| 1. |
- Acuña Mora, Mariela, et al.
(författare)
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The why and the how of communicating research
- 2023
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 22:3, s. e16-e18
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Acuña Mora, Mariela, 1990, et al.
(författare)
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The why and the how of communicating research
- 2023
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Ingår i: European journal of cardiovascular nursing. - : Oxford University Press (OUP). - 1873-1953 .- 1474-5151. ; 22:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Askenäs, Linda, 1972-, et al.
(författare)
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Co-Design To Self-Organizing Exergaming : A Study Of Stimulating Physical Activity For Elderly People With A Chronic Health Condition
- 2019
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Ingår i: IADIS International Conference Sustainability, Technology and Education 2019. - : IADIS Press. - 9789898533845 ; , s. 35-41
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Konferensbidrag (refereegranskat)abstract
- Life expectancy is increasing and physical activity has been shown to be an effective to improve outcomes for patients with chronic conditions. However, there are a lot of barriers that make elderly people with chronic disease not being physical active. The purpose of this study is to explore the potential of using co-design as a method to implement physical activity in a social context for elderly organizations. With the aim to explore exergaming in a social setting, a co-design process was conducted using the experience-based design theory. The study also relied on studies using gaming as exercise method for heart failure patients. The method was participative observations that was documented as a storytelling. The project contained a number of key co-design actions; engaging users early; using the competition element; engaging patient organization and bringing the design into an existing social context; focus on self-organizing, not as a plan more focus an emerging property that may appear; practical testing element in the design made it possible to understand the multiple views of motivational factors. The project should allow for and encourage a multifaceted outcome, as this would reach and satisfy broader layers of people.
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| 4. |
- Ben Gal, Tuvia, et al.
(författare)
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Psychometric Testing of the Hebrew Version of the European Heart Failure Self-Care Behaviour Scale
- 2020
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Ingår i: Heart, Lung and Circulation. - : Elsevier. - 1443-9506 .- 1444-2892. ; :7, s. E121-E130
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The assessment of self-care behaviour is important for tailoring care to patients and evaluating the effectiveness of heart failure (HF) disease-management programmes. The European HF Self-care Behaviour (EHFScB) scale is a validated instrument used worldwide.AIM: The purpose of the study was to evaluate psychometric properties of the Hebrew version of the nine-item EHFScB scale in Israeli patients with HF.METHOD: To develop the Hebrew version of the EHFScB scale, forward and back translation was performed. The psychometric evaluation was based on data from 102 patients with HF (mean age 61±12 yr, male 75%, New York Heart Association [NYHA] class II 42% and NYHA class III 51%) included in two cross-sectional studies performed in 2007 and 2015-2017 in an Israeli hospital. Content validity, construct validity, known-groups validity, and discriminant validity were assessed. Reliability was evaluated with internal consistency.RESULTS: Content validity and useability were confirmed by HF experts and patients with HF. Construct validity was tested using factor analysis and two factors were extracted (factor 1: consulting behaviour; factor 2: adherence to the regimen). Known-groups validity testing revealed a significant difference before and after an educational intervention in the total score (n=40 [41.6±23.8] vs [67.6±21.8]; p<0.01). A weak correlation between the self-care score and health-related quality of life (r= -0.299, p<0.01) was observed, showing that these concepts were related but not overlapping. Cronbach's alpha was 0.78 for the total scale, 0.76 for factor 1, and 0.68 for factor 2, suggesting that the internal consistency of this scale was acceptable.CONCLUSIONS: Our study provides support for the useability, validity, and reliability of the nine-item Hebrew version of the EHFScB scale.
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| 5. |
- Berglund, Aseel, 1973-, et al.
(författare)
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Understanding and assessing gamification in digital healthcare interventions for patients with cardiovascular disease
- 2022
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 21:6, s. 630-638
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Tidskriftsartikel (refereegranskat)abstract
- Gamification is defined as the use of game design elements in contexts other than gaming to increase user engagement and experience. Gamification in cardiovascular care can contribute to positively change health behaviour with possible effects and benefits on physical health and mental well-being. Based on previous literature, in this article we describe: the conceptualization of gamification, the five gamification principles for gamified digital health programmes or applications, the six most common game elements used to impact health behaviour applied in gamified digital health interventions and finally scientifically validated instruments to use for assessment of gamification in terms of self-reported psychological outcomes.
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| 6. |
- Blomqvist, Andreas, et al.
(författare)
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Usability and feasibility analysis of an mHealth-tool for supporting physical activity in people with heart failure
- 2024
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Ingår i: BMC Medical Informatics and Decision Making. - : BMC. - 1472-6947. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPhysical inactivity and a sedentary lifestyle are common among people with heart failure (HF), which may lead to worse prognosis. On an already existing mHealth platform, we developed a novel tool called the Activity coach, aimed at increasing physical activity. The aim of this study was to evaluate the usability of the Activity coach and assess feasibility of outcome measures for a future efficacy trial.MethodsA mixed-methods design was used to collect data. People with a HF diagnosis were recruited to use the Activity coach for four weeks. The Activity coach educates the user about physical activity, provides means of registering daily physical activity and helps the user to set goals for the next week. The usability was assessed by analysing system user logs for adherence, reported technical issues and by interviews about user experiences. Outcome measures assessed for feasibility were objective physical activity as measured by an accelerometer, and subjective goal attainment. Progression criteria for the usability assessment and for the proposed outcomes, were described prospectively.ResultsTen people with HF were recruited, aged 56 to 78 with median age 72. Data from nine of the ten study participants were included in the analyses. Usability: The Activity coach was used 61% of the time and during the first week two study participants called to seek technical support. The Activity coach was found to be intuitive and easy to use by all study participants. An increased motivation to be more physically active was reported by six of the nine study participants. However, in spite of feeling motivated, four reported that their habits or behaviours had not been affected by the Activity coach. Feasibility: Data was successfully stored in the deployed hardware as intended and the accelerometers were used enough, for the data to be analysable. One finding was that the subjective outcome goal attainment, was challenging to collect. A proposed mitigator for this is to use pre-defined goals in future studies, as opposed to having the study participants be completely free to formulate the goals themselves.ConclusionsIt was confirmed that the Activity coach was easy to use. Furthermore, it might stimulate increased physical activity in a population of people with HF, who are physically inactive. The outcomes investigated seem feasible to include in a future efficacy trial.Trial registrationClinicalTrials.gov identifier: NCT05235763. Date of first registration: 11/02/2022.
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| 7. |
- Blomqvist, Andreas, et al.
(författare)
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Utility of single-item questions to assess physical inactivity in patients with chronic heart failure
- 2020
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Ingår i: ESC Heart Failure. - : WILEY PERIODICALS, INC. - 2055-5822. ; 7:4, s. 1467-1476
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Tidskriftsartikel (refereegranskat)abstract
- Aim The purpose of this study was to explore the utility of two single-item self-report (SR) questions to assess physical inactivity in patients with heart failure (HF). Methods and results This is a cross-sectional study using data from 106 patients with HF equipped with accelerometers for 1 week each. Two SR items relating to physical activity were also collected. Correlations between accelerometer activity counts and the SR items were analysed. Patients were classified as physically active or inactive on the basis of accelerometer counts, and the SR items were used to try to predict that classification. Finally, patients were classified as having high self-reported physical activity or low self-reported physical activity, on the basis of the SR items, and the resulting groups were analysed for differences in actual physical activity. There were significant but weak correlations between the SR items and accelerometer counts: rho = 0.24, P = 0.016 for SR1 and rho = 0.21, P = 0.033 for SR2. Using SR items to predict whether a patient was physically active or inactive produced an area under the curve of 0.62 for SR1, with a specificity of 92% and a sensitivity of 30%. When dividing patients into groups on the basis of SR1, there was a significant difference of 1583 steps per day, or 49% more steps in the high self-reported physical activity group (P < 0.001). Conclusions There might be utility in the single SR question for high-specificity screening of large populations to identify physically inactive patients in order to assign therapeutic interventions efficiently where resources are limited.
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| 8. |
- Cacciata, Marysol C., et al.
(författare)
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Facilitators and Challenges to Exergaming Perspectives of Patients With Heart Failure
- 2022
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Ingår i: Journal of Cardiovascular Nursing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0889-4655 .- 1550-5049. ; 37:3, s. 281-288
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Tidskriftsartikel (refereegranskat)abstract
- Background Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure. Objectives In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure. Methods Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34-69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis. Results The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement. Conclusion Exergaming can increase individuals physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants preferences and capacities, participants past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.
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| 9. |
- Chiala, Oronzo, et al.
(författare)
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RELATIONSHIPS AMONG MEASURES OF PHYSICAL FITNESS IN ADULT PATIENTS WITH HEART FAILURE
- 2019
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 51:8, s. 607-615
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the relationships among 3 measures of physical fitness (exercise capacity, muscle function and functional capacity) in patients with heart failure, and to determine whether these measures are influenced by impairment of movement. Methods: Secondary analysis of baseline data from the Italian subsample (n= 96) of patients with heart failure enrolled in a randomized controlled trial, the HF-Wii study. Exercise capacity was measured with the 6-min walk test, muscle function was measured with the unilateral isotonic heel-lift, bilateral isometric shoulder abduction and unilateral isotonic shoulder flexion, and functional capacity was measured with the Duke Activity Status Index. Principal component analysis was used to detect covariance of the data. Results: Exercise capacity correlated with all of the tests related to muscle function (r=0.691-0.423, pamp;lt; 0.001) and functional capacity (r = 0.531). Moreover, functional capacity correlated with muscle function (r=0.482-0.393). Principal component analysis revealed the bidimensional structure of these 3 measures, thus accounting for 58% of the total variance in the variables measured. Conclusion: Despite the correlations among exercise capacity, muscle function and functional capacity, these measures loaded on 2 different factors. The use of a wider range of tests will help clinicians to perform a more tailored assessment of physical fitness, especially in those patients with heart failure who have impairment of movement.
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| 10. |
- Chiala, Oronzo, et al.
(författare)
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Relationships between exercise capacity and anxiety, depression, and cognition in patients with heart failure
- 2018
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 47:5, s. 465-470
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptoms of anxiety, depression, and cognitive impairment are common in heart failure (HF) patients, but there are inconsistencies in the literature regarding their relationship and effects on exercise capacity. Objectives: The aim of this study was to explore the relationships between exercise capacity and anxiety, depression, and cognition in HF patients. Methods: This was a secondary analysis on the baseline data of the Italian subsample (n = 96) of HF patients enrolled in the HF-Wii study. Data was collected with the 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale, and Montreal Cognitive Assessment. Results: The HF patients walked an average of 222 (SD 114) meters on the 6MWT. Patients exhibited clinically elevated anxiety (48%), depression (49%), and severe cognitive impairment (48%). Depression was independently associated with the distance walked on the 6MWT. Conclusions: The results of this study reinforced the role of depression in relation to exercise capacity and call for considering strategies to reduce depressive symptoms to improve outcomes of HF patients. (C) 2018 Elsevier Inc. All rights reserved.
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| 11. |
- Deka, Pallav, et al.
(författare)
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Combined Dietary Education and High-Intensity Interval Resistance Training Improve Health Outcomes in Patients with Coronary Artery Disease
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reducing cardiovascular risk through lifestyle changes that include a heart-healthy diet and regular exercise is recommended in the rehabilitation of patients with coronary artery disease (CAD). We pilot-tested the effectiveness of a dietary-education and high-intensity interval resistance training (DE-HIIRT) program on healthy food choices and associated anthropometric variables in patients with established CAD. Methods: A total of 22 participants, aged 60.0 +/- 7.2 years, were enrolled in the study. Over 3 months, under the guidance and supervision of a physiotherapist, participants performed the resistance exercises 2x/week in a group setting (cohort of 11). Participants additionally attended three sessions of dietary education led by a dietician. Participants demonstrated their knowledge and understanding of dietary education by picking heart-healthy foods by reading food labels. Outcomes included change in diet (measured using the tricipital skinfold thickness Mediterranean Diet Adherence questionnaire (MEDAS-14) and the Food Consumption Frequency Questionnaire (FCFQ)) and anthropometric measurements (body composition, body circumference, and tricipital skinfold thickness). A paired t-test was performed to analyze the differences between the baseline and post-intervention results. Results: Participants significantly increased their consumption of vegetables (p = 0.04) and lowered their consumption of sweet snacks (p = 0.007), pastries (p = 0.02), and processed food (p = 0.05). Significant improvements in body mass index (p = 0.001), waist circumference (p = 0.0001), hip circumference (p = 0.04), and body fat (p = 0.0001) were also achieved. Conclusion: Making lifestyle changes that include both diet and exercise is essential in the management of CAD. The HIIRT program combined with dietary changes shows promise in achieving weight-loss goals in this population and needs to be further investigated with appropriate study designs.
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| 12. |
- Deka, Pallav, et al.
(författare)
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Depression mediates physical activity readiness and physical activity in patients with heart failure
- 2021
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:6, s. 5259 --5265
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Tidskriftsartikel (refereegranskat)abstract
- Aims Although physical activity (PA) and exercise are essential for patients with heart failure (HF), adherence to the recommended guidelines is low. Not much is known about the mediating effect of HF patients mental state with their readiness for PA and reported activity levels. The purpose of this study is to investigate the mediatory effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA in patients with HF. Methods and results In this cross-sectional study, 163 New York Heart Association Class I and II HF patients, during their clinic visit, reported on their physical limitation (PAR-Q) and psychological readiness [self-efficacy (ESES) and motivation (RM 4-FM)] for PA, depression (HADS-D), and PA (s-IPAQ). Mediation analysis was performed to test the mediating effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA following the steps described by Baron and Kenny (1986). Hierarchical regression models were tested for their effects. The Self-Efficacy Theory and Self-Determination theory provided the theoretical platform for the study. Depression completely mediated the effect of physical limitation (beta(dep) = 268.57; P < 0.0001) and partially mediated the effect of self-efficacy on PA (beta(dep) = 344.16; P < 0.0001). Both intrinsic (P < .0001) and extrinsic motivation (P < .0001) for PA had an independent and significant effect on PA, not mediated by depression. Conclusions Patients with HF should be screened for depression throughout the trajectory of the disease as it can impact their physical and psychological readiness to perform PA.
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| 13. |
- Deka, Pallav, et al.
(författare)
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High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease
- 2022
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Ingår i: Journal of the American Medical Directors Association. - : ELSEVIER SCIENCE INC. - 1525-8610 .- 1538-9375. ; 23:1, s. 60-65
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Both high-intensity interval training (HIIT) and resistance exercises (R) are used in cardiac rehabilitation in patients with coronary artery disease (CAD). However, the combined effect of an HIIT + R exercise program in older adults with CAD is not well investigated. The studys purpose was to assess the changes in anthropometric parameters, physical activity, functional capacity, physiological parameters, and quality of life (QoL) in this population following a combined HIIT + R program. Design: The study was a 2-group (n = 45 each) randomized controlled single-blinded trial. Setting and Participants: The study was done at a treatment clinic of a tertiary hospital. The mean age of participants was 69.23 +/- 4.9 years. The HIIT + R group performed 8 sessions (1/wk) of HIIT + R training. The 30 minutes of the active exercise phase consisted of ten 3-minute bouts. Each bout comprised of 1 minute of high-intensity treadmill walking at 85% to 90% maximum heart rate (MHR), followed by a low-intensity walking at 60%-70% MHR, followed by low-to moderate-intensity resistance training. The Usual Care group underwent conventional medical treatment. Measures: Anthropometric measurements [weight, body mass index (BMI), waist circumference, body fat percentage, lean body mass], physical activity (International Physical Activity Questionnaire), functional capacity (Incremental Shuttle Walking Test), physiologic measurements (blood pressure, heart rate), and QoL (36-Item Short Form Health Survey) were measured pre- and postintervention. Results: Significant group and time interaction were found for the participants in the HIIT + R Group for BMI (P =.001), body fat percentage (P =.001), waist circumference (P <.001), physical activity (P <.001), functional capacity (P <.001), and QoL (P =.001) compared with the UC Group. Significant improvement in systolic blood pressure (P =.001) was seen in the HIIT + R group. Conclusions and Implications: A combined HIIT thorn R training protocol in older adults with CAD can be useful in producing desired health outcomes. Further evaluation of longer duration exercise programs with more frequent dosing needs to be evaluated for their benefits and sustainability. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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| 14. |
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| 15. |
- Deka, Pallav, et al.
(författare)
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Technology Usage, Physical Activity, and Motivation in Patients With Heart Failure and Heart Transplantation
- 2023
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Ingår i: Computers, Informatics, Nursing. - : LIPPINCOTT WILLIAMS & WILKINS. - 1538-2931 .- 1538-9774. ; 41:11, s. 903-908
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Tidskriftsartikel (refereegranskat)abstract
- The cross-sectional study enrolled 231 patients with heart failure (n = 115; 60.87% were men; mean age, 74.34 +/- 12.70 years) and heart transplantation (n = 116; 72.41% were men; mean age, 56.85 +/- 11.87 years) who self-reported their technology usage, physical activity, and source of motivation for exercise. Patients with heart failure were significantly older (P = .0001) than patients with heart transplantation. Physical activity levels in patients with heart failure decreased as the New York Heart Association classification increased. Patients with heart failure reported significantly lower physical activity than patients with heart transplantation (P = .0008). Smartphones were the most widely used electronic device to access the Internet in both groups. Patients with heart transplantation seemed to use more than one device to access the Internet. In both groups, patients reporting more technology usage also reported higher levels of physical activity. Patients who accessed the Internet daily reported lower levels of physical activity. Whereas patients with heart failure identified encouragement by family members as a source of motivation for exercise, patients with heart transplantation reported that they were likely to exercise if motivated by their healthcare provider. Patients with heart failure and heart transplantation have unique technological and motivational needs that need consideration for mobile health-driven interventions.
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| 16. |
- Delgado, Bruno, et al.
(författare)
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The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients : Results of a multicenter randomized controlled trial (ERIC-HF study)
- 2022
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 36:6, s. 813-821
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Tidskriftsartikel (refereegranskat)abstract
- Objective To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design A randomized controlled clinical trial with follow-up at discharge. Settings Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome Functional exercise tolerance was measured with a 6-min walking test at discharge. Results In total 257 patients with DHF were included, with a mean age of 67 +/- 11 years, 84% (n = 205) had a reduced ejection fraction and the hospital stay was 16 +/- 10 days. At discharge, patients in the intervention group walked further compared to the control group (278 +/- 117m vs 219 +/- 115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96 +/- 7 vs 93 +/- 12, p = 0.02) and dyspnea associated to ADL (13 +/- 5 vs 17 +/- 7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p = 0.02). Conclusion The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.
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| 17. |
- Dell'Acqua, Pierangelo, et al.
(författare)
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An Assistive Tool for Monitoring Physical Activities in Older Adults
- 2013
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Konferensbidrag (refereegranskat)abstract
- Active living in older adults reduces disabilities and increases quality of life. Adherence to physical activity is low in older adults, therefore new possibilities to motivate to exercise must be explored. One of this new possibilities is to use exergaming. In this paper, we present an assistive tool for monitoring daily, physical activities in older adults with access to exergaming in their home environments. The proposed system employs the Kinect device and allows one to analyse the body movements. From a pilot study, we proved that the system can detect movements through exergaming. In the future we plan to implement the developed monitoring tool as well as exergaming in nursing homes.
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| 18. |
- Durante, Angela, et al.
(författare)
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Psychological Health Among Older Adults During and After Quarantine: A Multi-Method Study
- 2023
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Ingår i: Western Journal of Nursing Research. - : SAGE PUBLICATIONS INC. - 0193-9459 .- 1552-8456.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Depression among older adults is a growing problem. With aging being a risk factor for COVID-19 infection, depression in this population may have been exacerbated. This study aimed to describe experiences and changes in depressive symptoms and well-being of older adults during and after the COVID-19 first wave in Spain. Methods: The study used a multi-method design. Participants self-reported depressive symptoms (Geriatric Depression Scale) and well-being (Cantril Ladder of Life). Participants were asked about changes in depressive symptoms or well-being during quarantine. If a change was perceived, they were asked to describe the change. In addition, the Patient Global Impression of Change scale was used. Both quantitative and qualitative analyses were performed on the data. Results: 111 participants (mean age: 71 +/- 5 years; 76% women) completed the study. Sixty-three percent reported mild and 2% reported major depressive symptoms. Nearly half (47.7%) reported changes in depressive symptoms during the lockdown. While 37% reported feeling better during the lockdown, about 11% reported depressive symptoms were worse now compared with during the lockdown. 60% reported worsening well-being during the quarantining period. The qualitative analysis revealed 2 main themes: (1) psychological discomfort (mood deflection, fear/worries, and boredom/inactivity) and (2) social issues (inability to go out, missing family members and others). Conclusions: Worsening depressive symptoms and lowering of well-being were noticed in this sample of older adults during and post-COVID lockdowns. Evaluation of mental health in the primary care setting and providing referrals for mental health services is essential for older adults who experienced COVID-19-related lockdowns.
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| 19. |
- Eckerblad, Jeanette, et al.
(författare)
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What frail, older patients talk about when they talk about self-care-a qualitative study in heart failure care
- 2023
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Ingår i: BMC Geriatrics. - : BMC. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSelf-care plays a crucial role in the management of heart failure (HF) and is especially important for older patients who are frail. However, there is limited knowledge about how frail, older patients with HF perceive and experience self-care. Therefore, the aim of this study was to describe the experiences of self-care among frail, older patients with HF.MethodsA qualitative descriptive design with semi-structured interviews with frail, older patients diagnosed with HF (n = 19; median age 82 years). Thematic analysis, guided by Braun and Clarke, was used to analyse the data.ResultsTwo main themes emerged from the analysis: 1) "To maintain my health," encompassing various aspects such as hygiene practices, engaging in physical activity, medication adherence, following a healthy diet, and ensuring adequate rest; and 2) "To maintain my well-being and happiness," highlighting the importance of hobbies, maintaining independence, participating in social activities, and creating a supportive environment.ConclusionThis study provides valuable insights into the perspectives of frail, older patients with HF regarding self-care. It was observed that older patients often associate self-care with general well-being, hygiene, and happiness. Clear communication between healthcare providers and patients is essential to align different perspectives on self-care and ensure that self-care plans are tailored to individual needs. Moreover, addressing the emotional well-being and happiness of patients should be prioritized, as these factors play a significant role in promoting self-care adherence.
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| 20. |
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Gender differences in participation motives for exercise and exergaming in heart failure patients.
- 2014
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Proceedings (redaktörskap) (refereegranskat)abstract
- Purpose: Regular daily exercise is recognized as important in patients with heart failure (HF). The use of exergames (games to improve physical exercise) might be an encouragement for HF patients, especially for people who may be reluctant to engage in more traditional forms of exercise. It is known that participation motives are important factors in able to become more physical active. Therefore the purpose of this study is to examine gender differences in participation motives before access to an exergame computer and the exercise motives after access to an exergame computer at home.Methods: The Wii was installed in the home of HF patients for a period of 12 weeks and patients were instructed to exergame 20 minutes a day (e.g. virtual bowling or tennis). Patients completed a questionnaire on baseline and 12 weeks which included the exercise motivation index (EMI), which measured participation motives. The EMI consists of 15 statements; each statement is followed by a five-point verbal rating from 0 (not important) to 4 (extremely important). Chi-square test was performed to look in gender in participation motives of the EMI and the ESE. P-values<.05 was considered significant.Results: Thirty-two HF patients (age 64 ± 14, 10 female) were included. The exercise motives which scored important or extremely important on baseline were: ‘I want to be in better shape so that my clothes sit better’, ‘I want the ageing process to slow down and feel younger’, ‘Exercise increases my overall well-being’ and ‘I want to be healthier and live longer’. After 12 weeks access to the Nintendo Wii only the participation motive: ‘I want to be healthier and perhaps life longer’ scored important or extremely inportant. Gender differences were found in participation motives at baseline. Female patients significant agreed more on 6 participation motives compared to men: I want to be in better shape so my clothes fit better (3 vs 1), I am proud of myself when I exercise regularly (3 vs 1), I want to look good (2 vs. 1), I want to be as active as my family and my friends (2 vs 1), I feel successful when I am on better shape (3 vs 1) and I want to feel less physical vulnerable (3 vs 1). At 12 weeks there were fewer differences in participation motives. Difference were found where women agreed more on 2 participation motives than men: I want to be as active as my family and my friends (2 vs 1) and People who are in good shape will be admired, I want to be admired too (2 vs 1).Conclusion: This study shows gender differences in the participation motives in becoming physical active and exergaming. Women have more participation motives than men. After 12 weeks access to the Nintendo Wii we found less difference in the participation motives between men and women. Gender differences in participation motives in exergaming were due to social facilitation and I want to be admired, where women agreed more than men.
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| 21. |
- Hammer, Yoav, et al.
(författare)
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Exergaming in patients with a left ventricular assist device : a feasibility study
- 2023
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 10:1, s. 738-741
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Tidskriftsartikel (refereegranskat)abstract
- Aims Exercise games (exergames) have been recently proposed as a mode of facilitating physical activity in patients with chronic diseases. Although patients supported with left ventricular assist devices (LVADs) benefit from physical activity, specific LVAD-related issues hinder their ability to exercise properly. The objective of this study was to assess the feasibility and safety of exergaming in LVAD-supported patients. Methods and results Eleven LVAD-supported patients were enrolled in a 4 week exergaming programme using Nintendo Wii console with five sport games. Patients were instructed to play for 30 min a day, 5 days a week. Data on exercise capacity and exergaming were collected by using the 6 min walk test (6MWT) and a daily self-report diary, respectively. Feasibility of using the console and its safety was assessed by a semi-structured patient interview. Quality of life was assessed by the Minnesota Living with Heart failure Questionnaire (MLHFQ) and the Cantrils Ladder of Life. Safety was assessed by patients report in interview and diary. The study group consisted of 10 male patients and 1 female patient, mean age of 67 +/- 7 years, of whom 10 were supported with the HeartMate 3 LVAD for a median of 10 (interquartile range 3, 21) months. Baseline exercise capacity assessed by the 6MWT ranged from 240 to 570 m (mean 448 +/- 112). After 4 weeks of exergaming, 6MWT distance increased from a mean of 448 +/- 112 (evaluated in six patients) to 472 +/- 113 m (P = 0.023). Patients Cantrils Ladder of Life score improved numerically from an average of 6.13 to 7.67, as did their MLHFQ score from 45.9 +/- 27 to 38.7 +/- 18, with higher and lower scores, respectively, reflecting higher quality of life. No specific LVAD-related safety issues regarding exergaming were reported. Conclusions Exergaming was found to be a safe and feasible mode for encouraging physical activity in LVAD-supported patients and carries a potential for improving exercise capacity and quality of life in these patients. Larger scale studies are warranted to further investigate the effect of exergaming in this patient population.
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| 22. |
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| 23. |
- Jaarsma, Tiny, et al.
(författare)
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Actiever worden met een spelcomputer
- 2011
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Ingår i: Ledenmagazine, de Hart & Vaatgroep. ; 28:3, s. 15-15
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 24. |
- Jaarsma, Tiny, et al.
(författare)
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Changes over time in patient-reported outcomes in patients with heart failure
- 2024
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Ingår i: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 11:2, s. 811-818
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper describes the trajectory during 1 year of four patient-reported outcomes (PROs), namely, sleep, depressive symptoms, health-related quality of life (HrQoL), and well-being, in patients with heart failure (HF), their relationship and the patient characteristics associated with changes in these PROs.METHODS AND RESULTS: Data analyses of PROs from 603 patients (mean age 67 years; 29% female, 60% NYHA II) enrolled in the HF-Wii study. On short term, between baseline and 3 months, 16% of the patients experienced continuing poor sleep, 11% had sustained depressive symptoms, 13% had consistent poor HrQoL, and 13% consistent poor well-being. Across the entire 1-year period only 21% of the patients had good PRO scores at all timepoints (baseline, 3, 6, and 12 months). All others had at least one low score in any of the PROs at some timepoint during the study. Over the 12 months, 17% had consistently poor sleep, 17% had sustained symptoms of depression, 15% consistently rated a poor HrQoL, and 13% poor well-being. Different patient characteristics per PRO were associated with a poor outcomes across the 12 months. Age, education, New York Heart Association, and length of disease were related to two PRO domains and submaximal exercise capacity (6 min test), co-morbidity, and poor physical activity to one.CONCLUSION: In total, 79% of the patients with HF encountered problems related to sleep, depressive symptoms, HrQoL, and well-being at least once during a 1-year period. This underscores the need for continuous monitoring and follow-up of patients with HF and the need for dynamic adjustments in treatment and care regularly throughout the HF trajectory.
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| 25. |
- Jaarsma, Tiny, et al.
(författare)
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Effects of exergaming on exercise capacity in patients with heart failure : results of an international multicentre randomized controlled trial
- 2021
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Ingår i: European Journal of Heart Failure. - : John Wiley & Sons. - 1388-9842 .- 1879-0844. ; 23:1, s. 114-124
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Tidskriftsartikel (refereegranskat)abstract
- AimsExergaming is a new tool to increase physical activity. This study aimed to determine the effects of access to a home‐based exergame (Nintendo Wii) in patients with heart failure (HF) on exercise capacity, self‐reported physical activity and patient‐reported outcome measures.Methods and resultsWe enrolled 605 HF patients in New York Heart Association functional class I–IV, independent of ejection fraction, in an international multicentre randomized controlled trial. Patients were randomized to exergame (intervention) or motivational support (control). The primary endpoint was change in submaximal aerobic exercise capacity as measured by the distance walked in 6 min (6MWT) between baseline and 3 months. Secondary endpoints included long‐term submaximal aerobic exercise capacity, muscle function, self‐reported physical activity, exercise motivation, exercise self‐efficacy at 3, 6 and 12 months. At baseline, patients on average walked 403 ± 142 m on the 6MWT. Patients in the exergame group walked further compared to controls at 3 months (454 ± 123 vs. 420 ± 127 m, P = 0.005), at 6 months (452 ± 123 vs. 426 ± 133 m, P = 0.015) and 12 months (456 ± 122 vs. 420 ± 135 m, P = 0.004). However, correcting for baseline 6MWT values by means of a linear mixed‐effects model revealed no main effect for the intervention on 6MWT. Small significant effects on muscle function were found. Statistically significant treatment effects were found for muscle function but after correction for baseline and confounders, only the treatment effect for the heel‐rise left at 6 months was significant (P < 0.05). No treatment effect was found for exercise motivation, exercise self‐efficacy, or self‐reported physical activity.ConclusionExergaming was safe and feasible in patients with HF with different profiles in different health care systems, cultures and climates. However, it was not effective in improving outcomes on submaximal aerobic exercise capacity. Subgroup analysis did not identify specific subgroups benefiting from the intervention.
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| 26. |
- Jaarsma, Tiny, et al.
(författare)
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Exploring factors related to non-adherence to exergaming in patients with chronic heart failure
- 2021
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Ingår i: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:6, s. 4644-4651
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Tidskriftsartikel (refereegranskat)abstract
- AimsThis study aimed to explore factors related to non-adherence to exergaming in patients with heart failure.Methods and resultsData from patients in the exergame group in the HF-Wii trial were used. Adherence to exergaming was defined as playing 80% or more of the recommended time. Data on adherence and reasons for not exergaming at all were collected during phone calls after 2, 4, 8, and 12 weeks. Logistic regression was performed between patients who were adherent and patients who were non-adherent. Secondly, a logistic regression was performed between patients who not exergamed at all and patients who were adherent to exergaming. Finally, we analysed the reasons for not exergaming at all with manifest content analysis. Almost half of the patients were adherent to exergaming. Patients who were adherent had lower social motivation [odds ratio (OR) 0.072; 95% confidence interval (CI) 0.054-0.095], fewer sleeping problems (OR 0.84; 95% CI 0.76-0.092), and higher exercise capacity (OR 1.003; 95% CI 1.001-1.005) compared with patients who were non-adherent. Patients who not exergamed at all had lower cognition (OR 1.18; 95% CI 1.06-1.31) and more often suffered from peripheral vascular disease (OR 3.74; 95% CI 1.01-13.83) compared with patients who were adherent to exergaming. Patients most often cited disease-specific barriers as a reason for not exergaming at all.ConclusionsA thorough baseline assessment of physical function and cognition is needed before beginning an exergame intervention. It is important to offer the possibility to exergame with others, to be able to adapt the intensity of physical activity.
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| 27. |
- Jaarsma, Tiny, et al.
(författare)
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Factors associated with lack of improvement in submaximal exercise capacity of patients with heart failure
- 2021
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Ingår i: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:6, s. 4539-4548
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Tidskriftsartikel (refereegranskat)abstract
- AimsImprovement in exercise capacity is the primary goal of physical activity programmes for patients with heart failure (HF). Although activity programmes are effective for some patients, others do not benefit. Identifying factors related to a lack of improvement in submaximal exercise capacity may help us interpret findings and design new interventions. The aim of this study is to identify factors contributing to a lack of improvement in submaximal exercise capacity 3 months after physical activity advice or an exergame intervention in patients with HF. Additionally, we aimed to assess differences in lack of improvement in submaximal exercise capacity of patients whose baseline exercise capacity predicted a worse compared with better prognosis of HF.Methods and resultsThis secondary analysis of the HF-Wii study analysed baseline and 3 month data of the 6 min walk test (6MWT) from 480 patients (mean age 67 years, 72% male). Data were analysed separately in patients with a pre-defined 6 min walking distance at baseline of <300 m (n = 79) and >= 300 m (n = 401). Among patients with a baseline 6MWT of >= 300 m, 18% had deteriorated submaximal exercise capacity. In the multiple logistic regression analysis, lower baseline levels of self-reported physical activity [odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.60-0.97], lower baseline levels of cognitive function (OR = 0.87, 95%CI = 0.79-0.96) were significantly associated with lack of improvement in exercise capacity at 3 months. Not randomized to exergaming (OR = 0.63, 95%CI = 0.37-1.09) was likely (P = 0.097) to be associated with lack of improvement in exercise capacity at 3 months. Among the 79 patients with baseline 6MWT of <300 m, 41% (n = 32) did not improve 6MWT distance at 3 months. Independent predictors for the lack of improvement for 6MWT were New York Heart Association class III/IV (OR = 4.68, 95%CI = 1.08-20.35), higher levels of serum creatinine (OR = 1.02, 95%CI = 1.003-1.03), lower cognitive function (OR = 0.86, 95%CI = 0.75-0.99), and fewer anxiety symptoms (OR = 0.84, 95%CI = 0.72-0.98).ConclusionsLower self-reported physical activity and cognitive impairment predict lack of improvement in submaximal exercise capacity in HF patients. Patients who have a worse prognosis (score <300 m at the 6MWT) are often frail and gain less in exercise capacity. These patients may need a more comprehensive approach to have an effect on exercise capacity, including an individually tailored exercise programme with aerobic exercise (if tolerated) and strength exercises.
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| 28. |
- Jaarsma, Tiny, et al.
(författare)
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Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: the rationale, design and methodology of the HF-Wii study; a multicentre randomized controlled trial
- 2015
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Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 17:7, s. 743-748
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Tidskriftsartikel (refereegranskat)abstract
- AimsExercise is known to be beneficial for patients with heart failure (HF), and these patients should therefore be routinely advised to exercise and to be or to become physically active. Despite the beneficial effects of exercise such as improved functional capacity and favourable clinical outcomes, the level of daily physical activity in most patients with HF is low. Exergaming may be a promising new approach to increase the physical activity of patients with HF at home. The aim of this study is to determine the effectiveness of the structured introduction and access to a Wii game computer in patients with HF to improve exercise capacity and level of daily physical activity, to decrease healthcare resource use, and to improve self-care and health-related quality of life.Methods and resultsA multicentre randomized controlled study with two treatment groups will include 600 patients with HF. In each centre, patients will be randomized to either motivational support only (control) or structured access to a Wii game computer (Wii). Patients in the control group will receive advice on physical activity and will be contacted by four telephone calls. Patients in the Wii group also will receive advice on physical activity along with a Wii game computer, with instructions and training. The primary endpoint will be exercise capacity at 3 months as measured by the 6 min walk test. Secondary endpoints include exercise capacity at 6 and 12 months, level of daily physical activity, muscle function, health-related quality of life, and hospitalization or death during the 12 months follow-up.ConclusionThe HF-Wii study is a randomized study that will evaluate the effect of exergaming in patients with HF. The findings can be useful to healthcare professionals and improve our understanding of the potential role of exergaming in the treatment and management of patients with HF.
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| 29. |
- Jaarsma, Tiny, et al.
(författare)
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Preference-based care and research
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
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| 30. |
- Jaarsma, Tiny, et al.
(författare)
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The rise of activity monitoring
- 2019
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Ingår i: European Journal of Preventive Cardiology. - : SAGE PUBLICATIONS LTD. - 2047-4873 .- 2047-4881. ; 26:4, s. 380-381
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
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| 31. |
- Klompstra, Leonie, et al.
(författare)
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A Clinical Tool (CUE-tool) for Health Care Professionals to Assess the Usability and Quality of the Content of Medical Information Websites : Electronic Delphi Study
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As patients are increasingly searching for information about their medical condition on the internet, there is a need for health professionals to be able to guide patients toward reliable and suitable information sources on the internet.OBJECTIVE: The aim of the study was to develop a clinical tool for health care professionals to assess the usability and quality of the content of websites containing medical information that could be recommended to patients.METHODS: A 3-round modified electronic Delphi (eDelphi) study was conducted with 20 health care professionals.RESULTS: In round one of the eDelphi study, of the 68 items initially created, 41 items (29 on usability and 12 on content) were rated as important or very important by more than half of the panel and thus selected for further evaluation in round two. In round two, of the 41 items chosen from round 1, 19 were selected (9 on usability and 10 on content) as important or very important by more than half of the panel for further evaluation. As a result of round three, 2 items were combined as a single item, leaving the instrument with 18 items in total (8 on usability and 10 on content). The tool is freely accessible online.CONCLUSIONS: The CUE-tool can be used to (1) evaluate the usability and reliability of the content of websites before recommending them to patients as a good information source; (2) identify websites that do not have reliable content or may be difficult for patients to use; (3) develop quality websites by using the criteria in the CUE-tool; and (4) identify different qualities between different websites.
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| 32. |
- Klompstra, Leonie, et al.
(författare)
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An in-depth, longitudinal examination of the daily physical activity of a patient with heart failure using a Nintendo Wii at home : a case report
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 45:6, s. 599-602
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the influence of the Nintendo Wii on the daily physical activity of a patient with chronic heart failure at home.METHODS: A 74-year-old Swedish patient with heart failure had access to a Nintendo Wii at home for 12 weeks. Exercise motivation, exercise self-efficacy and exercise capacity were assessed before and after the intervention. Data on perceived physical effort, global well-being and expended energy were collected every day during the intervention.RESULTS: During the 12 weeks of access to the Nintendo Wii, daily physical activity increased by 200% on weekdays and 57% on weekends, compared with baseline. The patient’s exercise motivation and exercise self-efficacy increased during the study, whereas perceived physical effort and global well-being did not change. The patient had no difficulties in using the system and did not suffer any major harm.DISCUSSION: The results of this case study suggest that providing patients with heart failure access to a Nintendo Wii is a promising and safe intervention. The energy expended by the patient per day increased, as did exercise capacity. Playing the Nintendo Wii did not increase the perceived physical effort, but increased motivation to exercise and decreased barriers to exercising.
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| 33. |
- Klompstra, Leonie, et al.
(författare)
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Exercise Motivation and Self-Efficacy Vary Among Patients with Heart Failure - An Explorative Analysis Using Data from the HF-Wii Study
- 2021
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Ingår i: Patient Preference and Adherence. - : Dove Medical Press LTD. - 1177-889X. ; 15, s. 2353-2362
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine profiles in patients with heart failure (HF) regarding their exercise motivation and self-efficacy. Patients & Methods: The baseline data of patients with HF participating in the HFWii study were analysed. In total, 517 patients were divided into four groups based on their exercise motivation (exercise motivation index) and self-efficacy (exercise self efficacy scale). To describe the differences in demographic and clinical variables between the groups, chi-square cross-tabulations and ANOVAs were conducted. Results: The four groups were labelled as insecure avoiders (25%), laid-back strugglers (10%), conscientious self-doubters (42%) and determined achievers (22%). Patients profiles differ according to their motivations and self-efficacy towards exercise. Most patients were conscientious self-doubters (high motivation and low self efficacy), and these patients had more comorbidities and lower exercise capacity compared to the other groups, which could decrease their confidence in exercising. However, only half of the patients who were determined achievers (high motivation and high self-efficacy) reached the recommended amount of physical activity per week. This indicates that motivation and self-efficacy are crucial determinants, but more factors are important for becoming more physically active. Conclusion: Understanding patients motivations and self-efficacy are necessary in order to provide meaningful physical activity counselling and promotion.
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| 34. |
- Klompstra, Leonie, et al.
(författare)
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Exergaming to increase the exercise capacity and daily physical activity in heart failure patients : a pilot study
- 2014
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 14:119
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRegular daily physical activity is recognised as important in heart failure (HF) patients, but adherence to physical activity is low (<50%). To improve adherence to exercise in HF patients, alternative approaches to motivate and increase self-efficacy to exercise are needed. Therefore, we have studied a new phenomenon: exergames (games to improve physical exercise). The aims of the study were to assess the influence of the exergame platform Nintendo Wii on exercise capacity and daily physical activity in heart failure patients, to study factors related to exercise capacity and daily physical activity, and to assess patients’ adherence to exergaming.MethodsA 12-week pilot study with a pretest-posttest design was conducted. The intervention consisted of an instruction on how to use the Wii and 12 weeks’ access to Wii at home. The main variables tested were exercise capacity (measured with a six-minute walking test), daily physical activity (measured with an activity monitor), and time exergaming (daily self-report with a diary). Bivariate correlations were used to assess associations between symptom experience, self-efficacy, motivation, anxiety, and depression.ResultsIn total, 32 heart failure patients were included. More than half of the patients (53%) significantly increased their exercise capacity after 12 weeks. No significant difference was found in daily physical activity between baseline and 12 weeks. Lower NYHA class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The daily mean time spent exergaming was 28 minutes, and having grandchildren and being male were related to more time spent exergaming.ConclusionExergaming has the potential to increase exercise capacity in elderly, chronically ill cardiac patients. Although the daily physical activity did not change over time, exergaming was feasible for heart failure patients and might be a rehabilitation option for patients with heart failure
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| 35. |
- Klompstra, Leonie, et al.
(författare)
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Experience of physical activity described by patients with heart failure who have received individualized exercise advice : A qualitative study
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the experience of physical activity in patients with heart failure who were randomized to a control group in which they received exercise advice and motivational support.Design: A qualitative descriptive interview study, using qualitative content analysis.Patients: Fifteen patients with heart failure.Methods: Interviews with members of the control group in a physical activity trial (Heart Failure-Wii study), who received exercise advice and telephone follow-ups.Results: The experience of physical activity was described by 4 categories: (1) affected by study participation; (ii) impact of having heart failure; (iii) mixed feelings when physically active; and (iv) influence of the social and physical environment. Study participation made patients feel encouraged or obliged, or they gained a sense of security in connection with becoming more physically active. Symptoms, side-effects and barriers could hamper their physical activity. They changed their type and level of physical activity, or used resources or equipment to become physically active. Patients experienced physical and emotional improvements and developed routines and structures, and their environment and caregivers were able to influence their physical activity.Conclusion: The role of study participation, having heart failure, and psychological and environmental factors describe the experiences of physical activity in patients with heart failure who were randomized to a control group, and are important in evaluating and motivating patients' physical activity.
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| 36. |
- Klompstra, Leonie, et al.
(författare)
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Factors related to health-related quality of life in older people with multimorbidity and high health care consumption over a two-year period
- 2019
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Ingår i: BMC Geriatrics. - : BMC. - 1471-2318. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe prevalence of multimorbidity is increasing worldwide, and older people with multimorbidity are frequent users of health care services. Since multimorbidity has a significant negative impact on Health-related Quality of Life (HrQoL) and is more common in older age it would be expected that factors related to HrQoL in this group might have been thoroughly researched, but this is not the case. Furthermore, it is important to look at old people living at home, considering the shift from residential to home-based care. Therefore, we aim to investigate factors that are related to HrQoL in older people with multimorbidity and high health care consumption, living at home.MethodsThis is a secondary analysis of a RCT study conducted in a municipality in south-eastern Sweden. The study had a longitudinal design with a two-year follow-up period assessing HrQoL, symptom burden, activities of daily living, physical activity and depression.ResultsIn total, 238 older people with multimorbidity and high health care consumption, living at home were included (mean age 82, 52% female). A multiple linear regression model including symptom burden, activities of daily living and depression as independent variables explained 64% of the HrQoL. Higher symptom burden, lower ability in activities of daily living and a higher degree of depression were negatively related to HrQoL. Depression at baseline and a change in symptom burden over a two-year period explained 28% of the change in HrQoL over a two-year period variability. A higher degree of depression at baseline and negative change in higher symptom burden were related to a decrease in HrQoL over a two-year period.ConclusionIn order to facilitate better delivery of appropriate health care to older people with high health care consumption living at home it is important to assess HrQoL, and HrQoL over time. Symptom burden, activities of daily living, depression and change in symptom burden over time are important indicators for HrQoL.Trial registrationClinicaltrials.gov identifier: NCT01446757, the trial was registered prospectively with the date of trial registration October 5(th), 2011.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Klompstra, Leonie, et al.
(författare)
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Measuring physical activity with activity monitors in patients with heart failure: from literature to practice. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology
- 2021
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Ingår i: European Journal of Heart Failure. - : WILEY. - 1388-9842 .- 1879-0844.
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this paper were to provide an overview of available activity monitors used in research in patients with heart failure and to identify the key criteria in the selection of the most appropriate activity monitor for collecting, reporting, and analysing physical activity in heart failure research. This study was conducted in three parts. First, the literature was systematically reviewed to identify physical activity concepts and activity monitors used in heart failure research. Second, an additional scoping literature search for validation of these activity monitors was conducted. Third, the most appropriate criteria in the selection of activity monitors were identified. Nine activity monitors were evaluated in terms of size, weight, placement, costs, data storage, water resistance, outcomes and validation, and cut-off points for physical activity intensity levels were discussed. The choice of a monitor should depend on the research aims, study population and design regarding physical activity. If the aim is to motivate patients to be active or set goals, a less rigorously tested tool can be considered. On the other hand, if the aim is to measure physical activity and its changes over time or following treatment adjustment, it is important to choose a valid activity monitor with a storage and battery longevity of at least one week. The device should provide raw data and valid cut-off points should be chosen for analysing physical activity intensity levels. Other considerations in choosing an activity monitor should include data storage location and ownership and the upfront costs of the device.
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| 43. |
- Klompstra, Leonie, et al.
(författare)
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Objectively measured physical activity in patients with heart failure : a sub-analysis from the HF-Wii study
- 2022
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 21:5, s. 499-508
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Tidskriftsartikel (refereegranskat)abstract
- Aims Physical activity (PA) is important in patients with heart failure (HF) to improve health outcomes. The adherence to PA is low, and therefore, novel approaches are necessary to increase PA. We aimed to determine the difference in PA in patients with HF who have access to exergaming compared to patients who received motivational support and to explored predictors of a clinically relevant change in non-sedentary time between baseline and 3 months. Methods and results In total, 64 patients (mean age 69 +/- 9 years, 27% female) wore an accelerometer 1 week before and 1 week after the intervention. Data were analysed using logistic regression analysis. Patients spent 9 h and 43 min (+/- 1 h 23 min) during waking hours sedentary. There were no significant differences in PA between patients who received an exergame intervention or motivational support. In total, 30 of 64 patients achieved a clinically relevant increase in non-sedentary time. Having grandchildren [odds ratio (OR) 7.43 P = 0.03], recent diagnosis of HF (OR 0.93 P = 0.02), and higher social motivation (OR 2.31 P = 0.03) were independent predictors of a clinically relevant increase of non-sedentary time. Conclusion Clinicians should encourage their patients to engage in alternative approaches to improve PA and reduce sedentary habits. Future exergaming interventions should target individuals with chronic HF who have low social motivation and a low level of light PA that may benefit most from exergaming. Also (non-familial), intergenerational interaction is important to enabling patients in supporting patients in becoming more active.
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| 44. |
- Klompstra, Leonie, et al.
(författare)
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Physical activity in daily life in heart failure patients living in two European countries, Volume 17, Issue Supplement S1
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aims: Exercise is recognized as important in patients with heart failure (HF). It is unclear if there are differences in physical activity between European Countries, therefore the aims of this study were to-Assess physical activity levels in HF patients,-Describe the different types of physical activity of HF patients -Explore differences between patients from Spain and Sweden Method: The short International Physical Activity Questionnaire (sIPAQ) was used to assess the level of physical activity during the previous week. The sIPAQ contains seven items to identify the frequency and duration of light, moderate, and vigorous PA, as well as inactivity during the past week. Data was collected during April-July 2014 in Swedish and Spanish HF patients. Differences were analysed using Pearson’s chi-square or Mann-Whitney U test.Results: Population:548 Spanish and 154 Swedish HF patients29% female, mean age 69±12 years, 75% NYHA class II/19% NYHA IIINo differences were found in gender, age NYHA class between the two countries Patients in Sweden compared to Spanish patients:Had a higher mean physical activity levelDid more vigorous activities, like lifting, digging, aerobics, or fast bicyclingDid more moderate activities like carrying light loads, bicycling at a regular pace, or doubles tennis.Did less walking (walking at work and at home, walking to travel from place to place, and any other walking that might be done solely for recreation, sport, exercise, or leisure) Conclusions: Despite that most of the patients were in NYHA class II and not symptomatic even at moderate to high level of activity, one third of them had a low physical activity level in their daily life.We found differences in the kind of physical activities between Spain and Sweden, which could be due to cultural and regional differences. Specific differences and consequences need to be further explored.
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| 45. |
- Klompstra, Leonie, 1982-
(författare)
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Physical activity in patients with heart failure : motivations, self-efficacy and the potential of exergaming
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Adherence to recommendations for physical activity is low in patients with heart failure (HF). It is essential to explore to what extent and why patients with HF are physically active. Self-efficacy and motivation for physical activity are important in becoming more physically active, but the role of self-efficacy in the relationship between motivation and physical activity in patients with HF is unknown. Alternative approaches to motivate and increase self-efficacy to exercise are needed. One of these alternatives might be using exergames (games to improve physical exercise). Therefore, it is important to obtain more knowledge on the potential of exergaming to increase physical activity.The overall aim was to describe the physical activity in patients with HF, with special focus on motivations and self-efficacy in physical activity, and to describe the potential of exergaming to improve exercise capacity.Methods: Study I (n = 154) and II (n = 101) in this thesis had a cross-sectional survey design. Study III (n = 32) was a 12-week pilot intervention study, including an exergame platform at home, with a pretest-posttest design. Study IV (n = 14) described the experiences of exergaming in patients who participated in the intervention group of a randomized controlled study in which they had access to an exergame platform at home.Results: In total, 34% of the patients with HF had a low level of physical activity, 46% had a moderate level, 23% reported a high level. Higher education, higher selfefficacy, and higher motivation were significantly associated with a higher amount of physical activity. Barriers to exercise were reported to be difficult to overcome and psychological motivations were the most important motivations to be physically active. Women had significantly higher total motivation to be physically active. Self-efficacy mediated the relationship between exercise motivation and physical activity; motivation leads to a higher self-efficacy towards physical activity.More than half of the patients significantly increased their exercise capacity after 12 weeks of using an exergame platform at home. Lower NYHA-class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The mean time spent exergaming was 28 minutes per day. Having grandchildren and being male were related to more time spent exergaming.The analysis of the qualitative data resulted in three categories describing patients’ experience of exergaming: (i) making exergaming work, (ii) added value of exergaming, (iii) no appeal of exergaming.Conclusion: One-third of the patients with HF had a low level of physical activity in their daily life. Level of education, exercise self-efficacy, and motivation were important factors to take into account when advising patients with HF about physical activity. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of exercise self-efficacy.Exergaming has the potential to increase exercise capacity in patients with HF. The results also showed that this technology might be suitable for some patients while others may prefer other kinds of physical activity.
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| 46. |
- Klompstra, Leonie, et al.
(författare)
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Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences
- 2015
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Ingår i: Patient Preference and Adherence. - : DOVE MEDICAL PRESS LTD. - 1177-889X. ; 9, s. 1603-1610
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adherence to recommendations for physical activity is low in both male and female patients with heart failure (HF). Men are more physically active than women. In order to successfully promote physical activity, it is therefore essential to explore how much and why HF patients are physically active and if this is related to sex. The aim of this study was therefore to evaluate physical activity in HF patients, to describe the factors related to physical activity, and to examine potential barriers and motivations to physical activity with special focus on sex differences. Methods: The study had a cross-sectional survey design. HF patients living at home received a questionnaire during May-July 2014, with questions on physical activity (from the Short Form-International Physical Activity Questionnaire), and potential barriers and motivations to physical activity. Results: A total of 154 HF patients, 27% women, with a mean age of 70 +/- 10 were included. In total, 23% of the patients reported a high level of physical activity, 46% a moderate level, and 34% a low level. Higher education, self-efficacy, and motivation were significantly associated with a higher amount of physical activity. Symptoms or severity of the disease were not related to physical activity. All the potential barriers to exercise were reported to be of importance. Psychological motivations were most frequently rated as being the most important motivation (41%) to be physically active. Physical motivations (33%) and social motivations were rated as the least important ones (22%). Women had significantly higher total motivation to be physically active. These differences were found in social, physical, and psychological motivations. Discussion: One-third of the HF patients had a low level of physical activity in their daily life. Severity of the disease or symptoms were not related, whereas level of education, exercise self-efficacy, and motivation were important factors to take into account when advising a HF patient about physical activity. Women reported higher motivation to be physically active than men, but there was no difference in the reported level of physical activity.
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| 47. |
- Klompstra, Leonie, et al.
(författare)
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Seasonal variation in physical activity in patients with heart failure
- 2019
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 48:5, s. 381-385
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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.
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| 48. |
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| 49. |
- Klompstra, Leonie, et al.
(författare)
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Using a virtual reality application to improve physical activity in heart failure patients
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: A virtual reality application might be a promising tool to increase exercise in the homes of patients with Heart failure (HF). However, the feasibility to use an exergame for elderly heart failure patients, from patient and provider perspective is currently not known. The aim is to assess the feasibility to increase daily activity in HF patients using the Wii game console.Method: A descriptive study design will be used. Nintendo Wii sport will be used by 40 patients with HF. Intervention: Nintendo Wii sport will be installed in the home of 10 heart failure patients for a period of 3 months. A personalized exercise plan will be made with the patient for 10 weeks by a physiotherapist or nurse. An instructor will help the patient to install and set up the program, to make a training plan and to help the patient to use the system.Data collection: At baseline, at 3 and 6 months data will be collected on self care behavior, heart failure knowledge, exercise self-efficacy, exercise motivation and depression and anxiety. During the use of the Wii computer patients fill in a diary which contains questions about heart failure symptom monitoring, global well-being, perceived exertion and daily activity. At 3 and 6 months a qualitative interview will be conducted to assess the feasibility of using the Wii computer. Patients will also use activity monitors (SenseWear and Direct Life) to assess the total daily activity. Actual use, problems and questions to the instructor will also be assessed.Results: The first patients are recruited for the study and data are planned to be available during the conferenceConclusion: This study will provide insight on the feasibly to apply virtual reality application in HF patients to increase their physical activity in their home.
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| 50. |
- Klompstra, Leonie, et al.
(författare)
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Using virtual reality to increase exercise capacity of heart failure patients
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose Exercise is an important self-care behaviour and is related to decreased mortality in heart failure (HF). There are several barriers for HF patients to start exercising in conventional ways (rehabilitation center, fitness club).Virtual reality might be a solution to increase exercise at home. The Wii, a video game console made by Nintendo, uses virtual reality to increases the possibilities to exercise. The aim of this study was to assess change in exercise capacity in HF patients using the Wii game console at home for 12 weeks and examine factors related to this change.Methods The Wii was installed in the home of 32 HF patients (age 64 ± 14 years, 10 female, 68% NYHA II) for a period of 12 weeks. At baseline and at 12 weeks the patients performed the 6-minute walking test (6MWT) to assess physical capacity and completed a questionnaire concerning exercise self-efficacy and exercise motivation. Patients also completed a diary about the amount of minutes playing on the Wii, HF symptoms and perceived exertion.Results At baseline patients walked on the 6MWT a mean distance of 500 (±93) meters and at 12 weeks this had increased to 521 (±101) meters. More than half of the patients (n=17) had a clinically significant improvement of 30 meters or more and 9 patients (28%) decreased the amount of meters walked. One patient (3%) increased in the amount of meters but less than 30 meters. Patients who increased the amount of meters during 6MWT had a significant lower NYHA class. No associations were found between change in meter walked and the amount of minutes played on the Wii, the perceived exertion, or HF symptomsConclusion Virtual reality in the rehabilitation of HF patients is a new innovative method to increase activity. More than half of the patients in this pilot study achieved a clinically relevant increase in exercise capacity due to access to the Wii at home for 12 weeks. Patients with a lower functional class at baseline seemed to benefit the most using the Wii.
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