Needs of family members of patients in a coronary care unit.

OBJECTIVE: To identify the need of family members of patients hospitalized in a coronary intensive care unit and their degree of satisfaction with the care provided. METHODS: An observational and cross-sectional study including family members of patients hospitalized in the coronary intensive care unit for acute coronary syndrome in Killip I or II. After the second visit of the same family member to the patient in the unit, a 43-item inventory of needs and stressors of family members was applied. Family members assessed each need for its importance and satisfaction using a four-point Likert scale. The scores in each dimension of importance and satisfaction were compared using the Wilcoxon test, considering a value of p<0.05 as significant. RESULTS: One hundred family members were interviewed. The most important needs were related to assurance and information. Family members had satisfaction scores corresponding to be very satisfied or totally satisfied, but with lower scores when compared to the needs scores (p<0.01). CONCLUSION: The most important needs of family members of patients hospitalized in the coronary intensive care unit were related to assurance and information. Multiprofessional interventions involving better communication of patient information to family members should be incorporated into the coronary intensive care unit.

Stressors in intensive cardiac care units: Patients' perceptions.

BACKGROUND: Patients with acute coronary syndrome (ACS) are often admitted to intensive cardiac care units (ICCUs) to have their vital signs and ventricular function monitored. In most cases, they are conscious and bedbound, causing high stress and anxiety levels. AIMS AND OBJECTIVES: To assess the stressors affecting patients admitted to ICCUs. DESIGN: This is a cross-sectional study performed in a public hospital in São Paulo, Brazil. METHODS: A sample of 100 patients with ACS admitted to an ICCU, after 24 hours of hospitalization, was recruited. Sociodemographic and clinical data were collected, and the Intensive Care Unit Stressor Assessment Scale (ICESS) was applied to investigate stressors. The ICESS' internal consistency was estimated by Cronbach's alpha, and the stressors were analysed by descriptive statistics, association tests, and correlation tests. RESULTS: Most patients were male, married, and aged 51 to 60 years. The ICESS showed an excellent internal consistency. The mean score identified in patients pointed to a non-stressed to moderately stressed condition. The indicators considered to be more stressful were as follows: "Not knowing ICU length of stay," "Being unable to fulfil family roles," "Missing husband or wife," and "Loss of self-control." CONCLUSIONS: Stress levels were considered to be non-stressful to moderately stressful. The main stressors were related to psychological distress and physical discomfort dimensions. RELEVANCE TO CLINICAL PRACTICE: Mapping the main stressors of patients with coronary artery disease will allow health professionals to implement strategies to reduce them and consequently reduce their anxiety levels.

Needs of family members of patients in a coronary care unit

ABSTRACT Objective: To identify the need of family members of patients hospitalized in a coronary intensive care unit and their degree of satisfaction with the care provided. Methods: An observational and cross-sectional study including family members of patients hospitalized in the coronary intensive care unit for acute coronary syndrome in Killip I or II. After the second visit of the same family member to the patient in the unit, a 43-item inventory of needs and stressors of family members was applied. Family members assessed each need for its importance and satisfaction using a four-point Likert scale. The scores in each dimension of importance and satisfaction were compared using the Wilcoxon test, considering a value of p<0.05 as significant. Results: One hundred family members were interviewed. The most important needs were related to assurance and information. Family members had satisfaction scores corresponding to be very satisfied or totally satisfied, but with lower scores when compared to the needs scores (p<0.01). Conclusion: The most important needs of family members of patients hospitalized in the coronary intensive care unit were related to assurance and information. Multiprofessional interventions involving better communication of patient information to family members should be incorporated into the coronary intensive care unit.

Crenças, valores e atitudes dos familiares conviventes com pacientes coronariopatas / Beliefs, values and attitudes of cohabiting relatives of coronary artery disease patients / Creencias, valores y actitudes de familiares de pacientes con coronariopatía

A alta incidência e prevalência da doença coronariana é evidente no Brasil e no mundo. A concepção de saúde e enfermidade influencia nas atitudes e condutas dos indivíduos diante do processo saúde doença e afeta o desempenho e o desenvolvimento do núcleo familiar. O objetivo foi analisar crenças, valores e atitudes dos familiares conviventes com pacientes com síndrome coronariana aguda sobre a doença coronariana. Trata-se de estudo transversal com abordagem qualitativa realizado em um Hospital Universitário. A amostra foi composta de nove familiares, mediante uma entrevista semi estruturada. Os dados foram coletados por meio de instrumentos com questões elaboradas tendo como base as premissas do referencial teórico e avaliados segundo o Modelo de Crença em Saúde. Os familiares tinham entre 26 e 66 anos. As categorias suscetibilidade, severidade, benefícios e barreiras percebidas derivadas do Modelo de Crença em Saúde, assim como a categoria conscientização e mudança, mostraram que os familiares possuem conhecimento sobre os aspectos preventivos e de controle das consequências da doença coronariana, porém as crenças e valores adquiridos ao longo de suas vidas, influenciados pelo contexto cultural, social, econômico, emocional e principalmente familiar, interferem nos comportamentos preventivos da doença e promotores de saúde. A despeito do conhecimento que os familiares conviventes possuem sobre a doença, o enfermeiro precisa adequar o processo educacional para minimizar os conflitos decorrentes de crenças, valores e contexto do ambiente familiar, facilitar e promover a incorporação de novos hábitos.

The high incidence and prevalence of coronary heart disease is evident in Brazil and worldwide. The concept that individuals have on health andillness influences their attitudes and behaviors before the health-disease process and affects the performance and development of the familynucleus. The objective was to analyze beliefs, values and attitudes of family members that live with patients with acute coronary syndrome ofcoronary heart disease. This is a cross-sectional study with qualitative approach conducted at a university hospital. The sample consisted ofnine relatives of patient. Semi-structured interviews were applied. Data were collected through instruments with questions prepared upon theassumptions of the theoretical framework. Data were evaluated according to the Health Belief Model. Family members were aged between 26 and66 years. The categories susceptibility, severity, benefits and perceived barriers derived from Health Belief Model, as well as the categories awarenessand change, showed that family members have knowledge about the prevention and control aspects of the consequences of coronary heart disease.However, the beliefs and values acquired throughout their lives, influenced by cultural, social, economic, emotional and especially family context,hinder behaviors with preventive and health promoter character. Despite the knowledge that family member of coronary patients have about thedisease, nurses need to tailor the educational process aiming to minimize conflicts arising from beliefs, values and family environment context, aswell as facilitate and promote the incorporation of new habits.

La elevada incidencia y prevalencia de la enfermedad coronaria en Brasil y en el mundo es evidente. El concepto de salud y enfermedad influye en las actitudesy comportamientos de los individuos en el proceso de salud-enfermedad y afecta el rendimiento y desarrollo del núcleo familiar. El objetivo del presenteestudio fue analizar las creencias, valores y actitudes de familiares que conviven con pacientes con síndrome coronario agudo de la enfermedad arterialcoronaria. Se trata de un estudio cualitativo transversal realizado en un hospital universitario. La muestra estaba compuesta por nueve familiares. Los datosfueron recogidos en entrevistas semiestructuradas a través de instrumentos con preguntas preparadas en base a los supuestos del marco teórico según elModelo de Creencias en Salud. Los familiares tenían entre 26 y 66 años. Las categorías “susceptibilidad”, “gravedad”, “beneficios” y “barreras” percibidasderivadas del modelo Creencias en Salud, así como la categoría “concienciación y cambio”, mostraron que los familiares tienen conocimiento sobre losaspectos de prevención y control de las consecuencias de la enfermedad cardíaca coronaria. Sin embargo, las creencias y valores adquiridos durante toda lavida, influenciados por el contexto cultural, social, económico y emocional de la familia interfieren con los comportamientos preventivos de la enfermedad ypromotores de la salud. A pesar del conocimiento que los familiares tienen sobre la enfermedad, los enfermeros precisan adecuar el proceso educativo paraminimizar los conflictos resultantes de las creencias, valores y contexto familiar para facilitar y promover la incorporación de nuevos hábitos.

Fatores de risco da doença arterial coronariana dos familiares conviventes de indivíduos com síndrome coronariana aguda / Risk factors of coronary artery disease in family members living with acute coronary patients / Factores de riesgo de la enfermedad arterial coronaria en familiares que convivencon pacientes con síndrome coronario agudo

A doença arterial coronariana é a principal causa de morbimortalidade no mundo e compromete o desempenho individual e familiar. O objetivo deste estudo foi identificar os fatores de risco da doença arterial coronariana e associá-los ao perfil sociodemográfico dos familiares conviventes de pacientes com síndrome coronariana aguda. Trata-se de estudo transversal realizado em um hospital universitário. A amostra foi composta de 50 famílias distintas e 158 familiares conviventes de pacientes com síndrome coronária aguda. Os fatores de risco foram avaliados mediante entrevista com instrumento elaborado pelos pesquisadores e por meio de instrumentos previamente validados. Os dados foram submetidos à estatística descritiva e para a avaliação das relações entre as variáveis foram utilizados testes de associação. A maioria das famílias apresentava baixa renda, baixo nível de escolaridade e elevado número de conviventes e dependentes. A hipertensão arterial, diabetes mellitus, dislipidemia, obesidade, sedentarismo, etilismo e tabagismo foram os fatores de risco mais encontrados. As associações registradas foram: idade acima dos 51 anos com diabetes mellitus, hipertensão arterial, dislipidemia; idade entre 20 e 50 com alcoolismo e tabagismo; baixa escolaridade com diabetes mellitus, obesidade e hipertensão arterial; estado civil com diabetes mellitus, hipertensão arterial, dislipidemia e alcoolismo; ocupação com alcoolismo e tabagismo; baixa renda com alcoolismo; e o alcoolismo com tabagismo. O estilo de vida inadequado associado aos fatores sociodemográficos e às comorbidades já existentes demonstram a necessidade de educação em saúde também para esses familiares conviventes.

Coronary artery disease is a major cause of morbidity and mortality in the world and such comorbidity when diagnosed affects the context individualand family performance, so the aim of this study was to identify risk factors for coronary artery disease in cohabiting family members patients withacute coronary syndrome and identify the association of these factors with sociodemographic profile. It is a cross-sectional study, conducted atthe University Hospital; the sample was composed of 50 different families and 158 cohabiting family members of patients with the acute coronarysyndrome. The risk factors were evaluated by an interview with an instrument developed by the researchers and previously validated instruments.Data were submitted to descriptive statistics and to assess the relationship between the variables association tests were used. Most families hadlow income, low education level and a high number of cohabiting and dependents. Hypertension, diabetes mellitus, dyslipidemia, obesity, physicalinactivity, alcohol consumption and smoking were risk factors most commonly found. The age over 51 years was associated with diabetes mellitus,hypertension, dyslipidemia and age between 20 to 50 years showed greater association with alcoholism and smoking; poor education with diabetesmellitus, obesity and high blood pressure; marital status with diabetes mellitus, hypertension, dyslipidemia and alcoholism; the occupation was related to alcoholism and smoking, low in come with alcoholism and alcohol abuse was associated with smoking. Improper lifestyle associated with sociodemographic factors and existing comorbidities demonstrate the need for health education also for these cohabiting family.

La enfermedad coronaria es la causa principal de morbilidad y mortalidad en el mundo y afecta el desempeño individual y familiar. El objetivo de este estudiofue identificar los factores de riesgo de la enfermedad coronaria y asociarlos con el perfil sociodemográfico de los familiares que conviven con pacientes consíndrome coronario agudo. Se trata de un estudio transversal realizado en un hospital universitario. La muestra consistió en 50 familias distintas y 158 familiaresde pacientes con síndrome coronario agudo. Los factores de riesgo fueron evaluados en entrevistas con un instrumento elaborado por los investigadores y pormedio de instrumentos previamente convalidados. Los datos fueron sometidos a la estadística descriptiva y se utilizaron pruebas de asociación para evaluar lasrelaciones entre las variables. La mayoría de las familias era de bajos ingresos, bajo nivel de escolaridad y alto número de convivientes y dependientes. Los factoresde riesgo más encontrados fueron hipertensión arterial, diabetes mellitus, dislipidemia, obesidad, sedentarismo, etilismo y tabaquismo. Las asociaciones másfrecuentes fueron: edad superior a los 51 años con diabetes mellitus, hipertensión arterial, dislipidemia; edad entre 20 y 50 años con alcoholismo y tabaquismo; baja escolaridad con diabetes mellitus, obesidad e hipertensión arterial; estado civil con diabetes mellitus, hipertensión arterial, dislipidemia y alcoholismo; ocupación con alcoholismo y tabaquismo; bajos ingresos con alcoholismo; y alcoholismo con tabaquismo. El estilo de vida inadecuado juntamente con los factores sociodemográficos y con las comorbilidades existentes demuestra que los familiares que conviven con estos pacientes deben recibir educación en salud.