| 1. |
- Jaarsma, Tiny, et al.
(författare)
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Sexual function in patients with advanced heart failure
- 1996
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Ingår i: Heart & Lung. - 0147-9563 .- 1527-3288. ; 25:4, s. 262-270
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the effect of low ejection fraction on sexual function and the relation between alterations in sexual function and pertinent clinical, demographic, and psychosocial variables in patients with advanced heart failure. DESIGN: This study was descriptive and correlational in design. SETTING: The setting was an outpatient clinic of a university-affiliated hospital. SUBJECTS: Sixty-two male (82%) and female (18%) patients with advanced heart failure (New York Heart Association [NYHA] class III or IV) were studied. MEASURES: Exercise tolerance and symptom severity were assessed by the 6-minute walk and NYHA classification. Ejection fraction was measured by echocardiography. Alterations in the patients' emotional, social, and sexual function were assessed with the self-report version of the Psychosocial Adjustment to Illness Scale. RESULTS: Approximately three quarters of the patients reported a marked decrease in sexual interest and in the frequency of sexual relations caused by illness, with one quarter having ceased all sexual activity. Half the patients described having experienced marked reductions, after heart failure developed, in the pleasure or satisfaction they normally experienced from sex. Few patients had arguments with their spouses about sex or reported significant marital problems as a result of their illness. A significant relation was documented between patients' sexual function and the results of the 6-minute walk (r = 0.32, p < 0.005), as well as between sexual function and NYHA functional class (r = 0.21, p < 0.05). Sexual function was also related to the patient's social environment (r = 0.59, p < 0.001), psychologic distress (r = 0.38, p < 0.001), and domestic environment (r = 0.29, p < 0.05). No significant differences in sexual function were noted when patients were compared on the basis of differences in ejection fraction, medications, gender, or age. CONCLUSION: Advanced heart failure results in marked changes in libido and in the ability to perform sexually. These changes do not affect the marital relationship negatively, at least in the view of the patient. As patients' symptoms of heart failure become increasingly more severe, physicians and nurses need to counsel patients and their spouses about the changes they may experience in their sexual relationships. Attention needs to focus on ways to cope with the decreasing physical status that accompanies advanced heart failure to minimize negative changes in sexual functioning.
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| 2. |
- Bengtson, Ann, 1947, et al.
(författare)
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Cardiovascular and psychosomatic symptoms among relatives of patients waiting for possible coronary revascularization.
- 1996
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Ingår i: Heart & Lung: Journal of Acute & Critical Care. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 25:6, s. 438-43
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the consequences for close family members of patients on a waiting list for possible coronary revascularization. BACKGROUND: An increasing number of patients with symptomatic ischemic heart disease require evaluation for possible revascularization. Many of these patients must wait a long time before receiving treatment. The negative consequences of this long wait for patients and their relatives have not been satisfactorily evaluated previously. DESIGN: Cross-sectional descriptive study. SETTING: All hospitals in Southwestern Sweden. STUDY POPULATION: One hundred relatives of patients referred for possible revascularization and a sex- and age-matched reference group. The convenience sample consisted of 85% (n = 76) women and 15% (n = 13) men. OUTCOME MEASURES: Frequency of cardiovascular and psychosomatic symptoms. EVALUATION: One hundred relatives and 100 members of the control group were sent a questionnaire to evaluate their clinical condition; working situation; use of tobacco, alcohol and sedatives; and cardiovascular and psychosomatic symptoms. RESULTS: Family members had a significantly higher frequency of anxiety, depression, and irritability compared with the control group. Furthermore, family members reported sleeping disorders, including difficulty waking, tiredness due to lack of sleep, and restless sleep, more frequently than did the control group. CONCLUSION: Close family members of patients waiting for coronary revascularization have particular difficulties, and these difficulties should receive more attention.
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| 3. |
- Everts, B, et al.
(författare)
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Localization of pain in suspected acute myocardial infarction in relation to final diagnosis, age and sex, and site and type of infarction
- 1996
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Ingår i: Heart & Lung. - : Heart & Lung. - 0147-9563 .- 1527-3288. ; 25:6, s. 430-437
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the localization of pain in consecutive patients admitted to the coronary care unit for possible acute myocardial infarction (AMI) and to relate it to the development of AMI, age, and gender. DESIGN: Prospective evaluation. SETTING: Sahlgrenska Hospital, covering half the area of the city of Göteborg, with half a million inhabitants. SUBJECTS: Nine hundred three consecutive patients admitted to the coronary care unit for possible AMI between 24 and 87 years old with a mean age of 64 years. OUTCOME MEASURES: Localizations of pain according to a self-constructed figure. Patient were approached between 1 and 14 days after onset of symptoms and asked to describe the localization of pain according to the figure, including nine positions on the chest, left and right arm, neck, and back. RESULTS: AMI developed in 50% of patients during the first 3 days in hospital. Patients in whom AMI developed localized their pain to an extent similar to those without AMI in seven of nine chest areas. However, patients with AMI reported pain in the upper right square of the chest more frequently (p < 0.001) and in the middle left square of the chest less frequently (p < 0.01) than did patients without AMI. Pain in both the right (p < 0.001) and left arms (p < 0.01) was more frequently reported by patients who had AMI. Among patients with AMI, women reported pain in the neck (p < 0.05) and in the back (p < 0.01) more frequently than did men. Compared with elderly patients, younger patients reported pain more frequently in the left arm (p < 0.01), right arm (p < 0.01), and neck (p < 0.05). CONCLUSIONS: Among consecutive patients with possible AMI admitted to the coronary care unit, patients who had confirmed AMI reported pain in both arms more frequently than did patients without AMI. However, both groups described their chest surface distribution of pain similarly in the majority of positions, thereby indicating that the localization of chest pain is of limited use in predicting which patients will eventually have AMI.
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| 4. |
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| 5. |
- Hofgren, K, et al.
(författare)
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Prodromal symptoms in subsets of patients hospitalized for suspected acute myocardial infarction
- 1995
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Ingår i: Heart & Lung. - : Mosby, Inc.. - 0147-9563 .- 1527-3288. ; 24:1, s. 3-10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the occurrence of prodromal symptoms in suspected acute myocardial infarction (AMI) and to relate such symptoms to final diagnosis and previous history. DESIGN: Prospective study. SETTING: Coronary care unit in Sahlgrenska Hospital in Göteborg, Sweden. PATIENTS: 914 patients admitted to the coronary care unit for suspected AMI. OUTCOME MEASURES: Chest pain within the last 48 hours or other prodromal symptoms. RESULTS: Among patients in whom AMI developed, 57% reported prodromal chest pain and 61% reported other prodromal symptoms. Size, location, or type (Q-wave versus non-Q-wave AMI) did not influence outcome. Women reported more prodromal symptoms than men (p < 0.05), whereas age did not influence results. A similar proportion of patients with no confirmed AMI reported prodromal symptoms. Fifty-nine percent of patients with prodromal symptoms had wished to contact a physician if possible, and in fact one third did so. Two thirds of all patients were at rest, and one third reported some emotional distress before onset of the symptoms that brought them to hospital. CONCLUSION: A large proportion of patients with suspected AMI experienced prodromal symptoms before onset of suspected AMI. Such symptoms were more common in women but were not affected by size, location, or type of AMI. The symptoms were so severe that 59% of the patients with such symptoms wished to contact a physician before arrival in hospital.
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| 6. |
- Strömberg, Anna, 1967-, et al.
(författare)
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Factors influencing patient compliance with therapeutic regimens in chronic heart failure : A critical incident technique analysis
- 1999
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 28:5, s. 334-341
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure.Methods: A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic.Results: Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals.Conclusions: By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.
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| 7. |
- Ekman, Inger, 1952, et al.
(författare)
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The meaning of hospital care as narrated by elderly patients with chronic heart failure
- 1999
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Ingår i: Heart & Lung. - 0147-9563. ; 28:3, s. 203-9
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Tidskriftsartikel (refereegranskat)abstract
- Chronic heart failure is the most common reason for hospitalization among the elderly in western societies. To elucidate the meaning of the experience of care received in the hospital, as narrated by 12 elderly patients with severe chronic heart failure, interviews were analyzed by an approach inspired by Ricoeur's phenomenologic hermeneutics. The analysis revealed that the study respondents experienced the care as "unpredictable." This essential theme captured the divergent descriptions of 2 subthemes: care was either "confident but incomprehensible" or "nonconfident and incomprehensible." When the patients sought care, it was as though they were launching themselves into the unknown because they knew that many experiences would be unpredictable. Despite experiences of indifferent and unpredictable care, the narratives revealed a need to rely on the caregivers' expertise.
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