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BACKGROUND: Cancer-associated cognitive decline may result in difficulties in maintaining daily life activities for older patients with cancer. It is, therefore, critical to identify changes in cognitive function throughout illness trajectories. AIM: To determine the longitudinal patterns and factors associated with cognitive function among older cancer survivors. METHODS: A secondary analysis was conducted using data from the 2012 to 2020 Korean Longitudinal Study of Aging database. A total of 207 cancer survivors aged 60 years and above were included in the analysis. Latent class growth modeling was employed to identify the trajectories of self-reported cognitive function, and logistic regression analysis was used to identify factors associated with these trajectories. RESULTS: The cognitive function of older adults with cancer was divided into 2 distinct trajectories, characterized by differences in intercept (8) and slope (0.7): the "low and declining class" and the "high and sustainable class." The proportion of individuals belonging to the "high and sustainable class" (n = 153, 73.9%) was significantly and considerably higher than those in the "low and declining class" (n = 54, 26.1%). Individuals with low and declining cognitive function were more likely to be older, have a lower education level, live in rural areas, have poor handgrip strength, experience depression, and have lower social participation compared to those with high and sustainable cognitive function. CONCLUSIONS: Our findings can help health care professionals develop tailored interventions for older cancer survivors with low cognitive function based on their physical and mental health status, as well as their environmental backgrounds.
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OBJECTIVES: To synthesize quantitative research findings on the prevalence and risk factors for in-hospital mortality of patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO). METHODS: A comprehensive search was conducted for the period from May 2008 to December 2023 by searching the five electronic databases of PubMed, CINAHL, Web of Science, EMBASE, and Cochrane library. The quality of included studies was assessed using the Newcastle-Ottawa scale. The meta-analysis estimated the pooled odds ratio or standard mean difference and 95% confidence intervals. RESULTS: A total of twenty-five studies with 10,409 patients were included in the analysis. The overall in-hospital mortality of patients on VA-ECMO was 56.7 %. In the subgroup analysis, in-hospital mortality of VA-ECMO for cardiogenic shock and cardiac arrest was 49.2 % and 75.2 %, respectively. The number of significant factors associated with an increased risk of in-hospital mortality in the pre-ECMO period (age, body weight, creatinine, chronic kidney disease, pH, and lactic acid) was greater than that in the intra- and post-ECMO periods. Renal replacement, bleeding, and lower limb ischemia were the most significant risk factors for in-hospital mortality in patients receiving VA-ECMO. CONCLUSION: Early detection of the identified risk factors can contribute to reducing in-hospital mortality in patients on VA-ECMO. Intensive care unit nurses should provide timely and appropriate care before, during, and after VA-ECMO. IMPLICATIONS FOR CLINICAL PRACTICE: Intensive care unit nurses should be knowledgeable about factors associated with the in-hospital mortality of patients on VA-ECMO to improve outcomes. The present findings may contribute to developing guidelines for reducing in-hospital mortality among patients considering ECMO.
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AIMS: Heart failure (HF) is one of the most frequent diagnoses for 30-day readmission after hospital discharge. Nurses have role in reducing unplanned readmission and providing quality of care during HF trajectories. This systematic review assessed the quality and significant factors of machine learning (ML)-based 30-day HF readmission prediction models. METHODS AND RESULTS: Eight academic and electronic databases were searched to identify all relevant articles published between 2013 and 2023. Thirteen studies met our inclusion criteria. The sample sizes of the selected studies ranged from 1,778 to 272,778 patients, and patients' average age ranged from 70 to 81 years. Quality appraisal was performed. CONCLUSION: The most commonly used ML approaches were Random Forest and XGBoost. The 30-day HF readmission rates ranged from 1.2% to 39.4%. The area under the receiver operating characteristic curve for models predicting 30-day HF readmission were between 0.51 and 0.93. Significant predictors included sixty variables with nine categories (socio-demographics, vital signs, medical history, therapy, echocardiographic findings, prescribed medications, laboratory results, comorbidities, and hospital performance index). Future studies using ML algorithms should evaluate the predictive quality of the factors associated with 30-day HF readmission presented in this review, considering different healthcare systems and type of HF. More prospective cohort studies with combining structured and unstructured data are required to improve the quality of ML based prediction model, which may help nurses and other healthcare professionals assess early and accurate 30-day HF readmission predictions and plan individualized care after hospital discharge. REGISTRATION: This study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD 42023455584).
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AIMS: We investigated the prevalence of sarcopenia and its influence on 1-year major adverse cardiac events (MACEs) in patients after successful percutaneous coronary intervention (PCI). METHODS AND RESULTS: This retrospective medical record review using purposive sampling was conducted at a tertiary care university hospital in Korea. Medical records of a total of 303 patients (≥40 years) who underwent successful PCI between January 2014 and December 2020 were analysed. We retrospectively assessed sarcopenia at initial admission. Sarcopenia was assessed by a sarcopenia index based on a ratio of serum creatinine to serum cystatin C. MACE rates were evaluated within l year after PCI. A Kaplan-Meier analysis with a log-rank test was performed to compare the time with 1-year MACE event-free survival between groups with and without sarcopenia. Cox proportional hazards regression was conducted to assess sarcopenia's influence on MACE. The prevalence of sarcopenia and 1-year MACE after PCI were 24.8 and 8.6%, respectively. We found that sarcopenia at admission (hazard ratio, 3.01; 95% confidence interval, 1.22-7.38, P = 0.017) was significantly associated with 1-year MACE among patients after PCI. CONCLUSION: Expanding knowledge of sarcopenia among cardiovascular nurses may aid in early recognition of patients at risk of sarcopenia. Our finding implies that the sarcopenia index based on serum creatinine and cystatin C may be available as a prognostic factor for MACE in patients undergoing PCI. Future studies should be conducted to prospectively validate the sarcopenia index with a multi-centre, large sample.
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Doenças Cardiovasculares , Intervenção Coronária Percutânea , Sarcopenia , Humanos , Prognóstico , Estudos Retrospectivos , Intervenção Coronária Percutânea/métodos , Cistatina C , Resultado do Tratamento , Creatinina , Sarcopenia/etiologia , Fatores de Risco , Doenças Cardiovasculares/etiologiaRESUMO
PURPOSE: This study aims to identify longitudinal patterns and predictors of cognitive function trajectories among Korean older adults with cardiovascular diseases. DESIGN: This study is a longitudinal panel analysis based on secondary data. Data from the the Korean Longitudinal Study of Ageing (KLoSA) were used for analysis. METHODS: The KLoSA is a representative panel survey of older Koreans. We analyzed responses from 301 participants aged ≥65 years who completed the same survey more than three times out of five waves between 2012 and 2020. FINDINGS: Latent class growth modeling identified two trajectories of cognitive function in older people with cardiovascular diseases: "low and declining" (n = 81, 26.9%) and "high and declining" (n = 220, 73.1%). Participants in "the low and declining trajectory group" were more likely to have a low educational level, weak handgrip strength, depression, and low social participation at baseline than those in "the high and declining trajectory group." CONCLUSIONS: Our results indicate a need to develop community-based tailored interventions for improving handgrip strength, mental health, and social participation in delaying cognitive decline in older people with cardiovascular diseases considering their educational level. CLINICAL RELEVANCE: Healthcare providers should be more concerned about older people with a weaker handgrip, depression, and low social activities as a high-risk group for cognitive decline over time in cardiovascular care. Therefore, it is necessary to evaluate them early with standardized tools and make subsequent strategies for the older population with cardiovascular diseases.
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Doenças Cardiovasculares , Disfunção Cognitiva , Humanos , Idoso , Estudos Longitudinais , Vida Independente , Força da Mão/fisiologia , Doenças Cardiovasculares/epidemiologia , Envelhecimento/fisiologia , Envelhecimento/psicologia , Cognição , Disfunção Cognitiva/epidemiologia , República da Coreia/epidemiologiaRESUMO
BACKGROUND: There is limited research exploring the behavioral intentions, beliefs, and application of theoretical models in relation to self-care in patients with atrial fibrillation (AF). OBJECTIVE: This study aimed to identify the factors that influence self-care behavior in patients with AF. METHODS: The study used an integrated behavioral model and collected data from 216 patients diagnosed with AF. Data were analyzed using SPSS 24.0 and AMOS/WIN 24.0 to verify the fit of the hypothesis model, confirm factor analysis, and the validity of the hypothesis itself. RESULTS: Self-care behavioral intention (ß = 0.433, p < .001) and habit (ß = 0.395, p = .005) had a significant direct effect, while instrumental attitude (ß = 0.077, p = .045), injunctive norm (ß = 0.084, p = .037), and self-efficacy (ß = 0.249, p = .011) had a significant indirect effect on self-care behavior, explaining 64.4% of the variance. CONCLUSION: The final model validated the factors that impact self-care behavior in patients with AF, highlighting the importance of fostering positive recognition of instrumental attitude, bolstering social influence and self-efficacy through significant individuals to improve self-care behavior. It is recommended to create an intervention program that encourages intentions and motivations for self-care behavior and incorporates tactics to make self-care behavior a habit. The study's path diagram can serve as a conceptual framework for designing strategies to enhance self-care behavior in patients with AF.
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Fibrilação Atrial , Humanos , Fibrilação Atrial/terapia , Autocuidado , Análise de Classes Latentes , Inquéritos e Questionários , AtitudeRESUMO
This study aimed to determine the factors associated with nursing professionalism among Korean nursing students. This cross-sectional study was carried out using a convenient sample comprising 247 students enrolled in a four-year Bachelor of Science Nursing program from September 6-27, 2021. A self-reported structured questionnaire was employed to explore the relationships among ego-resilience, self-leadership, clinical learning environment, academic satisfaction, clinical competency, and nursing professionalism by utilizing structural equation modeling. The modified model exhibited good fit indices. Learning-related factors, including clinical learning environments, academic satisfaction, and clinical competency, directly affected nursing professionalism. Self-leadership and the clinical learning environment were indirectly associated with nursing professionalism via both academic satisfaction and clinical competency. Regarding ego-resilience, it only indirectly affected nursing professionalism via academic satisfaction. Creating a student-centered learning environment may be vital to improve students' major and clinical performance, thereby boosting nursing professionalism. Furthermore, nurse educators should consider individual psychological aspects of students when designing the nursing curriculum to foster nursing professionalism. Longitudinal studies are needed to determine if our model is available to explain the development of professionalism among nursing students.
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OBJECTIVE: To identify factors associated with the 30-day in-hospital mortality rate among adult patients requiring extracorporeal membrane oxygenation (ECMO) in intensive care units. RESEARCH METHODOLOGY: Retrospective cohort study including 148 patients who underwent ECMO for at least 48 h between March 2010 and August 2021. The patients were divided into survivors and non-survivors based on their 30-day in-hospital survival. We obtained the sociodemographic information and pre- and post-ECMO data from electronic medical records. Kaplan-Meier survival curves and Multivariate Cox proportional hazards regression were used to analyse the data. SETTING: A tertiary-care university hospital in South Korea. MAIN OUTCOME MEASURES: The 30-day in-hospital mortality rate was the principal outcome measure. RESULTS: The 30-day in-hospital mortality rate was 49.3% (n = 73). Kaplan-Meier analysis demonstrated that the duration of ECMO support in the 50th percentile of surviving patients was 13 days. Multivariable Cox regression analysis showed that new-onset renal failure, lower mean arterial pressure, and ECMO weaning failure were associated with an increased 30-day in-hospital mortality risk among patients who received ECMO. Subgroup analysis also revealed a significant association between weaning failure and 30-day in-hospital mortality after adjusting for covariates in patients undergoing veno-arterial ECMO. CONCLUSION: Close monitoring of post-ECMO renal function and mean arterial pressure is required to minimize the risk of 30-day in-hospital mortality, especially in adults within the first two weeks of ECMO initiation. Moreover, the success of ECMO weaning should be optimized by collaboration within the ECMO team. IMPLICATIONS FOR CLINICAL PRACTICE: Critical care nurses should pay close attention to patients' response to weaning trials as well as alternations in renal function and mean arterial pressure during ECMO support. Furthermore, developing nursing care guidelines for adult patients receiving ECMO and standardized training programs for nurses in intensive care, are required in Korea.
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Oxigenação por Membrana Extracorpórea , Humanos , Adulto , Resultado do Tratamento , Estudos Retrospectivos , Oxigenação por Membrana Extracorpórea/efeitos adversos , Mortalidade Hospitalar , Estado TerminalRESUMO
AIMS: The aim of this study was to identify the effects of a 24-week interactive text message-based mobile health intervention (called) on enhancing the self-care behaviours of patients with heart failure. BACKGROUND: Whether text message-based mobile health intervention can be used to improve long-term adherence to self-care behaviours among heart failure patients remains unclear. DESIGN: A quasi-experimental study with a pretest-post-test design and repeated measures. METHODS: Data from 100 patients (mean age, 58.78 years; 83.0% men) were analysed. The intervention group (n = 50) used the program over 24 weeks, which consisted of weekly goal setting and interactive text messaging, while the control group (n = 50) received usual care. Trained research assistants collected data using self-reported Likert questionnaires. Primary (self-care behaviours) and secondary (health literacy, eHealth literacy, and disease knowledge) outcome variables were measured at baseline and at 1, 3 and 6 months after intervention for follow-up. RESULTS: The findings showed that the intervention group demonstrated significantly better self-care behaviours than the control group during the 6 months. Notably, the trajectory of self-care behaviours of the patients in the intervention group showed a steep rise between the first- and third-month follow-up, followed by high stability between the third- and sixth-month follow-up. In addition, the intervention group had significantly higher disease knowledge than the control group at the first- and sixth-month follow-up. CONCLUSIONS: We found that the program, as an interactive text messaging service, may be an optimal strategy for improving long-term adherence to self-care behaviours through motivating and providing social support. RELEVANCE TO THE NURSING PRACTICE: The WithUs program can help nurses and other healthcare professionals to track patients' health indicators such as symptom severity, diet and physical activity. In addition, nurses can take an important role in evaluating the efficacy of the app in relation to patients' health outcome. PATIENT OR PUBLIC CONTRIBUTION: Patients have completed a self-reported questionnaire after providing informed consent.
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Insuficiência Cardíaca , Telemedicina , Envio de Mensagens de Texto , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Autocuidado , Exercício Físico , Insuficiência Cardíaca/terapiaRESUMO
AIM: This study was aimed at investigating the level of patient activation, and its association with self-care behaviours in older people with heart failure. DESIGN: Cross-sectional secondary data analysis was conducted. METHODS: We included a total of 182 Korean patients with heart failure who were aged ≥65 years for a cardiovascular outpatient clinic visit. Baseline characteristics, the Patient Activation Measure (PAM), health literacy, disease knowledge and self-care behaviours were collected via a self-administered questionnaire. RESULTS: The proportion of patient activation at Levels 1 and 2 was 22.5% and 14.3%, respectively. Highly activated patients had a high level of health literacy, disease knowledge and self-care behaviours. After adjusting for confounding factors, we observed that patient activation was the only statiscally significant predictor of self-care behaviours among older people with heart failure. Healthcare professionals should help patients take active roles in their self-care through a comprehensive needs assessment including health literacy and disease knowledge.
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Insuficiência Cardíaca , Participação do Paciente , Humanos , Idoso , Estudos Transversais , Autocuidado , Insuficiência Cardíaca/terapia , República da CoreiaRESUMO
AIM: There is limited evidence of the association between dual tobacco-e-cigarette use and health-related variables in Korea. Thus, this study aimed to investigate the associations between types of cigarette smoking, sleep duration, physical activity and depressive symptoms among Korean adults. DESIGN: A cross-sectional study design using the 2019 Korean Community Health Survey. METHODS: The study subjects consisted of 179,004 adults older than 40 years from a total of 229,099 individuals. Self-reported general characteristics, smoking history, sleep duration, physical activity and depressive symptoms were analysed. RESULTS: In multinomial logistic regression, dual users of tobacco cigarettes and e-cigarettes were more likely to have sleep duration of less than 7 h per day and to report both mild and moderate-to-severe depressive symptoms than non-smokers. Single use of either cigarettes or e-cigarettes increased the risk of short sleep duration and moderate-to-severe depressive symptoms.
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Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Pessoa de Meia-Idade , Adulto , Humanos , Idoso , Estudos Transversais , Duração do Sono , Depressão/epidemiologia , Produtos do Tabaco/efeitos adversos , Exercício Físico , República da Coreia/epidemiologiaRESUMO
AIM AND OBJECTIVES: This study aimed to identify the associations between longitudinal trajectories of self-care behaviours and unplanned hospital readmissions in patients with heart failure. BACKGROUND: Adherence to self-care behaviours is crucial to prevent hospital readmissions; however, self-care behaviours remain unsatisfactory among patients with heart failure. Studies of long-term trajectories of self-care behaviours and their influence on hospital readmissions are limited in this population. DESIGN: A prospective, longitudinal observational study. METHODS: Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1-year follow-up data to determine the association between 1-year trajectories of self-care behaviours and hospital readmissions using Kaplan-Meier analysis and multivariable Cox regression, adjusted for confounding variables. RESULTS: Self-care behaviour trajectories of heart failure patients were classified as 'high-stable' (58.4%) or 'low-sustained' (41.6%). The cumulative rate of readmissions for the low-sustained class was higher than that of the high-stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self-care behaviours trajectories. The low-sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high-stable class. CONCLUSIONS: Longitudinal self-care behaviours pattern trajectories of heart failure patients were stratified as high-stable and low-sustained. Routine follow-up assessment of patients' self-care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions. RELEVANCE TO CLINICAL PRACTICE: Identification of trajectory patterns of self-care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self-care behavioural patterns in heart failure patients. REPORTING METHOD: The study has been reported in accordance with the STROBE checklist (Appendix S1). PATIENT OR PUBLIC CONTRIBUTION: Patients have completed a self-reported questionnaire after providing informed consent.
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Fragilidade , Insuficiência Cardíaca , Masculino , Humanos , Idoso , Feminino , Readmissão do Paciente , Estudos Longitudinais , Estudos Prospectivos , Autocuidado , Insuficiência Cardíaca/terapiaRESUMO
Background: Smartwatches are a consumer wearable device offering a potential, practical, and affordable method to collect personal health data in healthy adults. For patients with chronic diseases, this would enable symptom monitoring and aid clinical decision making. Therefore, providing customized checklists to recommend smartwatches is beneficial. However, few studies have evaluated the practical functions of smartwatches and their influence on user acceptance. We aimed at developing a reliable tool to assess the quality of smartwatches from the users' perspective. Methods: To develop the smartwatch rating scale (SWRS), we conducted a comprehensive literature review as well as reviewed relevant websites. The SWRS includes 22 items for the usability (usability, functionality, safety, material, and display) and five items for the acceptance and adoption domain (satisfaction and intention). We measured the scale's internal consistency and inter-rater reliability by evaluating seven smartwatches. Results: The overall scale demonstrated an excellent level of internal consistency (Cronbach's alpha = 0.91), with each subscale's internal consistency above good level (0.74 ~ 0.92). Inter-rater reliability using intraclass correlation coefficients (ICC) was at good level (2-way random ICC = 0.82, 95% CI 0.09 - 0.97). Conclusions: The SWRS is reliable, which can meet the need for assessment of smartwatch technology for utilizing in personal healthcare. Accounting for users' perspectives will help make the most of technology without impairing the human aspects of care, this study can help consumers choose a smartwatch based on their preferences and provide guidelines for developing user-friendly wearable devices aimed at health behavior changes.
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AIM: To investigate the factors associated with self-management after hybrid revascularization in patients with lower extremity peripheral artery disease using a structural equation modelling approach. DESIGN: A cross-sectional study was adopted. METHODS: A total of 221 patients who underwent hybrid revascularization for peripheral artery disease of the lower limbs were included from outpatient clinics at a 1200-bed tertiary care hospital in Korea. Data were collected using a self-reported questionnaire between December 1, 2019, and August 31, 2020. Structural equation modelling was applied to test the hypothetical model. RESULTS: The item mean score of participants' self-management was 6.28 (standard deviation, 0.83) out of 8. The structural equation modelling had a good fit index. Autonomy support from healthcare providers was directly associated with self-management (ß = 0.20, p = 0.041). Illness perception directly (ß = -0.33, p = 0.031) and indirectly (ß = -0.19, p = 0.032) influenced self-management through competence and relatedness in patients with peripheral artery disease. The construct of autonomy support from healthcare providers, illness perception, competence and relatedness accounted for 49% of the variance in self-management. The Sobel test confirmed the statistically significant mediating effects of competence (z = -4.52, p < 0.001) and relatedness (z = -2.12, p < 0.001) on the relationship between illness perception and self-management. CONCLUSION: Our findings revealed that autonomy support from healthcare providers and patients' illness perception directly influenced patients' self-management. Additionally, patients' illness perception can indirectly influence self-management through their perceived competence and relatedness. IMPACT: Healthcare providers' autonomy support to patients may promote self-care behaviours, leading to greater autonomous motivation. Assessment of patients' illness perception before patient education is vital to designing effective self-management strategies which can improve patients' perceived competency and meaningful relatedness with healthcare providers.
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Doença Arterial Periférica , Autogestão , Humanos , Estudos Transversais , Inquéritos e Questionários , Modelos Teóricos , Doença Arterial Periférica/cirurgiaRESUMO
PURPOSE: This study aimed to identify distinct trajectories of self-care behaviors over 6 months after hospital discharge in patients with heart failure, including the baseline predictors affecting these trajectories. DESIGN: This was a prospective longitudinal observational cohort study with a 6-month follow-up. METHODS: A total of 158 patients with heart failure (mean age = 66.75 years, 62.7% men) were included in this study. Patients' characteristics, including cognitive function, health literacy, and social support were collected as possible baseline predictors of self-care behavior trajectories using a structured questionnaire and an electronic medical record review. Self-care behaviors were evaluated using the Korean version of the nine-item European Heart Failure Self-care Behavior Scale at baseline, 1, 3, and 6 months after hospital discharge. Latent growth model analysis was conducted to identify the homogeneous subgroups with distinct trajectories of self-care behaviors. Subsequently, multinomial logistic regression was used to assess whether baseline predictors were associated with these trajectories in patients with heart failure. RESULTS: Three distinct self-care behavior trajectory groups were identified: "low-decreased" (n = 33, 20.9%), "middle-increased" (n = 93, 58.9%), and "high-sustained" (n = 32, 20.2%). The multinomial logistic regression analysis showed that baseline adequate health literacy and positive social support significantly predicted patients' belonging to both the middle-increased and high-sustained self-care behavior trajectory groups compared to the low-decreased group. Importantly, better cognitive function at baseline was only significantly associated with the high-sustained self-care behavior trajectory compared to the low-decreased trajectory. CONCLUSION: Our study revealed that only one-fifth of the patients belonged to the high-sustained self-care behavior group 6 months after hospital discharge. Strategies aimed at improving cognitive function, health literacy, and social support should be developed to sustain satisfactory self-care behaviors in patients with heart failure. Further studies with long-term follow-ups are required to identify other possible factors, as well as the baseline predictors of this study affecting longitudinal trajectories of self-care behaviors. CLINICAL RELEVANCE: Healthcare providers should recognize and evaluate the distinct patterns of self-care behaviors over time in patients with heart failure. Importantly, assessing baseline cognitive function, health literacy, and social support before hospital discharge may be necessary to prevent a decline in self-care behaviors over time.
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Insuficiência Cardíaca , Autocuidado , Masculino , Humanos , Idoso , Feminino , Estudos Prospectivos , Pacientes , Insuficiência Cardíaca/psicologia , República da Coreia , Estudos LongitudinaisRESUMO
AIMS: To evaluate the preliminary effectiveness and usability of a novel mobile phone-based self-care intervention (named WithUs) for patients with heart failure (HF). METHODS AND RESULTS: We conducted a mixed-methods pilot study with group pre-test-post-test design and usability testing. Participants were 26 Korean HF patients (20 men; median age 62 years) who took part in this study after hospital discharge. Data were collected at baseline and after the 24-week intervention, using questionnaires and interviews. The outcome variables were eHealth literacy, disease knowledge, and self-care behaviours. The Wilcoxon signed-rank test was used to compare the pre- and post-intervention results. Thematic analysis was used for analysing qualitative data. The WithUs programme improved the eHealth literacy (P = 0.005), disease knowledge (P < 0.001), and self-care behaviours (P < 0.001) of patients with HF. The median score of total app usability was 4.1 out of 5 (interquartile range = 4.0-5.0). Four themes were identified which complemented the quantitative results. These were increased awareness of the importance of routine self-care behaviours, enhanced motivation toward self-care behaviours, challenges adapting to the new app, and suggestions for improving app adoption. CONCLUSION: The app was effective in improving adherence to self-care behaviours, eHealth literacy, and disease knowledge in patients with HF. The usability evaluation results showed that the app is usable and has the potential to support HF patients in self-care. However, the app needs to be modified to improve its adoption.
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Telefone Celular , Insuficiência Cardíaca , Autocuidado , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Feminino , População do Leste AsiáticoRESUMO
AIMS: Poor health-related quality of life is prevalent among individuals with cardiovascular disease (CVD) and may be associated with frailty as well as low levels of self-efficacy and physical activity. This study aimed to identify the multiple mediating effects of exercise self-efficacy and physical activity on the relationship between frailty and health-related quality of life among community-dwelling adults with CVD. METHODS AND RESULTS: This cross-sectional study included 489 Korean patients aged >20 years diagnosed with CVD. Data were collected through an online survey conducted in June 2021. The mediation hypothesis was tested using a serial multiple mediation model and the bootstrapping method. Approximately, 39.5% of patients in this study were in a frail state. Our main finding revealed that frailty had an indirect effect on health-related quality of life through all three different pathways: each single mediation of exercise self-efficacy and physical activity, and the serial multiple mediation of exercise self-efficacy and physical activity as the first and second mediators, respectively. The direct effect of frailty on the health-related quality of life was also significant. CONCLUSION: Frail adults with CVD tended to have lower levels of self-efficacy, physical activity, and poor health-related quality of life. Thus, early identification of frailty and interventions targeting the promotion of self-efficacy and physical activity may improve health-related quality of life in adults with CVD. Longitudinal studies are necessary to further refine our findings across other samples and to address the limitations of the current study.
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Doenças Cardiovasculares , Fragilidade , Idoso , Humanos , Adulto , Idoso Fragilizado , Qualidade de Vida , Estudos Transversais , Autoeficácia , Exercício FísicoRESUMO
AIM: To investigate the associations of sleep duration and physical frailty with cognitive function in older patients with both atrial fibrillation and heart failure. DESIGN: This study used a cross-sectional, secondary data analysis design. METHOD: We included outpatients aged ≥ 65 years with coexisting atrial fibrillation and heart failure in South Korea. We used a sample of 176 patients (men = 100) with HF among 277 data from the parent study. The data were collected through a self-report, structured questionnaire and electronic medical record. RESULTS: Our main finding showed that long sleep duration and physically frail status were significant predictors of cognitive impairment in older adults with both atrial fibrillation and heart failure. Healthcare providers should be aware of the importance of assessing sleep duration and physical activity in older adults with both atrial fibrillation and heart failure to prevent or delay cognitive impairment.
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Fibrilação Atrial , Fragilidade , Insuficiência Cardíaca , Masculino , Humanos , Idoso , Fragilidade/complicações , Fibrilação Atrial/complicações , Duração do Sono , Estudos Transversais , Insuficiência Cardíaca/complicações , CogniçãoRESUMO
OBJECTIVES: The prevalence of cognitive frailty and its associated factors in older population with heart failure have not been extensively studied. We investigated the prevalence of cognitive frailty and its association with sleep duration and depression among older adults with heart failure. METHODS: This secondary analysis used a cross-sectional sample with 168 older adults with heart failure from an academic tertiary care hospital in South Korea. RESULTS: Cognitive frailty was found in 58 (34.5%) older adults with heart failure. Our main finding revealed that longer sleep durations of ≥ 8 h (adjusted odds ratio (OR) = 2.62, 95% confidence interval (CI) = 1.04-6.59) and depression (adjusted OR = 2.84, 95% CI = 1.22-6.61) predicted an increased risk of cognitive frailty. CONCLUSIONS: Early detection on changes in sleep patterns and depression can play a crucial role in reducing the risk of cognitive frailty in patients with heart failure. Longitudinal studies are needed to explore that sleep patterns and depression are both linked to greater risk of developing cognitive frailty among older adults with heart failure. CLINICAL IMPLICATIONS: Development of a validated instrument for cognitive frailty screening may be beneficial for older adults with heart failure to prevent adverse outcomes.
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OBJECTIVES: To systematically review qualitative studies about home-dwelling older adults' experiences of living with both frailty and multimorbidity. METHODS: This study adopted a meta-ethnography; the databases included PubMed, Embase, CINAHL, Web of Science, PsycINFO, SCOPUS, and Google Scholar. Qualitative peer-reviewed articles in English were searched up to December 31, 2021. Themes and concepts were extracted through constant comparison across the included studies by three reviewers. RESULTS: Of the 147 articles screened, nine qualitative articles, encompassing a total sample of 173 participants, were included. The four final synthesised themes were 'Being isolated in a closed life,' 'Being dependent on help from others,' 'Rebuilding to maximise quality of life,' and 'Struggling to live a meaningful life.' CONCLUSION: Home-dwelling older adults with both frailty and multimorbidity are more likely to be socially isolated due to their physical limitations and lack of integration between hospital-based care and community healthcare services.