[The role of nursing in right heart catheterization. Advantages from peripheral venous access]. / Papel de enfermería en el cateterismo cardiaco derecho. Ventajas del acceso venoso periférico.

INTRODUCTION: Pulmonary hypertension (PH) is a serious disease that requires early diagnosis to achieve a better patient prognosis. Right heart catheterization (RHC) has become the main diagnostic test for this disease, measuring the pressures from the right heart chambers invasively, using a catheter placed through venous access. Nursing performance has an important role in RHC through peripheral venous access due to its well-done skills for canalization and knowledge about the management and care of these accesses. RHC performed through peripheral venous access provide advantages over those performed through central venous access. OBJECTIVE: To analyze the benefits from RHC through peripheral venous access compared to those performed through central venous access, as well as highlighting the role of nursing during this type of procedures. METHOD: A retrospective, descriptive, and observational study was performed for patients who underwent RHC in our center between January 2019 to January 2023. We analyzed clinical characteristics, access, fluoroscopy parameters, periprocedural complications, and hospital admissions. RESULT: A total of 115 patients were included. The average age was 65±12 years, with 58.1% of females. Risk stratification of PH was the reason for conducting RHC in 82.9%. The anterocubital veins became the main approach (72.2%), performed by hemodynamics nurses, while the central venous ones composed the rest (27.8%), which were done by cardiology specialized doctors. We observed a significant reduction in radiation dose in RHC via anterocubital route compared to central venous access (4.4Gycm2 vs 12.5Gycm2 [IQR: 4.5]; P<.001), and it does also in fluoroscopy times (2.3minutes vs 4.6minutes [IQR: 2.6]; P<.001). No complications were recorded, independently of the approach. Patients who underwent a scheduled catheterization were discharged more frequently on the same day of the procedure whether a peripheral approach was performed (77.2%, 44 of 57 patients), in comparison with the central one (28.6%) (P=.001). CONCLUSIONS: The RHC is an essential tool for the diagnosis of PH, achieving nursing such an important role for those performed by peripheral venous access. Peripheral venous access provides benefits and advantages like the reduction of radiation exposure and scan times, reduced hospital stay. All this could bring greater comfort, safety and better quality of care to the patient.

Exploring Factors affecting Missed Nursing Care in Cardiovascular Care Units: A Qualitative Study.

Background: Cardiovascular care units are among the most crucial departments in any healthcare system. In these units, nurses play the most pivotal roles, and the quality of nursing care is essential; missing certain aspects of care can have irreversible adverse effects on patient health. This qualitative study aims to investigate the factors influencing Missed Nursing Care (MNCs) based on the experiences of nurses and patients in cardiovascular care units. Materials and Methods: This qualitative study utilized the conventional content analysis approach to explore the factors affecting MNCs in cardiovascular care units. Data were collected between December 2021 and September 2022 through in-depth, semi-structured individual interviews with 11 participants selected through purposive sampling. Data analysis followed the five-step method proposed by Graneheim and Lundman. Results: The analysis revealed five main themes: nurse's job characteristics, work-life conflict, nurse's professional competence, the cardiac work environment atmosphere, and organizational management. Conclusions: The findings of this study suggest that authorities should consider factors such as understanding the occupational characteristics of nurses when assigning them to cardiovascular care units, providing solutions to mitigate work-life conflicts for nurses, enhancing nurses' professional competence, improving the working environment for nurses, and enhancing the performance and skills of organizational managers.

Self-care Behavior Based on Integrated Behavioral Model in Patients With Atrial Fibrillation: A Structural Equation Modeling Approach.

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.

Conhecimento e sentimentos de pessoas pré-procedimento de cateterismo cardíaco / Knowledge and feelings of people before cardiac catheterization procedure / Conocimientos y sentimientos de las personas antes del procedimiento de cateterismo cardíaco

Objetivo: identificar o conhecimento e sentimentos de pessoas sobre o cateterismo cardíaco. Método: estudo descritivo, abordagem qualitativa, realizado com 12 pacientes em hospital referência em cardiologia, no município de João Pessoa, no período de novembro a dezembro de 2021. Os dados foram coletados através de entrevista gravada e semiestruturada, os dados analisados pela Análise de Conteúdo de Bardin. Resultados: a partir das entrevistas foram construídas três categorias temáticas: C1 - Conhecimento do procedimento de cateterismo cardíaco, C2 - Falta de orientação dos cuidados que envolvem o cateterismo cardíaco e C3 - Sentimentos à realização do cateterismo cardíaco. Os dados evidenciam um conhecimento insuficiente e limitado que podem se relacionar com o surgimento de sentimentos negativos. Considerações finais: Percebe-se a necessidade de orientações e informações, bem como o planejamento e construção de tecnologias educativas para as pessoas que irão realizar o cateterismo cardíaco, com a finalidade de promover um pré, intra e pós-exame seguro

Objective: to identify people's knowledge and feelings about cardiac catheterization. Method: descriptive study, qualitative approach, carried out with 12 patients in a cardiology reference hospital, in the city of João Pessoa, from November to December 2021. Data were collected through recorded and semi-structured interviews, the data analyzed by Analysis of Bardin content. Results: three thematic categories were constructed from the interviews: C1 - Knowledge of the cardiac catheterization procedure, C2 - Lack of guidance on care involving cardiac catheterization and C3 - Feelings regarding cardiac catheterization. The data highlights insufficient and limited knowledge that may be related to the emergence of negative feelings. Final considerations: There is a perceived need for guidance and information, as well as the planning and construction of educational technologies for people who will undergo cardiac catheterization, with the purpose of promoting a safe pre, intra and post-exam

Objetivos: identificar los conocimientos y sentimientos de las personas sobre el cateterismo cardíaco. Método: estudio descriptivo, de enfoque cualitativo, realizado con 12 pacientes en un hospital de referencia en cardiología, en la ciudad de João Pessoa, de noviembre a diciembre de 2021. Los datos fueron recolectados a través de entrevistas grabadas y semiestructuradas, los datos analizados por Análisis de Bardin contenido. Resultados: a partir de las entrevistas se construyeron tres categorías temáticas: C1 - Conocimiento sobre el procedimiento de cateterismo cardíaco, C2 - Falta de orientación sobre los cuidados relacionados con el cateterismo cardíaco y C3 - Sentimientos respecto al cateterismo cardíaco. Los datos destacan conocimientos insuficientes y limitados que pueden estar relacionados con la aparición de sentimientos negativos. Consideraciones finales: Se percibe la necesidad de orientación e información, así como la planificación y construcción de tecnologías educativas para las personas que serán sometidas a cateterismo cardíaco, con el propósito de promover un pre, intra y post examen seguro

Cardiovascular nurses and organizational well-being: a systematic review.

AIMS: This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it. METHODS AND RESULTS: The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1st December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library and Scopus. Critical appraisal and data extraction were conducted using standardized tools.Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, that highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping or ignoring the problem, or, in other cases, became somewhat aggressive. CONCLUSION: Considering the limited data, the cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes. REGISTRATION: PROSPERO.

Preparation for cardiac procedures: a cross-sectional study identifying gaps between outpatients' views and experiences of patient-centred care.

BACKGROUND: To examine and identify gaps in care perceived as essential by patients; this study examined outpatients': 1) views on what characterises essential care and 2) experiences of care received, in relation to cardiac catheterisation and subsequent cardiovascular procedures. METHODS: Cross-sectional descriptive study. Surveys were posted to outpatients who had undergone elective cardiac catheterisation in the prior six months at an Australian hospital. Participants completed a 65-item survey to determine: a) aspects of care they perceive as essential to patients receiving care for a cardiac condition (Important Care Survey); or b) their actual care received (Actual Care Survey). Numbers and percentages were used to calculate the most frequently identified essential care items; and the experiences of care received. Items rated as either 'Essential'/'Very important' by at least 80% of participants were determined. A gap in patient-centred care was identified as being any item that was endorsed as essential/very important by 80% or more of participants but reported as received by less than 80% of participants. RESULTS: Of 582 eligible patients, 264 (45%) returned a completed survey. 43/65 items were endorsed by > 80% of participants as essential. Of those, for 22 items, <80% reported the care as received. Gaps were identified in relation to GP consultation (1 item), preparation (1 item) subsequent decision making for treatment (1 item), prognosis (6 items) and post-treatment follow-up (1 item). CONCLUSIONS: Areas were identified where actual care fell short of patients' perceptions of essential care.

Cardiovascular Nursing Workforce Challenges: Transforming the Model of Care for the Future.

The complexities of acute and critical care cardiovascular management demand specialty trained and experienced nurses to ensure quality patient outcomes. An ongoing nurse labor shortage threatens to destabilize the healthcare system and presents a twofold challenge: a decreasing supply of registered nurses and increasing demand for nursing services. This article describes the numerous forces driving the current nursing shortage as well as the impact of the coronavirus-19 pandemic on nurse job satisfaction and turnover. We present a reinvented model of nursing care as a framework for healthcare organizations to address nurse staffing challenges.

Mitral valve-in-valve implantation: A case report.

INTRODUCTION: Mitral valve-in-valve implantation is a new therapeutic tool in the field of structural interventional cardiology for patients with bioprosthetic dysfunction due to severe mitral valve regurgitation and high surgical risk. The objective was to develop an individualised nursing care plan for a patient undergoing this procedure; the first case in our centre. CASE DESCRIPTION: A 75-year-old woman, independent for activities of daily living, with a history of chronic renal failure and biological mitral valve replacement due to rheumatic valve disease. She was admitted to the acute cardiac care unit for severe symptomatic mitral valve regurgitations secondary to mitral bioprosthesis dysfunction. Heart surgery was ruled out due to comorbidities and high surgical risk, and the patient underwent percutaneous mitral valve-in-valve implantation. The implantation was successful. ASSESSMENT: The nursing assessment followed Marjory Gordon's conceptual model identifying the following impaired patterns: pattern 2: bilateral malleolar oedema without pitting; pattern 3: urinary catheter and intravenous diuretic use; pattern 4: dyspnoea on moderate exertion, dry nocturnal cough, orthopnoea and respiratory disturbances, and activity intolerance; pattern 5: need for pharmacological assistance for a good night's rest. DIAGNOSES: The following nursing diagnoses were established using the NANDA taxonomy: Excess fluid volume; ineffective breathing pattern; Activity intolerance and problem collaborating: Hypotension and anaemia secondary to deep thigh haematoma. PLANNING: The following objectives were set based on the NOC taxonomy: Fluid balance; Respiratory status: ventilation; Cardiopulmonary status and the following NIC interventions: Hypervolaemia management; Respiratory monitoring and oxygen therapy; Vital sign monitoring and heart care. DISCUSSION: Nursing interventions aimed at monitoring haemodynamic status, fluid restriction together with the efficacy of diuretic treatment achieved a negative water balance which contributed to fluid depletion improving respiratory symptoms, enabling implantation under better conditions. CONCLUSIONS: Technological progress in the health sciences, and in the field of acute cardiology in particular, directly calls for training, revision and updating of critical care nursing. Given this dynamic and continually evolving process, the specialist intensive care nurse, the inclusion of the cardiovascular nurse specialist in multidisciplinary teams such as the heart team, and expanding the consultation of the haemodynamic nurse are urgently required to ensure optimal nursing care, safety, and care quality.

Integrating avatar technology into a telemedicine application in heart failure patients : A pilot study.

BACKGROUND: Heart failure is a severe condition and telemedicine can improve the care of heart failure. Many patients are unable to use telemedicine applications due to visual impairment and limited health-related literacy. Avatar technology might help to overcome these limitations. METHODS: A telemedicine application was combined with a nurse avatar and offered to heart failure outpatients for 3 months. System usability and patient satisfaction were evaluated monthly by the system usability score (maximum score=100) and the patient satisfaction scale (maximum score=50). RESULTS: In total, 37 heart failure patients were enrolled. The mean system usability score after 1 month was 73 (standard deviation=24) and 72 (standard deviation=10) after 3 months of follow-up, which was not significantly different (p = 0.40). The mean patient satisfaction scale after 1 month was 42 (standard deviation=5) and 39 (standard deviation=8) after 3 months, which was not significantly different (p = 0.10). CONCLUSION: A nurse look-a-like avatar integrated into a telemedicine application was positively assessed by heart failure patients. Future studies are warranted to clarify the role of avatar technology in telemedicine.

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.

Cardiovascular Nursing and Climate Change: A Call to Action From the CSANZ Cardiovascular Nursing Council.

This Call to Action aims to provide key considerations for cardiovascular nursing, related to climate and environmental impacts. Strategies to optimise nursing preparation, immediate response and adaptation to climate emergencies are crucial to ensure those at greatest risk, including First Nations peoples, are protected from potentially avoidable harm. Professionals who manage climate consequences must also understand the impact of their care on the root cause of the problem.

Agentes antitrombóticos utilizados por pessoas idosas: prevalência e fatores associados / Antithrombotic agents used by older people: prevalence and associated factors

Resumo Objetivo Analisar os tipos e a prevalência da utilização de medicamentos antitrombóticos por pessoas idosas, e os fatores associados. Método Estudo transversal com pessoas idosas domiciliares, na cidade de Goiânia, Centro-Oeste do Brasil. A classificação farmacológica dos medicamentos antitrombóticos foi efetuada de acordo com a classificação Anatômico Terapêutico Químico (Anatomical Therapeutic Chemical - ATC). Realizada análise bivariada e múltipla com nível de significância de 5%. Resultados Participaram do estudo 212 idosos com prevalência de uso de medicamentos antitrombóticos de 27,8%. Os tipos mais utilizados foram: ácido acetilsalicílico (AAS) (n= 49; 83%), Clopidogrel (n=6; 10,1%) e Cilostazol (n=4; 6,7%). Os fatores associados foram: faixa etária de 70-79 anos (p<0,001) e a polifarmácia (p<0,001). Conclusão A proporção do uso de antitrombóticos foi alta entre os idosos, e os fármacos mais consumidos possuem risco de complicações e de interações medicamentosas. A vigilância deve ser maior naqueles com mais de 70 anos e em polifarmácia, sendo necessário empreender esforços para o acompanhamento clínico desses idosos em terapia antitrombótica farmacológica.

Abstract Objective To analyze the types and prevalence of use of antithrombotic drugs by older people and associated factors. Method A cross-sectional study of community-dwelling older people was carried out in the city of Goiânia, Midwest Brazil. The pharmacological classification of antithrombotic drugs was performed according to the Anatomical Therapeutic Chemical (ATC) classification. Bivariate and multivariate analyses were performed with a significance level of 5%. Results 212 older people participated in the study and the prevalence of antithrombotic drug use was 27.8%. The most used types were acetylsalicylic acid (ASA) (n= 49; 83%), Clopidogrel (n=6; 10.1%) and Cilostazol (n=4; 6.7%). Associated factors were the 70-79 years age group (p<0.001) and polypharmacy (p<0.001). Conclusion The proportion of antithrombotic use by the participants was high and the most used drugs posed a risk of complications and drug-drug interactions. Attention should be heightened in individuals aged >70 years and in use of polypharmacy and efforts must be made to clinically monitor these users of antithrombotic drugs therapy.

Experiencia del síntoma en el Síndrome Coronario Agudo: comprobación de un modelo conceptual / Symptom Experience in Acute Coronary Syndrome: Testing a Conceptual Model / Experiência de sintomas nas Síndromes Coronarianas Agudas: verificação de um modelo conceitual

Introducción: el síndrome coronario agudo (SCA) se caracteriza por diferentes síntomas, por lo cual la experiencia varía de persona a persona. El Modelo conceptual del manejo de los síntomas (MCMS) de Dodd aborda este aspecto que requiere ser comprobado dentro de la práctica de enfermería. Objetivo: comprobar los postulados de la dimensión de la experiencia de los síntomas del Modelo conceptual de Dodd en personas con síndrome coronario agudo. Métodos: comprobación teórica por medio de ecuaciones estructurales. Participaron 256 individuos con diagnóstico de síndrome coronario agudo, seleccionados por muestreo probabilístico estratificado. Se recolectaron datos clínicos, sociodemográficos y se midió la evaluación y respuesta a los síntomas con cinco instrumentos válidos. Se realizó un análisis estadístico con ajuste absoluto, ajuste incremental y ajuste de parsimonia del cual derivó un modelo de ecuaciones estructurales. Resultados: se comprobó la relación bidireccional entre la severidad del síntoma (evaluación) y la toma de decisiones (respuesta al síntoma). Se conformó un modelo que explica el 44 % de la varianza sobre la toma de decisiones. Sobre esta variable también influyen otras variables como la evaluación cognitiva y el control personal. Conclusión: este modelo conceptual permitió comprender la dimensión de la experiencia del síntoma en pacientes con síndrome coronario agudo, comprobando sus postulados en la práctica.

Introduction: acute coronary syndrome (ACS) is characterized by different symptoms, so the experience varies from person to person. Dodd's Conceptual Model of Symptom Management addresses this aspect that requires testing within nursing practice. Objective: to test the postulates of the symptom experience dimension of Dodd's Conceptual Model of Symptom Management in persons with acute coronary syndrome. Methods: theoretical testing by means of structural equations. A total of 256 individuals with a diagnosis of acute coronary syndrome, selected by stratified probability sampling, participated. Clinical and sociodemographic data were collected, and symptom assessment and response were measured with five valid instruments. Statistical analysis was performed with absolute adjustment, incremental adjustment and parsimony adjustment from which a structural equation model was derived. Results: the bidirectional relationship between symptom severity (assessment) and decision making (symptom response) was tested. A model was formed that explains 44% of the variance on decision making. This variable is also influenced by other variables such as cognitive evaluation and personal control. Conclusion: this conceptual model allowed us to understand the dimension of symptom experience in patients with acute coronary syndrome, proving its postulates in practice.

Introdução: Síndromes coronarianas agudas (SCA) caracterizam-se por diferentes sintomas, pelo que a experiência muda de pessoa para pessoa. O Modelo conceitual do manejo dos sintomas (MCMS) de Dodd aborda esse aspecto que precisa testes na prática de enfermagem. Objetivo: verificar os postulados da dimensão da experiência dos sintomas do Modelo conceitual de Dodd em pacientes com síndrome coronariana aguda. Métodos: verificação teórica por meio de equações estruturais. Participaram 256 indivíduos com diagnóstico de síndrome coronariana aguda, selecionados por amostragem probabilística estratificada. Dados clínicos e sociodemográficos foram coletados e a avaliação e resposta aos sintomas foi medida com cinco instrumentos válidos. Foi realizada análise estatística com ajuste absoluto, ajuste incremental e ajuste de parcimônia que derivou num modelo de equaciones estruturais. Resultados: verificou-se o relacionamento bidirecional entre a gravidade do sintoma (avaliação) e a tomada de decisão (resposta ao sintoma). Um modelo que explica 44% da variância sobre a tomada de decisão foi conformado. Sobre essa variável também influem outras variáveis como a avaliação cognitiva e o controlo pessoal. Conclusão: este modelo conceitual permitiu compreender a dimensão da experiência do sintoma em doentes com síndrome coronariana aguda, verificando seus postulados na prática.

Influências dos transtornos de sono-vigília sobre a saúde cardiovascular na atenção primária à saúde / Influencia de los trastornos del sueñovigilia sobre la salud cardiovascular en la atención primaria a la salud / Influences of sleep-wake disorders on cardiovascular health in primary health care

Objetivos: discutir os fatores prejudiciais ao sono e suas influências sobre a saúde cardiovascular na percepção de hipertensos atendidos por uma Unidade Básica de Saúde brasileira. Método: estudo descritivo, de abordagem qualitativa, realizado em um serviço de Atenção Básica Mineiro, Brasil. Foram coletados dados de caracterização e entrevista individual em profundidade, em 2019, com 40 hipertensos de idade ?18 anos. Os dados de caracterização foram analisados com apoio do Microsoft Excel-365 para frequências e as entrevistas no Nvivo Pró-11. Resultados: as participantes, predominantemente mulheres, idosas, aposentadas, relataram sono de má qualidade e uso de fármacos ansiolíticos/antidepressivos. Duas categorias discursivas emergiram: Sono e repouso preservados como determinantes da qualidade de vida e saúde; e Insônia: uma realidade cotidiana ligada aos condicionantes psicossociais, biológicos e ambientais. Considerações finais: a insônia gera impactos negativos na saúde cardiovascular e na qualidade de vida, necessitando de cuidados especializados no âmbito da enfermagem cardiovascular.

Objetivos: discutir los factores dañinos al sueño y sus influencias sobre la salud cardiovascular en la percepción de hipertensos atendidos por una Unidad Básica de Salud brasileña. Método: estudio descriptivo, de abordaje cualitativo, realizado en un servicio de Atención Básica Minero, Brasil. Se recogieron datos de caracterización y entrevista individual en profundidad, en 2019, con 40 hipertensos de edad ?18 años. Los datos de caracterización fueron analizados con el apoyo de Microsoft Excel-365 para frecuencias y las entrevistas en el Nvivo Pro-11. Resultados: las participantes, predominantemente mujeres, ancianas, jubiladas, relataron sueño de mala calidad y uso de fármacos ansiolíticos/antidepresivos. Dos categorías discursivas surgieron: Sueño y reposo preservados como determinantes de la calidad de vida y salud; e Insomnio: una realidad cotidiana ligada a los condicionantes psicosociales, biológicos y ambientales. Consideraciones finales: el insomnio genera impactos negativos en la salud cardiovascular y en la calidad de vida, necesitando de cuidados especializados en el ámbito de la enfermería cardiovascular.

Objective: to discuss the harmful factors to sleep and their influence on cardiovascular health in the perception of hypertensive patients assisted by a Brazilian Basic Health Unit. Method: a descriptive study with a qualitative approach, conducted in a primary care service in Minas Gerais, Brazil. Characterization data and in-depth individual interviews were collected in 2019, with 40 hypertensive patients aged ?18 years. The characterization data were analyzed with the support of Microsoft Excel-365 for frequencies and the interviews in Nvivo Pró-11. Results: the participants, predominantly women, elderly, retired, reported poor sleep quality and use of anxiolytic/antidepressant drugs. Two discursive categories emerged: Sleep and rest preserved as determinants of quality of life and health; and Insomnia: an everyday reality linked to psychosocial, biological and environmental conditions. Final considerations: insomnia generates negative impacts on cardiovascular health and quality of life, requiring specialized care in cardiovascular nursing.

Efectividad de intervención de Enfermería para disminuir la depresión de personas en el preoperatorio cardiovascular / Effectiveness of a Nursing Intervention to Reduce Depression in Individuals during the Preoperative Period of Cardiovascular Surgery

Introducción: Durante el preoperatorio cardiovascular, las personas presentan con frecuencia niveles altos de depresión, los que se asocian a resultados quirúrgicos poco favorables y, por ende, a la necesidad de una intervención de Enfermería para disminuir estos niveles. Objetivo: Evaluar la efectividad de una intervención de Enfermería para disminuir la depresión de personas en el preoperatorio cardiovascular. Métodos: Estudio preexperimental con pretest y protest, en una población de 88 personas en el Servicio de Cirugía Cardiovascular en el Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba, desde marzo de 2019 a junio de 2020. La depresión fue medida con el test de Inventario de Depresión Rasgo-Estado. Se realizó una intervención de Enfermería sustentada en el Modelo de Adaptación de Sor Callista Roy, el Proceso de Atención de Enfermería y las taxonomías NANDA, NOC, NIC, para disminuir la depresión de personas en el preoperatorio cardiovascular. Los resultados se confrontaron y expresaron en porcentajes, media y números absolutos. Se utilizó la prueba de Chi cuadrado y probabilidad exacta de Fisher. La asociación de variables se obtuvo con la prueba no paramétrica de Wilcoxon, con regla de disociación: si p≤ 0,05 se rechaza HO. Resultados: El sexo masculino constituyó el 57,92 por ciento de los casos y la edad media fue de 57 años. Luego de la intervención se redujo la depresión en un 27,27 por ciento (p= 0,000). Conclusiones: La implementación de una intervención de Enfermería para disminuir la depresión de personas en el preoperatorio cardiovascular, sustentada en el Modelo de Adaptación de Sor Callista Roy, el PAE y las Taxonomías NANDA, NOC, NIC mostró efectividad, ya que se logró modificar de forma positiva y significativa la depresión, en tanto, optimizó los resultados posoperatorios(AU)

Introduction: During the preoperative period of cardiovascular surgery, people frequently present high levels of depression, associated with little favorable surgical outcomes and, therefore, with the need for a nursing intervention to reduce such levels. Objective: To evaluate the effectiveness of a nursing intervention to reduce depression in preoperative cardiovascular patients. Methods: A preexperimental study with pretest and protest was carried out in a population of 88 people in the cardiovascular surgery service at Centro de Investigaciones Médico-Quirúrgicas, in Havana, Cuba, from March 2019 to June 2020. Depression was measured using the State/Trait Depression Inventory test. A nursing intervention was performed, based on the Adaptation Model of Sister Callista Roy, the Nursing Care Process, as well as the NANDA, NOC and NIC taxonomies, in order to reduce depression in preoperative cardiovascular patients. The results were compared and expressed as percentages, mean and absolute numbers. The chi-square and Fisher's exact probability tests were used. The association of variables was obtained with the nonparametric Wilcoxon test, with the dissociation rule if p ≤ 0.05, H O is rejected. Results: The male sex accounted for 57.92 percent of the cases and the mean age was 57-years. After the intervention, depression was reduced by 27.27 percent (p= 0.000). Conclusions: The implementation of a nursing intervention to reduce depression in preoperative cardiovascular patients, based on the Adaptation Model of Sister Callista Roy, the Nursing Care Process, as well as NANDA, NOC and NIC taxonomies, showed effectiveness, since it was possible to modify depression in a positive and significant way, while optimizing postoperative outcomes(AU)

Espiritualidade como recurso terapêutico no ambulatório de cardiologia / Spirituality as a therapeutic resource in the cardiology outpatient clinic / La espiritualidad como recurso terapéutico en el ambulatorio de cardiología

Objetivo: analisar o papel da dimensão espiritual como um recurso terapêutico na consulta de enfermagem em saúde mental no ambulatório de cardiologia. Método: abordagem qualitativa, a partir da narrativa de vida de seis pessoas em acompanhamento no ambulatório vinculado a uma universidade pública, entre março e dezembro de 2019. Adotou-se a Análise Existencial de Viktor Frankl, utilizando a entrevista não estruturada. Estudo aprovado pelo Comitê de Ética e Pesquisa. Resultados: os dados foram organizados em duas categorias: "Se Deus existe, por que fez isso comigo?", "Estratégias de Enfrentamento Espiritual". A dimensão espiritual é propiciadora de significado e sentido da vida. Desenvolve valores essenciais como a recuperação da esperança e do desejo de viver, manifestado em ações de autocuidado e adesão ao tratamento. Conclusão: a consulta em saúde mental e cardiologia propiciou um movimento de abertura para além das limitações impostas pelo adoecimento e condições de vida, levando ao engajamento num projeto repleto de sentido.

Objective: to examine the role of the spiritual dimension as a therapeutic resource in the mental health nursing interview of cardiology outpatients. Method: this qualitative study was based on life narratives collected, between March and December 2019, in unstructured interviews using Viktor Frankl's Existential Analysis, from six people monitored at an outpatient clinic linked to a public university. The study was approved by the research ethics committee. Results: the data were organized into two categories: "If God exists, why did he do this to me?" and "Spiritual Coping Strategies". The spiritual dimension fostered meaning and sense in life. It developed essential values, including restoring hope and the desire to live, which were manifest in self-care actions and adherence to treatment. Conclusion: the mental health and cardiology interview fostered an openness, beyond the limitations imposed by illness and life conditions, which led to engagement in a project full of meaning.

Objetivo: analizar el papel de la dimensión espiritual como recurso terapéutico en la consulta de enfermería de salud mental en el ambulatorio de cardiología. Método: enfoque cualitativo, a partir de la narrativa de vida de seis personas en seguimiento médico en el ambulatorio vinculado a una universidad pública entre marzo y diciembre de 2019. Se adoptó el Análisis Existencial de Viktor Frankl, utilizando la entrevista no estructurada. Estudio aprobado por el Comité de Ética en Investigación. Resultados: se organizaron los datos en dos categorías: "Si Dios existe, ¿por qué me ha hecho esto?", "Estrategias de enfrentamiento espiritual". La dimensión espiritual propicia significado y sentido a la vida. Desarrolla valores esenciales como la recuperación de la esperanza y las ganas de vivir, manifestados en acciones de autocuidado y adherencia al tratamiento. Conclusión: la consulta de salud mental y cardiología proporcionó un movimiento de apertura más allá de las limitaciones impuestas por la enfermedad y las condiciones de vida, lo que conllevó al comprometimiento a un proyecto lleno de sentido.

Consulta de enfermagem na perceção da pessoa com doença cardiovascular / Nursing consultation from the perspective of the person with cardiovascular disease / Consulta de enfermería en la percepción de la persona con enfermedad cardiovascular

Resumo Enquadramento: A consulta de enfermagem é uma ação que potencializa a mudança de comportamentos nas pessoas com doença cardiovascular a serem seguidas em ambulatório. Objetivo: Conhecer a perceção das pessoas com doença cardiovascular sobre a consulta de enfermagem em ambulatório. Metodologia: Estudo transversal, qualitativo, com aplicação de entrevista semiestruturada a pessoas com doença cardiovascular seguidas em ambulatório. As entrevistas foram gravadas e transcritas e aplicou-se a análise de conteúdo temático categorial. Resultados: Foram incluídas 20 pessoas no estudo. Três categorias emergiram de 160 unidades de registo: 1) Expectativas para a consulta de enfermagem; 2) Compreensão sobre a consulta de enfermagem; e 3) Experiência - consulta de enfermagem. Conclusão: Os usuários que não passaram pela consulta de enfermagem não conhecem o que é a consulta nem a reconhecem como parte do cuidado longitudinal. Entretanto, aqueles que já vivenciaram a experiência da consulta, reconhecem-na como um espaço de vínculo, de possibilidade de realizar mudanças efetivas de comportamentos relacionados com a saúde e de esclarecimento de dúvidas.

Abstract Background: The nursing consultation promotes behavioral changes in the outpatient follow-up of people with cardiovascular diseases. Objective: To know the perceptions of people with cardiovascular diseases about the outpatient nursing consultation. Methodology: A cross-sectional, qualitative study was carried out using semi-structured interviews with people with cardiovascular diseases in outpatient follow-up. The interviews were recorded and transcribed, and the thematic-categorical content analysis method was applied. Results: Twenty people were included in the study. Three categories emerged from 160 registration units: 1) Expectations about the nursing consultation; 2) Understanding of the nursing consultation; and 3) Nursing consultation experience. Conclusion: Patients who have not experienced a nursing consultation are not familiar with what the consultation is nor recognize it as part of longitudinal care. However, those who have already experienced the consultation recognize it as a space for bonding, making effective changes in health-related behaviors, and clearing doubts.

Resumen Marco contextual: La consulta de enfermería es una acción que potencia el cambio de conducta en las personas con enfermedades cardiovasculares a las que se hará un seguimiento en las consultas externas. Objetivo: Conocer la percepción de las personas con enfermedades cardiovasculares sobre la consulta externa de enfermería. Metodología: Estudio transversal, cualitativo, en el que se aplicó la entrevista semiestructurada a personas con enfermedad cardiovascular a las que se hizo un seguimiento en una consulta externa. Las entrevistas se grabaron y transcribieron, y se aplicó el análisis de contenido categórico temático. Resultados: Se incluyeron 20 personas en el estudio. De las 160 unidades de registro surgieron tres categorías: 1) Expectativas de la consulta de enfermería; 2) Comprensión sobre la consulta de enfermería, y 3) Experiencia - consulta de enfermería. Conclusión: Los usuarios que no han pasado por una consulta de enfermería no saben lo que es la consulta ni la reconocen como parte de la atención longitudinal. Sin embargo, quienes ya han pasado por la consulta la reconocen como un espacio de vinculación, de posibilidad de realizar cambios efectivos en las conductas relacionadas con la salud y de aclaración de dudas.

From new kid on the block to leading journal: a review and reflection on the first 20 years of the European Journal of Cardiovascular Nursing.

BACKGROUND: This year marks the 20th birthday of the European Journal of Cardiovascular Nursing (EJCN). The official journal of the Association of Cardiovascular Nursing and Allied Professionals, is now recognized as one of the leading nursing and allied professional journals. AIMS: This article reflects on the developments and impact of the journal over its 20-year lifespan. METHODS AND RESULTS: We present a descriptive account of the journal from inception (2002) until present day (2021), using data provided by the EJCN editorial office and extracted from published and available information. In the last 20 years, the EJCN has published 20 volumes, 106 issues, and 1320 papers from 79 countries. The volume and quality of papers has been consistently increasing, culminating in a 2020 impact factor of 3.908, the highest in its history, ranking second for nursing science. Papers are predominantly patient focused with a range of research methods that cover an extensive range of cardiovascular conditions. Authors who contributed to the first issue continued their contribution; 293 articles in total. CONCLUSION: The EJCN has evolved into a leading journal of cardiovascular care. As the journal enters its next era, with a new Editor-in-Chief, it is appropriate to have reflected on the phenomenal contribution of the outgoing Editor-in-Chief, and the editorial team, over the last 20 years.

Analysis of the concept of cardiovascular risk: contributions to nursing practice / Análisis del concepto de riesgo cardiovascular: contribuciones a la práctica de enfermería / Análise do conceito de risco cardiovascular: contribuições para a prática de enfermagem

ABSTRACT Objectives: to analyze the concept of cardiovascular risk to support nursing practice. Methods: this is an analysis to define the concept of cardiovascular risk, through the use of eight steps of Walker's and Avant's framework, using a literature review in indexed scientific journals. Results: cardiovascular risk is defined in a broad and original way as a context of health and nursing care that makes it possible to identify modifiable (cardiometabolic, behavioral, psychosocial, cultural and occupational) and non-modifiable (biological) risk factors for cardiovascular diseases that act as early and interrelated markers, of multiple and heterogeneous etiology, predisposing to cardiovascular vulnerability. Conclusions: with the analysis and definition of the concept of cardiovascular risk, we realized that it will be possible to base nursing practice, with implications in clinical practice for identifying and reducing risk factors for cardiovascular diseases, with nursing relevance in the care of these subjects.

RESUMEN Objetivos: analizar el concepto de riesgo cardiovascular para apoyar la práctica de enfermería. Métodos: se trata de un análisis para definir el concepto de riesgo cardiovascular, mediante el uso de los ocho pasos del marco Walker y Avant, utilizando una revisión bibliográfica en revistas científicas indexadas. Resultados: el riesgo cardiovascular se define de manera amplia y original como un contexto de salud y cuidado de enfermería que permite identificar factores de riesgo modificables (cardiometabólicos, conductuales, psicosociales, culturales y laborales) y no modificables (biológicos) de enfermedades cardiovasculares, que actúan como marcadores tempranos e interrelacionados, de etiología múltiple y heterogénea, que predisponen a la vulnerabilidad cardiovascular. Conclusiones: con el análisis y definición del concepto de riesgo cardiovascular, percibimos que será posible fundamentar la práctica de enfermería, con implicaciones en la práctica clínica para la identificación y reducción de los factores de riesgo de enfermedades cardiovasculares, con protagonismo de enfermería en el cuidado de estas asignaturas.

RESUMO Objetivos: analisar o conceito de risco cardiovascular para fundamentar a prática de enfermagem. Métodos: trata-se de uma análise para definição do conceito de risco cardiovascular, por meio da utilização de oito etapas do referencial de Walker e Avant, utilizando uma revisão da literatura em periódicos científicos indexados. Resultados: define-se o risco cardiovascular de forma ampla e original como contexto de saúde e de cuidado de enfermagem que permite identificar fatores de risco para doenças cardiovasculares modificáveis (cardiometabólicos, comportamentais, psicossociais, culturais e laborais) e não modificáveis (biológicos), que atuam como marcadores precoces e inter-relacionados, de etiologia múltipla e heterogênea, predispondo à vulnerabilidade cardiovascular. Conclusões: com a análise e definição do conceito de risco cardiovascular, percebemos que será possível fundamentar a prática de enfermagem, com implicações na prática clínica para identificação e redução dos fatores de risco para doenças cardiovasculares, com protagonismo da enfermagem no cuidado desses sujeitos.

ICNP® terminology subset for the care of people with heart failure / Subconjunto terminológico de la CIPE® para la atención de personas con insuficiencia cardíaca / Subconjunto terminológico da CIPE® para o cuidado à pessoa com insuficiência cardíaca

ABSTRACT Objective: to develop an ICNP® terminology subset for the care of people with heart failure. Methods: this is a methodological study, which used the theoretical framework of the Mid-Range Nursing Theory for Cardiovascular Rehabilitation, with the steps: Construction of nursing diagnoses/outcomes and interventions statements and Cross-mapping of statements constructed. Results: forty-two diagnosis/outcome statements and 179 nursing intervention statements were constructed, organized based on five theory concepts, with a higher prevalence of statements related to "Rehabilitative care", "Psychosocial support for patients and families" and "Supervised cardiovascular rehabilitation program". Final considerations: it was possible to build nursing diagnosis/outcome and intervention statements for developing a terminology subset for the care of people with heart failure, based on the chosen theory.

RESUMEN Objetivo: desarrollar un subconjunto terminológico de la CIPE® para la atención de enfermería a las personas con insuficiencia cardíaca. Métodos: estudio metodológico, que utilizó el marco teórico de la Teoría de Enfermería de Rango Medio para la Rehabilitación Cardiovascular, con los pasos: Construcción de enunciados de diagnósticos/resultados e intervenciones de enfermería y Mapeo cruzado de enunciados construido. Resultados: se construyeron 42 enunciados de diagnósticos/resultados y 179 enunciados de intervenciones de enfermería, organizados en base a cinco conceptos de la teoría, con mayor prevalencia de enunciados relacionados con "Atención rehabilitadora", "Apoyo psicosocial al paciente y la familia" y el "Programa de rehabilitación cardiovascular supervisado". Consideraciones finales: fue posible construir enunciados de diagnósticos/resultados e intervenciones de enfermería para el desarrollo de un subconjunto terminológico para el cuidado de personas con insuficiencia cardíaca, basado en la teoría elegida.

RESUMO Objetivo: elaborar um subconjunto terminológico da CIPE® para o cuidado de enfermagem à pessoa com insuficiência cardíaca para a atenção hospitalar. Métodos: estudo metodológico, que utilizou o referencial teórico da Teoria de Enfermagem de Médio Alcance para Reabilitação Cardiovascular, com as etapas: Construção dos enunciados de diagnósticos/resultados e intervenções de enfermagem e Mapeamento cruzado dos enunciados construídos. Resultados: foram construídos 42 enunciados de diagnósticos/resultados e 179 enunciados de intervenções de enfermagem, organizados com base em cinco conceitos da teoria, destacando-se com maior prevalência de enunciados relacionados ao "Cuidado reabilitador", ao "Apoio psicossocial ao paciente e a família" e ao "Programa de reabilitação cardiovascular supervisionado". Considerações finais: foi possível construir enunciados de diagnósticos/resultados e intervenções de enfermagem para a elaboração de subconjunto terminológico para o cuidado à pessoa com insuficiência cardíaca, com base na teoria eleita.