| 1. |
- Jaarsma, Tiny, et al.
(författare)
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Sexual function in patients with advanced heart failure
- 1996
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Ingår i: Heart & Lung. - 0147-9563 .- 1527-3288. ; 25:4, s. 262-270
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the effect of low ejection fraction on sexual function and the relation between alterations in sexual function and pertinent clinical, demographic, and psychosocial variables in patients with advanced heart failure. DESIGN: This study was descriptive and correlational in design. SETTING: The setting was an outpatient clinic of a university-affiliated hospital. SUBJECTS: Sixty-two male (82%) and female (18%) patients with advanced heart failure (New York Heart Association [NYHA] class III or IV) were studied. MEASURES: Exercise tolerance and symptom severity were assessed by the 6-minute walk and NYHA classification. Ejection fraction was measured by echocardiography. Alterations in the patients' emotional, social, and sexual function were assessed with the self-report version of the Psychosocial Adjustment to Illness Scale. RESULTS: Approximately three quarters of the patients reported a marked decrease in sexual interest and in the frequency of sexual relations caused by illness, with one quarter having ceased all sexual activity. Half the patients described having experienced marked reductions, after heart failure developed, in the pleasure or satisfaction they normally experienced from sex. Few patients had arguments with their spouses about sex or reported significant marital problems as a result of their illness. A significant relation was documented between patients' sexual function and the results of the 6-minute walk (r = 0.32, p < 0.005), as well as between sexual function and NYHA functional class (r = 0.21, p < 0.05). Sexual function was also related to the patient's social environment (r = 0.59, p < 0.001), psychologic distress (r = 0.38, p < 0.001), and domestic environment (r = 0.29, p < 0.05). No significant differences in sexual function were noted when patients were compared on the basis of differences in ejection fraction, medications, gender, or age. CONCLUSION: Advanced heart failure results in marked changes in libido and in the ability to perform sexually. These changes do not affect the marital relationship negatively, at least in the view of the patient. As patients' symptoms of heart failure become increasingly more severe, physicians and nurses need to counsel patients and their spouses about the changes they may experience in their sexual relationships. Attention needs to focus on ways to cope with the decreasing physical status that accompanies advanced heart failure to minimize negative changes in sexual functioning.
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| 2. |
- Agerström, Jens, et al.
(författare)
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All else equal : Examining treatment bias and stereotypes based on patient ethnicity and socioeconomic status using in-hospital cardiac arrest clinical vignettes
- 2024
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Ingår i: Heart and Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 63, s. 86-91
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research on ethnic and socioeconomic treatment differences following in-hospital cardiac arrest (IHCA) largely draws on register data. Due to the correlational nature of such data, it cannot be concluded whether detected differences reflect treatment bias/discrimination – whereby otherwise identical patients are treated differently solely due to sociodemographic factors. To be able to establish discrimination, experimental research is needed. Objective: The primary aim of this experimental study was to examine whether simulated IHCA patients receive different treatment recommendations based on ethnicity and socioeconomic status (SES), holding all other factors (e.g., health status) constant. Another aim was to examine health care professionals’ (HCP) stereotypical beliefs about these groups. Methods: HCP (N = 235) working in acute care made anonymous treatment recommendations while reading IHCA clinical vignettes wherein the patient's ethnicity (Swedish vs. Middle Eastern) and SES had been manipulated. Afterwards they estimated to what extent hospital staff associate these patient groups with certain traits (stereotypes). Results: No significant differences in treatment recommendations for Swedish versus Middle Eastern or high versus low SES patients were found. Reported stereotypes about Middle Eastern patients were uniformly negative. SES-related stereotypes, however, were mixed. High SES patients were believed to be more competent (e.g., respected), but less warm (e.g., friendly) than low SES patients. Conclusions: Swedish HCP do not seem to discriminate against patients with Middle Eastern or low SES backgrounds when recommending treatment for simulated IHCA cases, despite the existence of negative stereotypes about these groups. Implications for health care equality and quality are discussed.
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| 3. |
- Andersson, Sven Ingmar, et al.
(författare)
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Perspectives that lay persons with and without health problems show toward coronary heart disease: An integrated biopsychosocial approach.
- 2007
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Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; 36:5, s. 330-338
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We studied what patients with acute coronary heart disease (CHD) considered the three most stressful factors experienced during the month before testing and what they attributed their heart disease to. Methods: We studied the occurrence and severity of physiologic, psychologic, and psychosocial stressors in 117 patients with acute CHD and 117 referents, not diagnosed with CHD, matched by age,, sex, and municipality. The subjects were first to select the factors they considered stressful from a list of potentially stressful factors. They were then to select the three they regarded as most stressful and to provide situational accounts of these. Results: The patients with CHD were found to less frequently live with a partner, to more frequently have a body mass index higher than 30.0, and to report a greater number of stressors. The stressors best differentiating them from the referents were fatigue, shortness of breath, pain, and high blood pressure. The causal factors they most frequently named were heart problems, smoking, heredity, high workload, and poor eating habits. Conclusions: The situational accounts the patients provided illustrate the biopsychosocial complexities involved in the various categories of stressful factors.
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| 4. |
- Annema, Coby, et al.
(författare)
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Reasons for readmission in heart failure : Perspectives of patients, caregivers, cardiologists, and heart failure nurses.
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:5, s. 427-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Despite efforts to improve outcomes in heart failure (HF), readmission rates remain relatively high. Reasons for readmission from different perspectives (patient, caregiver, health care providers) may help to optimize the future management of patients with HF. The aims of this study are to 1) gain insight into reasons for HF readmission from the perspective of patients, caregivers, cardiologists, and HF nurses; 2) examine similarities and differences in perspectives on the reason for an HF readmission, and 3) describe possibilities to prevent an HF readmission from different perspectives. METHODS AND RESULTS: Data on reasons for readmission were collected on 173 readmissions. Perspectives of patients, caregivers, cardiologists, and HF nurses were collected by interview and questionnaire. Worsening HF as the sole reason for readmission was reported most often; however, 36% of caregivers, 56% of patients, and 63% to 65% of health care providers indicated that other factors, such as comorbidity, nonadherence, and nonoptimal medication, were important contributing factors. In only 34% of readmissions, patients and their caregivers agreed with health care providers on the underlying reason. Respondents reported that 23% to 31% of the readmissions could probably have been prevented if adherence were higher, patients requested help earlier, and adequate multidisciplinary professional help were available. CONCLUSION: To prevent future readmissions of patients with HF, it is important to fully understand the reasons for readmission by gaining insight on the reason for readmission from different perspectives. Also, we may need another approach to prevent adverse outcomes in which other medical problems and new strategies to improve adherence have to be considered.
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| 5. |
- Axelsson, Malin, 1964-
(författare)
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Personality and reasons for not using asthma medication in young adults
- 2013
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 42:4, s. 241-246
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify young adults' stated reasons for not taking asthma medication and to determine the significance of personality, asthma control and health-related quality of life in relation to these stated reasons. Background: Reasons for non-adherence to asthma medication treatment have previously been studied, but research on the significance of personality in relation to stated reasons for not taking asthma medication is limited. Methods: Young adults with asthma (age 22years; n=216) stated their most common reasons for not taking asthma medication and completed postal questionnaires on personality, asthma control and health-related quality of life (HRQL). Results: The most common reason for non-adherence was ". No perceived need" (n=141). Participants giving this reason for not taking asthma medication scored lower on the personality trait Negative Affectivity and reported both higher asthma control and higher mental HRQL. "Insufficient routines" was the second most common reason (n=66), and participants stating it scored higher on Negative Affectivity and reported lower asthma control. An increase in asthma control increased the odds of stating ". No perceived need" as the reason for not taking asthma medication. An increase in Negative Affectivity was associated with an increase in the odds of giving ". Insufficient routines" as a reason. Conclusions: The personality trait Negative Affectivity and perceived asthma control played a role in the young adults' stated reasons for not taking asthma medication, which indicates that these parameters are of importance to young adults' medication management. © 2013 Elsevier Inc.
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| 6. |
- Bengtson, Ann, 1947, et al.
(författare)
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Cardiovascular and psychosomatic symptoms among relatives of patients waiting for possible coronary revascularization.
- 1996
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Ingår i: Heart & Lung: Journal of Acute & Critical Care. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 25:6, s. 438-43
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the consequences for close family members of patients on a waiting list for possible coronary revascularization. BACKGROUND: An increasing number of patients with symptomatic ischemic heart disease require evaluation for possible revascularization. Many of these patients must wait a long time before receiving treatment. The negative consequences of this long wait for patients and their relatives have not been satisfactorily evaluated previously. DESIGN: Cross-sectional descriptive study. SETTING: All hospitals in Southwestern Sweden. STUDY POPULATION: One hundred relatives of patients referred for possible revascularization and a sex- and age-matched reference group. The convenience sample consisted of 85% (n = 76) women and 15% (n = 13) men. OUTCOME MEASURES: Frequency of cardiovascular and psychosomatic symptoms. EVALUATION: One hundred relatives and 100 members of the control group were sent a questionnaire to evaluate their clinical condition; working situation; use of tobacco, alcohol and sedatives; and cardiovascular and psychosomatic symptoms. RESULTS: Family members had a significantly higher frequency of anxiety, depression, and irritability compared with the control group. Furthermore, family members reported sleeping disorders, including difficulty waking, tiredness due to lack of sleep, and restless sleep, more frequently than did the control group. CONCLUSION: Close family members of patients waiting for coronary revascularization have particular difficulties, and these difficulties should receive more attention.
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| 7. |
- Bergman, Eva, et al.
(författare)
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Longitudinal study of patients after myocardial infarction : Sense of coherence, quality of life, and symptoms
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:2, s. 129-140
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Myocardial infarction has pronounced effects on an individual that demand changes in lifestyle. Health is influenced by whether the individual experiences the world as comprehensible, meaningful, and manageable, that is, has a sense of coherence (SOC). High SOC scores indicate that the individual probably manages the situation by understanding the context and connections: action and effect. OBJECTIVE: The study objective was to identify the SOC, assess the quality of life (Short Form-12 Health Survey Questionnaire), assess the symptoms using the Seattle Angina Questionnaire, and create health curves from a baseline for patients with a first myocardial infarction. METHODS: A longitudinal and predictive Study of 100 participants in the heart care unit of a county hospital in southern Sweden was performed. RESULTS: Women score lower on SOC than men. Persons with high SOC scores have fewer angina attacks, are more physically active, drink more alcohol, are more satisfied with their treatments, and have better disease perception. CONCLUSION: By following SOC scores, a trend emerges that Suggests it may be a useful tool for identifying those who will need extra support.
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| 8. |
- Blohm, M, et al.
(författare)
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Reaction to a media campaign focusing on delay in acute myocardial infarction
- 1991
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 20:6, s. 661-666
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Tidskriftsartikel (refereegranskat)abstract
- A media campaign conducted to reduce delay time and to increase the use of ambulance transport in acute myocardial infarction was performed in an urban area with about half a million inhabitants during 1 year. The main message was that chest pain lasting more than 15 minutes might indicate acute myocardial infarction; dial 90,000 immediately for ambulance transport to the hospital. The target population was the general public. After 6 and 12 months 400 and 610 randomly chosen persons, respectively, were contacted by telephone to evaluate the reaction of the general public to the campaign. Of these, 60% and 71%, respectively, had heard of the campaign, and all parts of the message were spontaneously remembered by 15% and 19%, respectively. The reaction to the campaign was generally positive. Among all patients admitted to the coronary care unit of one of the two city hospitals, 65% were aware of the campaign and 31% of them were of the opinion that they came to the hospital faster because of the campaign. In conclusion, a media campaign aimed at reducing patient delay time in acute myocardial infarction was shown to reach a majority of people in the community and patients with ischemic heart disease. The reaction was positive and about one fifth of interviewed people spontaneously remembered the total message.
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| 9. |
- Bui, Quan M., et al.
(författare)
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The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
- 2019
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Ingår i: Heart and Lung. - : Elsevier BV. - 0147-9563. ; 48:2, s. 85-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Stanford integrated psychosocial assessment for transplantation (SIPAT) is a validated psychosocial evaluation tool in the transplant population. Objective: We evaluated SIPAT in predicting post-left ventricular assist device (LVAD) outcomes, including cumulative re-admissions, driveline infections, pump malfunction, pump thrombosis, gastrointestinal bleeding, major bleeding, stroke and right ventricular failure. Methods: This retrospective study included 50 LVAD patients at an academic institution in the United States who had a pre-implant SIPAT score during the years 2015-2017. Patients were split into two groups based on SIPAT score, separating a “excellent”/“good” from a “minimally acceptable”/“poor” candidate. Poisson regression, using SIPAT as both a categorical and continuous variable, was used to compare the incidence rates of the primary outcome of cumulative re-admissions and secondary outcomes of LVAD complications. Results: The patient cohort was predominantly male 93.5% vs 89.4% (p = 0.629) with a median age of 67.0 vs 58.0 years (p = 0.037), planned destination therapy 48.4% vs 68.4% (p = 0.242) and median LVAD follow-up time of 241 vs 379 days (p = 0.10) in the low- and high- SIPAT groups, respectively. SIPAT was not a significant predictor for cumulative re-admissions, but there was an association between higher SIPAT scores and major bleeding. Conclusion: In this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation.
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| 10. |
- Chiala, Oronzo, et al.
(författare)
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Relationships between exercise capacity and anxiety, depression, and cognition in patients with heart failure
- 2018
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 47:5, s. 465-470
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptoms of anxiety, depression, and cognitive impairment are common in heart failure (HF) patients, but there are inconsistencies in the literature regarding their relationship and effects on exercise capacity. Objectives: The aim of this study was to explore the relationships between exercise capacity and anxiety, depression, and cognition in HF patients. Methods: This was a secondary analysis on the baseline data of the Italian subsample (n = 96) of HF patients enrolled in the HF-Wii study. Data was collected with the 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale, and Montreal Cognitive Assessment. Results: The HF patients walked an average of 222 (SD 114) meters on the 6MWT. Patients exhibited clinically elevated anxiety (48%), depression (49%), and severe cognitive impairment (48%). Depression was independently associated with the distance walked on the 6MWT. Conclusions: The results of this study reinforced the role of depression in relation to exercise capacity and call for considering strategies to reduce depressive symptoms to improve outcomes of HF patients. (C) 2018 Elsevier Inc. All rights reserved.
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