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1.
  • Agerström, Jens, et al. (författare)
  • All else equal : Examining treatment bias and stereotypes based on patient ethnicity and socioeconomic status using in-hospital cardiac arrest clinical vignettes
  • 2024
  • Ingår i: Heart and Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 63, s. 86-91
  • 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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2.
  • Andersson, Sven Ingmar, et al. (författare)
  • Perspectives that lay persons with and without health problems show toward coronary heart disease: An integrated biopsychosocial approach.
  • 2007
  • Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; 36:5, s. 330-338
  • 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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3.
  • Annema, Coby, et al. (författare)
  • Reasons for readmission in heart failure : Perspectives of patients, caregivers, cardiologists, and heart failure nurses.
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:5, s. 427-34
  • 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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4.
  • Axelsson, Malin, 1964- (författare)
  • Personality and reasons for not using asthma medication in young adults
  • 2013
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 42:4, s. 241-246
  • 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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5.
  • Bengtson, Ann, 1947, et al. (författare)
  • Cardiovascular and psychosomatic symptoms among relatives of patients waiting for possible coronary revascularization.
  • 1996
  • Ingår i: Heart & Lung: Journal of Acute & Critical Care. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 25:6, s. 438-43
  • 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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6.
  • Bergman, Eva, et al. (författare)
  • Longitudinal study of patients after myocardial infarction : Sense of coherence, quality of life, and symptoms
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:2, s. 129-140
  • 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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7.
  • Blohm, M, et al. (författare)
  • Reaction to a media campaign focusing on delay in acute myocardial infarction
  • 1991
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 20:6, s. 661-666
  • 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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8.
  • Chiala, Oronzo, et al. (författare)
  • Relationships between exercise capacity and anxiety, depression, and cognition in patients with heart failure
  • 2018
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 47:5, s. 465-470
  • 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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9.
  • Dieperink, Willem, et al. (författare)
  • Implementation of Boussignac continuous positive airway pressure in the coronary care unit : experiences and attitudes.
  • 2008
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 37:6, s. 449-54
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Boussignac continuous positive airway pressure (BCPAP) delivered by face mask is useful for patients with acute cardiogenic pulmonary edema (ACPE). Although BCPAP is medically effective, we observed that not all suitable patients received it. In this descriptive, prospective, cohort study, we explored the experiences and attitudes of both patients and staff with BCPAP. METHODS: Patients were interviewed 12 to 48 hours after treatment with BCPAP. Nurses on the coronary care unit were interviewed on their knowledge, skills, experiences, and opinions concerning BCPAP. RESULTS: Of 117 patients with ACPE, 87 patients (74%) received BCPAP treatment. It was decided not to administer BCPAP in 30 patients with ACPE (26%). Patients who received BCPAP found that the reduction of dyspnea outweighed any discomfort. Barriers for the use of BCPAP were not related to nurses' skills but to the following: the nurses' belief that BCPAP created major discomfort, the lack of guidelines, the ultimate improvement of oxygenation without BCPAP, and the more labor-intensive treatment. CONCLUSION: Overestimation of patient discomfort by nurses and system-related factors impeded the use of BCPAP for all patients with ACPE.
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10.
  • Eckerblad, Jeanette, et al. (författare)
  • Symptom burden in stable COPD patients with moderate or severe airflow limitation
  • 2014
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 43:4, s. 351-357
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To describe a multidimensional symptom profile in patients with stable chronic obstructive pulmonary disease (COPD) and determine whether symptom experience differed between patients with moderate or severe airflow limitations.BACKGROUND: Patients with severe airflow limitation experience numerous symptoms, but little is known regarding patients with moderate airflow limitation.METHODS: A multidimensional symptom profile (Memorial Symptom Assessment Scale) was assessed in 42 outpatients with moderate and 49 with severe airflow limitations.RESULTS: The mean number of symptoms in the total sample was 7.9 (±4.3) with no difference between patients with moderate and severe airflow limitations. The most prevalent symptoms with the highest MSAS symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy in both groups.CONCLUSIONS: Patients with moderate or severe airflow limitations experience multiple symptoms with high severity and distress. An assessment of their multidimensional symptom profile might contribute to better symptom management.
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11.
  • Edell-Gustafsson, Ulla, 1947-, et al. (författare)
  • A gender perspective on sleeplessness behavior, effects of sleep loss, and coping resources in patients with stable coronary artery disease
  • 2006
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 35:2, s. 75-89
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The primary aim of this study was to systematically compare perceived sleep quality, sleeplessness behavior, sense of mastery, self-esteem, depression, subjective health, and effects of sleep loss in men and women with stable coronary artery disease (CAD). Further aims were to determine possible predictors of poor sleep quality and sense of mastery, as well as the consequences of too little sleep. METHODS: Comparative-correlation and predictive design were used. Patients with a history of stable angina pectoris scheduled to undergo coronary angiography at Linköping University Hospital in Sweden were included. There were 47 women and 88 men (mean age 62.4 years) with CAD. Structured interviews using validated questionnaires covered sleep quality and sleep habits, effects of sleep loss, psychologic resources, and depression. RESULTS: Multiple stepwise regression analysis showed that sleeplessness behavior, depressed mood, female gender, and pharmacologic treatments with inflammation inhibitors significantly (P < .0001) accounted for the variance of poorer sleep quality. The analysis also showed that the following factors in descending order significantly accounted (P < .0001) for the outcome of sleep quality: inability to feel refreshed by sleep, difficulty in maintaining sleep, gastrointestinal problems, too little sleep, final morning awakening time, sleep onset latency, lying down because of daytime tiredness, and daytime physical tiredness. CONCLUSIONS: Compared with men, women with stable CAD may be especially at risk of experiencing poor sleep quality, even when sleeplessness behavior and pharmacologic treatments with inflammation inhibitors are controlled. It is also possible that they may be more at risk of depressed mood. Copyright © 2006 by Mosby, Inc.
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12.
  • Eng, Sanna Hagelberg, et al. (författare)
  • Thirst and factors associated with frequent thirst in patients with heart failure in Spain
  • 2021
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 50:1, s. 86-91
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Thirst is a troublesome symptom in patients with Heart Failure (HF) and one that might be perceived differently in different countries depending on climate, food and cultural habits. The aims of the study were to describe thirst frequency, duration and intensity and to identify factors associated with frequent thirst in outpatients with HF in a Mediterranean country. Methods: Data was collected in a cross-sectional study involving 302 patients diagnosed with HF (age 67 +/- 12 years, 74% male, LVEF 43%+/- 14) in Spain on thirst frequency and duration, and thirst intensity by patient self-report (VAS, 0-100 mm). Clinical variables were collected from the medical files. Regression analysis was used to identify factors independently associated with frequent thirst. Results: Of all the patients, 143 (47%) were frequently thirsty, and their median (25th and 75th percentiles) thirst intensity was higher (VAS 50 mm [20-67] vs 7 [0-20], p <.001). Their thirst lasted longer compared to those who never/sometimes were thirsty (p < .001). Less treatment with angiotensin receptor blockers (Odds Ratio [OR] 2.72; 95% Confidence Interval [CI] 1.33-5.58), diuretics >40 mg/day (OR 1.92; 95% CI 1.02-3.64), depression (OR 2.99; CI 1.17-7.62), male gender (OR 1.98; CI 1.08-3.64) and worse New York Heart Association functional class (OR 1.92; 95% CI 1.05-3.52) were independently associated with frequent thirst. Conclusions: About half of patients with HF and fluid restriction experienced frequent thirst in a Mediterranean area of Spain, and their thirst duration and intensity were significantly increased. Frequent thirst was associated with demographic, clinical and therapeutic variables. The results may help to identify patients with a higher risk of frequent thirst and might suggest therapeutic changes in order to diminish this troublesome symptom. (C) 2020 The Authors. Published by Elsevier Inc.
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13.
  • Everts, B, et al. (författare)
  • Localization of pain in suspected acute myocardial infarction in relation to final diagnosis, age and sex, and site and type of infarction
  • 1996
  • Ingår i: Heart & Lung. - : Heart & Lung. - 0147-9563 .- 1527-3288. ; 25:6, s. 430-437
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To describe the localization of pain in consecutive patients admitted to the coronary care unit for possible acute myocardial infarction (AMI) and to relate it to the development of AMI, age, and gender. DESIGN: Prospective evaluation. SETTING: Sahlgrenska Hospital, covering half the area of the city of Göteborg, with half a million inhabitants. SUBJECTS: Nine hundred three consecutive patients admitted to the coronary care unit for possible AMI between 24 and 87 years old with a mean age of 64 years. OUTCOME MEASURES: Localizations of pain according to a self-constructed figure. Patient were approached between 1 and 14 days after onset of symptoms and asked to describe the localization of pain according to the figure, including nine positions on the chest, left and right arm, neck, and back. RESULTS: AMI developed in 50% of patients during the first 3 days in hospital. Patients in whom AMI developed localized their pain to an extent similar to those without AMI in seven of nine chest areas. However, patients with AMI reported pain in the upper right square of the chest more frequently (p < 0.001) and in the middle left square of the chest less frequently (p < 0.01) than did patients without AMI. Pain in both the right (p < 0.001) and left arms (p < 0.01) was more frequently reported by patients who had AMI. Among patients with AMI, women reported pain in the neck (p < 0.05) and in the back (p < 0.01) more frequently than did men. Compared with elderly patients, younger patients reported pain more frequently in the left arm (p < 0.01), right arm (p < 0.01), and neck (p < 0.05). CONCLUSIONS: Among consecutive patients with possible AMI admitted to the coronary care unit, patients who had confirmed AMI reported pain in both arms more frequently than did patients without AMI. However, both groups described their chest surface distribution of pain similarly in the majority of positions, thereby indicating that the localization of chest pain is of limited use in predicting which patients will eventually have AMI.
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14.
  • Flemme, Inger, et al. (författare)
  • Long-term quality of life and uncertainty in patients living with an implantable cardioverter defibrillator.
  • 2005
  • Ingår i: Heart & lung : the journal of critical care. - St. Louis, MO : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:6, s. 386-92
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: This study describes the quality of life (QOL) and uncertainty in patients who have an implantable cardioverter defibrillator (ICD) and predicts QOL at long-term follow-up. METHODS: Long-term follow-up was defined as 6.9 years +/- 1 year (range 4.11-8.7 years). QOL was measured with the Quality of Life Index, and uncertainty was measured with the Mishel Uncertainty in Illness Scale. RESULTS: The overall QOL and health/functioning were unchanged over time. QOL in the socioeconomic (P = .002) and psychologic/spiritual domains (P = .012) decreased in the first year. From baseline to long-term follow-up, the QOL in the family domain (P = .011) and uncertainty (P = .002) decreased. Uncertainty was a predictor of low QOL. CONCLUSION: QOL was reasonably good 6.9 years post-ICD implantation. Patients felt less uncertain once they had passed the first year of their illness.
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15.
  • Flemme, Inger, 1947-, et al. (författare)
  • Uncertainty is a major concern for patients with implantable cardioverter defibrillators
  • 2011
  • Ingår i: Heart & Lung. - St. Louis : Elsevier BV. - 0147-9563 .- 1527-3288. ; 40:5, s. 420-428
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The study objective was to explore the main concern of individuals living with an implantable cardioverter defibrillator (ICD) and how they handle this in daily life. For improved management and follow-up, it is important to understand how the ICD affects the recipient's daily life. METHODS: A grounded theory method was used. Sixteen Swedish recipients (9 men) living with an ICD for 6 to 24 months were interviewed. RESULTS: The core category labeled, "Incorporating uncertainty in daily life," illuminates the main concern. To handle uncertainty, recipients used the following strategies: restricting activities, distracting oneself, accepting being an ICD recipient, and reevaluating life. CONCLUSION: Recipients were not paralyzed by uncertainty. Instead, they incorporated uncertainty in life by using strategies to handle their daily life. Questions, comments, and plans for supportive communication were provided, which can be used by healthcare professionals in cardiac rehabilitation.
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16.
  • Fluur, Christina, et al. (författare)
  • Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues
  • 2013
  • Ingår i: Heart & Lung. - Philadelphia, PA : Mosby. - 0147-9563 .- 1527-3288. ; 42:3, s. 202-207
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin. Objective: This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD. Methods: Semistructured interviews were administered to 37 medically stable ICD-recipients. Results: The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks. Conclusion: The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation. © 2013 Elsevier Inc.
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17.
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19.
  • Hartford, M, et al. (författare)
  • Symptoms, thoughts and environmental factors in suspected acute myocardial infarction
  • 1993
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 22:1, s. 64-70
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To increase our understanding of patients' reactions and behavior at onset of symptoms of myocardial infarction. PROCEDURE: During a 5-month period a questionnaire focusing on symptoms, thoughts, and environmental factors at onset of symptoms was administered to all patients admitted to the coronary care unit at Sahlgrenska Hospital in Göteborg, Sweden, because of suspected acute myocardial infarction. RESULTS: A myocardial infarction developed in 48% of the 226 patients answering the questionnaire. In 81% of the patients, chest pain was the main symptom bringing them to the hospital. Forty-three percent characterized their symptoms as an oppression or uncomfortable feeling. Eighty-five percent suspected that the pain emanated from the heart, and yet 51% hesitated to go to the hospital, mainly because they expected the pain to disappear. Efforts to relieve pain were made by 63%, (mostly with nitroglycerin), which was taken more often by patients who did not subsequently develop a myocardial infarction than by those who did. Only 50% of the patients used an ambulance for transportation to hospital. There was a significant relation between subjective assessment of severity of symptoms and 1-year mortality (p < 0.05) and rehospitalization rate (p < 0.01), respectively. CONCLUSION: The majority of patients seem to interpret the symptoms of a myocardial infarction correctly and also have a correct perception of the severity of symptoms. For only a few is the natural next step to immediately call for an ambulance to get to the hospital.
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20.
  • Hildingh, Cathrine, et al. (författare)
  • Women's experiences of recovery after myocardial infarction : a meta-synthesis
  • 2007
  • Ingår i: Heart & Lung. - St. Louis, MO : Mosby Inc.. - 0147-9563 .- 1527-3288. ; 36:6, s. 410-417
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Women report lower well-being, compared with men, during recovery after myocardial infarction (MI). To support women in their recovery it is important to understand their experiences from their own perspective. However, a single study using a qualitative method does not have the potential to contribute to evidence-based nursing practice, and it is therefore important to synthesize findings from several qualitative studies. Objectives: The aim of this study was to perform a meta-synthesis of findings of women's experiences of recovery after MI. Methods: A meta-synthesis with seven qualitative studies, including a total of 70 women, was performed. Results: Recovery was characterized by subordination and superordination. The women strived to preserve their self, and at the same time they were strongly oriented toward other people. Four concepts emerged: protecting, adjusting, downgrading, and succumbing. Conclusion: Women oscillate between subordination and superordination. Protecting the matriarchy and being a victim of the patriarchy shed light on this ambivalence in the same way as adjusting to the situation and succumbing to the disease do.
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21.
  • Hjelm, Carina, et al. (författare)
  • The association between cognitive function and self-care in patients with chronic heart failure
  • 2015
  • Ingår i: Heart & Lung. - New York : Elsevier. - 0147-9563 .- 1527-3288. ; 44:4, s. 113-119
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To test the relationship between cognitive function and self-care in patients with heart failure after adjusting for the contribution of age, education, functional status, myocardial stress, sleep and depression. Further, the relationship between cognitive function and self-care was explored with depression and sleep as moderators.Background: Self-care can significantly impact functional capacity, well-being, morbidity, and prognosis in patients with heart failure (HF). However, self-care requires the cognitive ability to learn, perceive, interpret and respond. The influence of demographics and clinical symptoms on the relationship between cognition and self-care needs to be further understood.Design: Descriptive, cross-sectional study.Methods: The study included 142 patients with chronic HF (68% male, median age 72 years, 61% in NYHA II). Self-care was measured with the European Heart Failure Self-Care Behavior Scale. Cognitive function was evaluated with neuropsychological tests measuring global cognitive dysfunction, psychomotor speed, executive function, visual-spatial perception/construct, spatial performance, semantic and episodic memory.Findings: Psychomotor function (speed and attention) measured with the Trail Making A was the only dimension of cognitive function significantly associated with self-care. Neither depressive symptoms, nor sleep disturbances  moderated the relation between cognitive function and selfcare.Conclusion: Deficits in psychomotor speed have implications for how patients should be educated and supported to perform self-care. A decrease in sustained attention and ability to carry out more than one task at a same time could lead to difficulties in self-care. Screening for psychomotor speed is therefore advocated for patients with HF.
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22.
  • Hoekstra, Tialda, et al. (författare)
  • What keeps nurses from the sexual counseling of patients with heart failure?
  • 2012
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 41:5, s. 492-499
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: We sought to examine the current practice of discussing sexual health by heart failure (HF) nurses, and to explore which barriers prevent nurses from discussing sexuality. less thanbrgreater than less thanbrgreater thanMETHODS: The Nurses Survey of Sexual Counseling of Myocardial Infarction Patients and a list of barriers were used to form a questionnaire, which was sent to all HF clinics (n = 122) in the Netherlands. less thanbrgreater than less thanbrgreater thanRESULTS: The majority (75%) of nurses (n = 146) felt a certain responsibility to discuss patients sexual health. However, in practice, 61% of the nurses rarely or never addressed sexuality. Barriers that prevented nurses from addressing sexuality and that differed between nurses who do (n = 58) and do not (n = 88) discuss sexuality include a lack of organizational policy (49% vs. 79%, respectively; P andlt; .001) and lack of training (43% vs. 80%, respectively; P andlt; .001), and not knowing how to initiate the subject (24% vs. 72%, respectively; P andlt; .001). Nurses preferred to address sexuality during a follow-up visit or when discussing medication. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: Although HF nurses feel responsible for discussing sexuality, this topic is rarely addressed in clinics. Several barriers were identified, relating to personal, patient, and organizational factors.
  •  
23.
  • Hofgren, K, et al. (författare)
  • Prodromal symptoms in subsets of patients hospitalized for suspected acute myocardial infarction
  • 1995
  • Ingår i: Heart & Lung. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 24:1, s. 3-10
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To describe the occurrence of prodromal symptoms in suspected acute myocardial infarction (AMI) and to relate such symptoms to final diagnosis and previous history. DESIGN: Prospective study. SETTING: Coronary care unit in Sahlgrenska Hospital in Göteborg, Sweden. PATIENTS: 914 patients admitted to the coronary care unit for suspected AMI. OUTCOME MEASURES: Chest pain within the last 48 hours or other prodromal symptoms. RESULTS: Among patients in whom AMI developed, 57% reported prodromal chest pain and 61% reported other prodromal symptoms. Size, location, or type (Q-wave versus non-Q-wave AMI) did not influence outcome. Women reported more prodromal symptoms than men (p < 0.05), whereas age did not influence results. A similar proportion of patients with no confirmed AMI reported prodromal symptoms. Fifty-nine percent of patients with prodromal symptoms had wished to contact a physician if possible, and in fact one third did so. Two thirds of all patients were at rest, and one third reported some emotional distress before onset of the symptoms that brought them to hospital. CONCLUSION: A large proportion of patients with suspected AMI experienced prodromal symptoms before onset of suspected AMI. Such symptoms were more common in women but were not affected by size, location, or type of AMI. The symptoms were so severe that 59% of the patients with such symptoms wished to contact a physician before arrival in hospital.
  •  
24.
  • Hofgren, K, et al. (författare)
  • Word descriptors in suspected acute myocardial infarction. A comparison between patients with and without confirmed acute myocardial infarction
  • 1994
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 23:5, s. 397-403
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Acute myocardial infarction (AMI) will not develop in a large proportion of patients admitted to the coronary care unit because of suspected AMI. OBJECTIVE: To evaluate whether patients with confirmed AMI use different words to describe their pain than patients in whom AMI was not confirmed. DESIGN: A retrospective descriptive design. METHODS: The Pain-O-Meter, a verbal pain scale composed of 12 sensory and 10 emotional word descriptors, was used to assess pain. SETTING: Coronary care unit in Sahlgrenska Hospital in Goteborg, Sweden. SUBJECTS: A convenience sample of 889 consecutive patients admitted to the coronary care unit because of suspected AMI. RESULTS: SENSORY COMPONENT--patients with confirmed AMI differed from those without AMI in the use of the words "pricking" (12% vs 17%; p < 0.05) and "tearing" (11% vs 6%; p < 0.05). No difference was found in the remaining 10 words. Affective components--Patients with confirmed AMI differed from those without AMI in the use of "terrifying" (29% vs 18%; p < 0.001), "intolerable" (16% vs 10%; p < 0.01), and "worrying" (48% vs 59%; p < 0.01). Women used stronger word descriptors more frequently than men. CONCLUSION: The use of specific or more word descriptors to separate patients with AMI from those without AMI was not supported by the study data. Although patients with AMI more frequently used the sensory word tearing as well as the affective words terrifying and intolerable and less frequently used the sensory word pricking and the affective word worrying than patients without AMI, the differences do not suggest a clinical profile that can be used to differentiate these clinical entities.
  •  
25.
  • Hovgren, K, et al. (författare)
  • Initial pain course and delay to hospital admission in relation to myocardial infarct size
  • 1988
  • Ingår i: Heart & Lung. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 17, s. 274-280
  • Tidskriftsartikel (refereegranskat)abstract
    • In 47 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital because of acute myocardial infarction (MI), we evaluated the intensity of pain before admission and during the first 24 hours in the CCU and the delay time between the onset of symptoms and the decision to go to the hospital. Pain was assessed according to a modified visual analogue scale graded from 0 to 10, where 0 meant no pain and 10 meant the most severe pain. Patients generally scored their maximal pain before admission higher than their pain in the CCU. The maximal pain before admission did not seem to differ between patients with larger and smaller infarcts, estimated from maximal serum enzyme activity, whereas patients with larger infarcts tended to have more intensive pain in the hospital despite consuming more analgesics during the first 3 hours and the first 24 hours in the CCU. The time between onset of symptoms and decision to go to the hospital was not influenced by the intensity of pain before admission, but patients with larger infarcts made their decision much faster than those with smaller infarcts. In conclusion, infarct size, a major determinant of the initial prognosis, appeared to influence the initial pain course in the CCU and to markedly affect the delay time between onset of symptoms and the decision to seek medical care.
  •  
26.
  • Israelsson, Johan, et al. (författare)
  • A more conservative test of sex differences in the treatment and outcome of in-hospital cardiac arrest
  • 2023
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 58, s. 191-197
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Studies investigating sex disparities related to treatment and outcome of in-hospital cardiac arrest (IHCA) have produced divergent findings and have typically been unable to adjust for outstanding confounding variables.Objectives: The aim was to examine sex differences in treatment and survival following IHCA, using a comprehensive set of control variables including e.g., age, comorbidity, and patient-level socioeconomic status. Methods: This retrospective study was based on data from the Swedish Register of Cardiopulmonary Resuscitation and Statistics Sweden. In the primary analyses, logistic regression models and ordinary least square regressions were estimated.Results: The study included 24,217 patients and the majority (70.4%) were men. In the unadjusted analyses, women had a lower chance of survival after cardiopulmonary resuscitation (CPR) attempt, at hospital discharge (with good neurological function) and at 30 days (p<0.01). In the adjusted regression models, female sex was associated with a higher chance of survival after the CPR attempt (B = 1.09, p<0.01) and at 30-days (B = 1.09, p<0.05). In contrast, there was no significant association between sex and survival to discharge with good neurological outcome. Except for treatment duration (B=-0.07, p<0.01), no significant associations between sex and treatment were identified.Conclusions: No signs of treatment disparities or discrimination related to sex were identified. However, women had a better chance of surviving IHCA compared to men. The finding that women went from having a survival disadvantage (unadjusted analysis) to a survival advantage (adjusted analysis) attests to the importance of including a comprehensive set of control variables, when examining sex differences.
  •  
27.
  • Israelsson, Johan, et al. (författare)
  • Is there a difference in survival between men and women suffering in-hospital cardiac arrest?
  • 2014
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 43:6, s. 510-515
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival. Background: Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted. Methods: This registry study included 286 CAs. To investigate if sex was associated with survival, logistic regression analyses were performed. Results: The proportion of CA with a resuscitation attempt compared to CA without resuscitation was higher among men. There were no associations between sex and survival when controlling for previously known predictors and interaction effects. Conclusions: Sex does not appear to be a predictor for survival among patients suffering CA where resuscitation is attempted. The difference regarding proportion of resuscitation attempts requires more attention. It is important to consider possible interaction effects when studying the sex perspective. (C) 2014 Elsevier Inc. All rights reserved.
  •  
28.
  • Ivarsson, Bodil, et al. (författare)
  • Information from health care professionals about sexual function and coexistence after myocardial infarction : a Swedish national survey
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 38:4, s. 330-335
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: After a myocardial infarction (MI), many patients and their partners experience problems with marital and sexual life.METHODS: A Swedish national survey was carried out to obtain knowledge on the information provided by cardiac health care professionals on the subject of sexual function and coexistence after an MI. It consisted of a questionnaire that was designed, tested, and sent to 121 coronary care units.RESULTS: The coronary care unit teams rarely provided oral or written information about sexual function and coexistence to patients with MI or their partners. The health care professionals lacked competence in these areas.CONCLUSION: It is essential that health care professionals are educated on and inform the patient with MI about the significance of sexual function and coexistence. Further research is required regarding patients' and their partners' need for information and support in this area. 
  •  
29.
  • Ivarsson, Bodil, et al. (författare)
  • Relative's experiences before and after a heart or lung transplantation
  • 2014
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 43:3, s. 198-203
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Relatives take on great responsibilities during patients' heart or lung transplant process and an understanding for their situation is required. Objective: To describe relative's experiences before and during the patient's hospital stay as well as during the first 6 months after a heart or lung transplantation. Methods: Using qualitative content analysis, 15 relatives (eight women and seven men) aged 36-65 years were interviewed within 6 months of a heart or lung transplantation. Result: Three categories that illuminate relatives' experiences have been identified: "Navigate specific circumstances," "Facilitate throughout the transplantation journey" and "Experiences of strength and weakness of information and support." The relatives reported involvement in the transplantation decision, peer support, information seeking, burden and coping. Conclusion: Greater awareness about relatives' experiences with identification of appropriate support and information exchange between health care professionals and relatives is important. This awareness could provide benefits for heart or lung transplant patients, families and health care organizations. (C) 2014 Elsevier Inc. All rights reserved.
  •  
30.
  • Jaarsma, Tiny, et al. (författare)
  • Nurses strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: An in-depth look
  • 2012
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 41:6, s. 583-593
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom monitoring. less thanbrgreater than less thanbrgreater thanMETHODS: A qualitative study with a directed content analysis was performed, using data from a selected sample of Dutch-speaking heart failure nurses who completed booklets with two vignettes involving medication adherence and symptom recognition. less thanbrgreater than less thanbrgreater thanRESULTS: Nurses regularly assess and reassess patients before they decide on an intervention. They evaluate basic/factual information and barriers in a patients behavior, and try to find room for improvement in a patients behavior. Interventions that heart failure nurses use to improve adherence to medication and symptom monitoring were grouped into the themes of increasing knowledge, increasing motivation, and providing patients with practical tools. Nurses also described using technology-based tools, increased social support, alternative communication, partnership approaches, and coordination of care to improve adherence to medications and symptom monitoring. less thanbrgreater than less thanbrgreater thanCONCLUSION: Despite a strong focus on educational strategies, nurses also reported other strategies to increase patient adherence. Nurses use several strategies to improve patient adherence that are not incorporated into guidelines. These interventions need to be evaluated for further applications in improving heart failure management
  •  
31.
  • Jaarsma, Tiny, et al. (författare)
  • Self-care and quality of life in patients with advanced heart failure : the effect of a supportive educational intervention
  • 2000
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 29:5, s. 319-330
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure. DESIGN: The study design was an experimental, random assignment. SETTING: The study was located at the University Hospital in Maastricht, The Netherlands. PATIENTS: The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure. OUTCOME MEASURES: Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril's ladder of life). INTERVENTION: The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care. RESULTS: Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up. CONCLUSION: A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life.
  •  
32.
  • Jaarsma, Tiny, et al. (författare)
  • Sexual function in patients with advanced heart failure
  • 1996
  • Ingår i: Heart & Lung. - 0147-9563 .- 1527-3288. ; 25:4, s. 262-270
  • 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.
  •  
33.
  •  
34.
  • Klompstra, Leonie, et al. (författare)
  • Seasonal variation in physical activity in patients with heart failure
  • 2019
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 48:5, s. 381-385
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and objectives: Physical activity is important for all heart failure (HF) patients to improve quality of life and physical function. Since adherence to physical activity is low and could differ between seasons, it is essential to explore factors related to change that may depend on seasonal changes. The purpose of this study was to describe the seasonal differences in physical activity and assess factors that influence these differences in a country with markedly different winter-to-summer weather conditions (in temperature, hours of daylight and snow fall). Methods: The study had a cross-sectional survey design. Outpatients with HF completed a questionnaire on physical activity, motivation and self-efficacy to exercise and I-IF symptom severity in the summer and the winter in a northern hemisphere country. We used analysis of variance to evaluate seasonal differences in physical activity, motivation, self-efficacy and HF symptom severity. Results: Eighty-seven patients with HF (29% women, mean age 70 +/- 9 years) were included and 35% performed less physical activity (METs) in the winter, compared to the summer. Increased symptom severity during the winter was associated with lower activity levels. Conclusion: One-third of the patients performed less physical activity during the winter compared to the summer, and this was associated with symptom severity. Decreased physical activity was not related with motivation and self-efficacy. This study emphasises the need for personalised physical activity programmes that also assess symptom severity and change in symptom severity depending between seasons. (C) 2019 The Authors. Published by Elsevier Inc.
  •  
35.
  • Kristofferzon, Marja-Leena, 1950-, et al. (författare)
  • Perceived coping, social support, and quality of life 1 month after myocardial infarction : A comparison between Swedish women and men
  • 2005
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:1, s. 39-50
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.DESIGN: The study design was cross-sectional and descriptive-comparative.SETTING: The study took place in 1 hospital service area in the middle of Sweden.SUBJECTS: The sample consisted of 74 women and 97 men.INSTRUMENTS: The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.RESULTS: Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.CONCLUSION: The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.
  •  
36.
  • Lawoko, S, et al. (författare)
  • Psychosocial morbidity among parents of children with congenital heart disease: A prospective longitudinal study
  • 2006
  • Ingår i: Heart & Lung. - 0147-9563 .- 1527-3288. ; 35:5, s. 301-314
  • Tidskriftsartikel (refereegranskat)abstract
    • The study objectives were to assess long-term psychosocial morbidity and its determinants among parents of children with congenital heart disease (PCCHD), and to compare mothers with fathers on psychosocial variables.MethodThe study design was longitudinal. Data comprising PCCHD (n = 632, 58% were women) were collected on two occasions 1 year apart.ResultsMany PCCHD reported psychosocial problems manifested in depression (18%), anxiety (16%-18%), somatization (31%-38%), and hopelessness (16%) during both measurement points. In addition, 7% to 22% reported psychosocial problems persisting over a 1-year period. Consistently over time, mothers reported more severe symptoms of depression, anxiety, somatization, and hopelessness than fathers. Children’s clinical severity did not significantly explain parent’s psychosocial morbidity over time. Instead, parental caregiving burden, dissatisfaction with care, social isolation, and financial instability were associated with an increased risk of long-standing psychosocial morbidity.ConclusionsAn important proportion of PCCHD are at risk of long-standing psychosocial morbidity, suggesting that psychosocial intervention may be beneficial. Feasible interventions are discussed.
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37.
  • Lee, Christopher S., et al. (författare)
  • Patterns of self-care and clinical events in a cohort of adults with heart failure: 1 year follow-up
  • 2018
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 47:1, s. 40-46
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Heart failure (HF) self-care is important in reducing clinical events (all-cause mortality, emergency room visits and hospitalizations). HF self-care behaviors are multidimensional and include maintenance (i.e. daily adherence behaviors), management (i.e. symptom response behaviors) and consulting behaviors (i.e. contacting a provider when appropriate). Across these dimensions, patterns of successful patient engagement in self-care have been observed (e.g. successful in one dimension but not in others), but no previous studies have linked patterns of HF self care to clinical events. Objectives: To identify patterns of self-care behaviors in HF patients and their association with clinical events. Methods: This was a prospective, non-experimental, cohort study. Community-dwelling HF patients (n = 459) were enrolled across Italy, and clinical events were collected one year after enrollment. We measured dimensions of self-care behavior with the Self-Care of HF Index (maintenance, management, and confidence) and the European HF Self-care Behavior Scale (consulting behaviors). We used latent class mixture modeling to identify patterns of HF self-care across dimensions, and Cox proportional hazards modeling to quantify event-free survival over 12 months of follow-up. Results: Patients (mean age 71.8 +/- 12.1 years) were mostly males (54.9%). Three patterns of self-care behavior were identified; we labeled each by their most prominent dimensional characteristic: poor symptom response, good symptom response, and maintenance-focused behaviors. Patients with good symptom response behaviors had fewer clinical events compared with those who had poor symptom response behaviors (adjusted hazard ratio = 0.66 10.46-0.96], p = 0.03). Patients with poor symptom response behaviors had the most frequent clinical events. Patients with poor symptom response and those with maintenance-focused behaviors had a similar frequency of clinical events. Conclusions: Self-care is significantly associated with clinical events. Routine assessment, mitigation of barriers, and interventions targeting self-care are needed to reduce clinical events in HF patients. (C) 2017 Elsevier Inc. All rights reserved.
  •  
38.
  • Luttik, Marie Louise, et al. (författare)
  • Marital status, quality of life, and clinical outcome in patients with heart failure
  • 2006
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 35:1, s. 3-8
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This study investigated the impact of having a partner on quality of life (QoL), the number of hospital readmissions, and 9-month survival in patients with heart failure (HF). METHODS: The study population consisted of hospitalized patients with HF. QoL was measured by the Cantril Ladder of Life (0-10) during hospital admission. Clinical data, readmission rate, and number of deaths were registered by patient interview and chart review. RESULTS: Of the 179 patients, 96 (54%) were married or were living with a partner. Differences in QoL between married patients and those living alone were most pronounced with regard to future expectations of QoL (6.5 vs 5.0, P=.00). However, in a multivariate model QoL was primarily associated with socioeconomic status, age, and gender. Married patients had 12% less events in the 9-month follow-up period compared with patients living alone (P=not significant). CONCLUSION: This study indicates that most patients with HF who are living alone are mostly elderly women with a low socioeconomic status, who are at risk for recurrent events and a worse QoL.
  •  
39.
  • Melnikov, Semyon, et al. (författare)
  • Factors associated with body image among patients with an implanted left ventricular assist device
  • 2020
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 49:6, s. 803-807
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Among Left Ventricular Assist Device (LVAD) implanted patients, body image modifications might occur. Objectives: To explore the associations between sexual functioning, confidence in LVAD technology, personal wellbeing, and body image. Methods: The cross-sectional study included 30 conveniently recruited LVAD implanted patients who completed Body Image Scale, sexual functioning, confidence in LVAD technology, and Personal Wellbeing Index questionnaires. The associations between the research variables were examined with multiple regression analyses. Results: The mean age of the participants was 63 (SD=10), 90% were men. The mean scores were: sexual functioning 2.43 (SD=1.20, range 1-5); confidence in LVAD technology 2.63 (SD=1.04, range 1-5); Well-Being Index 6.61 (SD=1.53, range 0-10); and body image 14.5 (SD=4.17, range 5-20). Sexual functioning (p<.01) and LVAD technology confidence (p=.04) significantly predicted body image. Conclusions: Healthcare professionals should be aware of challenges regarding body image faced by LVAD implanted patients and to address related factors. (c) 2020 Elsevier Inc. All rights reserved.
  •  
40.
  • Miller, Jennifer L., et al. (författare)
  • Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients
  • 2019
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 48:4, s. 313-319
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Recent guidelines highlight the need for clinician-patient discussions regarding end-of-life (EOL) choices prior to implantable cardioverter defibrillator (ICD) implantation. Health literacy could affect the quality and quantity of such discussions. Objective: Our objective was to determine the association of health literacy with experiences, attitudes, and knowledge of the ICD at EOL. Methods: In this cross-sectional study, we used validated instruments to measure health literacy and patient experiences, attitudes, and knowledge of the ICD at EOL. Results: Of the 240 ICD recipients, 76% of participants reported never having discussed the implications of a future withdrawal of defibrillation therapy with their healthcare provider. Increased odds of choosing to maintain defibrillation therapy were associated with female gender and lower ICD knowledge. Conclusions: From patients perspectives, EOL discussions with providers were minimal. Most patients hold misperceptions about ICD function that could interfere with optimal EOL care, particularly for those with inadequate health literacy. (C) 2019 Elsevier Inc. All rights reserved.
  •  
41.
  • Mourad, Ghassan, et al. (författare)
  • Depressive symptoms and healthcare utilization in patients with noncardiac chest pain compared to patients with ischemic heart disease
  • 2012
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 41:5, s. 446-455
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: We compared depressive symptoms and healthcare utilization in patients admitted for noncardiac chest pain, acute myocardial infarction, and angina pectoris after hospitalization and at 1-year follow-up. METHODS: One hundred and thirty-one patients with noncardiac chest pain, 66 with acute myocardial infarction, and 70 with angina pectoris completed a depression screening questionnaire and the Montgomery Åsberg Depression Rating Scale. Healthcare utilization data were collected from a population-based, diagnosis-related database. RESULTS: More than 25% of respondents reported depressive symptoms, regardless of diagnosis. At follow-up, 9% had recovered, 19% were still experiencing depressive symptoms, and 13% had developed depressive symptoms. Noncardiac patients with chest pain had similar primary care contacts, but fewer hospital admissions, than patients with an acute myocardial infarction. Patients with angina pectoris and depressive symptoms used the most healthcare services. CONCLUSIONS: Depressive symptoms were common. Patients with noncardiac chest pain used as much primary care as did patients with an acute myocardial infarction. Interventions should focus on identifying and treating depressive symptoms.
  •  
42.
  • Mårtensson, Jan, et al. (författare)
  • Decisive situations influencing spouses' support of patients with heart failure : A critical incident technique analysis
  • 2001
  • Ingår i: Heart & Lung. - Amsterdam : Elsevier. - 0147-9563 .- 1527-3288. ; 30:5, s. 341-350
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE:The aim of this study was to describe decisive situations experienced by spouses of patients with heart failure that could potentially affect their ability to provide social support to the patient.METHODS:A qualitative descriptive design with a critical incident technique was used. Twenty-three informants, 15 women and 8 men, who were spouses of patients with severe heart failure were strategically chosen to ensure maximal variation in sociodemographic data and experiences as a spouse.RESULTS:Decisive situations influenced the experience of spouses of patients with heart failure in a manner that was either positive (involvement with others) or negative (feeling like an outsider). When spouses were given attention and treated like persons of value, they experienced involvement with others. In these cases, spouses had someone to turn to and were included in the physical care. In contrast, when spouses were kept at a distance by the patient, were socially isolated, and received insufficient support from children, friends, and health care professionals, they experienced feeling like an outsider.CONCLUSIONS:By identifying spouses' experiences, health care professionals can assess which kind of specific interventions should be used to improve the life situation of the patient with heart failure and his or her spouse.
  •  
43.
  • Nilsson, Ulrica, 1960- (författare)
  • The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:3, s. 201-207
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To evaluate the effect of bed rest with music on the first postoperative day to decrease stress for patients who have undergone heart surgery. Methods A repeated-measures randomized controlled trial was used. The study took place in a cardiothoracic intermediary unit of a university hospital in Sweden. Fifty-eight patients who had undergone open coronary artery bypass grafting or aortic valve replacement surgery were included. Stress response was assessed by determining the serum cortisol, heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels. At 12:00 noon on postoperative day 1, patients were allocated to receive 30 minutes of uninterrupted bed rest with music and then 30 minutes of bed rest or alternatively 60 minutes of uninterrupted bed rest. The music was soft and relaxing, included different melodies in new-age style, played with a volume at 50 to 60 dB, and distributed through a music pillow connected to an MP3 player. Results After 30 minutes of bed rest, there was a significant difference in s-cortisol levels between the groups; 484. 4 mmol/L in the music group versus 618.8 mmol/L in the control group (P < .02). However, this difference in s-cortisol levels was not found 30 minutes later (ie, after a total of 60 minutes). There was no difference in heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels between the groups. Conclusion There is sufficient practical evidence of stress reduction to suggest that a proposed regimen of listening to music while resting in bed after open heart surgery be put into clinical use.
  •  
44.
  • Nilsson, Ulf, et al. (författare)
  • The prevalence of prolonged QTc increases by GOLD stage, and is associated with worse survival among subjects with COPD
  • 2019
  • Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 48:2, s. 148-154
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The role of QTc-prolongation, in relation to the increased mortality in COPD, is unclear. Objectives: To estimate the prevalence and prognostic impact, assessed as mortality, of QTc-prolongation in COPD, restrictive spirometric pattern (RSP), and normal lung function (NLF), respectively. Methods: All individuals (n = 993) with COPD and age- and sex-matched non-obstructive referents were identified from well-defined population-based cohorts examined in Northern Sweden in 2002-04. In 2005, the study-sample was invited to re-examination including ECG; QTc was calculated and mortality data collected until 31st December 2010. Results: The prevalence of QTc-prolongation was higher among people with RSP than among those with NLF and, although similar in NLF and COPD, the prevalence increased by COPD-severity. Among participants with COPD, those with QTc prolongation had higher mortality than those with normal QTc, while no such differences were found among participants with NLF or RSP. Conclusion: Among participants with COPD, the prevalence of QTc-prolongation increased by disease-severity and was associated with mortality. (C) 2018 Elsevier Inc. All rights reserved.
  •  
45.
  • Perkiö Kato, Naoko, 1980-, et al. (författare)
  • Adherence to self-care behavior and factors related to this behavior among patients with heart failure in Japan
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 38:5, s. 398-409
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Adherence to self-care behavior is important for patients with heart failure (HF) to prevent exacerbation of HF. The aim of this study was to evaluate adherence, identify associated factors, and clarify the impact of previous HF hospitalizations on adherence in outpatients with HF.METHODS: A total of 116 outpatients completed a questionnaire, including the Japanese version of the European Heart Failure Self-Care Behavior Scale, to assess adherence.RESULTS: Regardless of previous hospitalizations, adherence to seek help if HF worsened was poor. Multivariate analysis adjusted for age and brain natriuretic peptide showed that diabetes mellitus and being employed were independent predictors of poorer adherence to self-care behavior (P = .03, P = .02, respectively), but the experience of previous HF hospitalizations was not a predictor.CONCLUSIONS: Self-care strategies for HF should target patients with diabetes mellitus and employed patients. Further study is necessary to develop effective programs for such patients.
  •  
46.
  • Pesonen, Erkki, et al. (författare)
  • Serum chlamydial lipopolysaccharide as a prognostic factor for a new cardiovascular event.
  • 2009
  • Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; 38:3, s. 176-181
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Infections caused by Chlamydia pneumoniae are considered to participate in inflammatory processes leading to coronary artery disease. After a primary infection, the bacteria remain dormant intracellularly causing a chronic inflammatory stimulus. MATERIALS AND METHODS: Blood samples were obtained from 235 patients with acute myocardial infarction (AMI) and 108 patients with unstable angina pectoris (UA). We evaluated the prognostic significance of bacterial and viral antibody titers, serum troponin T, C-reactive protein, and chlamydial lipopolysaccharide (cLPS) concentrations during acute coronary syndrome of patients with AMI and UA for cardiovascular death and new UA and AMI that required hospital care during a 6-year follow-up. RESULTS: Serum cLPS levels correlated with C-reactive protein and serum troponin T concentrations during acute coronary events. Patients with AMI had significantly higher serum concentration of cLPS compared with patients with UA. Enterovirus antibody titers and cholesterol-lowering therapy at admission of the index event were negatively correlated with cLPS concentration (r = -.198, P = .0003 and r = -.26, P = .019, respectively). The presence of circulating cLPS was associated with a hazard ratio of 2.04 for a new cardiovascular event during the follow-up period (P = .006). The area under the curve in the receiver operating graph was .572. CONCLUSION: cLPS is evidently liberated from the infected atherosclerotic tissue during an acute coronary event. Our study supports the view that inflammation caused by C. pneumoniae infection is an important but as yet poorly understood factor in the development of atherosclerosis and may play a role in acute vascular events.
  •  
47.
  • Poole, Jennifer, et al. (författare)
  • Grief and loss for patients before and after heart transplant
  • 2016
  • Ingår i: Heart & Lung. - Philadelphia, PA, USA : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 45:3, s. 193-198
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesThe purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts.BackgroundThere is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience.MethodsPart of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants.ResultsPatients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned.ConclusionsLoss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed.
  •  
48.
  • Prasun, Marilyn A., et al. (författare)
  • Perceptions of changes in practice patterns and patient care among heart failure nurses during the COVID-19 pandemic
  • 2022
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 52, s. 152-158
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The Coronavirus (COVID-19) had a profound impact on the delivery of care in both hospital and outpatient settings across the United States. Patients with heart failure (HF) and healthcare providers had to abruptly adapt. Objective: To describe how the COVID-19 pandemic affected practice patterns of HF nurses. Methods: Practicing HF nurses completed a cross-sectional, anonymous, web-based survey of perceptions of HF practice. Analyses involved descriptive and comparative statistics. Results: Of 171 nurses who completed surveys, outpatient HF visits decreased and 63.2% added telehealth visits. Despite spending about 29 min educating patients during visits, 27.5% of nurses perceived that the pandemic decreased patients abilities to provide optimal self-care. Nurses reported decreased ability to collect objective data (62.4%; n = 78), although subjective assessment stayed the same (41.6%; n = 52). Conclusion: Nurses practice patterns provided insight into patient care changes made during COVID-19. Most core components of HF management were retained, but methods of delivery during the pandemic differed. (C) 2022 Elsevier Inc. All rights reserved.
  •  
49.
  • Samuelson, Karin (författare)
  • Adult intensive care patients' perception of endotracheal tube-related discomforts: A prospective evaluation.
  • 2011
  • Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; Jul 1, s. 49-55
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: This study was designed to investigate adult patients' perceptions of endotracheal tube (ETT)-related discomfort at 5 days and 2 months after discharge from the intensive care unit (ICU). METHODS: This prospective cohort study in 2 general ICUs included 250 intubated, mechanically ventilated adults admitted for more than 24 hours. Patients were interviewed 5 days and 2 months after discharge from the ICU about their ETT-related discomfort, using a modified Swedish ETT version of the ICU Stressful Experience Questionnaire that comprises 14 items. RESULTS: Of 116 patients describing their ETT experience during their ICU stay, 88% rated their discomfort as moderately to extremely stressful. At 2 months after discharge from the ICU, 23% (51/226) reported bothersome discomfort, vs. 46% (104/226) 5 days after discharge from the ICU, and 10 patients suffered from severe, persistent hoarseness. CONCLUSION: The incidence of bothersome subjective complaints after tracheal intubation in the intensive-care setting is high, and severe ETT-related problems may persist several months after extubation.
  •  
50.
  • Stamp, Kelly D., et al. (författare)
  • Nursing research in heart failure care: a position statement of the american association of heart failure nurses (AAHFN)
  • 2018
  • Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 47:2, s. 169-175
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Heart Failure (HF) is a public health problem globally affecting approximately 6 million in the United States. Objectives: A tailored position statement was developed by the American Association of Heart Failure Nurses (AAHFN) and their Research Consortium to assist researchers, funding institutions and policymakers with improving HF clinical advancements and outcomes. Methods: A comprehensive review was conducted using multiple search terms in various combinations to describe gaps in HF nursing science. Based on gaps described in the literature, the AAHFN made recommendations for future areas of research in HF. Results: Nursing has made positive contributions through disease management interventions, however, quality, rigorous research is needed to improve the lives of patients and families while advancing nursing science. Conclusions: Advancing HF science is critical to managing and improving patient outcomes while promoting the nursing profession. Based on this review, the AAHFN is putting forth a call to action for research designs that promote validity, sustainability, and funding of future nursing research. (C) 2018 Elsevier Inc. All rights reserved.
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