| 1. |
- Blomstrand, Peter, et al.
(författare)
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Pulsed tissue Doppler imaging for the detection of myocardial ischaemia, a comparison with myocardial perfusion SPECT
- 2004
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Ingår i: Clinical Physiology and Functional Imaging. - : John Wiley & Sons. - 1475-0961 .- 1475-097X. ; 24:5, s. 289-295
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Tidskriftsartikel (refereegranskat)abstract
- In order to compare the diagnostic ability of pulsed tissue Doppler and myocardial perfusion Single Photon Emission Computed Tomography (SPECT) in patients with a history of unstable coronary artery disease, CAD, 26 patients, 22 men and four women, age 47-76 years, were investigated in a prospective study, 5-10 day after an episode of unstable angina. Tissue Doppler and two-dimensional echocardiography were performed during dobutamine stress testing and myocardial scintigraphy after bicycle exercise and at rest. Patients with a normal SPECT had higher peak systolic velocity during dobutamine infusion, 18.9 ± 4.1 cm s-1, than patients with ischaemia, 12.2 ± 3.8 cm s-1 (P<0.001) or scar, 8.8 ± 3.0 cm s-1 (P<0.01). In a territorial analysis the difference in peak systolic velocity between areas with a normal and abnormal SPECT was less apparent. Failure to achieve ≥13 cm s-1 in mean-peak systolic velocity was the most accurate criterion for detection of significant CAD on SPECT. We conclude that pulsed tissue Doppler can be used for objective quantification of left ventricular wall motion during dobutamine stress testing and for identification of patients with CAD on SPECT but not for identification of regional ischaemia.
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| 2. |
- Rönning, Helén, et al.
(författare)
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Description and initial evaluation of an educational and psychosocial support model for adults with congenitally malformed hearts
- 2011
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 83:2, s. 247-251
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Various programmes for adults with congenitally malformed hearts have been developed, but detailed descriptions of content, rationale and goals are often missing. The aim of this study was to describe and make an initial evaluation of a follow-up model for adults with congenitally malformed hearts, focusing on education and psychosocial support by a multidisciplinary team (EPS). METHODS: The model is described in steps and evaluated with regards to perceptions of knowledge, anxiety and satisfaction. RESULTS: The EPS model included a policlinic visit to the physician/nurse (medical consultation, computer-based and individual education face-to-face as well as psychosocial support) and a 1-month telephone follow-up. Fifty-five adults (mean age 34, 29 women) with the nine most common forms of congenitally malformed hearts participated in the EPS model as well as the 3-months follow-up. Knowledge about congenital heart malformation had increased in 40% of the participants at the 3-months follow-up. CONCLUSION: This study describes and evaluates a model that combines a multidisciplinary approach and computer-based education for follow-up of adults with congenitally malformed hearts. The EPS model was found to increase self-estimated knowledge, but further evaluations need to be conducted to prove patient-centred outcomes over time. PRACTICE IMPLICATIONS: The model is now ready to be implemented in adults with congenitally malformed hearts.
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| 3. |
- Rönning, Helén, et al.
(författare)
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Development and evaluation of a computer-based educational program for adults with congenitally malformed hearts
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:1, s. 78-86
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a lack of educational material for adults with congenitally malformed hearts. Computer-based education has shown to have significant effects on knowledge and management of chronic diseases. AIM: The aim of this study was to develop and evaluate a computer-based educational program for adults with congenitally malformed hearts. METHODS: The program was developed by a multidisciplinary team. Data were collected by questionnaires, observations, and structured interviews. RESULTS: The final product was a computer-based educational program consisting of ten separate modules, one for each particular malformation. The program was experienced as stimulating and easy to use. The appearance and quantity of the text was graded as good and the content as relevant and very useful. CONCLUSION: This is the first computer-based program developed for adults with congenitally malformed hearts. The evaluation found the program to have great potential as an important tool for improving care. Further studies are needed to test the outcomes of the program on knowledge, perceived control over the heart condition, anxiety/depression. and health-related quality of life. PRACTICE IMPLICATIONS: The program may be used as a complement to verbal information and every adult with a congenitally malformed hearts can receive individualized information from a personal CD.
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| 4. |
- Rönning, Helén, et al.
(författare)
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Development and psychometric evaluation of the knowledge scale for adults with congenitally malformed hearts
- 2013
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Ingår i: Journal of Cardiovascular Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0889-4655 .- 1550-5049. ; 28:3, s. 228-237
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Tidskriftsartikel (refereegranskat)abstract
- Background and Research Objective: Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts.Participants and Methods: The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability.Results: The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy.Conclusions: The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.
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| 5. |
- Rönning, Helén, et al.
(författare)
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Educational needs in adults with congenitally malformed hearts
- 2008
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Ingår i: Cardiology in the Young. - : Cambridge University Press (CUP). - 1047-9511 .- 1467-1107. ; 18:5, s. 473-479
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: The number of adults with congenitally malformed hearts is growing, and there is an increasing demand for their continuous follow-up. At present, different programmes have been established for adults with congenital cardiac disease, but there is a lack of knowledge regarding how education and psychosocial support should be given to achieve effects. Before developing educational programmes, it is necessary to be aware of the perspective of the patients. The aim of our study, therefore, was to describe how adults with congenitally malformed hearts experience their educational needs. Methods: The study had a qualitative design. We interviewed 16 adults, aged from 19 to 55 years, with congenitally malformed hearts. Results: Two-way communication emerged as crucial to individualising education. Without good communication, those with congenitally malformed hearts, receiving information from providers of healthcare, are unable to transfer the information received. Thus, individualised education gives access to knowledge and the tools required to manage important areas in life, such as the congenital cardiac malformation, physical activity, the situation of life, treatment, and resources available for healthcare. The information given should provide easy access to knowledge through proper educational materials and methods, and be given with respect for the individual. This is facilitated if the education is tailored to the requirements of the individual in a holistic approach, and is provided through good communication. Conclusion: Our investigation shows that a structured educational programme needs to start from the perspective of the individual patient, and that two-way Communication needs to be taken into consideration to enhance knowledge.
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| 6. |
- Rönning, Helén, et al.
(författare)
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Evaluation of a model focusing on computer-based and individualized care by face-to-face psycho-education for adults with congenitally malformed hearts: a randomized controlled trial
- 2014
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Ingår i: Experimental & Clinical Cardiology. ; 20:9, s. 5349-5369
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evaluate the effects of a psycho-educational model for follow-up in adults with congenitally malformed hearts.Methods: The study had a randomized controlled design. Usual care was compared with computer-based and individualized care by face-to-face psycho-education by a multidisciplinary team. Knowledge and perceived control regarding the heart condition, symptoms of anxiety and depression was analysed at baseline, 3 and 12-months.Results: The 114 participants (control group n=58, intervention group n=56) had an average age of 34 years, SD 13.5. The intervention group had significantly higher general knowledge after 3 (effect size (ES) 0.63, p= <0.01), and 12-months (ES 0.53, p= 0.02). Knowledge regarding endocarditis was significantly increased at 3 (ES 1.43, p=<0.001), and 12-months (ES 0.58, p= 0.02) compared to baseline. There were no changes in knowledge regarding medical treatment, contraceptives and pregnancy, perceived control or anxiety and depression in any of the groups.Conclusion: The model for follow-up was effective to improve and maintain knowledge about self-management.Practice implication: Future evaluation of how the improved knowledge will affect health behaviours over-time is needed. Clinical Trials NCT01234753
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