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- Perkiö Kato, Naoko, et al.
(författare)
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Heart Failure Telemonitoring in Japan and Sweden: A Cross-Sectional Survey
- 2015
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Ingår i: Journal of Medical Internet Research. - : JMIR PUBLICATIONS, INC. - 1438-8871. ; 17:11, s. e258-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Telemonitoring of heart failure (HF) patients is increasingly discussed at conferences and addressed in research. However, little is known about actual use in specific countries. Objective: We aimed to (1) describe the use of non-invasive HF telemonitoring, (2) clarify expectations of telemonitoring among cardiologists and nurses, and (3) describe barriers to the implementation of telemonitoring in Japan and Sweden. Methods: This study used a cross-sectional survey of non-invasive HF telemonitoring. A total of 378 Japanese (120 cardiologists, 258 nurses) and 120 Swedish (39 cardiologists, 81 nurses) health care professionals from 165 Japanese and 61 Swedish hospitals/clinics nationwide participated in the study (210 in Japan and 98 in Sweden were approached). Data were collected between November 2013 and May 2014 with a questionnaire that was adapted from a previous Dutch study on telemonitoring. Results: The mean age of the cardiologists and nurses was 47 years and 41 years, respectively. Experience at the current position caring for HF patients was 19 years among the physicians and 15 years among the nurses. In total, 7 Japanese (4.2%) and none of the Swedish health care institutions used telemonitoring. One fourth (24.0%, 118/498) of the health care professionals were familiar with the technology (in Japan: 21.6%, 82/378; in Sweden: 30.0%, 36/120). The highest expectations of telemonitoring (rated on a scale from 0-10) were reduced hospitalizations (8.3 in Japan and 7.5 in Sweden), increased patient self-care (7.8 and 7.4), and offering high-quality care (7.8 and 7.0). The major goal for introducing telemonitoring was to monitor physical condition and recognize signs of worsening HF in Japan (94.1%, 352/374) and Sweden (88.7%, 102/115). The following reasons were also high in Sweden: to monitor effects of treatment and adjust it remotely (86.9%, 100/115) and to do remote drug titration (79.1%, 91/115). Just under a quarter of Japanese (22.4%, 85/378) and over a third of Swedish (38.1%, 45/118) health care professionals thought that telemonitoring was a good way to follow up stable HF patients. Three domains of barriers were identified by content analysis: organizational barriers "how are we going to do it?" (categories include structure and resource), health care professionals themselves "what do we need to know and do" (reservation), and barriers related to patients "not everybody would benefit" (internal and external shortcomings). Conclusions: Telemonitoring for HF patients has not been implemented in Japan or Sweden. However, health care professionals have expectations of telemonitoring to reduce patients hospitalizations and increase patient self-care. There are still a wide range of barriers to the implementation of HF telemonitoring.
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| 2. |
- Perkiö Kato, Naoko, 1980-, et al.
(författare)
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Quality of Life and Influential Factors in Patients Implanted With a Left Ventricular Assist Device
- 2015
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Ingår i: Circulation Journal. - : JAPANESE CIRCULATION SOC. - 1346-9843 .- 1347-4820. ; 79:10, s. 2186-2192
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Tidskriftsartikel (refereegranskat)abstract
- Background: Improving quality of life (QOL) has become an important goal in left ventricular assist device (LVAD) therapy. We aimed (1) to assess the effect of an implantable LVAD on patients QOL, (2) to compare LVAD patients QOL to that of patients in different stages of heart failure (HF), and (3) to identify factors associated with patients QOL.Methods and Results: The QOL of 33 Japanese implantable LVAD patients was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and Short-form 8 (SF-8), before and at 3 and 6 months afterwards. After LVAD implantation, QOL significantly improved [MLHFQ, SF-8 physical component score (PCS), SF-8 mental component score (MCS), all Pless than0.05]. Implanted LVAD patients had a better QOL than extracorporeal LVAD patients (n=33, 32.1 +/- 21.9 vs. n=17, 47.6 +/- 18.2), and Stage D HF patients (n=32, 51.1 +/- 17.3), but the score was comparable to that of patients who had undergone a heart transplant (n=13). In multiple regression analyses, postoperative lower albumin concentration and right ventricular failure were independently associated with poorer PCS. Female sex and postoperative anxiety were 2 of the independent factors for poorer MCS (all Pless than0.05).Conclusions: Having an implantable LVAD improves patients QOL, which is better than that of patients with an extracorporeal LVAD. Both clinical and psychological factors are influence QOL after LVAD implantation.
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| 3. |
- Perkiö Kato, Naoko, et al.
(författare)
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Quality of life of family caregivers of patients with a left ventricular assist device in Japan
- 2018
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Ingår i: Journal of Cardiology. - : ELSEVIER SCIENCE BV. - 0914-5087 .- 1876-4738. ; 71:1-2, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of caregivers is important for the successful support of left ventricular assist device (LVAD) patients. We aimed to (1) evaluate quality of life (QoL) of caregivers pre-and post-LVAD implant and (2) identify factors associated with caregivers QoL. Methods: The caregivers QoL was assessed with the Short Form-8 before implant, at 3 and 6 months after LVAD implantation. The physical and mental component summary (PCS and MCS) scores were calculated. Caregiver burden was evaluated using the 8-item Zarit Caregiver Burden Interview. Results: Data were collected from LVAD patients as bridge-to-transplant and their family caregivers in Japan. No significant changes were found in caregivers PCS scores during the follow-up (before 52.7 +/- 7.1; at 3 months 49.7 +/- 6.5, and at 6 months 50.7 +/- 6.4, n = 20). Compared with the scores before implant (38.9 +/- 9.3), the caregivers MCS scores improved after LVAD implantation at 3 months (44.2 +/- 7.7; p = 0.03) and at 6 months (46.2 +/- 7.4, p = 0.003), but they were still lower than those of the Japanese general population (p amp;lt; 0.01). In multiple regression analysis at 3 months (n = 40), caregivers lower PCS scores were associated with older patient age [standard partial regression coefficients (s beta) = -0.36, p = 0.02] and caregiver unemployment (s beta = 0.30, p = 0.04), whereas being female (s beta = -0.26, p = 0.03), being the patients spouse (s beta = -0.23, p = 0.03), and having a mild to moderate caregiving burden (s beta = -0.63, p amp;lt; 0.001) were associated with lower MCS scores among caregivers. Conclusions: LVAD implantation improves caregivers mental QoL. Since caregivers MCS scores are lower than the general population, it is important to identify family caregivers at risk for low QoL and reduce their caregiving burden. (C) 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
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