Search

Background: Recovery following critical illness is complex due to the many challenges patients face which influence their long-term outcomes. We explored patients' views about facilitators of recovery after critical illness which could be used to inform the components and timing of specific rehabilitation interventions. Aims: To explore the views of patients after discharge from an intensive care unit (ICU) about their recovery and factors that facilitated recovery, and to determine additional services that patients felt were missing during their recovery. Methods: Qualitative study involving individual face-to-face semi-structured interviews at six months (n = 11) and twelve months (n = 10). Written, informed consent was obtained. [Ethics approval 17/NI/0115]. Interviews were audiotaped, transcribed and analysed using template analysis. Findings: Template analysis revealed four core themes: (1) Physical activity and function; (2) Recovery of cognitive and emotional function; (3) Facilitators to recovery; and (4) Gaps in healthcare services. Conclusion: Patient reported facilitators to recovery include support and guidance from others and self-motivation and goal setting, equipment for mobility and use of technology. Barriers include a lack of follow up services, exercise rehabilitation, peer support and personal feedback. Patients perceived that access to specific healthcare services was fragmented and where services were unavailable this contributed to slower or poorer quality of recovery. ICU patient recover could be facilitated by a comprehensive rehabilitation intervention that includes patient-directed strategies and health care services. [ABSTRACT FROM AUTHOR]

This article discusses the state of Canadian democracy. Although calling Canadian democracy as something to be in a crisis is still debatable, the author expresses worry over the declining turnout levels in recent elections. Canada--along with a number of other liberal democracies--has experienced a significant and consistent decline in election turnout since the 1980s. The author also points out that even when there are no simple answers to the question of what is causing this decline in election turnout, it is clear that the dropping turnout rate among young Canadians is an essential component of the explanation. (Contains 9 notes.)

Background: Secondary prevention is a priority after coronary revascularization for effective long‐term cardiovascular care. Coronary Heart Disease is a major health problem in Jordan, but little is known about the current provision of secondary prevention. Aim: The aim of this study was to evaluate risk factors and explore the current provision of secondary Coronary Heart Disease prevention among patients presenting with first‐time Coronary Heart Disease at two time points: during hospitalization (Time 1) and 6 months later (Time 2), in multicentre settings in Jordan. Methods: A descriptive, repeated measures research study design was applied to a consecutive sample of 180 patients with first‐time Coronary Heart Disease. Demographic and clinical details were recorded from medical files. Self‐administered questionnaires developed by the researchers were used to measure secondary prevention information related to Coronary Heart Disease, including secondary prevention services, lifestyle advice received and medical advice topics. A short form of the International Physical Activity Questionnaire was used to measure physical activity. Participants were assessed at Times 1 and 2. Results: Unstructured lifestyle advice given to the patients at Times 1 and 2 most frequently related to medications, smoking, diet and blood lipids control advice topics, with no statistically significant improvement in cardiovascular risk factors among patients between Times 1 and 2. Conclusion: Despite an extremely high prevalence of risk factors in this population, the provision of secondary prevention is poor in Jordan, which requires urgent improvement, and the contribution of nurses' to secondary prevention should be enhanced. Summary statement: What is already known about this topic? Cardiovascular diseases have relatively earlier onset and higher prevalence in the Middle East and North Africa. However, there is a limited knowledge about the prevalence of risk factors of cardiovascular diseases in the region.There is strong evidence that behavioural modification should be given high priority to help patients with Coronary Heart Disease to be compliant with healthy lifestyle behaviours.The prevalence of Coronary Heart Disease and premature mortality in the Middle Eastern countries is progressively increasing, indicating a lack of effective strategy. What this paper adds The prevalence of Coronary Heart Disease risk factors is still egregiously high in the Jordanian population.The secondary prevention strategy and lifestyle changes are insufficient among patients with Coronary Heart Disease in Jordan.Health policy makers are strongly recommended to establish cardiac rehabilitation programmes to reduce cardiac events and mortality in Jordan. The implications of the study Nursing administrations need to focus on secondary prevention strategies to minimize the risk factors of cardiovascular disease in developing countries.Nursing leaders in Jordan should develop health intervention programmes to help patients with Coronary Heart Disease change their lifestyles.Greater efforts are needed to stop progression of risk factors and improve secondary prevention in Jordan, and further studies are warranted, such as interventional studies to enhance secondary prevention for patients with Coronary Heart Disease. [ABSTRACT FROM AUTHOR]