| 1. |
- Denfeld, Quin E., et al.
(författare)
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Assessing and managing frailty in advanced heart failure: An International Society for Heart and Lung Transplantation consensus statement
- 2024
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Ingår i: The Journal of Heart and Lung Transplantation. - : Elsevier. - 1053-2498 .- 1557-3117. ; 43:1
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Tidskriftsartikel (refereegranskat)abstract
- Frailty is increasingly recognized as a salient condition in patients with heart failure (HF) as previous studies have determined that frailty is highly prevalent and prognostically significant, particularly in those with advanced HF. Definitions of frailty have included a variety of domains, including physical performance, sarcopenia, disability, comorbidity, and cognitive and psychological impairments, many of which are common in advanced HF. Multiple groups have recently recommended incorporating frailty assessments into clinical practice and research studies, indicating the need to standardize the definition and measurement of frailty in advanced HF. Therefore, the purpose of this consensus statement is to provide an integrated perspective on the definition of frailty in advanced HF and to generate a consensus on how to assess and manage frailty. We convened a group of HF clinicians and researchers who have expertise in frailty and related geriatric conditions in HF, and we focused on the patient with advanced HF. Herein, we provide an overview of frailty and how it has been applied in advanced HF (including potential mechanisms), present a definition of frailty, generate suggested assessments of frailty, provide guidance to differentiate frailty and related terms, and describe the assessment and management in advanced HF, including with surgical and nonsurgical interventions. We conclude by outlining critical evidence gaps, areas for future research, and clinical implementation. J Heart Lung Transplant 2024;43:1-27 (c) 2023 International Society for Heart and Lung Transplantation. All rights reserved.
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| 2. |
- Hill, Loreena, et al.
(författare)
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Integration of a palliative approach into heart failure care: aEuropean Society of Cardiology Heart Failure Associationposition paper
- 2020
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Ingår i: European Journal of Heart Failure. - : WILEY. - 1388-9842 .- 1879-0844. ; 22:12, s. 2327-2339
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Tidskriftsartikel (refereegranskat)abstract
- The Heart Failure Association of the European Society of Cardiology has published a previous position paper and various guidelines over the past decade recognizing the value of palliative care for those affected by this burdensome condition. Integrating palliative care into evidence-based heart failure management remains challenging for many professionals, as it includes the identification of palliative care needs, symptom control, adjustment of drug and device therapy, advance care planning, family and informal caregiver support, and trying to ensure a good death. This new position paper aims to provide day-to-day practical clinical guidance on these topics, supporting the coordinated provision of palliation strategies as goals of care fluctuate along the heart failure disease trajectory. The specific components of palliative care for symptom alleviation, spiritual and psychosocial support, and the appropriate modification of guideline-directed treatment protocols, including drug deprescription and device deactivation, are described for the chronic, crisis and terminal phases of heart failure.
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| 3. |
- Neubeck, Lis, et al.
(författare)
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The Core Curriculum for Cardiovascular Nurses and Allied Professionals
- 2023
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Ingår i: European Journal of Cardiovascular Nursing. - : OXFORD UNIV PRESS. - 1474-5151 .- 1873-1953. ; 22:7, s. e62-e113
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Tidskriftsartikel (refereegranskat)abstract
- This 2023 update of the Core Curriculum in Cardiovascular Nursing (2015) embraces the formation of the Association of Cardiovascular Nursing and Allied Professionals and reflects the diverse professional backgrounds of our members, including nurses, allied health professionals, and healthcare scientists (in this document referred to collectively as Nurses and Allied Professionals).
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| 4. |
- Uchmanowicz, Izabella, et al.
(författare)
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Can we prevent frailtyism?
- 2021
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Ingår i: European Journal of Cardiovascular Nursing. - : OXFORD UNIV PRESS. - 1474-5151 .- 1873-1953. ; 20:8, s. 731-732
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
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| 5. |
- Uchmanowicz, Izabella, et al.
(författare)
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Cross-cultural adaptation and reliability testing of Polish adaptation of the European Heart Failure Self-care Behavior Scale (EHFScBS)
- 2014
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Ingår i: Patient Preference and Adherence. - : Dove Medical Press. - 1177-889X. ; 8, s. 1521-1526
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Tidskriftsartikel (refereegranskat)abstract
- Background: Development of simple instruments for determination of self-care levels in heart failure (HF) patients is a subject of ongoing research. One such instrument, gaining growing popularity worldwide, is the European Heart Failure Self-care Behavior Scale (EHFScBS). The aim of this study was to adapt and to test reliability of the Polish version of EHFScBS. Method: A standard guideline was used for translation and cultural adaptation of the English version of EHFScBS into Polish. The study included 100 Polish HF patients aged between 24 and 91 years, among them 67 men and 33 women. Cronbachs alpha was used for analysis of the internal consistency of EHFScBS. Results: Mean total self-care score in the study group was 34.2 +/- 8.1 points. Good or satisfactory level of self-care were documented in four out of 12 analyzed EHFScBS domains. Cronbachs alpha for the entire questionnaire was 0.64. The value of Cronbachs alpha after deletion of specific items ranged from 0.55 to 0.65. Conclusion: Polish HF patients present significant deficits of self-care, which are to a large extent associated with inefficacy of the public health care system. Apart from cultural characteristics, the socioeconomic context of the target population should be considered during language adaptation of EHFScBS, as well as during interpretation of data obtained with this instrument. A number of self-care-related behaviors may be optimized as a result of appropriate educational activities, also those offered by nursing personnel.
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| 6. |
- Uchmanowicz, Izabella, et al.
(författare)
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Frailty Syndrome in cardiovascular disease: Clinical significance and research tools
- 2015
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier / SAGE Publications (UK and US): 12 month Embargo. - 1474-5151 .- 1873-1953. ; 14:4, s. 303-309
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Tidskriftsartikel (refereegranskat)abstract
- Frailty Syndrome is one of the key health problems in geriatrics, strongly affecting poor prognosis. There is a growing interest in the relevance of this syndrome in cardiovascular disease. The diagnosis of Frailty Syndrome in the elderly cardiac population is essential for an accurate risk stratification and for making therapeutic decisions. Most risk assessment systems used in cardiology are based on chronological age, which does not always reflect the biological age of a patient, therefore making an inadequate risk estimation. This paper discusses the definitions of Frailty Syndrome and research tools used to identify it. We specifically address the role of Frailty Syndrome in cardiovascular disease and the diagnostic and therapeutic difficulties in patients with Frailty Syndrome, emphasizing the role of the identification of Frailty Syndrome in making therapeutic decisions and the stratification of cardiovascular risk in patients with cardiologic conditions.
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| 7. |
- Uchmanowicz, Izabella, et al.
(författare)
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Optimising implementation of European guidelines on cardiovascular disease prevention in clinical practice : what is needed?
- 2021
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Ingår i: European Journal of Preventive Cardiology. - : Oxford Academic. - 2047-4873 .- 2047-4881. ; 28:4, s. 426-431
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular disease is a model example of a preventable condition for which practice guidelines are particularly important. In 2016, the joint task force created by the European Society of Cardiology (ESC) together with 10 other societies released the new version of the European guidelines on cardiovascular disease prevention. To facilitate the implementation of the ESC guidelines, a dedicated prevention implementation committee has been established within the European Association of Preventive Cardiology. The paper will first explore potential barriers to the guidelines' implementation. It then develops a discussion that seeks to inform the future development of the committee's work, including a new definition of the guidelines' stakeholders (health policy-makers, healthcare professionals and health educators, patient organisations, entrepreneurs and the general public), future activities within four specific areas: strengthening awareness of the guidelines among stakeholders; supporting organisational changes to facilitate the guidelines' implementation; motivating stakeholders to utilise the guidelines; and present ideas on new implementation strategies. Providing multifaceted cooperation between healthcare professionals, healthcare management executives and health policy-makers, the novel approach proposed in this paper should contribute to a wider use of the 2016 ESC guidelines and produce desired effects of less cardiovascular disease morbidity and mortality. Furthermore, the solutions presented within the paper may constitute a benchmark for the implementation of practice guidelines in other medical disciplines.
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| 8. |
- Wleklik, Marta, et al.
(författare)
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Psychometric Evaluation Of Appetite Questionnaires In Elderly Polish Patients With Heart Failure
- 2019
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Ingår i: Patient Preference and Adherence. - : Dove Medical Press LTD. - 1177-889X. ; 13, s. 1751-1759
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Loss of appetite is caused by multifaceted disorders and affects an average of 40% of patients with heart failure (HF). The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are designed to assess appetite among older adults. We aimed to assess the psychometric properties of both CNAQ and SNAQ questionnaires in elderly Polish patients with HF.Methods: The study sample involved 103 patients aged >= 65 years with HF diagnosed according to the New York Heart Association (NYHA) functional classes II-IV. The study was conducted among hospitalized patients with HF. In the study, the Mini Nutritional Assessment (MNA) questionnaire was used to assess the validity of the questionnaire. The evaluation of the following psychometric values was taken into account: data quality and homogeneity, factor structure, construct validity and internal consistency.Results: Parallel analysis confirmed the unidimensional structure of both CNAQ and SNAQ. The adjusted eigenvalues for CNAQ were 3.50 for the first factor and 0.62 for the second factor, and for SNAQ they were 2.2 and 0.31, respectively. For CNAQ, the desired CFA values were obtained after modification (RMSEA <0.06, CFI, TLI> 0.95), for SNAQ without modification (RMSEA <0.06, CFI, TLI> 0.95). The correlation between CNAQ and SNAQ and MNA was strong (rs = 0.8 and rs = 0.81, p <0.001, respectively). The internal consistency of the CNAQ and SNAQ tools was 0.88 and 0.86, respectively.Conclusion: The CNAQ and SNAQ questionnaires have positive psychometric properties and can be used to evaluate appetite among elderly Polish patients with HF.
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