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Background Postoperative cardiac surgery patients often experience appetite loss. Although nutritional status is known to be associated with time of recovery, functional status, and length of stay, less is known about factors related to patient’s loss of appetite after cardiac surgery. This review aimed to identify and understand factors related to loss of appetite in postoperative cardiac surgery patients, systematic review with narrative summary design was applied. Data sources including CINAHL, SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis were searched without restriction on publication year through August 2020. Methods We conducted the review following the Joanna Briggs Institute methodology, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist to categorize methodological quality and the PRISMA flow diagram to record the studies’ factors. Results Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 µmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a New York Heart Association class III and IV. Conclusion The small number of publications restrict our conclusions. Future research should focus on multiple factors related to appetite loss in postoperative cardiac surgery patients. Additional research will provide a foundation for evidence-based interventions to reduce appetite loss and improve patient nutritional status after cardiac surgery. Nurses and other health professionals should assess postoperative cardiac surgery patients for the presence of the 16 significant factors. To promote patients’ nutritional status, there should be evidence-based practice guidelines on the management of postoperative symptoms such as pain management, treatment of constipation, and reduction of emotional stress and depression.

Background: Postoperative cardiac surgery patients often experience appetite loss. Although nutritional status is known to be associated with time of recovery, functional status, and length of stay, less is known about factors related to patient’s loss of appetite after cardiac surgery. This review aimed to identify and understand factors related to loss of appetite in postoperative cardiac surgery patients , systematic review with narrative summary design was applied. Data sources including CINAHL, SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis were searched without restriction on publication year through August 2020. Methods: We conducted the review following the Joanna Briggs Institute methodology, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist to categorize methodological quality and the PRISMA flow diagram to record the studies’ factors. Results: Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 µmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a New York Heart Association class III and IV. Conclusion: The small number of publications restrict our conclusions. Future research should focus on multiple factors related to appetite loss in postoperative cardiac surgery patients. Additional research will provide a foundation for evidence-based interventions to reduce appetite loss and improve patient nutritional status after cardiac surgery. Nurses and other health professionals should assess postoperative cardiac surgery patients for the presence of the 16 significant factors. To promote patients’ nutritional status, there should be evidence-based practice guidelines on the management of postoperative symptoms such as pain management, treatment of constipation, and reduction of emotional stress and depression.

Acute myocardial infarction is a significant world-wide problem, especially among older adults. More than 50% of older adults who experience this die before arriving at the hospital because of delaying seeking treatment. The aim of this integrative review was to describe factors related to a delay in seeking treatment among older adults with acute myocardial infarction. Studies published up to 2019 were extracted from the literature that dealt with a delay in treatment for acute myocardial infarction. These needed to be published in peer reviewed English or Thai journals or thesis/dissertations; and involved studies where at least 75% of participants were over 55 years. However, studies without comparisons about factors related to delay treatment were excluded. A total of 23 papers were selected for final review following standard methods for an integrative review. Results revealed three phases related to delays in seeking treatment: patient/bystander recognition action, transportation, and hospital action phases. Most older adults spent the longest average of time delaying in the first phase. Factors associated with delay seeking treatment were in four categories: socio-demographic (advanced age, female, non-white, single/widowed/separated, low education, and low income) ; physiological and environmental (using private car, living alone, experiencing symptoms at home/weekday/night, and living in impoverished/rural area); psychological and behavioral (feelings and thoughts hesitancy/ambiguity/bother and self-management); and clinical (lack of cardiac history, positive history of diabetes mellitus, hypertension, stroke, heart failure, angina pectoris, smoking, and symptoms mismatch/low intensity/atypical symptoms). Findings suggest that nurses need to educate older populations about the early recognition of acute myocardial infarction symptoms and tailor interventions to improve understanding of symptoms and need for emergency treatment. [ABSTRACT FROM AUTHOR]