| 1. |
- Andersson, Sven Ingmar, et al.
(författare)
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Perspectives that lay persons with and without health problems show toward coronary heart disease: An integrated biopsychosocial approach.
- 2007
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Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; 36:5, s. 330-338
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We studied what patients with acute coronary heart disease (CHD) considered the three most stressful factors experienced during the month before testing and what they attributed their heart disease to. Methods: We studied the occurrence and severity of physiologic, psychologic, and psychosocial stressors in 117 patients with acute CHD and 117 referents, not diagnosed with CHD, matched by age,, sex, and municipality. The subjects were first to select the factors they considered stressful from a list of potentially stressful factors. They were then to select the three they regarded as most stressful and to provide situational accounts of these. Results: The patients with CHD were found to less frequently live with a partner, to more frequently have a body mass index higher than 30.0, and to report a greater number of stressors. The stressors best differentiating them from the referents were fatigue, shortness of breath, pain, and high blood pressure. The causal factors they most frequently named were heart problems, smoking, heredity, high workload, and poor eating habits. Conclusions: The situational accounts the patients provided illustrate the biopsychosocial complexities involved in the various categories of stressful factors.
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| 2. |
- Annema, Coby, et al.
(författare)
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Reasons for readmission in heart failure : Perspectives of patients, caregivers, cardiologists, and heart failure nurses.
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:5, s. 427-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Despite efforts to improve outcomes in heart failure (HF), readmission rates remain relatively high. Reasons for readmission from different perspectives (patient, caregiver, health care providers) may help to optimize the future management of patients with HF. The aims of this study are to 1) gain insight into reasons for HF readmission from the perspective of patients, caregivers, cardiologists, and HF nurses; 2) examine similarities and differences in perspectives on the reason for an HF readmission, and 3) describe possibilities to prevent an HF readmission from different perspectives. METHODS AND RESULTS: Data on reasons for readmission were collected on 173 readmissions. Perspectives of patients, caregivers, cardiologists, and HF nurses were collected by interview and questionnaire. Worsening HF as the sole reason for readmission was reported most often; however, 36% of caregivers, 56% of patients, and 63% to 65% of health care providers indicated that other factors, such as comorbidity, nonadherence, and nonoptimal medication, were important contributing factors. In only 34% of readmissions, patients and their caregivers agreed with health care providers on the underlying reason. Respondents reported that 23% to 31% of the readmissions could probably have been prevented if adherence were higher, patients requested help earlier, and adequate multidisciplinary professional help were available. CONCLUSION: To prevent future readmissions of patients with HF, it is important to fully understand the reasons for readmission by gaining insight on the reason for readmission from different perspectives. Also, we may need another approach to prevent adverse outcomes in which other medical problems and new strategies to improve adherence have to be considered.
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| 3. |
- Bergman, Eva, et al.
(författare)
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Longitudinal study of patients after myocardial infarction : Sense of coherence, quality of life, and symptoms
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:2, s. 129-140
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Myocardial infarction has pronounced effects on an individual that demand changes in lifestyle. Health is influenced by whether the individual experiences the world as comprehensible, meaningful, and manageable, that is, has a sense of coherence (SOC). High SOC scores indicate that the individual probably manages the situation by understanding the context and connections: action and effect. OBJECTIVE: The study objective was to identify the SOC, assess the quality of life (Short Form-12 Health Survey Questionnaire), assess the symptoms using the Seattle Angina Questionnaire, and create health curves from a baseline for patients with a first myocardial infarction. METHODS: A longitudinal and predictive Study of 100 participants in the heart care unit of a county hospital in southern Sweden was performed. RESULTS: Women score lower on SOC than men. Persons with high SOC scores have fewer angina attacks, are more physically active, drink more alcohol, are more satisfied with their treatments, and have better disease perception. CONCLUSION: By following SOC scores, a trend emerges that Suggests it may be a useful tool for identifying those who will need extra support.
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| 4. |
- Dieperink, Willem, et al.
(författare)
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Implementation of Boussignac continuous positive airway pressure in the coronary care unit : experiences and attitudes.
- 2008
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 37:6, s. 449-54
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Boussignac continuous positive airway pressure (BCPAP) delivered by face mask is useful for patients with acute cardiogenic pulmonary edema (ACPE). Although BCPAP is medically effective, we observed that not all suitable patients received it. In this descriptive, prospective, cohort study, we explored the experiences and attitudes of both patients and staff with BCPAP. METHODS: Patients were interviewed 12 to 48 hours after treatment with BCPAP. Nurses on the coronary care unit were interviewed on their knowledge, skills, experiences, and opinions concerning BCPAP. RESULTS: Of 117 patients with ACPE, 87 patients (74%) received BCPAP treatment. It was decided not to administer BCPAP in 30 patients with ACPE (26%). Patients who received BCPAP found that the reduction of dyspnea outweighed any discomfort. Barriers for the use of BCPAP were not related to nurses' skills but to the following: the nurses' belief that BCPAP created major discomfort, the lack of guidelines, the ultimate improvement of oxygenation without BCPAP, and the more labor-intensive treatment. CONCLUSION: Overestimation of patient discomfort by nurses and system-related factors impeded the use of BCPAP for all patients with ACPE.
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| 5. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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A gender perspective on sleeplessness behavior, effects of sleep loss, and coping resources in patients with stable coronary artery disease
- 2006
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 35:2, s. 75-89
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to systematically compare perceived sleep quality, sleeplessness behavior, sense of mastery, self-esteem, depression, subjective health, and effects of sleep loss in men and women with stable coronary artery disease (CAD). Further aims were to determine possible predictors of poor sleep quality and sense of mastery, as well as the consequences of too little sleep. METHODS: Comparative-correlation and predictive design were used. Patients with a history of stable angina pectoris scheduled to undergo coronary angiography at Linköping University Hospital in Sweden were included. There were 47 women and 88 men (mean age 62.4 years) with CAD. Structured interviews using validated questionnaires covered sleep quality and sleep habits, effects of sleep loss, psychologic resources, and depression. RESULTS: Multiple stepwise regression analysis showed that sleeplessness behavior, depressed mood, female gender, and pharmacologic treatments with inflammation inhibitors significantly (P < .0001) accounted for the variance of poorer sleep quality. The analysis also showed that the following factors in descending order significantly accounted (P < .0001) for the outcome of sleep quality: inability to feel refreshed by sleep, difficulty in maintaining sleep, gastrointestinal problems, too little sleep, final morning awakening time, sleep onset latency, lying down because of daytime tiredness, and daytime physical tiredness. CONCLUSIONS: Compared with men, women with stable CAD may be especially at risk of experiencing poor sleep quality, even when sleeplessness behavior and pharmacologic treatments with inflammation inhibitors are controlled. It is also possible that they may be more at risk of depressed mood. Copyright © 2006 by Mosby, Inc.
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| 6. |
- Flemme, Inger, et al.
(författare)
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Long-term quality of life and uncertainty in patients living with an implantable cardioverter defibrillator.
- 2005
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Ingår i: Heart & lung : the journal of critical care. - St. Louis, MO : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:6, s. 386-92
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study describes the quality of life (QOL) and uncertainty in patients who have an implantable cardioverter defibrillator (ICD) and predicts QOL at long-term follow-up. METHODS: Long-term follow-up was defined as 6.9 years +/- 1 year (range 4.11-8.7 years). QOL was measured with the Quality of Life Index, and uncertainty was measured with the Mishel Uncertainty in Illness Scale. RESULTS: The overall QOL and health/functioning were unchanged over time. QOL in the socioeconomic (P = .002) and psychologic/spiritual domains (P = .012) decreased in the first year. From baseline to long-term follow-up, the QOL in the family domain (P = .011) and uncertainty (P = .002) decreased. Uncertainty was a predictor of low QOL. CONCLUSION: QOL was reasonably good 6.9 years post-ICD implantation. Patients felt less uncertain once they had passed the first year of their illness.
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| 7. |
- Hildingh, Cathrine, et al.
(författare)
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Women's experiences of recovery after myocardial infarction : a meta-synthesis
- 2007
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Ingår i: Heart & Lung. - St. Louis, MO : Mosby Inc.. - 0147-9563 .- 1527-3288. ; 36:6, s. 410-417
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women report lower well-being, compared with men, during recovery after myocardial infarction (MI). To support women in their recovery it is important to understand their experiences from their own perspective. However, a single study using a qualitative method does not have the potential to contribute to evidence-based nursing practice, and it is therefore important to synthesize findings from several qualitative studies. Objectives: The aim of this study was to perform a meta-synthesis of findings of women's experiences of recovery after MI. Methods: A meta-synthesis with seven qualitative studies, including a total of 70 women, was performed. Results: Recovery was characterized by subordination and superordination. The women strived to preserve their self, and at the same time they were strongly oriented toward other people. Four concepts emerged: protecting, adjusting, downgrading, and succumbing. Conclusion: Women oscillate between subordination and superordination. Protecting the matriarchy and being a victim of the patriarchy shed light on this ambivalence in the same way as adjusting to the situation and succumbing to the disease do.
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| 8. |
- Ivarsson, Bodil, et al.
(författare)
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Information from health care professionals about sexual function and coexistence after myocardial infarction : a Swedish national survey
- 2009
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 38:4, s. 330-335
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: After a myocardial infarction (MI), many patients and their partners experience problems with marital and sexual life.METHODS: A Swedish national survey was carried out to obtain knowledge on the information provided by cardiac health care professionals on the subject of sexual function and coexistence after an MI. It consisted of a questionnaire that was designed, tested, and sent to 121 coronary care units.RESULTS: The coronary care unit teams rarely provided oral or written information about sexual function and coexistence to patients with MI or their partners. The health care professionals lacked competence in these areas.CONCLUSION: It is essential that health care professionals are educated on and inform the patient with MI about the significance of sexual function and coexistence. Further research is required regarding patients' and their partners' need for information and support in this area.
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| 9. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
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Perceived coping, social support, and quality of life 1 month after myocardial infarction : A comparison between Swedish women and men
- 2005
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:1, s. 39-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.DESIGN: The study design was cross-sectional and descriptive-comparative.SETTING: The study took place in 1 hospital service area in the middle of Sweden.SUBJECTS: The sample consisted of 74 women and 97 men.INSTRUMENTS: The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.RESULTS: Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.CONCLUSION: The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.
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| 10. |
- Lawoko, S, et al.
(författare)
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Psychosocial morbidity among parents of children with congenital heart disease: A prospective longitudinal study
- 2006
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Ingår i: Heart & Lung. - 0147-9563 .- 1527-3288. ; 35:5, s. 301-314
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Tidskriftsartikel (refereegranskat)abstract
- The study objectives were to assess long-term psychosocial morbidity and its determinants among parents of children with congenital heart disease (PCCHD), and to compare mothers with fathers on psychosocial variables.MethodThe study design was longitudinal. Data comprising PCCHD (n = 632, 58% were women) were collected on two occasions 1 year apart.ResultsMany PCCHD reported psychosocial problems manifested in depression (18%), anxiety (16%-18%), somatization (31%-38%), and hopelessness (16%) during both measurement points. In addition, 7% to 22% reported psychosocial problems persisting over a 1-year period. Consistently over time, mothers reported more severe symptoms of depression, anxiety, somatization, and hopelessness than fathers. Children’s clinical severity did not significantly explain parent’s psychosocial morbidity over time. Instead, parental caregiving burden, dissatisfaction with care, social isolation, and financial instability were associated with an increased risk of long-standing psychosocial morbidity.ConclusionsAn important proportion of PCCHD are at risk of long-standing psychosocial morbidity, suggesting that psychosocial intervention may be beneficial. Feasible interventions are discussed.
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| 11. |
- Luttik, Marie Louise, et al.
(författare)
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Marital status, quality of life, and clinical outcome in patients with heart failure
- 2006
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 35:1, s. 3-8
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study investigated the impact of having a partner on quality of life (QoL), the number of hospital readmissions, and 9-month survival in patients with heart failure (HF). METHODS: The study population consisted of hospitalized patients with HF. QoL was measured by the Cantril Ladder of Life (0-10) during hospital admission. Clinical data, readmission rate, and number of deaths were registered by patient interview and chart review. RESULTS: Of the 179 patients, 96 (54%) were married or were living with a partner. Differences in QoL between married patients and those living alone were most pronounced with regard to future expectations of QoL (6.5 vs 5.0, P=.00). However, in a multivariate model QoL was primarily associated with socioeconomic status, age, and gender. Married patients had 12% less events in the 9-month follow-up period compared with patients living alone (P=not significant). CONCLUSION: This study indicates that most patients with HF who are living alone are mostly elderly women with a low socioeconomic status, who are at risk for recurrent events and a worse QoL.
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| 12. |
- Nilsson, Ulrica, 1960-
(författare)
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The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:3, s. 201-207
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the effect of bed rest with music on the first postoperative day to decrease stress for patients who have undergone heart surgery. Methods A repeated-measures randomized controlled trial was used. The study took place in a cardiothoracic intermediary unit of a university hospital in Sweden. Fifty-eight patients who had undergone open coronary artery bypass grafting or aortic valve replacement surgery were included. Stress response was assessed by determining the serum cortisol, heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels. At 12:00 noon on postoperative day 1, patients were allocated to receive 30 minutes of uninterrupted bed rest with music and then 30 minutes of bed rest or alternatively 60 minutes of uninterrupted bed rest. The music was soft and relaxing, included different melodies in new-age style, played with a volume at 50 to 60 dB, and distributed through a music pillow connected to an MP3 player. Results After 30 minutes of bed rest, there was a significant difference in s-cortisol levels between the groups; 484. 4 mmol/L in the music group versus 618.8 mmol/L in the control group (P < .02). However, this difference in s-cortisol levels was not found 30 minutes later (ie, after a total of 60 minutes). There was no difference in heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels between the groups. Conclusion There is sufficient practical evidence of stress reduction to suggest that a proposed regimen of listening to music while resting in bed after open heart surgery be put into clinical use.
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| 13. |
- Perkiö Kato, Naoko, 1980-, et al.
(författare)
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Adherence to self-care behavior and factors related to this behavior among patients with heart failure in Japan
- 2009
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 38:5, s. 398-409
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Adherence to self-care behavior is important for patients with heart failure (HF) to prevent exacerbation of HF. The aim of this study was to evaluate adherence, identify associated factors, and clarify the impact of previous HF hospitalizations on adherence in outpatients with HF.METHODS: A total of 116 outpatients completed a questionnaire, including the Japanese version of the European Heart Failure Self-Care Behavior Scale, to assess adherence.RESULTS: Regardless of previous hospitalizations, adherence to seek help if HF worsened was poor. Multivariate analysis adjusted for age and brain natriuretic peptide showed that diabetes mellitus and being employed were independent predictors of poorer adherence to self-care behavior (P = .03, P = .02, respectively), but the experience of previous HF hospitalizations was not a predictor.CONCLUSIONS: Self-care strategies for HF should target patients with diabetes mellitus and employed patients. Further study is necessary to develop effective programs for such patients.
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| 14. |
- Pesonen, Erkki, et al.
(författare)
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Serum chlamydial lipopolysaccharide as a prognostic factor for a new cardiovascular event.
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; 38:3, s. 176-181
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Infections caused by Chlamydia pneumoniae are considered to participate in inflammatory processes leading to coronary artery disease. After a primary infection, the bacteria remain dormant intracellularly causing a chronic inflammatory stimulus. MATERIALS AND METHODS: Blood samples were obtained from 235 patients with acute myocardial infarction (AMI) and 108 patients with unstable angina pectoris (UA). We evaluated the prognostic significance of bacterial and viral antibody titers, serum troponin T, C-reactive protein, and chlamydial lipopolysaccharide (cLPS) concentrations during acute coronary syndrome of patients with AMI and UA for cardiovascular death and new UA and AMI that required hospital care during a 6-year follow-up. RESULTS: Serum cLPS levels correlated with C-reactive protein and serum troponin T concentrations during acute coronary events. Patients with AMI had significantly higher serum concentration of cLPS compared with patients with UA. Enterovirus antibody titers and cholesterol-lowering therapy at admission of the index event were negatively correlated with cLPS concentration (r = -.198, P = .0003 and r = -.26, P = .019, respectively). The presence of circulating cLPS was associated with a hazard ratio of 2.04 for a new cardiovascular event during the follow-up period (P = .006). The area under the curve in the receiver operating graph was .572. CONCLUSION: cLPS is evidently liberated from the infected atherosclerotic tissue during an acute coronary event. Our study supports the view that inflammation caused by C. pneumoniae infection is an important but as yet poorly understood factor in the development of atherosclerosis and may play a role in acute vascular events.
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| 15. |
- Thuresson, Marie, et al.
(författare)
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Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome.
- 2007
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Ingår i: Heart & Lung. - Amsterdam : Elsevier BV. - 0147-9563 .- 1527-3288. ; 36:6, s. 398-409
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Tidskriftsartikel (refereegranskat)abstract
- Objective The objective was to study patients’ interpretations, thoughts, and actions after symptom onset in acute coronary syndrome (ACS) in total and in relation to gender, age, history of coronary artery disease, type of syndrome, and residential area and its influence on prehospital delay. Setting We performed a national survey comprising intensive cardiac care units at 11 hospitals in Sweden. Method A total of 1939 patients with diagnosed ACS and symptom onset outside hospital completed a questionnaire containing standardized questions within 3 days after admission. Results Three-quarters of the patients interpreted their symptoms as cardiac in origin, and the most common reason was that they knew someone who had had an acute myocardial infarction. The majority contacted a family member, whereas only 3% directly called for an ambulance. Interpreting the symptoms as cardiac in origin and severe pain were major reasons for deciding to seek medical care. Approaching someone after symptom onset and the belief that the symptoms were cardiac in origin were factors associated with a shorter prehospital delay, whereas taking medication to relieve pain resulted in the opposite. The reaction pattern was influenced by gender, age, a history of coronary artery disease, and the type of ACS, but to a lesser extent by residential area. Conclusions Interpreting symptoms as cardiac in origin and approaching someone after symptom onset were major reasons for a shorter prehospital delay in ACS.
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| 16. |
- van der Wal, Martje H L, et al.
(författare)
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Unraveling the mechanisms for heart failure patients' beliefs about compliance.
- 2007
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 36:4, s. 253-61
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Compliance with medication, diet, and monitoring symptoms is a problem in heart failure (HF) patients. Noncompliance can lead to worsening symptoms and is associated with personal beliefs about compliance. To intervene effectively, knowledge of factors related to patients' beliefs about compliance is needed. OBJECTIVES: The aims of this study are to: (1) gain insight into patients' beliefs about compliance; (2) examine the association of demographic variables and depressive symptoms to beliefs; (3) assess compliance with medication, diet, and daily weighing; and (4) examine the association of compliance to patients' beliefs. METHODS: Nine hundred fifty-four HF patients completed questionnaires on beliefs about medication and diet; 297 patients also completed a questionnaire on beliefs about symptom monitoring. Most important barriers and benefits were assessed as well as differences in beliefs between subgroups and the association between compliance and beliefs. RESULTS: The most important barriers were diuresis during the night (57%), the taste of food (51%), and limited ability to go out (33%). A barrier related to failure to weigh daily was forgetfulness (26%). Patients with depressive symptoms and patients with a low level of HF knowledge experienced more barriers to compliance with the HF regimen. Self-reported compliance with medication was almost 99%, compliance with diet 77%, and with daily weighing 33%. CONCLUSIONS AND IMPLICATIONS: In order to improve compliance, it is important that interventions should be directed to those patients who experience more barriers to compliance, such as patients with depressive symptoms and patients with a low level of knowledge on the HF regimen. Improvement of knowledge, therefore, will remain an important issue in HF management programs.
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| 17. |
- Ågren, Susanna, et al.
(författare)
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Addressing spouses unique needs after cardiac surgery when recovery is complicated by heart failure
- 2009
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Ingår i: HEART and LUNG. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:4, s. 284-291
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience difficult and demanding situations when the partner becomes critically ill. OBJECTIVES: To identify, describe, and conceptualize the individual needs of spouses of patients with complications of heart failure after cardiac surgery. METHODS: Grounded theory using a mix of systematic coding, data analysis, and theoretical sampling was performed. Spouses, 10 women and 3 men between 39 and 85 years, were interviewed. RESULTS: During analysis, the core category of confirmation was identified as describing the individual needs of the spouses. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among spouses. CONCLUSIONS: By identifying spouses needs for security, rest for mind and body, and inner strength, health care professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions to confirm spouses needs are important because they are vital to the patients recovery.
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| 18. |
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