that a tool should increase awareness, understanding and knowledge concerning palliative care needs. A tool needs to: be adaptable to different disease stages, facilitate early identification of palliative care needs and ease open conversations about palliative care. The complexity of chronic heart failure should be considered in a personalized approach.ConclusionsThe current study revealed the characteristics of a tool for timely identification of palliative care needs in chronic heart failure needed for successful implementation. The next steps will be to define the content of the tool, followed by development of a preliminary version and iterative testing of this version by the different stakeholders.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-06T02:10:59Z
      DOI: 10.1177/1474515120918962
      Issue No: Vol. 19, No. 8 (2020)
       
  • Effectiveness of the nurse-led Activate intervention in patients at risk
           of cardiovascular disease in primary care: a cluster-randomised controlled
           trial

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      Authors: Heleen Westland, Marieke J Schuurmans, Irene D Bos-Touwen, Marjolein A de Bruin-van Leersum, Evelyn M Monninkhof, Carin D Schröder, Daphne A de Vette, Jaap CA Trappenburg
      Pages: 721 - 731
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 721-731, December 2020.
      BackgroundTo understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutch primary care.AimThe aim of this study was to evaluate the effectiveness of the Activate intervention and identifying which patient-related characteristics modify the effect.MethodsA two-armed cluster-randomised controlled trial was conducted comparing the intervention with care as usual. The intervention consisted of four nurse-led behaviour change consultations within a 3-month period. Data were collected at baseline, 3 months and 6 months. Primary outcome was the daily amount of moderate to vigorous physical activity at 6 months. Secondary outcomes included sedentary behaviour, self-efficacy for physical activity, patient activation for self-management and health status. Prespecified effect modifiers were age, body mass index, level of education, social support, depression, patient provider relationship and baseline physical activity.ResultsThirty-one general practices (n = 195 patients) were included (intervention group n = 93; control group n = 102). No significant between-group difference was found for physical activity (mean difference 2.49 minutes; 95% confidence interval -2.1; 7.1; P = 0.28) and secondary outcomes. Patients with low perceived social support (P = 0.01) and patients with a low baseline activity level (P = 0.02) benefitted more from the intervention.ConclusionThe Activate intervention did not improve patients’ physical activity and secondary outcomes in primary care patients at risk of cardiovascular disease. To understand the results, the intervention fidelity and active components for effective self-management require further investigation.Trial registration: ClinicalTrials.gov NCT02725203.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-07T01:29:51Z
      DOI: 10.1177/1474515120919547
      Issue No: Vol. 19, No. 8 (2020)
       
  • Comorbidity as a mediator of depression in adults with congenital heart
           disease: A population-based cohort study

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      Authors: Hsiao-Ling Yang, Nien-Tzu Chang, Jou-Kou Wang, Chun-Wei Lu, Yong-Chen Huang, Philip Moons
      Pages: 732 - 739
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 732-739, December 2020.
      BackgroundThe population of adults with congenital heart disease (CHD) has increased dramatically with a high prevalence of acquired cardiac and non-cardiac comorbidities. However, the relationship among congenital heart disease, physical comorbidities, and psychological health in this population is not well studied.AimsThe purpose of this study was to investigate (a) the association between adult congenital heart disease and the occurrence of depression and (b) whether physical comorbidities mediated the association between congenital heart disease and the occurrence of depression.MethodsThis retrospective cohort study was followed from 1 January 2010–31 December 2013, based on the data from the National Health Insurance Research Database 2010 in Taiwan. We used mediation analysis in survival data to assess the mediated effect. The hazard ratios were adjusted by age, sex, area of residence, and estimated propensity scores.ResultsWe recruited 2122 adult congenital heart disease patients and 8488 matched controls. Nearly half of patients diagnosed with simple congenital heart disease, 39.0% had complex congenital heart disease, and 11.2% had unclassified congenital heart disease. Adult congenital heart disease patients had a significantly higher risk of depression than matched controls (adjusted hazard ratio = 1.43 and 1.48, for all and complex congenital heart disease, respectively, p
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-20T03:33:40Z
      DOI: 10.1177/1474515120923785
      Issue No: Vol. 19, No. 8 (2020)
       
  • Self-rated stress and experience in patients with Takotsubo syndrome: a
           mixed methods study

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      Authors: Runa Sundelin, Chatarina Bergsten, Per Tornvall, Patrik Lyngå
      Pages: 740 - 747
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 740-747, December 2020.
      BackgroundA relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients’ self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome.AimsThe aim of this study was to describe stress before and after the onset of Takotsubo syndrome.MethodsTwenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up.ResultsSelf-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful.ConclusionPatients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-03T04:15:27Z
      DOI: 10.1177/1474515120919387
      Issue No: Vol. 19, No. 8 (2020)
       
  • Predictors of patient-reported outcomes at discharge in patients with
           heart failure

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      Authors: Anne A Rasmussen, Søren P Johnsen, Selina K Berg, Trine B Rasmussen, Britt Borregaard, Lars Thrysoee, Charlotte B Thorup, Rikke E Mols, Henrik Wiggers, Signe H Larsen
      Pages: 748 - 756
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 748-756, December 2020.
      Background:It is well-established that heart failure has a negative impact on quality of life. However, little is known about patient-related predictors of health-related quality of life, anxiety and depression, symptoms and illness perception among patients with heart failure.Aim:To study the association between patient-related predictors and patient-reported outcome measures at discharge from hospital in a cohort of patients with heart failure.Methods:We used data from 1506 patients with heart failure, participating in the national DenHeart Survey of patient-reported outcome measures in patients with heart disease. The potential patient-related predictors included demographic, administrative, clinical and socioeconomic factors. The patient-reported outcome measures included six questionnaires: the Short Form-12, the Hospital Anxiety and Depression Scale, the EuroQol five-dimensional, five-level questionnaire, the HeartQoL, the Brief Illness Perception Questionnaire and the Edmonton Symptom Assessment Scale. Data were linked to national patient registry data and medical records. We performed multivariable linear and logistic regression analyses.Results:In adjusted linear regression analyses we found that a length of hospital stay of >2 days was associated with worse scores across questionnaires, except for the Brief Illness Perception Questionnaire. Higher comorbidity level was associated with worse scores across all questionnaires, whereas low social support was associated with worse scores across questionnaires, except for the physical domain of the Short Form-12 and the HeartQoL global score.Conclusions:This study identified length of hospital stay > 2 days, a higher comorbidity level and low social support to be associated with worse scores across questionnaires at discharge from a cardiac-related hospitalisation in patients with heart failure.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-04T06:09:29Z
      DOI: 10.1177/1474515120902390
      Issue No: Vol. 19, No. 8 (2020)
       
  • A guide to improve your causal inferences from observational data

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      Authors: Koen Raymaekers, Koen Luyckx, Philip Moons
      Pages: 757 - 762
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 757-762, December 2020.
      True causality is impossible to capture with observational studies. Nevertheless, within the boundaries of observational studies, researchers can follow three steps to answer causal questions in the most optimal way possible. Researchers must: (a) repeatedly assess the same constructs over time in a specific sample; (b) consider the temporal sequence of effects between constructs; and (c) use an analytical strategy that distinguishes within from between-person effects. In this context, it is demonstrated how the random intercepts cross-lagged panel model can be a useful statistical technique. A real-life example of the relationship between loneliness and quality of life in adolescents with congenital heart disease is provided to show how the model can be practically implemented.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-10-11T06:56:29Z
      DOI: 10.1177/1474515120957241
      Issue No: Vol. 19, No. 8 (2020)
       
  • ESC Clinical Case Gallery and YoCo National Ambassadors

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      Authors: Trond R Pettersen
      Pages: 763 - 764
      Abstract: European Journal of Cardiovascular Nursing, Volume 19, Issue 8, Page 763-764, December 2020.

      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-10-07T07:33:06Z
      DOI: 10.1177/1474515120957861
      Issue No: Vol. 19, No. 8 (2020)
       
  • Acceptance of the disease and sexual functions of patients with heart
           failure

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      Authors: Alicja Wiśnicka, Izabella Uchmanowicz, Dorota Dyjakon, Ewelina Cichoń, Remigiusz Szczepanowski, Ewa A Jankowska
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Sexual activity is an important element of quality of life for many individuals suffering from heart failure.Aims:The study investigated the influence of disease acceptance on sexual function in a population of male patients with chronic heart failure.Methods:The study included 80 patients with chronic heart failure (mean age 63.3±9.2 years) who filled in the Mell–Krat Scale questionnaire to evaluate sexual needs and reactions. We also used the International Index of Erection Function (IIEF-5) inventory and the Acceptance of Illness Scale (AIS).Results:The study showed that the acceptance of the illness was positively associated with all of the Mell–Krat components such as sexual need, F = (3.27), frequency of intercourse, F = (2.46), position and technique, F = (1.88). Also, according to the IIEF-5 questionnaire, 84.42% of respondents had erectile dysfunction. Taken together these indicated that psychological adjustments such as acceptance of disease increase quality of all aspects of sexual functions in heart failure patients, including their erectile functions.Conclusions:Our findings suggest that psychological adjustments to feelings of loss associated with the onset of heart failure disease is the important determinant of quality of sexual life among male adults. Our research implicates that effects of AIS on sexual functioning give reasonable information to tailor sexual counselling for males suffering from heart failure.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-11-04T05:44:59Z
      DOI: 10.1177/1474515120944518
       
  • Enablers and barriers for being physically active: experiences from adults
           with congenital heart disease

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      Authors: Annika Bay, Kristina Lämås, Malin Berghammer, Camilla Sandberg, Bengt Johansson
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:In general, adults with congenital heart disease have reduced exercise capacity and many do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and to counteract acquired cardiovascular disease, therefore enablers and barriers for being physically active are important to identify.Aim:To describe what adults with complex congenital heart diseases consider as physical activity, and what they experience as enablers and barriers for being physically active.Methods:A qualitative study using semi-structured interviews in which 14 adults with complex congenital heart disease (seven women) participated. The interviews were analysed using qualitative content analysis.Results:The analysis revealed four categories considered enablers and barriers – encouragement, energy level, approach and environment. The following is exemplified by the category encouragement as an enabler: if one had experienced support and encouragement to be physically active as a child, they were more positive to be physically active as an adult. In contrast, as a barrier, if the child lacked support and encouragement from others, they had never had the opportunity to learn to be physically active.Conclusion:It is important for adults with congenital heart disease to have the opportunity to identify barriers and enablers for being physically active. They need knowledge about their own exercise capacity and need to feel safe that physical activity is not harmful. This knowledge can be used by healthcare professionals to promote, support and eliminate misconceptions about physical activity. Barriers can potentially be transformed into enablers through increased knowledge about attitudes and prerequisites.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-10-30T11:46:52Z
      DOI: 10.1177/1474515120963314
       
  • The influence of dyadic congruence and satisfaction with dyadic type on
           patient self-care in heart failure

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      Authors: Andrew Bugajski, Harleah Buck, Valentina Zeffiro, Hailey Morgan, Laura Szalacha, Rosaria Alvaro, Ercole Vellone
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined.Aims:The purpose of this study was to examine the role of dyadic-type congruence on patient self-care (maintenance, symptom perception, and management) while controlling for actor and partner effects.Methods:This secondary data analysis of 277 dyads consisted of a series of multilevel models to examine the impact of dyadic congruence on a patient’s self-care maintenance, symptom perception, and self-care management. Patient-level and caregiver-level data were input into each model simultaneously to account differential appraisals of factors related to the dyad.Results:Bivariate analyses yielded dyad congruence which was associated with better patient self-care maintenance, symptom perception and management. However, after multilevel models were constructed, dyad congruence was found to be a significant predictor of patient’s symptom perception scores, but not self-care maintenance or management scores. Caregiver’s satisfaction with the dyad was differentially and significantly associated with self-care – it was inversely associated with patient self-care maintenance and positively associated with patient self-care management.Conclusion:This is the first study, to our knowledge, reporting that congruence in heart failure dyads is associated with better patient symptom perception and this advances our prior hypothesis that dyad typologies could be used to predict patient self-care performance. Since symptom perception is the key to preventing heart failure exacerbation, screening heart failure patient and caregiver dyads for congruence is important in clinical settings.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-10-07T07:33:23Z
      DOI: 10.1177/1474515120960002
       
  • Early risk stratification of acute myocardial infarction using a simple
           physiological prognostic scoring system: insights from the REACP study

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      Authors: Dongze Li, Yisong Cheng, Jing Yu, Yu Jia, Fanghui Li, Qin Zhang, Xiaoli Chen, Yongli Gao, Jiang Wu, Lei Ye, Zhi Wan, Yu Cao, Rui Zeng
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:A more accurate and simpler scoring systems for early risk stratification of acute myocardial infarction at admission can accelerate and improve decision-making.Aim:To develop and validate a simple physiological prognostic scoring system for early risk stratification in patients with acute myocardial infarction.Methods:Easily accessible physiological vital signs and demographic characteristics of patients with acute myocardial infarction at the time of presentation in the multicentre Retrospective Evaluation of Acute Chest Pain study were used to develop a multivariate logistic regression model predicting 12 and 24-month mortality. The study population consisted of 2619 patients from seven hospitals and was divided into a 70% sample for model derivation and a 30% sample for model validation. A nomogram was created to enable prospective risk stratification for clinical care.Results:The simple physiological prognostic scoring system consisted of age, heart rate, body mass index and Killip class. The area under the receiver operating characteristic curve of the simple physiological prognostic scoring system was superior to that of several risk scoring systems in clinical use. Net reclassification improvement, integrated discrimination improvement and decision curve analysis of the derivation set also revealed superior performance to the Global Registry of Acute Coronary Events score, and the Hosmer–Lemeshow test indicated good calibration for predicting mortality in patient with acute myocardial infarction in the validation set (P=0.612).Conclusion:This simple physiological prognostic scoring system may be a useful risk stratification tool for early assessment of patients with acute myocardial infarction.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-30T06:28:42Z
      DOI: 10.1177/1474515120952214
       
  • Hostility predicts mortality but not recurrent acute coronary syndrome

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      Authors: Tracey K Vitori, Susan K Frazier, Martha J Biddle, Gia Mudd-Martin, Michele M Pelter, Kathleen Dracup, Debra K Moser
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Hostility is associated with greater risk for cardiac disease, cardiac events and dysrhythmias. Investigators have reported equivocal findings regarding the association of hostility with acute coronary syndrome (ACS) recurrence and mortality. Given mixed results on the relationship between hostility and cardiovascular outcomes, further research is critical.Aims:The aim of our study was to determine whether hostility was a predictor of ACS recurrence and mortality.Methods:We performed a secondary analysis of data (N = 2321) from a large randomized clinical trial of an intervention designed to reduce pre-hospital delay among patients who were experiencing ACS. Hostility was measured at baseline with the Multiple Adjective Affect Checklist (MAACL) and patients were followed for 24 months for evaluation of ACS recurrence and all-cause mortality. We used Cox proportional hazards modeling to determine whether hostility was predictive of time to ACS recurrence or all-cause mortality.Results:The majority of patients were married (73%), Caucasian (97%), men (68%), and had a mean age of 67 ± 11 years. Fifty-seven percent of participants scored as hostile based on the established MAACL cut point (mean score = 7.56 ± 3.8). Hostility was an independent predictor of all-cause mortality (p = < 0.039), but was not a predictor of ACS recurrence (p = 0.792).Conclusion:Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-14T11:05:01Z
      DOI: 10.1177/1474515120950913
       
  • Caregiver experiences of paediatric inpatient cardiac services: A
           qualitative systematic review

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      Authors: Rachel Knight Lozano, Stephen May, Carl Clarkson, Rebecca Sarjeant
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Advances in paediatric care have contributed to an increasing survival of children with complex heart disease. Yet, life-saving management demands prolonged inpatient admissions, which contribute to emotional and psychological distress for parents and other caregivers in a role of main custody.Aim:The purpose of this study was to identify, appraise and synthesise qualitative studies exploring caregivers’ experiences of paediatric inpatient cardiac services, generating an understanding of their needs in hospital and informing priorities for change in healthcare delivery.Methods:Searches were conducted in Medline, Allied and Complimentary Medicine Database, Cumulative Index of Nursing and Allied Health Literature, EMCARE, Scopus, PsychINFO, Proquest, OpenGrey and ETHOs from 2008–2019, reflecting recent advances in cardiac healthcare. Articles were selected using predetermined eligibility criteria dictating qualitative inquiry into caregiver perspectives whilst their child received hospital-based interventions for heart disease. All eligible studies underwent quality appraisal. Framework synthesis was used to analyse and summarise findings.Results:Twenty-seven studies involving 689 caregivers from 11 countries were included. Three overarching themes were identified: ‘emotional capacity to care’, ‘practicalities of caring’, and ‘the bigger picture of caring’.Conclusions:Through analysis and summary of qualitative primary research, this review captures the emotional challenges that caregivers face and practicalities of undertaking a caregiver role, whilst looking after their child with heart disease in hospital. The results widen the context of the caregiver role, encompassing the whole family unit beyond the hospital environment. This review exposes the impact of these challenges on caregiver competence, wellbeing and attachment to their unwell child, informing priorities for development of family-centred paediatric inpatient cardiac services.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-14T07:56:02Z
      DOI: 10.1177/1474515120951974
       
  • Applying the COM-B behaviour model to overcome barriers to heart failure
           self-care: A practical application of a conceptual framework for the
           development of complex interventions (ACHIEVE study)

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      Authors: Amanda Whittal, Stefan Störk, Barbara Riegel, Oliver Rudolf Herber
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Effective interventions to enhance adherence to self-care recommendations in patients with heart failure have immense potential to improve health and wellbeing. However, there is substantial inconsistency in the effectiveness of existing self-management interventions, partly because they lack theoretical models underpinning intervention development.Aim:To outline how the capability, opportunity and motivation behaviour model has been applied to guide the development of a theory-based intervention aiming to improve adherence to heart failure self-care recommendations.Methods:The application of the capability, opportunity and motivation behaviour model involved three steps: (a) identification of barriers and facilitators to heart failure self-care from two comprehensive meta-studies; (b) identification of appropriate behaviour change techniques to improve heart failure self-care; and (c) involvement of experts to reduce and refine potential behaviour change techniques further.Results:A total of 119 barriers and facilitators were identified. Fifty-six behaviour change techniques remained after applying three steps of the behaviour model for designing interventions. Expert involvement (n=39, of which 31 were patients (67% men; 45% New York Heart Association II)) further reduced and refined potential behaviour change techniques. Experts disliked some behaviour change techniques such as ‘anticipated regret’ and ‘salience of consequences’. This process resulted in a final comprehensive list consisting of 28 barriers and 49 appropriate behaviour change techniques potentially enhancing self-care that was put forward for further use.Conclusion:The application of the capability, opportunity and motivation behaviour model facilitated identifying important factors influencing adherence to heart failure self-care recommendations. The model served as a comprehensive guide for the selection and design of interventions for improving heart failure self-care adherence. The capability, opportunity and motivation behaviour model enabled the connection of heart failure self-care barriers to particular behaviour change techniques to be used in practice.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-14T07:55:27Z
      DOI: 10.1177/1474515120957292
       
  • The symptom experience of early and late treatment seekers before an
           atrial fibrillation diagnosis

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      Authors: Ryan E Wilson, Kathy L Rush, R Colin Reid, Carol G Laberge
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Atrial fibrillation is a complex condition associated with a broad spectrum of symptoms, coupled with variability in the frequency, duration and severity of symptoms. Early treatment seeking is important to reduce the risk of stroke, heart failure and dementia. Despite the increasing prevalence, there remains a limited understanding of the symptom experience prior to an atrial fibrillation diagnosis, and how these experiences influence treatment-related decisions and time frames.Aims:This qualitative study aimed to explore the symptom experiences of patients receiving an early diagnosis of less than 48 hours and a late diagnosis of 48 hours or more after symptom awareness.Methods:Twenty-six adults were interviewed guided by the symptom experience model. The symptom checklist was used to probe patient’s symptoms further. Data were analysed using a two-step approach to thematic analysis utilising concepts from the symptom experience model.Results:The two groups differed in their perception, evaluation and response to symptoms. The early diagnosis group (n=6) experienced traumatic, severe and persistent symptoms, evoking concern and urgent treatment seeking. Conversely, the late diagnosis group (n=20) reported more vague, paroxysmal symptoms that were readily ignored, self-theorised as non-illness related, and engaged in non-treatment strategies. Healthy self-perceptions, past experiences, atrial fibrillation knowledge and healthcare provider interactions influenced early or late treatment seeking.Conclusion:For many, the atrial fibrillation pre-diagnosis was a tumultuous period, requiring prolonged periods to recognise symptoms and formulate treatment-seeking responses. This study may promote future research and strategies aimed at facilitating the early identification and response to symptoms among atrial fibrillation patients.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-09T07:17:53Z
      DOI: 10.1177/1474515120952220
       
  • Factors influencing patient decision delay in activation of emergency
           medical services for suspected ST-elevation myocardial infarction

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      Authors: Ahmad Alrawashdeh, Ziad Nehme, Brett Williams, Karen Smith, Michael Stephenson, Stephen Bernard, Janet Bray, Dion Stub
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Objective:The purpose of this study was to identify factors associated with time delay to emergency medical services for patients with suspected ST-elevation myocardial infarction.Methods:This observational study involved 1994 suspected ST-elevation myocardial infarction patients presenting to the emergency medical services in Melbourne, Australia, between October 2011–January 2014. Factors associated with delays to emergency medical services call of >1 h and emergency medical services self-referral were analyzed using multivariable logistic regression.Results:The time of symptom onset was reported for 1819 patients (91.2%), the median symptom onset-to-call time was 52 min (interquartile range=17–176). Of all emergency medical services calls, 17% were referred by healthcare professionals. Compared to self-referred patients, patients who presented to a general practitioner or hospital had higher odds of delay >1 h to emergency medical services activation (adjusted odds ratio 7.76; 95% confidence interval 5.10–11.83; and 8.02; 3.65–17.64, respectively). The other factors associated with emergency medical services call delays of >1 h were living alone, non-English speaking background, a history of substance abuse, less severe symptoms, symptom onset at home and at rest, and self-treatment. Emergency medical services self-referred patients were more likely to be older than 75 years, have a history of ischemic heart disease or revascularization, more severe symptoms, and symptom onset at home, with activity, during the weekends and out-of-hours.Conclusion:Almost one-fifth of emergency medical services calls for suspected ST-elevation myocardial infarction were healthcare referrals, and this was associated with increased delays. A wide range of factors could influence a patient’s decision to directly and rapidly seek emergency medical services. More efforts are needed to educate at-risk populations about early self-referral to the emergency medical services.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-04T06:10:18Z
      DOI: 10.1177/1474515120953737
       
  • Can you see frailty' An exploratory study of the use of a patient
           photograph in the transcatheter aortic valve implantation programme

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      Authors: Sandra B Lauck, Leslie Achtem, Britt Borregaard, Jennifer Baumbusch, Jonathan Afilalo, David A Wood, Jacqueline Forman, Anson Cheung, Jian Ye, John G Webb
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Frailty is an important consideration in the assessment of transcatheter aortic valve implantation patients. The documentation of a patient photograph to augment the objective measurement of frailty has been adopted by some transcatheter aortic valve implantation multidisciplinary (TAVI) programmes.Methods:We used a prospective two-part multimethod study design. In part A, we examined the concordance between the Essential Frailty Toolset (EFT) and the score attributed by healthcare professionals based on visual rating of photographs using kappa estimates and linear regression. In part B, we conducted a content analysis qualitative study to elicit information about how the TAVI multidisciplinary team used photographs to form impressions about frailty.Findings:Part A: 94 healthcare professionals (registered nurses/allied health 65%; physicians 35%) rated 40 representative photographs (women 42.5%; mean age 83.4±7.5; mobility aid 40%) between 0 (robust) and 5 (very frail). The estimate of weighted kappa was 0.2575 (95% confidence interval 0.082–0.433), indicating fair agreement between median healthcare professional visual and EFT score, especially when the EFT was 1 or 4. There was significant discordance among raters (kappa estimate 0.110, 95% confidence interval 0.079–0.141). Age, sex and mobility aid did not have a significant effect on score discordance. Part B: 12 members of the TAVI multidisciplinary team (registered nurses 27.5%; physicians 72.5%) were shown a series of six representative patient photographs. The following themes emerged from the data: (a) looking at the outside; (b) thinking about the inside; (c) use but with caution; and (d) a better approach.Conclusion:A patient photograph offers complementary information to the multimodality assessment of TAVI patients.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-09-04T06:09:41Z
      DOI: 10.1177/1474515120953739
       
  • “In the tube” following sternotomy: A quasi-experimental study

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      Authors: L Park, C Coltman, H Agren, S Colwell, KM King-Shier
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Traditionally, physical movement has been limited for cardiac surgery patients, up to 12-weeks post-operatively. Patients are asked to use “standard sternal precautions,” restricting their arm movement, and thereby limiting stress on the healing sternum.Aim:To compare return to function, pain/discomfort, wound healing, use of pain medication and antibiotics, and post-operative length of hospital stay in cardiac surgery patients having median sternotomy who used standard sternal precautions or Keep Your Move in the Tube movement protocols post-operatively.Methods:A quasi-experimental design was used (100 standard sternal precautions and 100 Keep Your Move in the Tube patients). Patients were followed in person or by telephone over a period of 12-weeks postoperatively. Outcomes were measured at day 7, as well as weeks 4, 8, and 12 weeks.Results:The majority of participants (77% in each group) were male and had coronary artery bypass graft surgery (66% standard sternal precautions and 72% Keep Your Move in the Tube). Univariate analysis revealed the standard sternal precautions group had lesser ability to return to functional activities than the Keep Your Move in the Tube group (p
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-26T05:49:07Z
      DOI: 10.1177/1474515120951981
       
  • The need for palliative and support care services for heart failure
           patients in the community

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      Authors: Freda DeKeyser Ganz, Keshet Roeh, Muhammad Eid, Tal Hasin, Chen Harush, Israel Gotsman
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Palliative care is a care option considered appropriate for those with heart failure, but is uncommon partially due to a lack of timely identification of those needing palliative care. A standard mechanism that triggers which heart failure patients should receive palliative care is not available. The Gold Standards Framework (GSF) identifies those needing palliative care but has not been investigated with heart failure patients.Objectives:To describe palliative care provided in the community and determine whether the GSF can identify heart failure patients in need of palliative care.Methods:Descriptive study. A total of 252 heart failure patients in the community completed a demographic characteristics questionnaire, the Edmonton symptom assessment scale-revised and the Minnesota living with heart failure questionnaire. Clinical data were collected from the medical chart and the primary physician completed the GSF prognostic indicator guidance.Results:Participants had a mean age of 76.9 years (standard deviation 10.9), most at New York Heart Association level III (n=152, 60%). Fewer than half received pain medications (n=76, 30%), anxiolytics (n=35, 14%), antidepressants (n=64, 25%) or sleep medications (n=65, 26%). Eight patients spoke with a psychologist or psychologist (3%). One had an advanced directive and 16 (6%) had a record of discussions with their family caregivers. Three (1%) had end-of-life discussions with their healthcare providers. Most healthcare providers responded ‘no’ to the ‘surprise question’ (n=160, 63%). Sensitivity and specificity of the gold standards framework was poor.Conclusions:Few community dwelling heart failure patients received most aspects of palliative care. The gold standards framework was not a good indicator of those who should receive palliative care.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-26T05:48:40Z
      DOI: 10.1177/1474515120951970
       
  • Symptom experience as a predictor of cardiac rehabilitation education
           programme attendance after percutaneous coronary intervention: A
           prospective questionnaire survey

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      Authors: Ji-Su Kim, Gwang S Kim, Seok-Min Kang, Sang H Chu
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Despite evidence that participation in cardiac rehabilitation programmes after percutaneous coronary intervention is associated with better clinical outcomes, many patients with coronary artery disease do not participate in such programmes. A traditional educational approach is recommended to provide patients with information regarding the benefits of cardiac rehabilitation in relation to their underlying coronary artery disease and modification of risk factors.Aims:The purpose of this study was to examine the role of patient factors (symptom experience and health belief) on cardiac rehabilitation education programme attendance among Korean patients subjected to percutaneous coronary intervention.Methods:A prospective survey was conducted enrolling 173 patients who underwent percutaneous coronary intervention. Information on symptom experience, health belief (perceived susceptibility/severity/benefits/ barriers) and sociodemographic and clinical characteristics was collected at baseline (after percutaneous coronary intervention). Three to four weeks later, information on disease-related knowledge and health behaviour was compared between cardiac rehabilitation education programme attendees and non-attendees.Results:Eighty of 173 (46.2%) patients surveyed attended the cardiac rehabilitation education programme. Symptom experience before percutaneous coronary intervention was the most significant predictor of programme attendance (odds ratio=3.46; 95% confidence interval 1.45–8.27), followed by higher perceived socioeconomic status (odds ratio=2.90; 95% confidence interval 1.28–6.58), perceived susceptibility (odds ratio=1.22, 95% confidence interval 1.08–1.39), perceived benefits (odds ratio=1.09; 95% confidence interval 1.02–1.17) and perceived severity (odds ratio=1.04; 95% confidence interval 1.00–1.08). Better disease-related knowledge and health behaviour were significantly associated with cardiac rehabilitation education programme attendance.Conclusion:This study provides evidence that educational programmes to help improve patients’ perceptions of their disease susceptibility and severity, especially health behaviour benefits in patients without symptom experience before percutaneous coronary intervention, are necessary.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-21T12:00:11Z
      DOI: 10.1177/1474515120940534
       
  • Acute and short-term efficacy of sauna treatment on cardiovascular
           function: A meta-analysis

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      Authors: Zhongyou Li, Wentao Jiang, Yu Chen, Guanshi Wang, Fei Yan, Tao Zeng, Haidong Fan
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Objective:The role of sauna bathing in cardiovascular function treatment has been increasingly explored, but insufficient attention has been paid to its efficacy. We performed a meta-analysis to provide more evidence for the efficacy of sauna treatment in cardiovascular nursing.Methods:Sixteen peer-reviewed journal articles were screened to summarize the efficacy of the sauna on cardiovascular function. Both acute (0–30 min after the sauna) and short-term (2–4 weeks following the sauna treatment) efficacies were investigated.Results:For pooled acute efficacy, body temperature and heart rate significantly (p
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-20T07:00:02Z
      DOI: 10.1177/1474515120944584
       
  • Trajectories and associations between depression and physical activity in
           patients with cardiovascular disease during participation in an
           internet-based cognitive behavioural therapy programme

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      Authors: Peter Johansson, Erland Svensson, Gerhard Andersson, Johan Lundgren
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:There is a lack of knowledge about internet-based cognitive behavioural therapy in patients with cardiovascular disease, and its effects on depressive symptoms and physical activity.Aim:To examine trajectories of depressive symptoms and physical activity, and to explore if these trajectories are linked with the delivery of internet-based cognitive behavioural therapy.Methods:A secondary-analysis of data collected in a randomised controlled trial that evaluated the effects of a 9-week internet-based cognitive behavioural therapy programme compared to an online discussion forum on depressive symptoms in cardiovascular disease patients. Data were collected at baseline, once weekly during the 9-week intervention period and at the 9-week follow-up. The Montgomery Åsberg depression rating scale – self-rating (MADRS-S) was used to measure depressive symptoms. Two modified items from the physical activity questionnaire measuring frequency and length of physical activity were merged to form a physical activity factor.Results:After 2 weeks the internet-based cognitive behavioural therapy group had a temporary worsening in depressive symptoms. At 9-week follow-up, depressive symptoms (P
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-06T05:56:02Z
      DOI: 10.1177/1474515120947250
       
  • Are survivors of cardiac arrest provided with standard cardiac
           rehabilitation' – Results from a national survey of hospitals and
           municipalities in Denmark

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      Authors: Lars H Tang, Vicky Joshi, Cecilie Lindström Egholm, Ann-Dorthe Zwisler
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Aim:To quantify the provision of standard cardiac rehabilitation to Danish survivors of cardiac arrest at a programme level, and to analyse whether organizational factors influenced the provision.Method:We mapped the provision of cardiac rehabilitation core components to survivors of cardiac arrest and compared this with a reference group of patients after acute myocardial infarction using data from a cross-sectional programme-level survey among all hospitals (n=34) and municipalities (n= 98) in Denmark. Organizational factors of potential importance to service provision were considered: health care region, size of catchment area/population, type of department/municipality and socioeconomic index.Results:Response rates for the provision of each core component of cardiac rehabilitation ranged from 64% to 98%. All hospitals and municipalities provided some aspect of cardiac rehabilitation to survivors of cardiac arrest. Across hospitals, provision of four core components of cardiac rehabilitation to survivors of cardiac arrest was lower compared with post acute myocardial infarction patients: patient education (relative risk (RR) =0.45 (95% confidence interval (CI) 0.27 to 0.75)), exercise training (RR=0.69 (95% CI 0.49 to 0.98)), screening for anxiety and depression (RR=0.64 (95% CI 0.46 to 0.90) and nutritional counselling RR=0.76 (95% CI 0.62 to 0.93)). No difference was found in the provision of core components across municipalities. Overall, the provision of cardiac rehabilitation to survivors of cardiac arrest was not affected by organizational factorsConclusion:This study indicates a need for future research to inform the development, adoption and implementation of equal access to all components of cardiac rehabilitation for survivors of cardiac arrest in Denmark
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-04T06:10:37Z
      DOI: 10.1177/1474515120946313
       
  • Care needs, social support and meaning in life in patients after acute
           heart failure hospitalisation: a longitudinal study

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      Authors: Min-Hui Liu, Chao-Hung Wang, Tao-Hsin Tung, Chii-Ming Lee, Ai-Fu Chiou
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Meaning in life serves as a protective mechanism for coping with persistent, often distressful symptoms in patients with heart failure. However, meaning in life and its associated factors are not adequately explored in patients after acute hospitalisation for heart failure.Aims:To explore the associated factors of meaning in life in patients with heart failure from acute hospitalisation to 3 months post-discharge.Methods:A total of 103 hospitalised patients with heart failure in Northern Taiwan were recruited using a longitudinal study design and interviewed with structured questionnaires including meaning in life, symptom distress, care needs, and social support at hospitalisation, 1 month and 3 months post-discharge.Results:A total of 83 patients completed the 3 months follow-up. The presence of meaning in life significantly increased from hospitalisation to 3 months post-discharge. Decreases in care needs (B=−0.10, P=0.020) and social support (B=−0.18, P=0.016) from hospitalisation to 3 months post-discharge were significantly associated with an increase in the presence of meaning in life, while a decrease in social support was associated with an increase in the search for meaning in life (B=−0.17, P=0.034).Conclusion:Care needs and social support were pivotal factors for developing meaning in life for patients with heart failure. Assessments of care needs and social support might help strengthen their meaning in life.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-08-04T06:10:08Z
      DOI: 10.1177/1474515120945478
       
  • HeartBeat

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      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.

      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-18T08:45:53Z
      DOI: 10.1177/1474515120944332
       
  • A single educational intervention on heart failure self-care: Extended
           follow-up from a multisite randomized controlled trial

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      Authors: Hiba Deek, Samar Noureddine, Dalia Allam, Phillip J Newton, Patricia M Davidson
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Heart failure outcomes remain poor, and little is known about the causes and predictors of these outcomes in Lebanon.Aim:The purpose of this article is to report the causes and predictors of the 6- and 12-month readmission and mortality of previously recruited patients to the Family focused Approach to iMprove Heart Failure care In LebanonQualitY intervention (FAMILY) study.Methods:A multi-site block randomized controlled trial in three tertiary medical centers in Beirut. Initially, participants were randomized to either the control or the intervention group. The latter group, with their family caregivers, received heart failure self-care resources and an educational intervention on self-care and symptom management during their index admission. Participants from the FAMILY study were followed up with through phone calls for readmission and mortality at 6 and 12 months following their hospital discharge.Results:A total of 218 (85%) patients were followed up with for this evaluation. There was a significant difference between the intervention group and the control group in terms of mortality at 6 months (n=18 (16%) versus n=36 (33%); p
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-17T10:05:16Z
      DOI: 10.1177/1474515120941645
       
  • Association between sleep quality and self-care in adults with heart
           failure: A systematic review

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      Authors: Valentina Spedale, Michela Luciani, Alessandro Attanasio, Stefania Di Mauro, Rosaria Alvaro, Ercole Vellone, Davide Ausili
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Sleep disturbance is one of the most common symptoms among heart failure patients. Sleep disturbance reduces quality of life and leads to higher rates of mortality. It may affect the ability of patients to perform adequate self-care. Although some research has evaluated the association between sleep quality and heart failure self-care, a synthesis of the most recent available evidence is lacking.Aims:This systematic review aimed to assess the association between sleep quality and self-care in adults with heart failure.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was used. Medline, CINAHL, PsycINFO and SCOPUS were searched. Observational, case-control and cohort studies were considered. The quality of the studies was evaluated with the Joanna Briggs Institute’s Critical Appraisal Tools.Results:Six articles were included. Association between sleep quality and self-care was reported by three studies. One of these did not find an association between sleep disturbance and heart failure self-care, while the other two studies did. An association between sleep quality and medication adherence was reported by three studies. All three of these studies found associations between these two variables. Studies have measured similar but different constructs. Two studies assessed sleep quality, while four other studies measured excessive daytime sleepiness. Half of the studies examined self-care, while the other half measured medication adherence.Conclusions:Although the evidence should be strengthened, sleep quality seems to affect self-care in heart failure patients. The mechanism underlying the effect of sleep quality on heart failure self-care remains unclear. Future longitudinal interaction analyses could be useful to clarify this mechanism.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-16T08:21:38Z
      DOI: 10.1177/1474515120941368
       
  • Undiagnosed sleep apnoea in cardiac rehabilitation: Age-dependent effect
           on diastolic function in coronary artery disease patients with preserved
           ejection fraction

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      Authors: Audrius Alonderis, Nijole Raskauskiene, Vaidute Gelziniene, Violeta Zaliunaite, Julija Brozaitiene
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Focusing on detection of sleep apnoea early in the cardiac rehabilitation process may improve the recovery process and reduce recurrence of cardiovascular events. Patients who continue to be undiagnosed may experience a significantly worse outcome during their cardiac rehabilitation and recovery. Diastolic dysfunction has both diagnostic and prognostic importance in the management of coronary artery disease. We hypothesise that undiagnosed/untreated sleep apnoea in middle-aged coronary artery disease patients with preserved left ventricular ejection fraction changes the pattern of diastolic filling close to that in elderly patients without sleep apnoea.Methods and results:This cross-sectional study included the 450 coronary artery disease patients with undiagnosed sleep apnoea who had left ventricular ejection fraction ⩾50% and were referred consecutively to the Clinic of Cardiovascular Rehabilitation within two weeks after treatment for acute coronary syndrome. Polysomnographic and echocardiographic measurements were analysed. Mild to severe sleep apnoea was defined as the apnoea-hypopnea index ⩾5. Age was dichotomised into under the age of 60 years and age 60 years or over. Up to 35% of coronary artery disease patients were likely to have undiagnosed sleep apnoea. There was a statistically significant interaction between the effect of sleep apnoea and age group on diastolic function defined as the ratio peak flow velocity in early diastole/peak flow velocity in atrial contraction ratio (p=0.036). This ratio was significantly (p=0.029) lower in the mild-severe sleep apnoea group (0.97, 95% confidence interval 0.88–1.06) than in the non-sleep apnoea group (1.09, 95% confidence interval 1.03–1.15) among middle aged (
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-15T09:56:57Z
      DOI: 10.1177/1474515120941373
       
  • Fear of graft rejection after heart transplantation – a nationwide
           cross-sectional cohort study

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      Authors: Anna Forsberg, Annika M Kisch, Annika Paulsson, Cecilia Ragntoft, Marita Dalvindt, Annette Lennerling
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Cellular rejection is most common 3–6 months after heart transplantation while chronic rejection, that is, cardiac allograft vasculopathy and malignancy are the most common causes of death in heart-transplant recipients beyond the third year after transplantation. However, the heart transplantation recipient’s perceived threat of graft rejection has never been explored.Aim:The aim was to explore perceived threat of the risk of graft rejection and its relationship to psychological wellbeing, fatigue, health literacy, adherence and self-efficacy 1–5 years after heart transplantation.Methods:In a nationwide, cross-sectional study that constituted part of the Self-management after thoracic transplantation project, 79 heart recipients (68% men and 32% women with a mean age of 52.6 years) were investigated after one year (n=28), two years (n=17), three years (n=11), four years (n=17) and five years (n=6). The instruments used were: the Perceived Threat of the Risk of Graft Rejection, the Psychological General Well-being, Self-efficacy for Managing Chronic Disease, the Multidimensional Fatigue Inventory, the Newest Vital Sign and the Basel Assessment of Adherence to Immunosuppressive Medication Scale.Results:Twenty-eight per cent of the heart transplantation recipients perceived graft rejection as a serious threat. Intrusive anxiety was low and 37% perceived the threat of the risk of graft rejection as being beyond their control. Heart transplant recipients with high level of fatigue and low psychological well-being reported stronger intrusive anxiety and less control.Conclusion:A perceived threat of the risk of graft rejection is present in the everyday lives of heart transplantation recipients and is strongly related to overall psychological well-being.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-08T11:04:00Z
      DOI: 10.1177/1474515120937838
       
  • Impact of a mobile phone app on adherence to treatment regimens among
           hypertensive patients: A randomised clinical trial study

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      Authors: Nasser Ibrahim Abu-El-Noor, Yousef Ibrahim Aljeesh, Bettina Bottcher, Mysoon Khalil Abu-El-Noor
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Hypertension is one of the most prevalent long-term diseases seen in many countries, including Palestine. Patients with poorly controlled blood pressure are more likely to develop several complications. Therefore; it is imperative to control their blood pressure by improving their adherence to the treatment regimen.Aim:The objective of this study was to evaluate the impact of using a mobile phone app on the level of adherence to treatment regimens among hypertensive patients in the Gaza Strip.Methods and results:This study used an experimental design with a pre and post-intervention assessment. Using the Hill–Bone compliance to high blood pressure therapy scale, 191 participants completed the study: 94 in the control group and 97 in the intervention group. The intervention group used a phone app which reminds participants to take their medication, reminding them about their follow-up appointments and sending educational information about hypertension management. After 3 months of intervention, the level of adherence to treatment was reassessed. Results showed that participants in both groups showed a significant improvement in adherence levels, with higher improvements in the intervention group in the total score as well as all three domain scores: adherence to medication, diet and keeping appointments.Conclusion:The use of a mobile phone app resulted in improvements in adherence to hypertension treatment. Thus, this study confirms the potential effectiveness of mobile technology in improving treatment adherence in hypertension and an opportunity to reduce cardiovascular mortality and morbidity. However, wider adoption has to be accompanied by ongoing evaluation and integration in public health systems.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-07-07T08:31:35Z
      DOI: 10.1177/1474515120938235
       
  • Effectiveness of dyadic interventions to improve stroke
           patient–caregiver dyads’ outcomes after discharge: A systematic review
           and meta-analysis study

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      Authors: Gianluca Pucciarelli, Marzia Lommi, Gayenell S Magwood, Silvio Simeone, Sofia Colaceci, Ercole Vellone, Rosaria Alvaro
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      BackgroundBecause of the importance of a dyadic approach, it is necessary to conduct a systematic review to identify which dyadic intervention could be implemented for stroke survivor–caregiver dyads after discharge from the rehabilitation hospital to improve outcomes.AimsThe aims were to systematically review the evidence to identify which dyadic interventions have been implemented in stroke survivor–caregiver dyads to improve stroke survivor–caregiver dyads’ outcomes and to analyse, through a meta-analysis, which intervention was found to be the most effective.MethodsA systematic review and meta-analysis were conducted using the following electronic databases: PubMed, CINAHL and PsycInfo. Randomized controlled trials (RCTs) and quasi-RCT studies published within the last 10 years were included. Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Pooled effects were analysed between the experimental and control groups for each outcome.ResultsSixteen studies involving 2997 stroke survivors (male gender=58%) and 2187 caregivers (male gender=25%) were included in this review. In 16 studies, which were subdivided into three quasi-RCTs and 13 RCTs, the application of dyadic interventions for stroke survivors and caregivers was systematically reviewed, but only a few of these identified a significant improvement in the stroke survivors’ and caregivers’ outcomes of its intervention group. Dyadic interventions showed a significant effect on stroke survivors’ physical functioning (p=0.05), memory (p
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-21T05:54:23Z
      DOI: 10.1177/1474515120926069
       
  • Pre-hospital versus hospital acquired HEART score for risk classification
           of suspected non ST-elevation acute coronary syndrome

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      Authors: Dominique N van Dongen, Erik A Badings, Marion J Fokkert, Rudolf T Tolsma, Aize van der Sluis, Robbert J Slingerland, Arnoud WJ van’t Hof, Jan Paul Ottervanger
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      IntroductionAlthough increasing evidence shows that in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) both hospital and pre-hospital acquired HEART (History, ECG, Age, Risk factors, Troponin) scores have strong predictive value, pre-hospital and hospital acquired HEART scores have never been compared directly.MethodsIn patients with suspected NSTE-ACS, the HEART score was independently prospectively assessed in the pre-hospital setting by ambulance paramedics and in the hospital by physicians. The hospital HEART score was considered the gold standard. Low-risk (HEART score ≤3) was considered a negative test. Endpoint was occurrence of major adverse events within 45 days.ResultsA total of 699 patients were included in the analyses. In 516 (74%) patients pre-hospital and hospital risk classification was similar, in 50 (7%) pre-hospital risk classification was false negative (45 days mortality 0%) and in 133 (19%) false positive (45 days mortality 1.5%). False negative risk classifications were caused by differences in history (100%), risk factor assessment (66%) and troponin (18%) and were more common in older patients. Occurrence of major adverse events was comparable in pre-hospital and hospital low-risk patients (2.9% vs. 2.7%, p = 0.9). Incidence of major adverse events was 0% in the true negative group, 26% in the true positive group, 10% in the false negative group and 5% in the false positive group. Predictive value of both pre-hospital and hospital acquired HEART scores was high, although the ‘area under the curve’ of hospital acquired HEART score was higher (0.84 vs. 0.74, p 
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-16T02:30:36Z
      DOI: 10.1177/1474515120927867
       
  • Cognitive impairment and psychological state in acute coronary syndrome
           patients: A prospective descriptive study at cardiac rehabilitation entry,
           completion and follow-up

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      Authors: Robyn Gallagher, Anna Woolaston, Geoffrey Tofler, Adrian Bauman, Emma Zhao, Yun-Hee Jeon, Lis Neubeck, Julie-Anne Mitchell, Sharon L Naismith
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      BackgroundCognitive impairment may limit the uptake of secondary prevention in acute coronary syndrome patients, but is poorly understood, including in cardiac rehabilitation participants.AimThe aim of this study was to explore cognitive impairment in relation to psychological state in acute coronary syndrome patients over the course of cardiac rehabilitation and follow-up.MethodsAcute coronary syndrome patients without diagnosed dementia were assessed on verbal learning, processing speed, executive function and visual attention, at cardiac rehabilitation entry, completion and follow-up and scores adjusted using normative data. The hospital anxiety and depression scale measured psychological state.ResultsParticipants (n = 40) had an average age of 66.2 (±8.22) years and were 70% men. Mild cognitive impairment occurred at cardiac rehabilitation entry in single 62.5% and multiple 22.5% domains but was significantly less prevalent by cardiac rehabilitation completion (52.5% and 15.0%) and follow-up (32.5% and 7.0%). Domains most often impaired were verbal learning (52.5%) and processing speed (25.6%), again decreasing significantly with time (verbal learning cardiac rehabilitation completion 42.5%, follow-up 22.5%; processing speed cardiac rehabilitation completion 15.0%, follow-up 15.0%). A small group of patients had persistent multiple domain cognitive impairment. At cardiac rehabilitation entry patients with cognitive impairment in processing speed, a single domain or multiple domains had more depression, and patients with cognitive impairment in executive function had more depression and anxiety.ConclusionsAt cardiac rehabilitation entry, mild cognitive impairment is very common in post-acute coronary syndrome patients and worse in patients who have depression or anxiety symptoms. Cognitive impairment decreases significantly by cardiac rehabilitation follow-up. A small proportion of patients has persistent, multiple domain cognitive impairment flagging potential long-term changes and the need for further investigations and cognitive rehabilitation.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-16T02:30:35Z
      DOI: 10.1177/1474515120933105
       
  • Factors associated with self-care behaviours among Koreans with heart
           failure

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      Authors: Choung Ryou, Seok-Min Kang, Yeonsoo Jang
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      Background:Self-care behaviours are important to improve health outcomes in patients with heart failure. However, little is known about the factors related to the subdimensions of self-care behaviours in these patients.Aims:To identify the factors associated with the subdimensions of self-care behaviours among South Korean patients with heart failure.Methods:The participants in this cross-sectional descriptive study conducted between October 2016 and January 2017 were 178 patients with heart failure. Self-care behaviours were measured using the EHFScB-9, which has three subdimensions: autonomy-based adherence; provider-directed adherence; and consulting behaviours. Demographic characteristics, experience of heart failure education, physical function, patient health questionnaire-9, Pittsburgh sleep quality index and self-care confidence were also measured. Descriptive statistics and multiple linear regression analysis were conducted.Results:The mean age was 62 ± 12 years, and 37% were women. Younger age (P=0.023), no experience of heart failure education (P=0.039), poor physical function (P=0.003), poor sleep quality (P=0.037) and lower self-care confidence (P=0.001) were significantly associated with poor autonomy-based adherence. Being employed (P=0.042), poor sleep quality (P=0.042) and lower levels of self-care confidence (P=0.001) were associated with poor provider-directed adherence. Younger age (P=0.001) and lower self-care confidence (P=0.001) were associated with lower engagement in consulting behaviours.Conclusion:The three subdimensions of self-care behaviours were associated with different psychosocial factors, necessitating the development of tailored interventions and educational materials based on unique self-care behaviour patterns in patients with heart failure.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-15T10:01:28Z
      DOI: 10.1177/1474515120934060
       
  • Sense of coherence in adults with congenital heart disease in 15
           countries: Patient characteristics, cultural dimensions and quality of
           life

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      Authors: Philip Moons, Silke Apers, Adrienne H. Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Maayke A. Sluman, Jou-Kou Wang, Jamie L. Jackson, Paul Khairy, Stephen C. Cook, Shanthi Chidambarathanu, Luis Alday, Erwin Oechslin, Katrine Eriksen, Mikael Dellborg, Malin Berghammer, Bengt Johansson, Andrew S. Mackie, Samuel Menahem, Maryanne Caruana, Gruschen Veldtman, Alexandra Soufi, Susan M. Fernandes, Kamila White, Edward Callus, Shelby Kutty, Koen Luyckx
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      BackgroundPrevious studies have found that sense of coherence (SOC) is positively related to quality of life (QoL) in persons with chronic conditions. In congenital heart disease (CHD), the evidence is scant.AimsWe investigated (i) intercountry variation in SOC in a large international sample of adults with CHD; (ii) the relationship between demographic and clinical characteristics and SOC; (iii) the relationship between cultural dimensions of countries and SOC; and (iv) variation in relative importance of SOC in explaining QoL across the countries.MethodsAPPROACH-IS was a cross-sectional, observational study, with 4028 patients from 15 countries enrolled. SOC was measured using the 13-item SOC scale (range 13–91) and QoL was assessed by a linear analog scale (range 0–100).ResultsThe mean SOC score was 65.5±13.2. Large intercountry variation was observed with the strongest SOC in Switzerland (68.8±11.1) and the lowest SOC in Japan (59.9±14.5). A lower SOC was associated with a younger age; lower educational level; with job seeking, being unemployed or disabled; unmarried, divorced or widowed; from a worse functional class; and simple CHD. Power distance index and individualism vs collectivism were cultural dimensions significantly related to SOC. SOC was positively associated with QoL in all participating countries and in the total sample, with an explained variance ranging from 5.8% in Argentina to 30.4% in Japan.ConclusionIn adults with CHD, SOC is positively associated with QoL. The implementation of SOC-enhancing interventions might improve QoL, but strategies would likely differ across countries given the substantial variation in explained variance.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-11T10:21:42Z
      DOI: 10.1177/1474515120930496
       
  • Self-efficacy, recovery and psychological wellbeing one to five years
           after heart transplantation: a Swedish cross-sectional study

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      Authors: Matilda Almgren, Pia Lundqvist, Annette Lennerling, Anna Forsberg
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      BackgroundSelf-efficacy refers to a person´s confidence in carrying out treatment-related activities and constitutes the foundation of self-management as well as long-term follow-up after heart transplantation. Exploring the heart recipients´ experiences by means of self-report instruments provides healthcare professionals with valuable information on how to supply self-management support after heart transplantation.AimsThe aim was to explore self-efficacy in relation to the self-reported level of recovery and psychological wellbeing, among adult heart recipients, one to 5 years after transplantation.MethodsThis cross-sectional study includes 79 heart recipients, due for follow-up one to 5 years after transplantation. Three different self-assessment instruments were employed: the self-efficacy for managing chronic disease 6-item scale; the postoperative recovery profile; and the psychological general wellbeing instrument.ResultsThe reported level of self-efficacy was high (median 8.3, maximum score 10). Significantly higher self-efficacy was seen among those who had returned to work (P = 0.003) and those without pre-transplant mechanical circulatory support (P = 0.033). In total, 65.5% (n = 52) reported being reasonably recovered, while 18.8% (n = 12) were not recovered. The median total psychological general wellbeing score was 108 (P25 = 24, P75 = 117), suggesting overall good psychological wellbeing in the whole group of heart recipients.ConclusionThe heart transplant recipients in our study had an overall high level of self-efficacy. Low self-efficacy was found among those with a low self-reported level of recovery, pre-transplant treatment with mechanical circulatory support or who had not returned to work. This is important information for transplant professionals when helping heart recipients to balance their expectations about recovery.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-06-09T12:21:53Z
      DOI: 10.1177/1474515120927121
       
  • Self-care and related factors associated with left ventricular systolic
           function in patients under follow-up after myocardial infarction

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      Authors: Sun Hwa Kim, Seon Young Hwang, Jeong-Hun Shin, Young-Hyo Lim
      Abstract: European Journal of Cardiovascular Nursing, Ahead of Print.
      BackgroundRecent advances in treatment have led to long-term survival after myocardial infarction (MI), but subsequent complications such as heart failure have also increased, and, therefore, the relationship between prognosis and self-care needs to be investigated.AimsThis study aimed to confirm the relationship of potential variables affecting self-care of patients after MI and to determine whether self-care predicts left ventricular systolic function.MethodsUsing a descriptive study design, a hypothetical model was constructed based on previous studies, and 191 post-MI patients were recruited from three university hospital outpatient clinics in Korea. The modified model was verified by constructing a structural equation model using AMOS version 24.0. The exogenous variables were illness perception, social support, and depression symptoms. The endogenous variables were self-efficacy, self-care compliance, and changes in left ventricular ejection fraction (LVEF).ResultsThe average patient age and disease duration were 66.3 (±11.5) years and 62.1 (±56.6) months, respectively. Self-care compliance was directly influenced by self-efficacy and indirectly affected by social support. Self-care compliance had a direct effect on LVEF changes, which was indirectly associated with illness perception, social support, and self-efficacy.ConclusionThis study confirmed the direct effect of self-care compliance on changes in LVEF in patients under follow-up after MI. It is necessary to periodically monitor the degree of self-care in outpatients who are undergoing follow-up after MI to prevent a decrease in cardiac function. Counseling and education may be effective forms of social support to improve disease awareness and self-efficacy among patients with low self-care compliance.
      Citation: European Journal of Cardiovascular Nursing
      PubDate: 2020-05-13T02:56:37Z
      DOI: 10.1177/1474515120923201
       
 
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