Effects of Aerobic Exercise Therapy through Nordic Walking Program in Lactate Concentrations, Fatigue and Quality-of-Life in Patients with Long-COVID Syndrome: A Non-Randomized Parallel Controlled Trial.

BACKGROUND: Long-COVID syndrome comprises a variety of signs and symptoms that develop during or after infection with COVID-19 which may affect the physical capabilities. However, there is a lack of studies investigating the effects of Long-COVID syndrome in sport capabilities after suffering from COVID-19 infection. The purpose of the study was to evaluate and compare lactate concentration and quality of life (QoL) in patients with Long-COVID with those who have not developed non-Long-COVID during Nordic walking exercise therapy. METHODS: Twenty-nine patients (25.5 ± 7.1 years) took part in a non-randomized controlled trial, divided into two groups: a Long-COVID group (n = 16) and a non-Long-COVID control (n = 13). Patients were confirmed as having Long-COVID syndrome if they experienced fatigue or tiredness when performing daily activities and worsening of symptoms after vigorous physical or mental activity. All participants underwent a 12-week Nordic Walking program. Lactate concentration after exercise and distance covered during all sessions were measured. Pre- and Long-Nordic Walking program, the Modified Fatigue Impact Scale (MFIS), the Short Form 36 Health Survey (SF-36), and EURO QoL-5D (EQ-ED) were administered to assess fatigue and quality of life, respectively. RESULTS: There was a lactate concentration effect between groups (F = 5.604; p = 0.024). However, there was no significant effect as a result of the session (F = 3.521; p = 0.121) with no interaction of group × session (F = 1.345; p = 0.414). The group main effect (F = 23.088; p < 0.001), time effect (F = 6.625; p = 0.026), and group × time (F = 4.632; p = 0.002) interaction on the SF-36 scale were noted. Also, there were a significant group main effect (F = 38.372; p < 0.001), time effect (F = 12.424; p = 0.005), and group × time interaction (F = 4.340; p = 0.014) on EQ-5D. However, there was only a significant group main effect (F = 26.235; p < 0.001) with no effect on time (F = 2.265; p = 0.160) and group × time (F = 1.584; p = 0.234) interaction on the MFIS scale. CONCLUSIONS: The Long-COVID group showed higher lactate concentration compared with the control group during the 12 weeks of the Nordic Walking program. The Long-COVID group presented a decrease in fatigue with respect to the control group according to the MFIS scale, as well as improvement in quality of life after aerobic exercise therapy.

Predictive Factors and ACE-2 Gene Polymorphisms in Susceptibility to Long COVID-19 Syndrome.

Long COVID-19 syndrome is present in 5-10% of patients infected with SARS-CoV-2, and there is still little information on the predisposing factors that lead to its development. The purpose of the study was to evaluate the predictive factors in early symptoms, clinical features and the role of Angiotensin-Converting Enzyme-2 (ACE-2) c.513-1451G>A (rs2106806) and c.15643279T>C (rs6629110) polymorphisms in the susceptibility to developing Long COVID-19 syndrome subsequent to COVID-19 infectionA total of 29 patients who suffered COVID-19 were recruited in a descriptive longitudinal study of two groups: Long COVID-19 (n = 16) and non-Long COVID-19 (n = 13). Early symptoms and clinical features during COVID-19 were classified by a medical service. ACE-2 polymorphisms were genotyped by using a Single Nucleotide Primer Extension (SNPE). Of the early symptoms, fatigue, myalgia and headache showed a high risk of increasing Long COVID-19 susceptibility. Clinical features such as emergency care, SARS-CoV-2 reinfection, previous diseases, respiratory disease and brain fog also had a high risk of increasing Long COVID-19 susceptibility. The A allele in the rs2106806 variant was associated with an odds ratio (OR) of 4.214 (95% CI 2.521-8.853; p < 0.001), and the T allele in the rs6629110 variant was associated with an OR of 3.754 (95% CI 1.785-6.105; p = 0.002) of increasing Long COVID-19 susceptibility. This study shows the risk of ACE-2 polymorphisms, different early symptoms and clinical features during SARS-CoV-2 infection in susceptibility to Long COVID-19.

Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction.

AIMS AND OBJECTIVES: To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours after myocardial infarction. BACKGROUND: Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. DESIGN: The study used a multicentre, quasi-experimental, pre-post design without a control group. METHODS: Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification (NOC) outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon's functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student's t-tests for related samples. The results of the study are reported in compliance with the TREND Statement. RESULTS: A total of 132 patients completed the intervention. The indicators for each NOC outcome and the variations in scores before and after the intensive follow-up showed a statistically significant improvement (p-value = 0.000). Compliance Behaviour: Prescribed Diet (pre = 3.7; post = 4.1); Compliance Behaviour: Prescribed Activity (pre = 3.9; post = 4.3); Compliance Behaviour: Prescribed Medication (pre = 3.9; post = 4.7). CONCLUSION: Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients. To facilitate patients' self-efficacy, the use of health education tools such as a cardiovascular self-care notebook can also be helpful. RELEVANCE TO CLINICAL PRACTICE: This study highlights the benefits of intensive, protocolised, comprehensive patient follow-up in primary care during the first few months after an acute myocardial infarction (AMI). Primary care nurses train patients in cardiovascular self-care. PATIENT OR PUBLIC CONTRIBUTION: Patients were not involved in either the design or the carrying out of the study. However, at the end of the study, they participated in an evaluation process about the utility of the research study and their satisfaction with it. This process was carried out using an ad hoc survey consisting of 10 questions assessing the nursing care and follow-up inputs that were received.

Chronic cardiovascular nursing care in Spanish primary care: A qualitative study.

AIMS: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self-efficacy in cardiovascular self-care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow-up. METHODS: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi-structured interviews. A thematic analysis was applied using the data. RESULTS: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. CONCLUSIONS: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease.

Construct Validity and Test-Retest Reliability of a Free Mobile Application to Evaluate Aerobic Capacity and Endurance in Post-COVID-19 Syndrome Patients-A Pilot Study.

Introduction: Disability associated with the symptoms of post-COVID-19 syndrome is one of its main features and can have a considerable impact on care and rehabilitation units. This, linked to a decreased aerobic capacity and endurance in post-COVID-19 syndrome patients, increases interest in studying the potential of mobile applications to assess performance capacity. The purpose of this research was to study how a free mobile application assesses aerobic capacity and endurance and its relationship with aerobic capacity, test-retest reliability, and endurance evaluated by a conventional test, along with fatigue and health-related quality of life. Methods: An observational study was conducted. RUNZI®, a free mobile application, was used by mounting a Samsung Galaxy S8 smartphone using a strap on the right forearm while all participants simultaneously performed a 6-Minute Walking Test (6MWT). Construct validity between the 6MWT and the total distance performed evaluated by RUNZI® was explored. Additionally, evaluation scales to assess fatigue (MFIS) and health-related quality of life (SF-36) were used to analyze the construct validity of RUNZI®. For test−retest reliability of the app, the same instructions about the 6MWT and procedure with the app were given to all participants at two different time periods. Results: A total of 16 post-COVID-19 syndrome patients (15 females and 1 male) completed the procedure. Distance measured with the RUNZI® showed an excellent correlation with the 6MWT assessed conventionally (p < 0.0001; r = 0.851). No statistical correlations were found between the distance assessed by the RUNZI® app with MFIS and the SF-36. Test−retest reliability was found to be close to statistical significance (p = 0.058) for distance (m) measured by RUNZI® with an ICC of 0.482. Conclusions: Instrumental 6MWT assessed by the RUNZI® app for the Android® operating system showed an excellent correlation with conventional 6MWT, indicating its construct validity in post-COVID-19 syndrome patients. Further, values for the test−retest reliability for the free mobile application were close to statistical significance with a reliability considered poor in an indoor setting.

Long-Term Care Facilities and Nursing Homes during the First Wave of the COVID-19 Pandemic: A Scoping Review of the Perspectives of Professionals, Families and Residents.

The COVID-19 pandemic has had significant repercussions for nursing home residents, their families, and professionals. The objective was to describe the perspectives of residents, their families, and nursing home employees during the COVID-19 pandemic. A scoping review was carried out using the PRISMA Extension for Scoping Reviews. The inclusion criteria were: qualitative and/or mixed methods studies in English, French, Portuguese, and Spanish. The review covers studies published from 11 March 2020 to 15 February 2021. CINAHL, PubMed, Web of Science, ScienceDirect, Scopus, British Nursing Index, Proquest, PsycInfo, and Google Scholar databases were used. We conducted a systematic narrative synthesis, presenting the results narratively and showing descriptive statistics on the studies reviewed. Sixteen documents were obtained from 175 results. Two studies focused on residents and one on their families. The remaining studies looked at professionals. Nursing homes had great difficulty managing resources, which was exacerbated by emotional exhaustion among residents, employees, and family members. In nursing homes, creative initiatives and new forms of leadership appeared to meet emerging needs during the pandemic. The results of the study show the impact of the pandemic on nursing homes and the response capacity present among residents, family members, and professionals.

Efectividad de un programa de capacitación en cuidados integrales para la prevención secundaria cardiovascular en enfermeras de atención primaria / The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk

Objetivo: Evaluar el efecto del «Programa de Capacitación en Cuidados Integrales para la Prevención Secundaria Cardiovascular en Enfermería de Atención Primaria» sobre el nivel de conocimientos, el grado de aplicación de los cuidados cardiovasculares integrales y sobre la continuidad asistencial y de cuidados entre las unidades de rehabilitación cardiaca y atención primaria, con relación a los pacientes postinfartados. Métodos: Estudio cuasiexperimental antes-después no comparativo. Comprendía una encuesta ad-hoc previa a una formación vía Internet y una encuesta posterior a la formación; tanto la encuesta previa como la posterior al curso eran anónimas. El programa consistía en formación en prevención secundaria cardiovascular, cronicidad en el paciente cardiovascular y adherencia al plan terapéutico, y protocolización del seguimiento. Resultados: Más de una tercera parte no conocía los objetivos de control de los distintos factores de riesgo cardiovascular, de forma más marcada para el control lipídico. El programa mejoró de forma significativa el conocimiento de los objetivos de presión arterial, colesterol total y colesterol LDL, y la autopercepción de un mejor seguimiento de los parámetros lipídicos y el perímetro abdominal. En los casos que contaban con una unidad de rehabilitación cardiaca, antes del curso un 73% de los encuestados indicaron que no había «ninguna» comunicación con ella, reduciéndose al 55% en la encuesta posterior al curso. Conclusión: Existen claras necesidades de formación de las enfermeras para su implicación en estos programas de prevención secundaria. Una formación continua específica en prevención secundaria cardiovascular para enfermeras del ámbito de la atención primaria podría mejorar la adquisición de conocimientos a este nivel así como el abordaje de los pacientes con evento cardiovascular durante los primeros meses de dicho evento y la comunicación con las unidades de rehabilitación cardiaca de referencia.(AU)

Objective: To assess the effect of the “Program of Training in Integral Care for Secondary Cardiovascular Prevention in Primary Care Nursing” on the level of knowledge, the degree of application of comprehensive cardiovascular care, and on the continuity of care between the cardiac rehabilitation and primary care units, in relation to post-infarction patients. Methods: Quasi-experimental before-after study without control group. Comprised an ad-hoc survey prior to training via the Internet and a post-training survey; both the pre- and post-course surveys were anonymous. The program consisted of secondary cardiovascular prevention training, chronicity in the cardiovascular patient and adherence to the therapeutic plan, and follow-up protocol. Results: Over one third of the respondents did not know the control objectives of the different cardiovascular risk factors, more marked regarding lipid control. The program significantly improved the knowledge of the objectives of blood pressure, total cholesterol and LDL cholesterol, and the self-perception of better monitoring of lipid parameters and waist circumference. In centers with a cardiac rehabilitation unit, 73% of respondents indicated that there was “no” communication with the unit before the course, reducing to 55% in the post-course survey. Conclusion: There are clear training needs of nurses for their involvement in these secondary prevention programs. A specific continuous training in secondary cardiovascular prevention for nurses in the field of primary care, improves and facilitates the acquisition of knowledge at this level, can improve the approach of patients with cardiovascular events during the first months of said event and communication with the reference cardiac rehabilitation units.(AU)

The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk.

OBJECTIVE: to assess the effect of the "Program of Training in Integral Care for Secondary Cardiovascular Prevention in Primary Care Nursing" on the level of knowledge, the degree of application of comprehensive cardiovascular care, and on the continuity of care between the cardiac rehabilitation and primary care units, in relation to post-infarction patients. METHODS: Quasi-experimental before-after study without control group. Comprised an ad-hoc survey prior to training via the Internet and a post-training survey; both the pre- and post-course surveys were anonymous. The program consisted of secondary cardiovascular prevention training, chronicity in the cardiovascular patient and adherence to the therapeutic plan, and follow-up protocol. RESULTS: Over one third of the respondents did not know the control objectives of the different cardiovascular risk factors, more marked regarding lipid control. The program significantly improved the knowledge of the objectives of blood pressure, total cholesterol and LDL cholesterol, and the self-perception of better monitoring of lipid parameters and waist circumference. In centers with a cardiac rehabilitation unit, 73% of respondents indicated that there was "no" communication with the unit before the course, reducing to 55% in the post-course survey. CONCLUSION: There are clear training needs of nurses for their involvement in these secondary prevention programs. A specific continuous training in secondary cardiovascular prevention for nurses in the field of primary care, improves and facilitates the acquisition of knowledge at this level, can improve the approach of patients with cardiovascular events during the first months of said event and communication with the reference cardiac rehabilitation units.

The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk. / Efectividad de un programa de capacitación en cuidados integrales para la prevención secundaria cardiovascular en enfermeras de atención primaria.

OBJECTIVE: To assess the effect of the "Program of Training in Integral Care for Secondary Cardiovascular Prevention in Primary Care Nursing" on the level of knowledge, the degree of application of comprehensive cardiovascular care, and on the continuity of care between the cardiac rehabilitation and primary care units, in relation to post-infarction patients. METHODS: Quasi-experimental before-after study without control group. Comprised an ad-hoc survey prior to training via the Internet and a post-training survey; both the pre- and post-course surveys were anonymous. The program consisted of secondary cardiovascular prevention training, chronicity in the cardiovascular patient and adherence to the therapeutic plan, and follow-up protocol. RESULTS: Over one third of the respondents did not know the control objectives of the different cardiovascular risk factors, more marked regarding lipid control. The program significantly improved the knowledge of the objectives of blood pressure, total cholesterol and LDL cholesterol, and the self-perception of better monitoring of lipid parameters and waist circumference. In centers with a cardiac rehabilitation unit, 73% of respondents indicated that there was "no" communication with the unit before the course, reducing to 55% in the post-course survey. CONCLUSION: There are clear training needs of nurses for their involvement in these secondary prevention programs. A specific continuous training in secondary cardiovascular prevention for nurses in the field of primary care, improves and facilitates the acquisition of knowledge at this level, can improve the approach of patients with cardiovascular events during the first months of said event and communication with the reference cardiac rehabilitation units.

Estratificación del riesgo cardiovascular, según tabla SCORE, en el Día Europeo de la Prevención del Riesgo Cardiovascular en centros de salud de la comunidad de Madrid / Cardiovascular risk stratification using the score scale on the European cardiovascular prevention risk day in health centres in the madrid region

Objetivo. Identificar el riesgo cardiovascular en la población que acude a los servicios de Atención Primaria, a través de la tabla SCORE. Método. Estudio descriptivo, observacional, transversal y multicéntrico en el que participaron 1324 profesionales (enfermeras, médicos, estudiantes, etc.) pertenecientes a las once Áreas Sanitarias de la Comunidad de Madrid, para determinar el riesgo cardiovascular mediante la tabla SCORE, en sujetos (40-65 años) que acudieron voluntariamente a su centro de salud con motivo del Día Europeo de la Prevención del Riesgo Cardiovascular. Resultados. Se obtuvieron 5.025 cuestionarios recogidos en 142 centros. El 69,6% mujeres. Edad media de 53,1 años (DE: 7,4). Tuvieron un SCORE alto un 4,1%; medio un 3,9% y bajo un 92,4%. Existen diferencias significativas entre el promedio del SCORE de hombres y mujeres, siendo mayor en hombres p<0,001 (IC 95%: 0,9-1,1). Los hombres tenían un 10% más de probabilidad de tener un SCORE alto/moderado que las mujeres p<0,001 (IC 95%: 6,2-12,3). A más nivel educativo el SCORE es inferior p<0,001 (IC 95%: -1,1 -0,5). Las personas con sobrepeso y obesidad tuvieron un riesgo de 2,6 veces mayor que las normopeso p<0,001 (IC 95%: 1,7-3,9). Conclusiones. El riesgo cardiovascular en general es bajo en personas que acuden a los centros de salud. En hombres es más probable un SCORE alto-moderado. Un bajo nivel de estudios y un sobrepeso-obesidad podrían estar asociados a un mayor riesgo de padecer un evento cardiovascular (AU)

Objective. To quantify the cardiovascular risk in a Primary Health Care population using the SCORE chart. Method. Multicenter, observational, descriptive study including 1324 health professionals (nurses, physicians, students, etc) employees of any of the eleven Madrid Region Health Areas in order to determinate the cardiovascular risk by the SCORE chart in subjects between 40 and 65 years that attended to their health centre in a voluntary way because of the European Day of Prevention of Cardiovascular Risk. Results. A total of 5025 questionnaires were collected from 142 health centres, with 69.6% being completed by women. Mean age was 53.1 years (SD 7.4). A high SCORE was found in 4.1% of the population, a medium one in 3.9%, and low in 92.4%. There were significant differences in the mean SCORE between men and women, with men having higher ones, P<.001 (95% CI, 0.9-1.1). The probability of men of having a medium/high SCORE was 10% higher than that of women P<.001 (95% CI, 6.2-12.3). Those with higher educational levels had lower SCORE results, P<.001 (95% CI, 1.1-0.5). Obese and over weight people had a 2.6 higher risk than those of normal weight, P<.001 (95% CI: 1.7-3.9). Conclusions. Cardiovascular risk is generally low in people who visit health centres. A Medium-high SCORE is more probable in men. Low educational level and overweight and obesity could be associated with a higher risk of being affected by a cardiovascular adverse event (AU)

[Cardiovascular risk stratification using the score scale on the European cardiovascular prevention risk day in health centres in the Madrid region]. / Estratificación del riesgo cardiovascular, según tabla SCORE, en el Día Europeo de la Prevención del Riesgo Cardiovascular en centros de salud de la comunidad de Madrid.

OBJECTIVE: To quantify the cardiovascular risk in a Primary Health Care population using the SCORE chart. METHOD: Multicenter, observational, descriptive study including 1324 health professionals (nurses, physicians, students, etc) employees of any of the eleven Madrid Region Health Areas in order to determinate the cardiovascular risk by the SCORE chart in subjects between 40 and 65 years that attended to their health centre in a voluntary way because of the European Day of Prevention of Cardiovascular Risk. RESULTS: A total of 5025 questionnaires were collected from 142 health centres, with 69.6% being completed by women. Mean age was 53.1 years (SD 7.4). A high SCORE was found in 4.1% of the population, a medium one in 3.9%, and low in 92.4%.. There were significant differences in the mean SCORE between men and women, with men having higher ones, P<.001 (95% CI, 0.9-1.1). The probability of men of having a medium/high SCORE was 10% higher than that of women P<.001 (95% CI, 6.2-12.3). Those with higher educational levels had lower SCORE results, P<.001 (95% CI, 1.1-0.5). Obese and over weight people had a 2.6 higher risk than those of normal weight, P<.001 (95% CI: 1.7-3.9). CONCLUSIONS: Cardiovascular risk is generally low in people who visit health centres. A Medium-high SCORE is more probable in men. Low educational level and overweight and obesity could be associated with a higher risk of being affected by a cardiovascular adverse event.

El método de resolución de problemas. Experiencia de organización en Enfermería / Problem Solving Method: an experience in organization in Nursing

Se desarrolla y mejora la planificación y organización del equipo de enfermería a través de soluciones compartidas y consensuadas en grupo, con el fin de lograr una mayor motivación y satisfacción laboral. Es un estudio de gestión mediante el método empresarial de mejora por resolución de problemas. Identificación de problemas y/o necesidades, búsqueda y ejecución de soluciones grupalmente. Evaluado por medio de encuestas de opinión y satisfacción, tanto a la mitad del proyecto como a la finalización, por parte de los componentes de enfermería, y al terminar el mismo por el equipo multidisciplinar del centro de salud. Tras el análisis estadístico comparativo se evidencia una efectividad de los problemas resueltos y una mejoría organizativa. La satisfacción del equipo de enfermería es positiva siendo más dispersa la opinión del resto del equipo. Trabajo de investigación. Metodología de la Investigación en Salud. IDER. Universidad de Alcalá - Universidad de Antioquia (AU)

[Problem solution method. Experience of a nursing organization]. / El método de resolución de problemas. Experiencia de organización en enfermería.

To develop and improve nursing teams' planning and organization by means of shared and consensual group solutions with the goal to achieve greater motivation and satisfaction in their work. The author employs a management study using a business improvement method by means of problem solving techniques which involves the identification of problems and/or necessities and a group search for, and execution of, solutions. Evaluation is carried out by means of satisfaction and opinion questionnaires, both at the half-way point in this study and at the end of it filled out by nursing personnel and by the health center's multidisciplinary team as well at the end of this study. Place where this study is carried out: INSALUD Primary Health Care Center Móstoles, Area 8 in Madrid. After a comparative statistical analysis of the questionnaire results and of the methodology used, the author noted an effectiveness in problems solved and an organizational improvement. Nursing team satisfaction is positive when the opinion of the rest of the team is more dispersed.