| 1. |
- Agerström, Jens, et al.
(författare)
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All else equal : Examining treatment bias and stereotypes based on patient ethnicity and socioeconomic status using in-hospital cardiac arrest clinical vignettes
- 2024
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Ingår i: Heart and Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 63, s. 86-91
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research on ethnic and socioeconomic treatment differences following in-hospital cardiac arrest (IHCA) largely draws on register data. Due to the correlational nature of such data, it cannot be concluded whether detected differences reflect treatment bias/discrimination – whereby otherwise identical patients are treated differently solely due to sociodemographic factors. To be able to establish discrimination, experimental research is needed. Objective: The primary aim of this experimental study was to examine whether simulated IHCA patients receive different treatment recommendations based on ethnicity and socioeconomic status (SES), holding all other factors (e.g., health status) constant. Another aim was to examine health care professionals’ (HCP) stereotypical beliefs about these groups. Methods: HCP (N = 235) working in acute care made anonymous treatment recommendations while reading IHCA clinical vignettes wherein the patient's ethnicity (Swedish vs. Middle Eastern) and SES had been manipulated. Afterwards they estimated to what extent hospital staff associate these patient groups with certain traits (stereotypes). Results: No significant differences in treatment recommendations for Swedish versus Middle Eastern or high versus low SES patients were found. Reported stereotypes about Middle Eastern patients were uniformly negative. SES-related stereotypes, however, were mixed. High SES patients were believed to be more competent (e.g., respected), but less warm (e.g., friendly) than low SES patients. Conclusions: Swedish HCP do not seem to discriminate against patients with Middle Eastern or low SES backgrounds when recommending treatment for simulated IHCA cases, despite the existence of negative stereotypes about these groups. Implications for health care equality and quality are discussed.
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| 2. |
- Eng, Sanna Hagelberg, et al.
(författare)
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Thirst and factors associated with frequent thirst in patients with heart failure in Spain
- 2021
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 50:1, s. 86-91
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Tidskriftsartikel (refereegranskat)abstract
- Background: Thirst is a troublesome symptom in patients with Heart Failure (HF) and one that might be perceived differently in different countries depending on climate, food and cultural habits. The aims of the study were to describe thirst frequency, duration and intensity and to identify factors associated with frequent thirst in outpatients with HF in a Mediterranean country. Methods: Data was collected in a cross-sectional study involving 302 patients diagnosed with HF (age 67 +/- 12 years, 74% male, LVEF 43%+/- 14) in Spain on thirst frequency and duration, and thirst intensity by patient self-report (VAS, 0-100 mm). Clinical variables were collected from the medical files. Regression analysis was used to identify factors independently associated with frequent thirst. Results: Of all the patients, 143 (47%) were frequently thirsty, and their median (25th and 75th percentiles) thirst intensity was higher (VAS 50 mm [20-67] vs 7 [0-20], p <.001). Their thirst lasted longer compared to those who never/sometimes were thirsty (p < .001). Less treatment with angiotensin receptor blockers (Odds Ratio [OR] 2.72; 95% Confidence Interval [CI] 1.33-5.58), diuretics >40 mg/day (OR 1.92; 95% CI 1.02-3.64), depression (OR 2.99; CI 1.17-7.62), male gender (OR 1.98; CI 1.08-3.64) and worse New York Heart Association functional class (OR 1.92; 95% CI 1.05-3.52) were independently associated with frequent thirst. Conclusions: About half of patients with HF and fluid restriction experienced frequent thirst in a Mediterranean area of Spain, and their thirst duration and intensity were significantly increased. Frequent thirst was associated with demographic, clinical and therapeutic variables. The results may help to identify patients with a higher risk of frequent thirst and might suggest therapeutic changes in order to diminish this troublesome symptom. (C) 2020 The Authors. Published by Elsevier Inc.
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| 4. |
- Israelsson, Johan, et al.
(författare)
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A more conservative test of sex differences in the treatment and outcome of in-hospital cardiac arrest
- 2023
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 58, s. 191-197
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies investigating sex disparities related to treatment and outcome of in-hospital cardiac arrest (IHCA) have produced divergent findings and have typically been unable to adjust for outstanding confounding variables.Objectives: The aim was to examine sex differences in treatment and survival following IHCA, using a comprehensive set of control variables including e.g., age, comorbidity, and patient-level socioeconomic status. Methods: This retrospective study was based on data from the Swedish Register of Cardiopulmonary Resuscitation and Statistics Sweden. In the primary analyses, logistic regression models and ordinary least square regressions were estimated.Results: The study included 24,217 patients and the majority (70.4%) were men. In the unadjusted analyses, women had a lower chance of survival after cardiopulmonary resuscitation (CPR) attempt, at hospital discharge (with good neurological function) and at 30 days (p<0.01). In the adjusted regression models, female sex was associated with a higher chance of survival after the CPR attempt (B = 1.09, p<0.01) and at 30-days (B = 1.09, p<0.05). In contrast, there was no significant association between sex and survival to discharge with good neurological outcome. Except for treatment duration (B=-0.07, p<0.01), no significant associations between sex and treatment were identified.Conclusions: No signs of treatment disparities or discrimination related to sex were identified. However, women had a better chance of surviving IHCA compared to men. The finding that women went from having a survival disadvantage (unadjusted analysis) to a survival advantage (adjusted analysis) attests to the importance of including a comprehensive set of control variables, when examining sex differences.
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| 5. |
- Melnikov, Semyon, et al.
(författare)
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Factors associated with body image among patients with an implanted left ventricular assist device
- 2020
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 49:6, s. 803-807
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Tidskriftsartikel (refereegranskat)abstract
- Background: Among Left Ventricular Assist Device (LVAD) implanted patients, body image modifications might occur. Objectives: To explore the associations between sexual functioning, confidence in LVAD technology, personal wellbeing, and body image. Methods: The cross-sectional study included 30 conveniently recruited LVAD implanted patients who completed Body Image Scale, sexual functioning, confidence in LVAD technology, and Personal Wellbeing Index questionnaires. The associations between the research variables were examined with multiple regression analyses. Results: The mean age of the participants was 63 (SD=10), 90% were men. The mean scores were: sexual functioning 2.43 (SD=1.20, range 1-5); confidence in LVAD technology 2.63 (SD=1.04, range 1-5); Well-Being Index 6.61 (SD=1.53, range 0-10); and body image 14.5 (SD=4.17, range 5-20). Sexual functioning (p<.01) and LVAD technology confidence (p=.04) significantly predicted body image. Conclusions: Healthcare professionals should be aware of challenges regarding body image faced by LVAD implanted patients and to address related factors. (c) 2020 Elsevier Inc. All rights reserved.
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| 6. |
- Prasun, Marilyn A., et al.
(författare)
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Perceptions of changes in practice patterns and patient care among heart failure nurses during the COVID-19 pandemic
- 2022
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Ingår i: Heart & Lung. - : MOSBY-ELSEVIER. - 0147-9563 .- 1527-3288. ; 52, s. 152-158
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Coronavirus (COVID-19) had a profound impact on the delivery of care in both hospital and outpatient settings across the United States. Patients with heart failure (HF) and healthcare providers had to abruptly adapt. Objective: To describe how the COVID-19 pandemic affected practice patterns of HF nurses. Methods: Practicing HF nurses completed a cross-sectional, anonymous, web-based survey of perceptions of HF practice. Analyses involved descriptive and comparative statistics. Results: Of 171 nurses who completed surveys, outpatient HF visits decreased and 63.2% added telehealth visits. Despite spending about 29 min educating patients during visits, 27.5% of nurses perceived that the pandemic decreased patients abilities to provide optimal self-care. Nurses reported decreased ability to collect objective data (62.4%; n = 78), although subjective assessment stayed the same (41.6%; n = 52). Conclusion: Nurses practice patterns provided insight into patient care changes made during COVID-19. Most core components of HF management were retained, but methods of delivery during the pandemic differed. (C) 2022 Elsevier Inc. All rights reserved.
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| 7. |
- Westland, Heleen, et al.
(författare)
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Self-care management of bothersome symptoms as recommended by clinicians for patients with a chronic condition : A Delphi study
- 2022
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Ingår i: Heart & Lung. - : Elsevier Science Inc. - 0147-9563 .- 1527-3288. ; 56, s. 40-49
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronically medically ill patients often need clinical assistance with symptom management, as well as self-care interventions that can help to reduce the impact of bothersome symptoms. Experienced clinicians can help to guide the development of more effective self-care interventions. Objective: To create a consensus-based list of common bothersome symptoms of chronic conditions and of self-care management behaviors recommended to patients by clinicians to reduce the impact of these symptoms. Methods: A two-round Delphi study was performed among an international panel of 47 clinicians using online surveys to identify common and bothersome symptoms and related self-care management behaviors recommended to patients with heart failure, chronic obstructive pulmonary disease, asthma, type 2 diabetes, or arthritis. Results: A total of 30 common bothersome symptoms and 158 self-care management behaviors across the five conditions were listed. Each chronic condition has its own bothersome symptoms and self-care management behaviors. Consensus was reached on the vast majority of recommended behaviors. Conclusions: The list of common bothersome symptoms and self-care management behaviors reflect consensus across four countries on many points but also disagreement on others, and a few recommendations are inconsistent with current guidelines. Efforts to encourage clinicians to recommend effective self-care management behaviors may reduce symptom impact in chronically ill patient populations.(C) 2022 The Author(s). Published by Elsevier Inc.
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| 8. |
- Ding, Yunmei, et al.
(författare)
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Factors influencing self-management behavior during the “Blanking Period” in patients with atrial fibrillation : A cross-sectional study based on the information-motivation-behavioral skills model
- 2023
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Ingår i: Heart and Lung. - : Elsevier BV. - 0147-9563. ; 58, s. 62-68
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atrial fibrillation (AF) is becoming increasingly common. Effective self-management during the “Blanking Period” is critical. The Information-Motivation-Behavioral skills (IMB) model can be used to study health behaviors in chronic disease patients, but it has not been studied in AF patients. Objective: The goal of this study was to explore the influencing factors and interaction pathways of self-management behavior in AF patients during the "Blanking Period" using the IMB model. Methods: From June to December 2021, a cross-sectional design was conducted. Patients with AF during the "Blanking Period" (N=220) were recruited. They filled out several quantitative questionnaires, including the Jessa Atrial Fibrillation Knowledge Questionnaire, the Confidence in Atrial Fibrillation Management Scale, the Perceived Social Support Scale, the All Aspects of Health Literacy Scale, and the Self-care Scale for Chronic Atrial Fibrillation Patients. Data were analyzed using correlation analysis, multiple regression analysis, and path analysis. Results: Total score of self-management behavior was (33.83 ± 10.66). AF knowledge (β = 0.252, P < 0.001), self-management confidence (β = 0.219, P < 0.001), social support (β = 0.291, P < 0.001), and health literacy (β = 0.262, P < 0.001) were all positively correlated with patients' self-management behavior, accounting for 66.50 percent of the total variance. Conclusions: During the "Blanking Period", the IMB model can be used to predict the factors that influence self-management behavior in AF patients. By using IMB model, interventions targeting patient-specific influencing factors could improve self-management behavior and quality of life in AF patients.
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