Lessons Learned from the Lived Experiences of COVID-19 ICU Survivors Who are Struggling Through Critical Conditions and Surviving to Champion Life: A Qualitative Study.

Background: Due to the coronavirus disease 2019 (COVID-19) pandemic, millions of lives were lost globally, including in Indonesia. Some patients with COVID-19 may experience severe symptoms of hypoxia, while some may be critically ill and admitted to the intensive care unit (ICU) for survival. Purpose: This study aimed to understand the lived experiences of COVID-19 ICU survivors who were in a critical condition. Methods: This phenomenological study used semistructured interviews with nine participants who were COVID-19 ICU survivors. Data analysis was performed using the Colaizzi approach. Results: The phenomenon of the lived experiences of COVID-19 ICU survivors was presented in seven subthemes and four main themes: struggling in a state of helplessness, fostering a positive spirit from within, amplifying the support from nurses and doctors, and strengthening the connection with family and the Almighty. These themes indicated the essential aspects of psychosocial support needed to boost strength and energy and elevate the body's immune system, which is crucial to champion life through critical conditions. Conclusion: The new insight resulting from the study is shown in the four main themes, which play a significant role in elevating the healing process and enabling patients to survive critical conditions. Therefore, this study recommends the importance of psychosocial support for patients with critical conditions, which involves family and their significant others, and facilitating the connection between the patient and God.

Safety of Early Discharge Among Low-Risk Patients After Primary Percutaneous Coronary Intervention: An Updated Systematic Review and Meta-Analysis.

Background: Guidelines for early discharge (ED) strategies after primary percutaneous coronary intervention (PPCI) in low-risk patients still need to be informed. Previous meta-analysis evidence is considered to have limitations, from the level of heterogeneity, which is still relatively high, and the sample size still needed to be more significant. Purpose: This study aims to identify the safety of early discharge after PPCI in low-risk patients. Methods: The literature search used five primary databases: CINAHL, PubMed, ScienceDirect, Scopus, Taylor and Francis, and one search engine: Google Scholar. Two reviewers independently screened and critically appraised studies using JBI's and Cochrane's Risk of Bias tool. Fixed and random effects model were applied to collect standardized mean differences and risk differences. Statistical analysis was performed using Review Manager 5.3 and JAMOVI version 2.4.8.0. Results: Seven RCTs consisting of 1.780 patients and seven cohort studies consisting of 46.710 patients were included in the quantitative analysis. The results of the RCT analysis showed no significant differences in all-cause readmission (RD -0.01; 95% CI: -0.04 to 0.01; Z=1.20; p=0.23; I2=0%) and mortality (RD 0.00; 95% CI: -0.01 to 0.01; Z=0.01; p=0.99; I2=0%) and also significant in reducing LOS in hour (SMD -2.32; 95% CI: -3.13 to -1.51; Z=5.64; p<0.001; I2=93%) and day (SMD -0.58; 95% CI: - 1.00 to -0.17; Z=2.76; p=0.006; I2=84%). In addition, analysis of cohort studies showed that ED strategy was associated with all-cause readmission (RD -0.00; 95% CI: -0.01 to -0.00; Z =2.18; p=0.03; I2=0%) and mortality (RD -0.01; 95% CI: -0.02 to -0.00; Z=2.04; p=0.04; I2=94%). Conclusion: ED strategies in low-risk patients after PPCI can be completely safe. This is proven by the absence of significant differences in readmission and mortality rates as well as reduce the length of stay.

Healthcare Professionals' Experiences in Providing Palliative Care in an Intensive Care Unit in Indonesia: A Phenomenological Study.

Background: In the Intensive Care Unit (ICU), it is vital to meticulously monitor symptoms and thoroughly understand the treatment objectives for critically ill patients. This highlights the necessity of integrating palliative care in this environment. Despite the potential advantages, several barriers impede the effective integration of palliative care in the ICU. Notably, many healthcare professionals (HCPs) in Indonesian ICUs have not fully leveraged the incorporation of palliative care. Purpose: This study aimed to investigate and clarify the experiences of healthcare providers (HCPs) involved in administering palliative care to ICU patients in Indonesia. Methods: This research employed a qualitative descriptive phenomenological approach. Semi-structured, in-depth individual interviews were conducted with four nurses and three doctors working in an Indonesian hospital. Colaizzi's method was used for data analysis. Results: The analysis identified six themes from the interviews, reflecting the experiences of healthcare professionals in delivering palliative care in the ICU. These themes are: 1) Provide Professional Caring, 2) Caring and curing collaboration, 3) Quality Intensive Communication, 4) End-of-Life Care, 5) Controlling Feelings, and 6) Provide Holistic Caring. Conclusion: Providing care for ICU patients demands not only the expertise of HCPs but also compassion, communication skills, and a holistic approach to patient care. By offering comprehensive palliative care in the ICU, healthcare professionals can address the diverse needs of patients and their families, promoting comfort, respect, and an improved quality of life throughout the illness. This inclusive approach enhances the experience for both patients and their families while supporting healthcare providers in delivering empathetic and patient-centered care. It is recommended that hospitals develop policies to enhance palliative care services in Indonesia.

Factors Associated to Community Practices Toward the COVID-19 Pandemic: A Cross-Sectional Study in Indonesia.

Background: COVID-19 still continue to spread and affects most nations globally to date. In this context, community knowledge, attitudes, and practices (KAP) toward COVID-19 are the most important for controlling and preventing the infectious pandemic disease. Objective: This study aimed to investigate the factors associated with community practices related to COVID-19. Methods: Cross-sectional study was conducted on 330 residents of Sumedang District, Indonesia. Selection of the sample using stratified random sampling. KAP toward COVID-19 was measured using the WHO questionnaire which is valid and reliable. The data were analyzed using the Rasch model, Pearson correlation, and linear regression. Results: This study revealed that most respondents tend to answer correctly on the sociality and disease transmission knowledge (+2.08 logit; SE 1.63), incorrectly in conceptual knowledge (logit measure -2.05; SE 0.45), tended to have a positive attitude (+1.6 logit; 0.54) and practice (+1.63 logit; SE 0.61). Based on the results of the Wright map, the most challenging statement for respondents was to use masks. Knowledge and attitude were significantly associated with the practice of COVID-19 prevention (p<0.001). Attitude is the dominant factor influencing society practice towards COVID-19 (Stand. Estimate= 0.2737; 95% CI=0.1608-0.378; p<0.001) and knowledge play an important role in improving COVID-19 prevention behaviour. Conclusion: New insight from this research shows that even attitude is the most dominant factor, yet this study also indicated that knowledge is critical for positive attitudes of society to support COVID-19 prevention practices. Since, knowledge is the basis for positive attitudes in preventing the transmission of Covid 19. Therefore, health education that explicates concepts, sociality and disease transmission is important to boost attitudes of the society in the practice of Covid 19 prevention.

Health Educational Methods for Improving Self-Efficacy Among Patients with Coronary Heart Disease: A Scoping Review.

Background: Coronary heart disease (CHD) is the leading cause of death and disability worldwide, with higher prevalence in low and middle-income countries. Self-efficacy (SE) is an essential element that affects a patients ability to manage their care, and low SE levels in patients with CHD can lead to poor health outcomes and quality of life. Planning suitable methods to improve SE in CHD patients is essential. Purpose: This review explores health education methods to improve SE in patients with CHD. Methods: Scoping review is reported based on the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A literature search was conducted using relevant keywords from six primary databases, such as CINAHL Plus with Full Text and Academic Search Complete, PubMed, ScienceDirect, Scopus, Taylor and Francis, and one search engine, Google Scholar. The inclusion criteria were full-text articles in English that were accessible, research articles with experimental designs. The quality of evidence was assessed using the Joanna Briggs Institute critical appraisal checklist, and data synthesis was used thematically with an explorative, descriptive approach. Results: Fifteen articles were found and included in the review. There are two types of interventions such as traditional and digital-based health education. The media used in traditional health education are booklets, pamphlets, posters, and workbooks. In addition, digital-based health education generally uses websites, social platforms, mobile applications, video players and sound clips. Conclusion: This review found that traditional health education and digital-based interventions improve SE, knowledge, self-esteem and health literacy levels, in CHD patients. Health professionals, including nurses, may used both methods in improving self efficacy in CHD patients.

Efficacy of Cognitive Behavior Therapy in Reducing Depression among Patients with Coronary Heart Disease: An Updated Systematic Review and Meta-Analysis of RCTs.

PURPOSE: The aim of this review is to identify the efficacy of cognitive behavior therapy (CBT) and the characteristics of CBT therapy that effectively improve depression among patients with coronary heart disease (CHD). METHODS: Studies that assessed CBT efficacy in decreasing depression among CHD patients with randomized controlled trials (RCTs) were searched through PsycINFO, PubMed, CINAHL, Academic Search Complete, Scopus, and Google Scholar. Two reviewers independently screened and critically appraised them using the Cochrane risk-of-bias tool. The fixed- and random-effect models were applied to pool standardized mean differences. RESULTS: Fourteen RCTs were included in the quantitative analysis. Depression was significantly lower in the CBT group (SMD -0.37; 95% CI: -0.44 to -0.31; p < 0.00001; I2 = 46%). Depression in the CBT group was significantly lower in the short-term follow-up (SMD -0.46; 95% CI: -0.69 to -0.23; p < 0.0001; I2 = 52%). Moreover, the subsequent therapy approaches were effective in reducing depression, including face-to-face and remote CBT, CBT alone or combination therapy (individual or mixed with a group), and frequent meetings. CONCLUSIONS: CBT therapy effectively reduces depression, particularly in short-term follow-up. The application of CBT therapy in CHD patients should consider these findings to increase the efficacy and efficiency of therapy. Future research is needed to address generalizability.

Islamic Spiritual Care, Depression, and Quality of Life Among Patients With Heart Disease: A Systematic Review.

Objectives: This study sought to identify the potential effect of Islamic-Spiritual care and how it is delivered in treating depression and improving the quality of life (QoL) of patients with heart disease. Methods: This systematic review is reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched using relevant keywords through PubMed, CINAHL, Scopus, Springer Link, and Academic Search Complete. Articles with an experimental or cohort design were included, without date restrictions. The quality of evidence was assessed using the Joanna Briggs Institute critical appraisal checklist, and data synthesis used thematic analysis. Results: The analysis included 6 of the 47 identified studies. All studies were conducted in Iran, and a small number had a low risk of bias. The intervention was given through an Islamic teaching strategy, indicating the potential to reduce depression and improve QoL. Moreover, the learning core consists of belief and surrender in God's providence, strengthened meaning and life's purposes, worship, and skills to overcome obstacles. Conclusions: The interventions had the potential to treat depression and improve the QoL. However, a further study considering the risks of bias and involving a larger patient population with other Muslim backgrounds is necessary.

Barriers to Participation in Cardiac Rehabilitation Among Patients with Coronary Heart Disease After Reperfusion Therapy: A Scoping Review.

Patients with coronary heart disease (CHD) experience many barriers to participate in cardiac rehabilitation (CR) programs. Several studies identify barriers that can affect participation in CR among patients with CHD after reperfusion therapy. However, there has yet to be a review specifically in this population. This review aims to identify the literature systematically that analyzes the barriers that affect the participation of CHD patients after reperfusion therapy in implementing the CR program. This study used the Preferred Reporting Item for PRISMA Extension for Scoping Reviews (PRISMA-ScR) with databases PubMed, ScienceDirect, EBSCO-hosted Academic Search Complete, Scopus, Taylor & Francis, and Sage Journals. The keywords used in English were "coronary artery disease OR myocardial infarction OR cardiovascular disease OR heart disease" AND "Barrier OR obstacle", AND "percutaneous coronary intervention OR PCI OR angioplasty OR coronary artery bypass graft surgery OR CABG" AND "cardiac rehabilitation OR rehabilitation OR recovery". The inclusion criteria in this review were full-text articles in English, articles with a descriptive, cross-sectional, and cohort design with a minimum of 100 participants that discussed barriers to participation in patients with CHD after undergoing reperfusion therapy, and the CR phases such as I, II, III, and IV have also been identified. Based on the initial search, there are 23 relevant studies out of 7400. The results of this study reported that most of the participants from the studies analyzed had a low level of participation in CR (≤50%). We classify the factors that affect the level of CR participation into five categories: individual factors, health history, environmental, logistical, and health system. The most reported barriers in each category were age, comorbidities, lack of support from friends, family and health workers, distance or travel time, and cost and economic status. Professional health workers, especially nurses, can identify various barriers that patients feel so that they can increase their participation in attending CR.

Self-Efficacy in Self-Care and Its Related Factors Among Patients with Coronary Heart Disease in Indonesia: A Rasch Analysis.

Background: Low self-efficacy (SE) can impact decreasing health status, poor self-care, and quality of life among patients with Coronary Heart Disease (CHD). Many factors can affect SE. However, studies on SE in CHD patients with Rasch Model analysis have not been carried out widely. Purpose: This study aims to identify the SE in self-care and its related factors that correlate SE among CHD patients. Patients and Methods: Cross-sectional study was conducted on 104 adult patients (≥18 years) diagnosed with CHD. Selection of the sample using convenience sampling technique with several predetermined criteria. SE was measured using the SEQ-CHDM questionnaire, with high validity and reliability results. Data were analyzed using the Rasch model and chi-square test. Results: The results showed that most respondents had a moderate SE (51.5%). Care units (p=0.003) and duration of illness (p=0.049) were significantly correlated to SE among patients with CHD. "Maintaining an ideal body weight" is the most challenging thing. On the other hand, stop smoking is the most confident thing to be performed by the respondents. Conclusion: We conclude that CHD patients in the acute care unit and patients with a duration of illness >6 months have a lower tendency for SE. Health interventions such as raising awareness about the disease, modifying health behavior, and immediately screening can improve patients' SE. Besides that, proper diagnosis and ongoing treatment are crucial to improving SE and CHD care outcomes.

A Scoping Review of Predictors Associated with Self-Efficacy Among Patients with Coronary Heart Disease.

Self-efficacy (SE) is the main predictor of self-care behaviour in patients with coronary heart disease (CHD). Several studies identified factors that influence SE in CHD patients. However, review studies have yet to synthesize these results systematically. This review aims to identify SE and the factors influencing SE in CHD patients. This scoping review is reported based on the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched using relevant keywords using five databases: CINAHL Plus with Full Text and Academic Search Complete, PubMed, ScienceDirect, Scopus, Taylor and Francis, and one search engine: Google Scholar, which was accessed on June 23, 2023. Articles with an observational design were included without date restrictions. The quality of evidence was assessed using the Joanna Briggs Institute critical appraisal checklist, and data synthesis used thematic analysis. We found 11 articles discussing SE and the factors influencing SE in CHD patients. In this review, most studies reported that the SE level of CHD patients tends to be low to moderate. Factors associated with SE in this population are classified into three categories (low, moderate, and high). Cardiac knowledge and patient activation are the most influential predictors of SE in CHD patients. Public health interventions such as raising awareness about heart disease, modifying health behaviours, early screening, diagnosis, and appropriate treatment are critical to improving SE and cardiac care outcomes.

Factors Associated with Increased Length of Stay in Post Primary Percutaneous Coronary Intervention Patients: A Scoping Review.

Several studies identify factors affecting increased length of stay (LOS) in patients with post-primary percutaneous coronary intervention (PCI). However, there has not been a review study that synthesizes these results. This study aimed to describe the duration of LOS and factors associated with increased LOS among patients with STEMI after PPCI. This study used scoping review using EBSCO-host Academic Search Complete, PubMed, Scopus, Taylor & Francis, and Google Scholar databases. The keywords used in English were "adults OR middle-aged" AND "length of stay OR hospital stay" AND "primary percutaneous coronary intervention OR PPCI" AND "myocardial infarction OR coronary infarction OR cardiovascular disease". The inclusion criteria for articles were: the article was a full-text in English; the sample was STEMI patients who had undergone a PPCI procedure; and the article discussed the LOS. We found 13 articles discussing the duration and factors affecting LOS in patients post-PPCI. The duration of LOS was the fastest 48 hours, and the longest of LOS was 10.2 days. Factors influencing LOS are categorized into three predictors: low, moderate, and high. Post-procedure complications after PPCI was the most influential factors in increasing the LOS duration. Professional health workers, especially nurses, can identify various factors that can be modified to prevent complications and worsen disease prognosis to increase LOS efficiency.

The Potential of Prognostic Biomarkers of Uric Acid Levels in Coronary Heart Disease Among Aged Population: A Scoping Systematic Review of the Latest Cohort Evidence.

BACKGROUND: This study sought to determine whether uric acid levels have a relationship with and can potentially be used as a prognosis for coronary heart disease (CHD) biomarkers using a scoping review. METHODS: This study was conducted following Arksey and O'Malley's scoping review framework. It was reported as obeying the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review (PRISMA-ScR). The subject was extensively searched for in PubMed, CINAHL, and ScienceDirect. The inclusion criteria in the study were that the sources were journal articles written in English and were available in full text. The age of the subject in the item is the elderly population to capture the relationship between uric acid levels and the prognosis of CHD. The publication time limit was 2010 to 2020. The study was analyzed using thematic analysis. RESULTS: We identified 592 studies in our initial search, and 21 studies with a cohort design were included in this study's analysis. The majority of the evidence suggests an independent correlation with a poor prognosis of CHD in the elderly population. The prognosis of gout includes the prognosis of clinical outcome, severity, and mortality, all of which influence the prognosis value, which becomes a marker. CONCLUSION: Uric acid levels have been identified as a potential biomarker for poor CHD prognosis. Nurses and other healthcare workers should learn how to control poor CHD prognosis.

Illness cognition and depression among patients with coronary heart disease.

Background: Depression is a significant predictor of the quality of life among patients with coronary heart disease. Therefore, it is essential to explore the factors associated with depression. Illness cognition is considered one of the factors affecting depression. However, the relationship between illness cognition and the incidence of depression among Indonesian patients have not been widely investigated. Objective: This study aimed to investigate the correlation between illness cognition, consisting of the acceptance, perceived benefits, and helplessness variables, and depression in patients with coronary heart disease. Methods: This study employed a correlational research design with a total of 106 patients undergoing treatment at a hospital in West Java, Indonesia, selected using convenience sampling. Data were collected using a demographic questionnaire, Beck-Depression Inventory-II (BDI-II), and ICQ (Illness-Cognition Questionnaire). Data were analyzed using mean (SD), median, frequency distribution, and Spearman-rank. Results: 72% of respondents had no depression. Nevertheless, mild, moderate, and major depression suffered by 15%, 9%, and 4% of respondents, respectively. In terms of illness cognition, patients scored higher within the perceived benefits dimension (mean 20.13, SD 3.05), followed by acceptance (mean 18.22, SD 3.33) and helplessness (mean 13.20, SD 4.77), respectively. Furthermore, helplessness was significantly associated with depression (p <.01) with a positive correlation coefficient (r). Also, all items on the helplessness dimension had a significant correlation (p <.01) with depression accompanied by a positive r-value. Conclusion: Helplessness had a significant relationship with depression. So, cardiovascular nurses can anticipate depression in patients by making nursing interventions that can decrease the patients' feelings of helplessness. Thus, factors that reduce helplessness need to be explored and taken into accounts in the treatment of patients with coronary heart disease.