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Aims: The aim of this study was to describe case management as experienced by patients with heart failure and their health professionals with the aim of understanding why case management might contribute in reducing hospital admissions. Background: Heart failure is a common cause of unplanned hospital admission. The evidence for case management in patients with heart failure for reducing admissions is promising. Design: Systematic review and qualitative evidence synthesis. Data source: Searches were conducted in Medline, Psychinfo, Kings Fund database and Cinahl from inception of each database to 16 February 2017. Review methods: Robust systematic review methodology was used to identify qualitative studies describing the experiences of patients with heart failure and healthcare providers of case management. Data were synthesized thematically, and analytic themes were developed. Findings: Five studies (six papers) from which nine descriptive themes were used to determine three analytic themes. This synthesis showed that case management provides positive quality of care for patients, increases perceived access to services and creates more time to ask questions and develop trusted relationships. For health professionals, case management enhanced care by improved relationships with both patients and colleagues although concerns remained around resources, training and inter-professional conflict. Conclusions: This synthesis emphasizes the importance of the quality of being cared for as a patient and caring as a health professional. Case management enhances communication between patients and health professionals, supports patient self-care and self-management and can be an important contributing factor in reducing unplanned admissions for patients with heart failure. [ABSTRACT FROM AUTHOR]

Heart failure is a condition that is increasing in prevalence in the UK, with high patient mortality rates and frequent hospital admissions. Nurse-led heart failure services help to improve patient outcomes through aiding pharmacological, interventional and holistic care. Heart failure management teams that work to support patients can vary greatly from service to service. This article discusses the evidence and guidelines supporting an integrated multidisciplinary approach to chronic heart failure nursing care. [ABSTRACT FROM AUTHOR]

Heart failure readmissions are associated with significant morbidity and mortality. Adequate education on adherence and self-care behaviours can affect readmission rates positively and nurses are at the frontline of patient education. Such education is valuable when establishing heart failure programmes in developing countries, in light of the challenging socioeconomic circumstances in these. This study aimed to evaluate nurses' heart failure knowledge, to assess patients' baseline knowledge, and to evaluate the effectiveness of structured nurse-driven education. Methods: a total of 131 cardiac centre-based nurses and 30 chronic heart failure patients participated in the study in Kuwait. Patients were surveyed a second time 3 to 6 months later, while being followed at an advanced heart failure clinic by dedicated heart failure nurses. Results: the majority of the nurses (80%) had not received heart failure education previously, although they were able to recognise most heart failure symptoms. Significant improvement in patients' knowledge was noted between the initial and follow-up surveys. Conclusion: establishing a dedicated advanced heart failure programme to care for patients in a developing country can result in significant improvement in disease awareness and self-care behaviours when led by well-trained heart failure nurses. More research is needed to determine if these findings are shared by other countries in the Middle-East and other developing countries. [ABSTRACT FROM AUTHOR]

Background: The American Heart Association's (AHA) Council on Cardiovascular and Stroke Nursing (CVSN) plays a critical role in advancing the mission of the AHA in the discovery of new scientific knowledge. The aim was to identify priority research topics that would promote and improve cardiovascular (CV) health, provide direction for the education of future nurse scientists, and serve as a resource and catalyst for federal and organizational funding priorities. Methods: A Qualtrics survey, which included 3 questions about priorities for CVSN nurse researchers, was sent to the CVSN Leadership Committee and all CVSN Fellows of the AHA (n = 208). Responses to the questions were reviewed for word repetitions, patterns, and concepts and were then organized into thematic areas. The thematic areas were reviewed within small groups at the November (2016) in-person CVSN leadership meeting. Results: Seventy-three surveys were completed. Five thematic areas were identified and included (1) developing and testing interventions, (2) assessment and monitoring, (3) precision CV nursing care, (4) translational and implementation science, and (5) big data. Topic areas noted were stroke, research methods, prevention of stroke and CV disease, self-management, and care and health disparities. Conclusion: Five thematic areas and 24 topic areas were identified as priorities for CV nursing research. These findings can provide a guide for CV nurse scientists and for federal and foundational funders to use in developing funding initiatives. We believe additional research and discovery in these thematic areas will help reduce the rising global burden of CV disease. [ABSTRACT FROM AUTHOR]

Background: Valid and reliable instruments to assess family functioning, health and social support in families with heart failure constitute a cornerstone in the detection of the families’ needs, in improving their functioning and in evaluating the effects of nursing interventions. Aim: To translate the three scales of the Family Functioning, Family Health and Social Support (FAFHES) questionnaire from Finnish into Danish, to test validity and reliability of the Danish version among outpatients with heart failure and to add to previous studies by reconstructing scales using confirmatory factor analysis. Methods: A cross‐sectional design was used to study a sample of 330 patients with heart failure who completed the FAFHES. The validity (dimensionality) and reliability (internal consistency and test–retest) were assessed for each of the three scales. The scales were constructed using confirmatory factor analysis. Results: Patients were primarily men (76%) with a mean age of 66.5 (SD 12.5), categorised as New York Heart Association (NYHA) classification II (80%) and NYHA III (20%) for clinical severity of symptoms. In all three modified scales, construct validity was supported by the analysis. There were strong correlations within the factors, with Cronbach's alpha ranging from 0.73 to 0.95 across the three scales, and significant, though weak, correlations between most of the factors. None of the revised scales showed good model fit according to the goodness‐of‐fit indices used. The test–retest showed interclass correlation coefficients ranging between 0.69 and 0.86, indicating acceptable test–retest reliability. Conclusion: The Danish version of the FAFHES is an instrument that can be used to measure family functioning, family health and social support from the perspective of the patient with heart failure. Further testing is recommended. [ABSTRACT FROM AUTHOR]

Interventional cardiovascular nursing is a critical care nursing specialty providing complex nursing interventions to patients prone to clinical deterioration, through the combined risks of the pathophysiology of their illness and undergoing technically complex interventional cardiovascular procedures. No guidelines were identified worldwide to assist health care providers and educational institutions in workforce development and education guidelines to minimise patients' risk of adverse events. The Interventional Nurses Council (INC) developed a definition and scope of practice for interventional cardiac nursing (ICN's) in 2013. The INC executive committee established a working party of seven representatives from Australia and New Zealand. Selection was based on expertise in interventional cardiovascular nursing and experience providing education and mentoring in the clinical and postgraduate environment. A literature search of the electronic databases Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Health Source was performed, using the search terms: clinical deterioration, ST elevation myocardial infarction, vital signs, primary percutaneous coronary intervention, PCI, AMI, STEMI, acute coronary syndrome, peri-procedural care, unstable angina, PCI complications, structural heart disease, TAVI, TAVR, cardiac rhythm management, pacing, electrophysiology studies, vascular access, procedural sedation. Articles were limited to the cardiac catheterisation laboratory and relevance to nursing based outcomes. Reference lists were examined to identify relevant articles missed in the initial search. The literature was compared with national competency standards, quality and safety documents and the INC definition and scope of practice. Consensus of common themes, a taxonomy of education and seven competency domains were achieved via frequent teleconferences and two face-to-face meetings. The working party finalised the standards on 14 July 2017, following endorsement from the CSANZ, INC, Heart Rhythm Council, CSANZ Quality Standards Committee and the Australian College of Critical Care Nurses (ACCCN). The resulting document provides clinical practice and education standards for interventional cardiac nursing practice. [ABSTRACT FROM AUTHOR]

Background: Some studies suggest that female practitioners are more likely to provide guideline-concordant care than male practitioners; however, little is known about the role of practitioner gender in cardiology. Objective: The aim of the study was to measure the association between practitioner gender and adherence to the cardiovascular performance measures in the American College of Cardiology's ambulatory Practice Innovation and Clinical Excellence Registry. Methods: Patients with at least 1 outpatient visit with a unique practitioner were included. Among eligible patients, adherence to 7 guideline-supported performance measures for coronary artery disease, heart failure, and atrial fibrillation over 12 months after registry entry was compared by practitioner gender using hierarchical models adjusting for practitioner type (physicians vs advance practice practitioners) and number of visits. Results: The study cohort included 1493 individual practitioners who saw 769 139 patients; 80% of practitioners were men. Male practitioners were more often physicians compared with female practitioners (98.2% vs 43.7%, P < .01). Accounting for practitioner category and visit frequency, guideline adherence rates were similar by practitioner gender for all measures with the exception of marginally higher rates for coronary artery disease performance measures for male practitioners compared with female practitioners (antiplatelet: rate ratio [RR] = 1.06; 95% confidence interval [CI], 1.03-1.09; "-blockers: RR = 1.06; 95% CI, 1.01-1.10; and lipid-lowering drug: RR = 1.07; 95% CI, 1.04-1.10) and atrial fibrillation (oral anticoagulants: RR = 1.05; 95% CI, 1.01-1.09). Conclusion: Male practitioners marginally outperformed their female counterparts in ambulatory practices enrolled in a voluntary cardiovascular performance improvement registry program. Overall low adherence to some performance measures suggests room for improvement among all practitioners. [ABSTRACT FROM AUTHOR]

Aim This article offers nurse managers guidance on analysing, managing and addressing a potentially dissatisfied nursing workforce, focusing on three priority shortage specialties: emergency care, paediatrics and cardiology. The aim of the study was to explore to what extent registered nurses and healthcare assistants, referred to collectively here as 'nursing staff', are satisfied with teamworking opportunities, continuing professional development (CPD) opportunities and workplace autonomy. Method A survey questionnaire was developed to evaluate three derived determinants of nurse satisfaction: team working, CPD and autonomy. The NHS West Midlands region was the focus given that it is among the poorest performing regions outside London in filling nursing posts. Findings Overall, nursing staff respondents were satisfied with teamworking, CPD and autonomy, which challenges the perception that nurses in NHS England are dissatisfied with these satisfaction determinants. The findings give a complex picture of nurse satisfaction; for example a large minority of respondents were dissatisfied with their ability to carry out duties as they see fit. Conclusion When developing management systems to investigate, manage and enhance nurse satisfaction, nurse managers must recognise the complexity and subtleties of determining factors. This will increase as nursing becomes more specialised. Subsequently, nurse managers need to work closely with staff at higher education institutions and other professional agencies to commission appropriate professional development. [ABSTRACT FROM AUTHOR]

The prevalence of long-term health conditions is increasing as the population ages. Resources are limited and costs are increasing. Patients are often elderly with multiple co-morbidities. This article focuses on heart failure and the complexities and challenges of managing it in a community setting. It describes the authors' roles of heart failure specialist nurse and advanced community practitioner for long-term conditions, and how they have worked together to improve patients' experiences and provide timely, holistic care. Their aim is to reduce unnecessary hospital admissions, improve patients' quality of life and end of life care, and support their family and carers. [ABSTRACT FROM AUTHOR]

Background: No studies have been conducted in Jordan to examine the effect of cardiac education on knowledge and self-care behaviors among patients with heart failure in Jordan. Purpose: The purpose of this study was to examine the effect of a cardiac educational program on knowledge and self-care behaviors among patients with heart failure. Method: A quasi-experimental pretest/posttest design was used. A convenient sample of 127 patients with heart failure was recruited. The participants were randomly assigned to either experimental (n = 55) or control (n = 65) group. Knowledge and self-care were measured at 1 and 3 months after the program application. Results: Results indicated that the change of knowledge mean score was statistically significant, P ≤ .001, between the pretest and both the first and second posttests for the experimental group compared with the control group. The change of maintenance self-care mean was statistically significant, P ≤ .001, between the pretest and both the first and second posttests for the experimental group compared with the control group. Moreover, the change in the management self-care mean was statistically significant, P ≤ .001, between the pretest and both the first and second posttests for the experimental group compared with the control group. Finally, the change of confidence self-care mean was statistically significant, P ≤ .001, between the pretest and both the first and second posttests for the experimental group compared with the control group. Conclusion: Applying cardiac education program helps improve knowledge and self-care among patients with heart failure. Such educational programs should be adopted in clinical settings to enhance knowledge and self-care behaviors. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common dysrhythmia encountered in the United States. Symptoms may be similar to those of other cardiac conditions, which can delay the timely detection, diagnosis, and management of AF. This article provides an overview of AF and modalities used in remote monitoring. [ABSTRACT FROM AUTHOR]

Background: In contrast to recommendations in recent guidelines, prognosis is not optimally discussed with patients with heart failure (HF). Reasons for not doing so can be related to both patient and provider characteristics. Purpose: The purpose of the study was to explore which patient- and nurse-related variables influence discussing prognosis with patients at an HF clinic. Method: Data from a previous survey on attitudes and clinical practice of HF nurses on discussing prognosis that was conducted in Sweden and the Netherlands were combined with data from a registration on topics that nurses discussed with their patients during a prespecified week at the HF clinic. Multivariable logistic regression analysis was performed to assess which variables are related to discussing prognosis. Results: A total of 275 HF nurses (mean age, 49 years) and data of 1633 patients with HF (mean age, 71 years) were included in the study. Prognosis was discussed with 42% of all patients during the visit at the HF clinic. Patients with whom prognosis was discussed were more often in New York Heart Association classes III to IV (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.44-2.26). Nurses discussing prognosis reported more knowledge on the topic (OR, 1.71; 95% CI, 1.36-2.16) and discussed more topics with the patient (OR, 1.27; 95% CI, 1.21-1.32). Dutch HF nurses were more likely to discuss prognosis compared with their Swedish colleagues (OR, 1.83; 95% CI, 1.43-2.33). Conclusions: Discussing prognosis with patients with HF by nurses at the HF clinic is related to the characteristics of patients and HF nurses. Future interventions to improve communications about prognosis therefore should have a broad approach. [ABSTRACT FROM AUTHOR]

Aims and objectives: To gain in-depth knowledge of patients’ experiences of the consultation processes at a multidisciplinary atrial fibrillation outpatient clinic in a university hospital in Denmark. Background: Atrial fibrillation is the most common cardiac arrhythmia associated with morbidity and mortality if not diagnosed and treated as recommended. Patients with newly diagnosed atrial fibrillation preferably should be managed in an outpatient setting which includes medical examination, patient education and decision-making on medical therapy. Design: This is a qualitative study of 14 patients newly diagnosed with atrial fibrillation, ranging from asymptomatic patients, to those with mild to severe symptoms; they were all referred from general practitioners. Methods: Data were generated in 2013-2015 using participant observation during each consultation, followed by individual interviews postconsultation. Results: Patients were referred with limited information on AF and knowledge about the management consultation procedures. The consultations were performed in a professional way by the cardiologist as well as by the nurses with an emphasis on the medical aspects of atrial fibrillation. The understanding that atrial fibrillation is not a fatal disease in itself was very important for patients. At the same time, visiting the clinic was overwhelming, information was difficult to understand, and patients found it difficult to be involved in decision-making. Conclusions: This study indicates that patients were uncertain on what AF was before as well as after their consultation. The communication was concentrated on the medical aspects of atrial fibrillation and visiting the clinic was an overwhelming experience for the patients. They had difficulty understanding what atrial fibrillation was, why they were treated with anticoagulation, and that anticoagulating was a lifelong treatment. Relevance for clinical practice: This study demonstrates some lack of patient centred care and an absence of tailored patient AF-related education. Furthermore, the study highlights the need for and importance of active patient involvement. [ABSTRACT FROM AUTHOR]

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt. [ABSTRACT FROM AUTHOR]

This is a research involving nursing care for patients undergoing catheterization and angioplasty. The objective was to characterize the care prioritized by the hemodynamics nurses. The study, which used the quantitative-qualitative method, explains the complications, risks and possible nursing diagnoses. To systematize the two hundred and three answers of the five nurses questioned, the researchers elaborated a checklist, based on the stages of the nursing process. Care was divided into pre, trans and post-procedure, ranging from checking the patient's allergic history to discharge guidelines. The nurses' answers allowed the confirmation of some risks, for example, already presented in theory, such o hematoma and restenosis; in addition, others not revealed in the literature used and indicate the need for further studies. The application of the systematization of nursing care through an organized work instrument was adapted according to the reality and the professional practice. [ABSTRACT FROM AUTHOR]

Background: The European Society of Cardiology (ESC) has a comprehensive clinical guideline development programme, relevant for all clinicians. However, implementation of guidelines is not always optimal. Aim: The aim of this study was to determine nurses’ and allied professionals’ awareness and barriers regarding clinical guideline implementation. Methods: A cross-sectional survey was administrated online and in print at EuroHeartCare 2015. A questionnaire was developed which examined awareness and barriers to implementation of ESC guidelines on cardiovascular disease prevention in clinical practice (2012) and ESC guidelines in general. Results: Of the 298 respondents, 12% reported that the prevention guidelines were used in their practice area. Respondents identified, in order of magnitude, that lack of leadership, workload, time, resources and a perception that they were unable to influence current practice were barriers to the use of the prevention guidelines. When asked to rank barriers to use of any ESC guidelines, time (22%) and leadership (23%) were ranked highest. Conclusions: Implementation of ESC guidelines by nurses, the majority responders in this survey, is a serious problem, requiring urgent improvement to ensure patients receive optimal evidence based care. Issues of leadership, workload, time and resources are significant barriers to guideline implementation. It is of concern that these professionals perceive both that they have little influence on implementation decisions and lack of leadership regarding guideline implementation. Educational and organisational strategies to improve leadership skills are imperative. These will build self-efficacy and empower nurses and allied professionals to advocate for evidence-based care in the clinical environment. [ABSTRACT FROM AUTHOR]

The article focuses on the need to accelerate the translation of knowledge from cardiovascular research into clinical practice. It discusses the gap between research production and its implementation in patient care, emphasizing the importance of knowledge translation (KT) to bridge this gap. It introduces the "KT Corner" as an addition to the journal, aiming to provide readers with clinical tools and insights into how to apply research evidence in cardiovascular care.

The article presents the discussion on Obstructive sleep apnoea (OSA) being highly prevalent in patients with atrial fibrillation (AF). Topics include describing the potential for a multidisciplinary integrated approach for comprehensively managing OSA and AF; and patient-centred approach focusing on engagement and education of patients with AF allowing the clarification of the role of OSA management as part of AF treatment.

The article announces the appointment of Izabella Uchmanowicz as president of the Association of Cardiovascular Nursing and Allied Professions.

Background: This study examined the long-term effects of nurse-led, individualized education on self-efficacy, self- care compliance, and health-related quality of life (HRQoL) in middle-aged patients with new-onset acute coronary syndrome. Methods: A quasi-experimental pretest-posttest design was used in the study. A cardiovascular nurse provided individualized education to the intervention group (n = 32), and self-efficacy, self-care compliance, and HRQoL at baseline and 3 and 12 months after discharge were compared to those of a control group (n = 30). Patients were recruited from a cardiovascular care unit at a university hospital between 2012 and 2013. Repeated measures analysis of variance was used to compare time-related changes. Results: There was no significant difference in self-efficacy between the 2 groups over a fixed period (F = 3.47, p = 0.067) and showed no interaction between the 2 groups (F = 0.45, p = 0.636). However, significant differences were found in the main and interaction effects between the 2 groups and changes in self-care compliance over the follow-up period differed significantly between the 2 groups (F = 28.72, p < 0.001). Changes in mental HRQoL over the follow-up period differed significantly between the 2 groups (F = 33.34, p < 0.001) and significant interaction effect (F = 4.40, p = 0.040). Conclusions: Structured nurse-led education should be provided to middle-aged patients with new-onset acute coronary syndrome, as part of routine predischarge education, to increase self-care compliance and mental HRQoL and prevent secondary adverse events. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the clinical and construct validity of the nursing diagnosis 'decreased cardiac output' (DCO) in patients with chronic heart failure. METHODS Cross-sectional study. RESULTS A total of 200 people were studied. The defining characteristics with the highest prevalence were as follows: arrhythmia (62.5%) and fatigue (61.5%). Adjustment measures such as infit and outfit were maintained between 0.50 and 1.56 and the total variance explained by the measures was 29.3%. CONCLUSIONS This study determined the clinical validity of the nursing diagnosis DCO. Regarding construct validity, adjustment of the defining characteristics to the Rasch model was observed. IMPLICATIONS FOR NURSING PRACTICE This study improves the evidence-based practice of nursing and strengthened the role of the nurse who leads care to this population. OBJETIVO Determinar la validez clínica y de constructo del diagnóstico de enfermería 'Disminución del Gasto Cardíaco' en pacientes con falla cardíaca crónica. MÉTODOS Estudio de corte transversal. RESULTADOS Un total de 200 pacientes fueron estudiados. Las características definitorias con las mayores prevalencias fueron: arritmia (62.5%) y fatiga (61.5%). Medidas de ajuste como el infit y outfit se mantuvieron entre 0.50 y 1.56. El total de la varianza explicada por las medidas fue de 29.3%. CONCLUSIONES Este estudio determinó la validez clínica del diagnóstico de enfermería 'Disminución del Gasto Cardíaco'. En cuanto a la validez de constructo, se observó que 19 de las 21 características definitorias se ajustaron al modelo Rasch. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA Este estudio mejora la práctica basada en la evidencia de enfermería y fortalece el rol de las enfermeras que lideran el cuidado en esta población. [ABSTRACT FROM AUTHOR]

Nurses and allied professionals are at the forefront of care delivery in patients with arrythmogenic risk and have a responsibility to deliver care that is focused on their individual needs. The 2015 European Society of Cardiology guideline on prevention of ventricular arrhythmia and sudden cardiac death heralds a step-change in patient and family focus and interdisciplinary involvement. This development reflects a recognition within the European Society of Cardiology that chronic care of patients with cardiovascular conditions can be improved by involving all stakeholders, making use of multidisciplinary interventions, and placing the patient at the centre of the care process. In this article, taskforce contributors discuss the latest evidence and highlight some of the most pertinent issues for nurses involved in patientcentred care of patients and families with ventricular arrhythmias and/or risk of sudden death. [ABSTRACT FROM AUTHOR]

ABSTRACT Intensive behavioral counseling interventions combined with nicotine replacement therapy have increased smoking abstinence rates in cardiac patients, but little is known about their feasibility when initiated upon hospital admission and continued post-discharge. The current study was an evaluation of the use, appreciation, and fidelity of two post-discharge counseling interventions designed for cardiac patients to quit smoking that differed in their delivery mode. In a controlled trial with cross-over randomization at the cardiac unit level, hospitalized smokers in eight cardiac units of eight Dutch hospitals were assigned either telephone counseling ( n = 223) or nurse-administered face-to-face counseling ( n = 157) using the Ask-Advise-Refer strategy. Eligible patients also received nicotine replacement therapy. Data based on counselors' registration forms and patients' telephone surveys at 6-month follow-up were analyzed. Most patients (>90%) participated in at least one counseling session, and the majority participated in at least five out of a maximum of seven sessions. Higher levels of adherence to either the telephone or face-to-face counseling sessions were associated with higher smoking abstinence rates at the 6-month follow-up, whereas higher nicotine patch use was not associated with abstinence. Patients positively evaluated the content, duration, and number of sessions, and rated the face-to-face counseling significantly better than the telephone counseling for quitting smoking. The counselors largely complied with the intervention protocols. The current intervention offers evidence of feasibility and may improve outpatient continuity of smoking care. Monitoring the use and delivery of such complex interventions is recommended to promote effective dissemination in cardiac practice. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are increasing rapidly and have become a major health problem worldwide. The incidence and prevalence of cardiovascular disease are increasing rapidly, predominantly in the developing countries. Patients with cardiovascular disease who do not respond to routine medical treatment will have to follow cardiac surgical procedures. The objective of this study was to apprise the evidence of the effect of various complementary therapies on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science, and the Cochrane Library databases for original research studies published between 2000 and 2015. Original articles that reported the effect of complementary therapies in patients undergoing cardiac surgery were included. Twenty-eight studies were analyzed, and they have produced conflicting results. Most of the studies (n = 25) have documented the effects of complementary therapies on improving postoperative outcomes of patients, whereas other studies (n = 3) found no evidence of improvement. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive postoperative outcomes. Evidence of the efficacy of complementary therapies in cardiac surgical patients remains inconclusive. Additional research is needed to provide a strong evidence base for the use of complementary therapies to improve postoperative outcomes and recovery in patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

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Background: Vascular complications are still common in the catheterization laboratory setting. However, no risk scores for their prediction have been described. With a view to bridging this gap, the present study sought to develop and validate a score for prediction of vascular complications associated with arterial access in patients undergoing interventional cardiology procedures. Methods: This prospective multicenter cohort study included adult patients who underwent cardiac catheterization via the femoral or radial route. The outcomes of interest were: access site hematoma; major and minor bleeding; and retroperitoneal hemorrhage, pseudoaneurysm, or arteriovenous fistula requiring surgical repair. Past medical history as well as pre-procedural, intra-procedural, and post-procedural variables were collected. Patients were randomly allocated to the derivation or validation cohorts at a 2:1 ratio. The following equation constituted the score: (>6F introducer sheath×4.0)+(percutaneous coronary intervention×2.5)+(history of vascular complication after prior interventional cardiology procedure×2.0)+(prior use of warfarin or phenprocoumon×2.0)+(female sex×1.5)+(age⩾60 years×1.5). The maximum score is 13.5 points. Results: A score dichotomized at ⩾3 (best cutoff for balancing sensitivity and specificity) was moderately accurate (sensitivity=0.66 (95% confidence interval: 0.59–0.73); specificity=0.59 (95% confidence interval: 0.56–0.61)). Patients with a score ⩾3 were at increased risk of complications (odds ratio: 2.95; 95% confidence interval: 2.22–3.91). Conclusions: This study yielded a score that is capable of predicting vascular complications and easily applied in daily practice by providers working in the catheterization laboratory setting. [ABSTRACT FROM AUTHOR]

Introduction: There is increasing evidence supporting the relationship between family support and patient outcomes. Therefore, involving families in the care of cardiovascular patients is expected to be beneficial for patients. The quality of the encounter with families highly depends on the attitudes of nurses towards the importance of families in patient care. Aim: The aim of this study was to describe the attitudes of nurses towards family involvement in patient care and to investigate the individual contributions of demographic, professional and regional background characteristics. Method: A survey was distributed among cardiovascular nurses attending an international conference in Norway and a national conference in Belgium. Nurses were asked to complete a questionnaire, including the Families’ Importance in Nursing Care – Nurses’ Attitudes scale. The study population consisted of respondents from Belgium (n = 348) and from Scandinavian countries (Norway, Sweden and Denmark; n = 77). Results: In general, nurses viewed the family as important in care. However, attitudes towards actively inviting families to take part in patient care were less positive. Higher educational level and a main practice role in research, education or management were significantly associated with more positive attitudes. Furthermore, the attitudes of respondents living in Scandinavia were more positive as compared to the attitudes of respondents living in Belgium. Conclusion: Education on the importance of families and active family involvement in patient care seems to be necessary in basic, undergraduate education, but also in clinical practice. More research is necessary in order to explore the cultural and regional differences in the attitudes of nurses towards the involvement of families in patient care. [ABSTRACT FROM AUTHOR]

Background The American Heart Association's 2020 Strategic Goals have defined a new concept of cardiovascular health for adults and children, emphasizing the importance of primordial prevention of cardiovascular diseases. However, detailed data on the trends of ideal cardiovascular health in Chinese children and adolescents are sparse. Methods A total of 5596 children and adolescents (aged 6–18 years) were selected from two cross-sectional surveys conducted in 2004 and 2014, respectively. Cardiovascular health behaviors (smoking, body mass index, physical activity, and diet) and factors (total cholesterol, blood pressure, and glucose) were evaluated, and only participants with information on all 7 metrics ( n = 4309) were included for the cardiovascular score analysis. Results During 2004–2014, ideal levels of almost all the seven metrics decreased, except for a marked increase in physical activity (boys: 23.0% vs 52.8%; girls: 16.2% vs 41.0%). Overall, only 19.5% of boys and 22.0% of girls had ideal cardiovascular health (score ≥ 6) in 2004, which worsened in 2014 (boys: 9.8%; girls: 16.0%). The prevalence of ideal cardiovascular health factors also declined, but the prevalence of ideal cardiovascular health behaviors increased. Being a girl and having a younger age (aged 6–11 years) were associated with higher prevalence of ideal cardiovascular health. Higher family income and parental education were associated with a higher prevalence of ideal cardiovascular health behaviors. Conclusion Adverse trends in ideal cardiovascular health were observed among Chinese children and adolescents during 2004–2014. Effective intervention programs, in particular targeting children and adolescents, need to be developed to promote cardiovascular health in China. [ABSTRACT FROM AUTHOR]

Background: Opioid and sedative medications are commonly used to treat pediatric patients with congenital heart disease; however, their use is not without adverse effects. Symptoms of withdrawal can occur if the medications are discontinued abruptly or weaned too quickly. Objective: The aim of this study was to understand and describe the current management of opioid and sedative weaning in pediatric congenital heart disease patients in freestanding children's hospitals across the United States. Methods: A Web-based survey of pediatric congenital heart centers was conducted. Survey participants were recruited from the Consortium of Congenital Cardiac Care--Measurement of Nursing Practice. Quantitative data were summarized using frequency and proportions. Qualitative data were summarized using content analysis. Results: Twelve sites participated in the survey (44% response rate). Methadone was used as a weaning medication at 100% of participating sites, lorazepam at 83% of sites, and clonidine at 75% of sites. Seventy-five percent of sites reported using a clinical assessment tool to monitor withdrawal symptoms. Twenty-five percent of sites used a standardized clinical pathway when weaning opioid and sedative medications. Eighty-three percent of sites will consider discharging a patient to complete the medication wean at home. Discussion: Weaning practices varied across sites. While some similarities were observed among sites, substantial practice variation exists. The majority of sites used a clinical assessment tool to assess for withdrawal symptoms. Few sites reported using a standardized approach to weaning patients. Discharging patients to complete an opioid or sedative wean at home was common practice. Opportunities exist for the development of weaning practice guidelines. [ABSTRACT FROM AUTHOR]

The number of people with heart failure requiring implantation of a cardiac resynchronization device is increasing in Iran. Although this intervention is an effective life-saving treatment, several challenges are associated with patients' lifestyle after insertion. This study identified the challenges and coping mechanisms of Iranians with heart failure living with cardiac resynchronization therapy. A qualitative approach using conventional content analysis was adopted. Seventeen people with heart failure and three nurses were recruited between December 2014 and November 2015 from a teaching hospital and a private clinic in Rasht, Iran. Participants were interviewed using semi-structured interviews lasting 30-60 min. Five themes emerged: (i) fear of implantation, (ii) the panic of receiving a shock from the device, (iii) lack of control over life, (iv) inadequacies of the healthcare system, and (v) psychosocial coping. A heightened understanding of these challenges and coping strategies could prepare healthcare professionals to provide better routine care, education, and support to the recipients of cardiac resynchronization therapy prior to implantation, during the recovery period, and for long-term management. [ABSTRACT FROM AUTHOR]

Background: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). Methods: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge. Referrals were by the advanced nurses during consult hours and out-of-hours were by the ED physicians. Data were extracted from case notes. This was a 1 -site cross-sectional study of patients attending the chest pain clinic over 2 years. Results: Confirmed coronary disease was diagnosed in 24% of patients. Of the 1041 patients, 45% were referred by the advanced nurses, who referred significantly more patients who were older (56.5 years/52.3 years), had positive exercise stress test results (21%/12%), and were diagnosed with stable coronary artery disease (19%/11 %) and less patients with musculoskeletal diagnosis (5%/13%) and other noncardiac pain (36%/45%). Conclusions: The study fills a gap in the literature on the follow up of non-ACS patients who present to ED and used advanced cardiology nursing expertise in the ED and chest pain clinic. The advanced nurse referred more patients who were diagnosed with coronary disease, reflecting the expertise, experience, and efficiency of the advanced cardiology nurse-led service. [ABSTRACT FROM AUTHOR]

Referral to specialist centres for treatment of lymphoedema can often have long waiting times. Management of a patient with massive lymphoedema and lymphorrhoea was provided in a vascular outpatient setting. A new form of compression using a wraparound system was used for the management (Juxta-Fit, Medi UK). Despite having previously been non-concordant with treatment options, the patient was independent with product use. Lymphorrhoea ceased and there was a marked decrease in girth size. The patient's quality of life improved and maintenance treatment was provided. The use of this compression system could be a valuable treatment alternative to compression bandaging for a select patient group for the treatment of lymphoedema. Declaration of interest: No conflicts of intrest to declare. [ABSTRACT FROM AUTHOR]

Aims and Objectives The aim of this study was to identify the differences in perceived learning needs between cardiac patients who have undergone major coronary interventions and their nurses. Background The decrease in length of stay after cardiac interventions has signalled an urgent need to provide effective in-hospital health education. Therefore, the content of health education should bridge the gap between nurses' and patients' views of what information is important for ensuring patients' optimum recovery. Design A descriptive comparative design was employed. Methods Patients were invited to participate if they had undergone angioplasty or bypass surgery and were ready for discharge within 24-48 hours. A convenience sample of 365 cardiac patients and 166 cardiac nurses participated in this study. Baseline data on patients' and nurses' sociodemographics, clinical history and experience were collected through personal interviews. Then, participants completed the Patient Learning Needs Scale to identify their perceptions of the learning needs after cardiac interventions. Results The top-priority learning needs according to both patients and cardiac nurses was information on wound care and medication. In contrast, the lowest-priority learning need was physical activity. Nurses perceived information about physical activity as most needed to patients, whereas patients perceived information about medications, postintervention complications and postintervention concerns as mostly needed. Conclusion The disparity between perceptions of patient and nurses on the essential content to be learned highlights the importance of considering both of these parties when establishing health education programmes. In addition, nurses should focus more on information related to the recovery period and immediate needs after discharge. Relevance to clinical practice Information about wound care, medication and potential complications should be the core of predischarge education programmes. In addition, nurses should focus on improve patients' awareness of secondary prevention and lifestyle modification, as patients pay less attention to these vital topics. [ABSTRACT FROM AUTHOR]

Background: Depression is common among patients with coronary heart disease (CHD) and has a major impact on their quality of life, morbidity and mortality. Aim: The aim of this study was to map the 12-month psychosocial outcomes of patients with CHD who were screened positive for depression in an acute cardiac ward. Methods: A prospective cohort study was conducted of the psychosocial trajectory (depression, anxiety, wellbeing, social support, mental health service access) of 212 patients with CHD who were screened for depression after being admitted to acute cardiac wards of a major metropolitan hospital. Outcomes were assessed before hospital discharge and at one, three, six and 12 months post-discharge. Results: Linear mixed models identified that those patients screened at 'moderate to high' risk of depression at baseline had higher levels of depression (F(1,173)=53.93, p<0.0001) and anxiety (F(1,180)=67.01, p<0.001), and lower levels of wellbeing (F(1,186)=42.47, p<0.001) and social support (F(1,177)=25.40, p<0.0001), compared to those at 'no to low' risk of depression. Levels of depression and wellbeing remained fairly constant over the 12-month trajectory. Surgical and medical treatment groups were of similar psychological composition over the 12-month period. Conclusions: These findings attest to the effectiveness and predictive validity of a simple nurse-administered screening tool designed to identify depression in hospital patients with CHD and also indicate that a screening and referral tool alone is not sufficient to achieve optimal disease management. A collaborative care model involving family members and integrated pathways to primary care is recommended. [ABSTRACT FROM AUTHOR]

The article presents table of contents, statistics and submission on abstracts, and abstracts on the topics including heart failure, arrhythmias, and acute cardiac care.

Introduction: chronic degenerative diseases such as coronary heart disease are caused by various risk factors, habits and styles of unhealthy life, so that prevention and health promotion based on theories or models of nursing, play an essential role in solving public health problems. Objective: To develop a proposal for implementation of nursing care to patients with cardiovascular risk supported by the Health Promotion Model (HPM) of Nola J Pender. Proposal: The care of people is proposed based on the HPM where the nurse: 1)basally determines the self-efficacy perceived, health perception, risk factors, the profile of healthy lifestyles and personal factors; 2) gets involved in an education course with the participation of a "model patient" (3-12 sessions of 30-60 minutes during the (s) week (s) of hospitalization) and home monitoring with workshops and written tools; 3) evaluates the effect of the intervention; and 4) follows up with information technology and communication. Conclusion: Nursing care of patients with cardiovascular risk based on the HPM, using information technology and communication, can influence cognitive-perceptual factors, barriers to action, perceived benefits, affections, competition and especially the perceived self-efficacy, modifying active, vicarious, persuasive or emotional risk behavior. However, it is essential to consider the personal, interpersonal, situational factors and prior conduct in educational nursing interventions. [ABSTRACT FROM AUTHOR]

Purpose The purpose of the study was to identify key nursing diagnoses with related factors and signs/symptoms using NANDA- I for patients with heart failure (HF). Methods A retrospective descriptive design was used to address the research questions. Data were obtained from the records of patients discharged for 1 year with the medical diagnoses of HF from a Midwestern community hospital. A total of 272 inpatient records were analyzed to describe the frequency and percentage of NANDA- I diagnosis with related factors and signs/symptoms. Results The top 10 NANDA- I diagnoses associated with related factors and signs/symptoms were identified. Conclusion Further research related to standardized nursing terminologies such as NANDA- I using large clinical databases from health information systems is needed to support evidence-based nursing diagnosis decision making. [ABSTRACT FROM AUTHOR]

Heart failure is one of the most common causes of hospital readmission. Self-care is an essential but challenging task for patients with heart failure, and inadequate self-care is closely related to unplanned readmission and unnecessary health expenditure. Patient-centered education using the teach-back method emerged as a key strategy to prevent patients' adverse events by improving self-care. To evaluate the effects of discharge education using the teach-back method on self-care, self-care efficacy, symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization among patients with heart failure. A prospective, two-arm randomized controlled trial. Four adult cardiology units at a tertiary hospital in Seoul, South Korea. A total of 100 patients diagnosed with heart failure and scheduled to be discharged to their homes. The intervention group received the HEART program® in addition to the usual discharge education by a trained nurse before discharge, while the control group received usual discharge education only. The discharge education included the definition of heart failure, medication, symptom management, diet, physical activity, and other precautions. Data on self-care (self-care maintenance; symptom-perception; self-care management), self-care efficacy, symptoms of heart failure, and caregiver dependency were measured at 7-days after discharge (T1), and unplanned healthcare resource utilization (including readmission, emergency room visit, and healthcare professional contacts) was assessed at 1-month after discharge (T2). Outcomes were analyzed with ANCOVA. A total of 94 patients (intervention group = 45, control group = 49) completed outcome measurements at the three-time points. Participants in the intervention group showed a significant improvement in self-care maintenance (F = 11.597, p = 0.001), symptom perception (F = 20.173, p < 0.001), self-care management (F = 7.205, p = 0.009), and self-care efficacy (F = 4.210, p = 0.043) compared to the control group. However, there were no statistically significant differences in symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization between the two groups (all ps > 0.05). The findings demonstrated that discharge education using the teach-back method is an effective educational strategy to improve self-care and self-care efficacy in patients with heart failure. We recommend nurses implement discharge education using the teach-back method for patients with heart failure. This study was registered at the Clinical Research Information Service (KCT0004444) on November 15, 2019, and the participant recruitment was initiated in June 2020. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications. Background Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal. Design A systematic quantitative review of intervention effects. Data Sources We conducted systematic searches for English-language, peer-reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004-December 2014. Review methods According to pre-determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers; 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool; and included in the review. Results Study findings were presented descriptively; due to the heterogeneity of studies meta-analysis was not possible. Included papers described interventions categorized as: (1) multifaceted; and (2) behavioural and educational, comprising: (a) text message and mail message; (b) telephone calls; (c) motivational interviewing and (d) nurse-led counselling and education. Conclusions Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target individual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review. [ABSTRACT FROM AUTHOR]

The article focuses on field of cardiovascular nursing and rehabilitation and varying degrees of a sense of self-importance, entitlement and even aggrandisement and actual contributions to the academy and the profession. It mentions history and development of nursing and sense of selective amnesia seems to pervade discipline with nursing care plans and evidence-based nursing. It also mentions significant impact on nursing care, workforce planning and research development.

An editorial is presented on research in cardiovascular nursing. Topics include aim of the study is to investigate the relationship between components of healthcare system performance and PRO; investigate differences in adults with congenital heart disease living in different areas of the world; and gain insight to understand the international differences.

The article focuses on the new Association of Cardiovascular Nursing and Allied Professions. It mentions cardiovascular nurses have been important contributors to improving cardiovascular health; and also mentions the portfolio of e-learning offers webinars to help nurses and allied professionals.

An introduction is presented in which the editor discusses articles in the issue on topics including manuscripts on cardiac care, identifying people with cardiovascular risk factors and coronary artery disease.

An introduction is presented in which the editor discusses articles in the issue on mindfulness-based cognitive behavioral therapy (CBT) on health-related quality of life and sense of coherence were investigated.