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- Amofah, Hege A., et al.
(författare)
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Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:2, s. 168-177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep–wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep–wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep–wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.
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| 3. |
- Fålun, Nina, et al.
(författare)
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Patients’ goals, resources, and barriers to future change : A qualitative study of patient reflections at hospital discharge after myocardial infarction
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:7, s. 495-503
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Tidskriftsartikel (refereegranskat)abstract
- Background: Myocardial infarction (MI) patients may find it challenging to adhere to lifestyle advice and medications. Understanding motivational factors and barriers to change is crucial. However, empirical evidence on patients’ ability to effect lifestyle changes at the time of discharge is limited.Aim: The aim of this study was to identify at the time of hospital discharge the goals, resources, and barriers to future change in MI patients.Methods: We conducted a qualitative interview study with a purposive sample of 20 MI patients (eight women) in a cardiac department at a university hospital in Norway. All interviews were conducted before hospital discharge, transcribed verbatim, and analysed using qualitative content analysis.Findings: Three themes suggested that, at the time of discharge, patients’ views of their MI were complex and diverse. Patients were motivated to change their lifestyle and contemplated taking their life in new directions, adopting a change of life perspective. Frequently, patients struggled to understand the context of living with an MI, manage symptoms, and understand the precipitating causes of MI. There were also patients who wanted to maintain their present lifestyle and live as normal as possible. They just wanted to keep going.Conclusions and implications: There is a need for a different approach to communicating with MI patients at the time of discharge. Person-centred care that allows personal narratives to emerge may enable health-care professionals to offer more individualised guidance to MI patients that will help them cope with the everyday challenges they experience after discharge.
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| 4. |
- Fålun, Nina, et al.
(författare)
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Patients' reflections on prehospital symptom recognition and timely treatment of myocardial infarction
- 2021
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 20:6, s. 526-533
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Tidskriftsartikel (refereegranskat)abstract
- AimsEarly treatment is crucial to successful therapy in patients with acute myocardial infarction (MI). Prehospital delay is associated with increased morbidity and mortality. There is little empirical evidence of patients' reflections on prehospital symptoms of MI and timely treatment at the time of discharge from hospital. To explore patients' reflections on prehospital symptoms of MI and their experiences of interaction with local hospitals, general practitioners, and laypersons.Methods and resultsAn inductive explorative design with a qualitative method approach was used to conduct in-depth interviews of patients after confirmed MI. Twenty patients were purposefully selected based on age and gender. Face-to-face, semi-structured interviews were conducted prior to hospital discharge. The interviews were organized around a set of predetermined, open-ended questions, transcribed verbatim and analysed using qualitative content analysis. There were patients who acted upon severe symptoms of MI by seeking medical assistance. Patients commonly experienced that the time from the onset of symptoms to treatment posed a transitional challenge. They did not take subtle signs of MI seriously; they underestimated symptoms of MI and delayed seeking medical assistance. Patients frequently experienced that healthcare professionals did not take them seriously, as they struggled to gain access to healthcare services.ConclusionThis study highlights patients' unique experiences of the pathway from symptom onset to confirmed MI. Severe chest pain is associated with MI and triggers an immediate need for care. However, patients often underestimated moderate chest pain or subtle signs and symptoms of MI. Existing knowledge gaps concerning the misinterpretation of symptoms in primary care need to be addressed in order to reduce this clinical challenge.
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| 8. |
- Olsen, Siv J. S., et al.
(författare)
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Changes in self-reported health and quality of life in octogenarian patients one month after transcatheter aortic valve implantation
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:1, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In addition to favourable results regarding mortality and morbidity it is important to identify the impact transcatheter aortic valve implantation (TAVI) has on patients' quality of life.AIMS: The aims were: (i) to describe clinical characteristics, self-reported health and quality of life in octogenarians before TAVI intervention; (ii) to determine changes in self-reported health and quality of life one month after TAVI; and (iii) to establish the clinical importance of the findings.METHODS: A prospective cohort study was conducted on consecutively enrolled octogenarians with severe aortic stenosis undergoing TAVI (N = 65). Self-reported health and quality of life were recorded at baseline and one month later using two global questions from the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF), the generic Short Form Health 12 and the disease-specific Minnesota Living with Heart Failure Questionnaire.RESULTS: One month after TAVI, WHOQOL-BREF showed that self-reported health improved moderately (p < 0.001), while quality of life improved slightly, but not statistically significantly (p = 0.06). There were changes in all Short Form Health 12 domains, except social functioning and role emotional. The estimated changes were 3.6 to 5.8 with large confidence intervals. The Physical Component Summary increased statistically significantly from baseline to 30 days (30.6-34.7; p = 0.02), but the Mental Component Summary did not (46.9-50.0; p = 0.13).CONCLUSION: Despite being an advanced treatment performed in a high risk population, TAVI in octogenarians improves short-term self-reported global health and generic physical health and quality of life. These patient-reported outcomes have importance, particularly in this age group.
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| 9. |
- Pettersen, Trond R, et al.
(författare)
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European cardiovascular nurses' and allied professionals' knowledge and practical skills regarding cardiopulmonary resuscitation.
- 2018
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Ingår i: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - : Oxford University Press (OUP). - 1873-1953 .- 1474-5151. ; 17:4, s. 336-344
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Tidskriftsartikel (refereegranskat)abstract
- Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to investigate whether there was an association between participants' cardiopulmonary resuscitation training and their practical cardiopulmonary resuscitation test results.This comparative study was conducted at the 2014 EuroHeartCare meeting in Stavanger ( n=133) and the 2008 Spring Meeting on Cardiovascular Nursing in Malmö ( n=85). Participants performed cardiopulmonary resuscitation for three consecutive minutes CPR training manikins from Laerdal Medical®. Data were collected with a questionnaire on demographics and participants' level of cardiopulmonary resuscitation training.Most participants were female (78%) nurses (91%) from Nordic countries (77%), whose main role was in nursing practice (63%), and 71% had more than 11 years' experience ( n=218). Participants who conducted cardiopulmonary resuscitation training once a year or more ( n=154) performed better regarding ventilation volume than those who trained less (859 ml vs. 1111 ml, p=0.002). Those who had cardiopulmonary resuscitation training offered at their workplace ( n=161) also performed better regarding ventilation volume (889 ml vs. 1081 ml, p=0.003) and compression rate per minute (100 vs. 91, p=0.04) than those who had not.Our study indicates a positive association between participants' performance on the practical cardiopulmonary resuscitation test and the frequency of cardiopulmonary resuscitation training and whether cardiopulmonary resuscitation training was offered in the workplace. Large ventilation volumes were the most common error at both measuring points.
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| 10. |
- Scholte op Reimer, Wilma, et al.
(författare)
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Cardiovascular risk estimation by professionally active cardiovascular nurses : Results from the Basel 2005 Nurses Cohort
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:4, s. 258-263
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. Methods: Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (κw). Results: Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (≥ 5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of < 1%, while 13% reported having a risk ≥ 5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was < 1% for 96% of responders: only 2% had a ≥ 5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (κw = 0.27). Conclusion: Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment. © 2006 European Society of Cardiology.
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