| 61. |
- Drevenhorn, E., et al.
(author)
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Counselling on lifestyle factors in hypertension care after training on the stages of change model
- 2007
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; :6, s. 46-53
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Journal article (peer-reviewed)abstract
- BACKGROUND:In assisting the nurse's counselling on lifestyle changes in hypertension care a behaviour model can be used.AIM:To analyse the effects of nurses' training on the use of the stages of change model when counselling hypertensive patients to perform lifestyle changes.METHODS:As part of a randomised, controlled trial, 19 nurses belonging to the intervention group took part in video-recorded consultation training with simulated patients. To evaluate the training, the nurses audio-recorded their consultations with two patients before and after the intervention. Analysis focused on the areas of non-pharmacological treatment and the nurses' attention to the patients' readiness for change.RESULTS:Patient participation in the consultations increased after the training. The importance of non-pharmacological treatment was mentioned more frequently for all areas of lifestyle behaviour, exercise, smoking, alcohol consumption, food and stress, and the nurses acquired a more distinct structure for their consultations. The mean length of the recorded consultations increased from 18 min to 20.5 min. All the criteria for fulfillment of attention to patient's readiness to change were met in nine consultations before the training and in seven after it. After the training, attention was paid to support more frequently than before in the action and maintenance stages and a great deal of information was provided.
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| 62. |
- Drevenhorn, Eva, 1954, et al.
(author)
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Evaluation of consultation training in hypertension care
- 2009
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In: European Journal of Cardivascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:5, s. 349-354
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Journal article (peer-reviewed)abstract
- Background Nurses in hypertension care play an important role in minimising the risk factors for cardiovascular diseases, but this care can be improved. Aim To evaluate the content of nurses' consultations with hypertensive patients before and after consultation training. Methods Nineteen nurses from a randomised study of nurse-led hypertension clinics at health centres received three days of residential training in patient-centred counselling and cardiovascular prevention. To assess the result, two consultations with hypertensive patients in clinical practice before and after the training were audio-recorded. Content analysis was used for the analysis. Results Diet and exercise were the most frequent topics in the consultations both before and after the training. Discussions about alcohol and the patient's responsibility for treatment increased after the training. The time spent talking about various issues, other health problems, history and appointment scheduling decreased in the consultations after the training. Conclusion After the consultation training, the nurses succeeded in emphasising important issues for risk factor control to a greater extent.
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| 63. |
- Ekman, Inger, 1952, et al.
(author)
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Gender makes a difference in the description of dyspnoea in patients with chronic heart failure.
- 2005
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In: Eur J Cardiovasc Nurs. - : Oxford University Press (OUP). - 1474-5151. ; 4:2, s. 117-21
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Journal article (peer-reviewed)abstract
- Background: Dyspnoea is a common symptom of chronic heart failure (CHF). In the community setting, patients with CHF are most often women. Aim: To examine the impact of gender on the description of dyspnoea and to explore which clinical variables support a diagnosis of CHF. Methods: From four primary health care centres, 158 patients with CHF were included. Patients were examined with echocardiography and a cardiologist assessed the diagnosis of CHF. The patients filled in a questionnaire containing 11 descriptors of dyspnoea. Results: A diagnosis of CHF was confirmed in 87 (55%) patients (47 males and 40 females). One descriptor, I feel that I am suffocating, was significantly scored higher in CHF patients ( p=0.014) as compared to non-CHF patients. Three descriptors, My breath does not go in all the way ( p=0.006), I feel that I am suffocating ( p=0.040), and I cannot get enough air ( p=0.0327) were significantly scored higher among men with CHF, compared to no descriptor among women with CHF. Being male (OR=2.7; CI: 1.3–5.6, p=0.008), having diabetes (OR=5.6; CI: 1.7–18.2, p=0.004), IHD (OR=3.3; CI: 1.3–8.5, p=0.014), and a borderline significance for age (OR=1.04; CI: 0.99–1.08, p=0.058) predicted a confirmed diagnosis of CHF. Conclusion: Three descriptors of dyspnoea were associated with CHF among men, whereas no such association was found among women. Our results suggest that gender is an important factor and should—together with age, underlying heart disease, and diabetes—be taken into account when symptoms are evaluated in the diagnosis of CHF in primary care.
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| 64. |
- Eldh, Ann Catrine, et al.
(author)
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The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure
- 2006
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:1, s. 45-53
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Journal article (peer-reviewed)abstract
- BackgroundThe legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resources in CHF. AimTo explore the phenomena of patient participation and non-participation as shown in patient visits to a nurse-led clinic for CHF and as experienced by the patients and nurses. MethodsData triangulation of field notes from participatory observations and texts from narrative interviews with the patients and assigned nurse specialists. Data were analyzed according to the phenomenological hermeneutic tradition. FindingsPatients' experience of participation and non-participation was interpreted as “Being responsible and accepting responsibility” and “Lacking an equal relationship while being controlled”, respectively. Nurses experienced patient participation as “Getting information and security to act” and patient non-participation as “Not accepting”. ConclusionConflicting values of patients and nurses, which were interpreted with respect to participation and non-participation, presumably might influence patient information and education negatively. The issue of participation should be raised as a means of attaining concordance and to facilitate patient participation with education specifically tailored to the individual patient's needs.
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| 65. |
- Eriksson, Monica, 1960-, et al.
(author)
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Patients´and their partners´experiences of returning home after hospital discharge following acute myocardial infarction
- 2009
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In: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 8:4, s. 267-273
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Journal article (peer-reviewed)abstract
- Background: Returning home from hospital after an acute myocardial infarction [AMI] can be a period of vulnerability both for the patient and his/her partner. This study focuses on the time immediately after discharge. Aims: The aim of this study was to describe the patient’s and his/her partner’s experiences after hospital discharge following AMI. Methods: 15 couples took part in individual interviews, 4- 8 weeks after discharge. Data were analysed using qualitative content analysis. Results: The results are presented by means of three themes, ´ at home in one’s own home`, ´ at home within oneself ` and ´having normality in sight`, comprising ten categories that describe the experiences of both the patient and his/her partner. Conclusions: The patients as well as partners described the period after discharge from hospital comprising ambitions of feeling safety in their home, an inner sense of security and seeking normalisation.The results of this study could be useful for nurses when planning for patient discharge. During hospitalization nurses can prepare both the patient and their partner for what to expect when the patient returns home.
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| 66. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(author)
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Cardiac surgery patients' evaluation of the quality of theatre nurse postoperative follow-up visit
- 2009
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:2, s. 105-111
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Journal article (peer-reviewed)abstract
- Theatre nurses at the Department of Cardiothoracic Surgery in Orebro, Sweden, have since 2001 routinely conducted a follow-up visit to postoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both a retrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-up visit conducted by the theatre nurses and find out if the quality was related to gender or type of admission. The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by a theatre nurse in Sweden. The instrument measuring quality, from the patient's perspective, measured the quality of the visit, and consisted of 16 items modified to suit the study. The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who had undergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higher scores in two items. In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who had undergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individual with his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.
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| 67. |
- Falk, Kristin, 1949, et al.
(author)
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Fatigue in patients with chronic heart failure - a burden associated with emotional and symptom distress.
- 2009
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In: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - : Oxford University Press (OUP). - 1873-1953 .- 1474-5151. ; 8:2, s. 91-6
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Journal article (peer-reviewed)abstract
- BACKGROUND: The relationship between experience of fatigue and emotional and symptom distress in chronic heart failure (CHF) needs to be thoroughly explored, because fatigue has major impact on daily activities in life. AIMS: The purpose was to examine the association between fatigue, as a multidimensional experience and anxiety, depression and symptom distress, and to explore the relationships between individual symptoms and the dimensions of fatigue in patients with CHF. METHODS: A consecutive sample of 112 patients with exacerbation of symptoms of CHF answered the Multidimensional Fatigue Inventory (MFI-20), the Hospital Depression and Anxiety (HAD) Scale and the Symptom Distress Scale (SDS). RESULTS: Anxiety was associated with mental fatigue, whereas depression was associated with reduction of activity, low motivation and decreased functioning. Physical fatigue was affected by symptom distress, with women reporting more distress than men. With exception of breathlessness, poor agreement was found between fatigue and the most intensive reported symptoms. CONCLUSIONS: The relationship between emotional distress and the experience of fatigue in patients with CHF may have a devastating affect on the patient's ability to cope and manage daily activities, including self-care and adherence to recommended treatment.
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| 68. |
- Falk, Solvig, et al.
(author)
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Keeping the maintenance of daily life in spite of Chronic Heart Failure : A qualitative study
- 2007
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In: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 6:3, s. 192-199
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Journal article (peer-reviewed)abstract
- Background:Patients with CHF (Chronic Heart Failure) is an increasing group in the society. They often experience increasing powerlessness and depression in daily life as well as difficulties adhering to other physical symptoms. Many patients have difficulties to deal with daily demands.Aims:To describe how persons, living with CHF, perceived the maintenance of their daily life.Methods:This study was following a phenomenographic method in order to describe variations of perceptions. Data was collected through taped interviews, taken from 17 patients. The sample was selected from patients attending a specialist Chronic Heart Failure day care unit.Results:Five main categories were identified from 345 statements describing variations in how patients with CHF kept maintenance in their daily life. The categories include: dealing with the realities of life, dealing with thoughts about life's infinity, taking responsibility, dealing with the surrounding world and keeping up with values of life.Conclusion:The illness symptoms clearly affected daily routines but participants showed remarkable resolve and showed that values in life could be maintained albeit with a few adjustments. No patient expressed a desire to give up. Understanding patients' perceptions the specialist nurse can transfer these knowledge to other patients in similar situations.
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| 69. |
- Franzén, Kristofer (current name Årestedt, Kristofer), et al.
(author)
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Impact of Chronic Heart Failure on Elderly Persons' Daily Life : A Validation Study
- 2006
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 5:2, s. 137-145
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Journal article (peer-reviewed)abstract
- BACKGROUND: Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons.AIM: To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population.METHODS: The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used.RESULTS: A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbach's alpha for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%).CONCLUSIONS: The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.
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| 70. |
- Franzén, Kristofer, et al.
(author)
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Predictors for health related quality of life in persons 65 years or older with chronic heart failure.
- 2006
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:2, s. 112-120
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Journal article (peer-reviewed)abstract
- Background A main goal in nursing care of persons with chronic heart failure (HF) is to strengthen their health related quality of life (HRQoL). This presupposes knowledge about the relation between heart failure and HRQoL. Existing studies have shown incongruent results about whether HRQoL is affected differently depending on age or sex of elderly persons with chronic HF. Aim This study aimed to investigate if age, sex, disease severity, comorbidity and living conditions predict health related quality of life among persons 65 years or older with chronic HF. Methods The study included a sample of 357 persons. HRQoL was measured by the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. Multiple regression analyses were performed to analyse the relation between the predictors and HRQoL. Results The main finding was that self-rated disease severity was strongly associated with HRQoL, but also age, sex, diabetes and respiratory diseases was associated with some of the dimensions of HRQoL. Conclusions Interventions aimed at delaying the progress of the disease, assist persons' to cope with the disease and maintain the domains of HRQoL that are still feasible could be important to improve HRQoL in elderly persons with chronic HF.
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