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1.
Rio de Janeiro; s.n; 20190000. 72 p. ilus, tab.
Tese em Português | LILACS, BDENF - Enfermagem | ID: biblio-1026652

RESUMO

Introdução: As doenças cardiovasculares são uma das principais causas de mortalidade no mundo. A forma aguda desta situação é denominada Síndrome Coronariana Aguda (SCA) que pode ser classificada como: angina instável e infarto agudo do miocárdio. Após o diagnóstico médico definido como SCA, o paciente necessita de internação em uma Unidade Coronariana. Neste ambiente é oferecida uma assistência guiada por protocolos clínicos e diretrizes de forma a contribuir na sua recuperação, minimizar o risco de complicações e prevenir os danos. Entre os protocolos que envolvem esse cuidado destaca-se o banho, que pode ser classificado como no leito ou de aspersão. Para a tomada de decisão do do enfermeiro quanto a indicação ao banho do paciente coronariopata são necessárias informações clinicas, e da hemodinâmica atual do paciente. Pontua-se como problema "A ausência de sistematização para tomada de decisão quanto a escolha banho do paciente coronariopata em uma Unidade Coronariana". Objetivo: Elaborar um algoritmo no formato de aplicativo móvel para auxiliar a tomada de decisão do enfermeiro quanto ao banho do paciente coronariopata em uma Unidade Coronariana. Método: Trata-se de estudo exploratório, metodológico e abordagem quantitativa para a elaboração de um algoritmo no formato de aplicativo móvel. O estudo foi realizado em duas etapas: 1ªetapa: elaborou-se um intrumento a partir de uma revisão de literatura abordando as temáticas reabilitação cardíaca e banho. Este instrumento foi submetido a validação de seus critérios por enfermeiros. A abordagem dos dados, foi realizada por estatística descritriva como cálculo do Coeficiente de Alfa de Cronbach. 2ªetapa: Elaboração do algoritmo baseado nos achados do instrumento aplicado, em formato de aplicativo móvel para auxiliar na tomada de decisão quanto ao banho do paciente coronariopata na UTI. Resultados: Avaliaram o instrumento um total de 29 enfermeiros, em um período de 03 meses. Dentre estes 26 (89%) eram do sexo feminino, com idade na faixa de 23 à 58 anos e todos os enfermeiros possuíam algum tipo de pós-graduação em seu currículo. Foram 22 critérios submetidos à validação por 29 especialistas, totalizando 638 avaliações. Dentre estes, 63% (401) foi classificada como Concordância. O valor encontrado para o coeficiente α foi de aproximadamente 0,9536. Foram 19 itens validados, através do coeficiente α, e 19 itens sugeridos e utilizados pelos especialistas. Após categorização, foram selecionados 19 itens, organizados em formato de algoritmo, com respostas dicotômicas (sim ou não) o que sugere a cada final de fluxo o tipo do banho (não banho, banho no leito ou banho de aspersão) indicado ao paciente, devido suas condições clínicas. Conclusão: O aplicativo móvel, produto desta pesquisa, foi elaborado por um colaborador que o utilizou a interface de desenvolvimento Android Studio® com a linguagem Java® a partir do algoritmo estruturado baseado nos achados do julgamento prévio dos especialistas para auxiliar na tomada de decisão quanto ao banho do paciente em uma Unidade Coronariana, para sua disponibilização para download, sugere-se a validação através de um estudo piloto, para garantir a segurança ao paciente


Introduction: Cardiovascular diseases are one of the leading causes of mortality in the world. The acute form of this condition is called Acute Coronary Syndrome (ACS), which can be classified as unstable angina and acute myocardial infarction. After the medical diagnosis defined as SCA, the patient needs hospitalization in a Coronary Unit. In this environment, it is offered assistance guided by clinical protocols and guidelines in order to contribute to its recovery, to minimize the risk of complications and to prevent damages. Among the protocols that involve this care is the bath, which can be classified as bedding or spraying. The clinician's clinical information and the patient's current hemodynamics are necessary for the decision-making of the nurse regarding the indication to the coronary patient's bath. The problem "The absence of systematization for decision making regarding the choice of bath of the coronariopata patient in a Coronary Unit" is a problem. Objective: To elaborate an algorithm in the format of a mobile application to aid the decision making of the nurse regarding the bath of the coronariopata patient in a Coronary Unit. Method: This is an exploratory, methodological and quantitative approach to the elaboration of an algorithm in the mobile application format. The study was carried out in two stages: 1st stage: an instrument was elaborated from a literature review addressing the themes of cardiac and bath rehabilitation. This instrument was submitted to validation of its criteria by nurses. The data approach was carried out by a statistic described as the calculation of Cronbach's Alpha Coefficient. 2nd stage: Elaboration of the algorithm based on the findings of the applied instrument, in a mobile application format to aid in decision making regarding the coronary patient's ICU bath. Results: A total of 29 nurses were evaluated in a period of 03 months. Of these, 26 (89%) were female, ranging in age from 23 to 58 years old and all nurses had some type of postgraduate degree in their curriculum. There were 22 criteria submitted to validation by 29 specialists, totaling 638 evaluations. Of these, 63% (401) was classified as Concordance. The value found for the coefficient α was approximately 0.9536. There were 19 items validated through the α coefficient and 19 items suggested and used by the specialists. After categorization, we selected 19 items, organized in an algorithm format, with dichotomic responses (yes or no), which suggests to each end of the flow the type of bath (not bath, bath in the bed or bath of sprinkling) due to its clinical conditions. Conclusion: The mobile application, the product of this research, was developed by a developer who used the Android Studio® development interface with the Java® language from a structured algorithm based on the findings of the expert's prior judgment to assist in decision making to the patient's bath in a Coronary Unit, for its availability for download, validation is suggested through a pilot study, to guarantee patient safety


Assuntos
Humanos , Banhos/métodos , Doença das Coronárias/enfermagem , Enfermagem de Cuidados Críticos , Aplicativos Móveis
2.
Rev Med Liege ; 73(5-6): 229-236, 2018 May.
Artigo em Francês | MEDLINE | ID: mdl-29926560

RESUMO

To cope with overcrowding, a consequence of their constant growth, emergency departments have implemented operational strategies based on triage systems. Despite its interest, nurse triage has been limited by several hindrances, and new strategies are emerging. Among those, advanced nurse triage, allowing a nurse to initiate the diagnostic process just after categorization of the patient, seems to be promising. A study on advanced nurse triage for patients presenting with chest pain has been conducted in the emergency department of the CHU of Liège. The encouraging results obtained following this new system demonstrate a reduction of the delay to management of patients, and a reduction of the total length of stay in the emergency unit mainly during overcrowding periods. Advanced nurse triage, in addition to a conventional triage during overcrowding periods, improves management of patients in terms of time and reduces the total time spent in the emergency department.


Assuntos
Prática Avançada de Enfermagem/métodos , Dor no Peito/diagnóstico , Triagem , Adulto , Idoso , Dor no Peito/enfermagem , Doença das Coronárias/diagnóstico , Doença das Coronárias/enfermagem , Doença das Coronárias/terapia , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Triagem/métodos , Recursos Humanos
3.
Int J Nurs Stud ; 84: 28-39, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29730084

RESUMO

BACKGROUND: Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. OBJECTIVES: This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. DESIGN: A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. DATA SOURCES: Twenty-three English and seven Chinese electronic databases were searched to identify the trials. REVIEW METHODS: The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. RESULTS: 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of SF-36. Furthermore, from single-study results, the intervention was favorable in improving the patients' weight management and alcohol consumption. However, it did not show significant effects on improving the patient's dietary habits, certain cardiac physiological parameters, mortality and self-efficacy. Currently, no addition long-term benefit of the intervention on secondary cardiac prevention was identified. CONCLUSION: This review has systematically analyzed the effects of nurse-led patient-centered care on patients' behavioral risks, cardiac physiological parameters, mortality, health-related quality of life and self-efficacy. Given limited quantity of existing evidence regarding certain outcomes and long-term follow-up period; cross-trial heterogeneity of the interventions, measurement methods and statistical results; high or unclear risk of bias in some quality dimensions, the effectiveness of the intervention on secondary cardiac prevention remains inconclusive and subject to additional trials and evidences.


Assuntos
Terapia Comportamental , Doença das Coronárias/enfermagem , Doença das Coronárias/prevenção & controle , Relações Enfermeiro-Paciente , Assistência Centrada no Paciente , Prevenção Secundária , Doença das Coronárias/psicologia , Humanos , Qualidade de Vida , Fatores de Risco
4.
Res Theory Nurs Pract ; 32(1): 46-62, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29490777

RESUMO

BACKGROUND AND PURPOSE: The purpose of this study was to assess the relationships between an individual's characteristics and experiences (age, gender, level of education, income, and employment), knowledge of coronary heart disease (CHD) risk factors, perception of health status, awareness of CHD, and health promotion behaviors among adult Omanis. METHODS: Using Pender's health promotion model, a cross-sectional and correlational survey design was employed. A self-administered questionnaire was distributed to 180 participants in Muscat, the capital of Oman. Descriptive and multivariate linear regression analyses were employed. RESULTS: Increasing age was associated with high levels of awareness about CHD. Participants who were employed and knowledgeable about CHD risk factors were more likely to have lower perceptions of health. The regression model showed that knowledge of CHD risk factors and awareness of CHD had positive associations with health promotion behaviors. Meanwhile, employed participants had lower health promotion behaviors scores. IMPLICATIONS FOR PRACTICE: Interventions to increase health promotion behaviors should include application of behavioral change strategies that are suitable for age and employment status. The strategies must focus on providing information to enhance knowledge and awareness about CHD.


Assuntos
Doença das Coronárias/epidemiologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Doença das Coronárias/etiologia , Doença das Coronárias/enfermagem , Doença das Coronárias/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omã/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Asian Nurs Res (Korean Soc Nurs Sci) ; 11(3): 187-193, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28991599

RESUMO

PURPOSE: Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk. METHODS: A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n = 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL). RESULTS: A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = -2.49, p = .015), cholesterol (t = -2.44, p = .017), body mass index (t = -2.58, p = .011), and depression (t = -2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported. CONCLUSION: A 6-month community-based intervention in a CHD high-risk population improved disease-related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Doença das Coronárias/enfermagem , Relações Enfermeiro-Paciente , Educação de Pacientes como Assunto/organização & administração , Idoso , China/epidemiologia , Doença das Coronárias/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
6.
J Clin Nurs ; 26(21-22): 3636-3645, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28102921

RESUMO

AIMS AND OBJECTIVES: To explore changes in illness perception and health-related quality of life in patients with coronary heart disease following percutaneous coronary intervention from the time when patients were discharged from hospital and five months later and to investigate association between illness perception and physical and mental health-related quality of life at five-month follow-up. BACKGROUND: Illness perception is known to influence patients' motivation to engage in preventive behaviour. DESIGN: Prospective and comparative with two measurement points: at discharge from hospital (time 1) and five months later (time 2). METHODS: Two self-administered questionnaires were used as follows: the Illness Perception Questionnaire-Revised measured illness perception and the Short Form Health Survey (SF-36) measured physical and mental health-related quality of life. The sample consisted of patients with coronary heart disease admitted to University Hospital between November 2011-April 2012. RESULTS: A total of 69 questionnaires were returned for both measurement times. Most responders were male (71%), mean age was 68·9 (SD 10·3) years. Health-related quality of life increased over time, and illness perception changed; five months after discharge, participants were more aware that the disease was chronic and could worsen suddenly, and they perceived that the disease had less of a consequence on their lives compared to when they were staying in the hospital. Associations between increased personal control, changeability of the disease, perceptions of less of a consequence of the disease on daily life and increased health-related quality of life were demonstrated at time 2. CONCLUSION: Perceptions of personal control, changeability and consequences of the disease should be assessed and discussed with cardiac patients, as these illness perceptions are related to physical and mental health-related quality of life. RELEVANCE TO CLINICAL PRACTICE: Increased understanding of consequences of the disease, personal control and perceived changeability of the illness affects health-related quality of life; these are factors that nurses in clinical practice can influence and thereby improve patients' outcomes.


Assuntos
Doença das Coronárias/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Qualidade de Vida , Idoso , Doença das Coronárias/enfermagem , Doença das Coronárias/terapia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Percepção , Intervenção Coronária Percutânea , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Tempo
7.
Crit Care Nurse ; 36(5): 37-46, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27694356

RESUMO

HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk factors for atherosclerosis compounded by the pathophysiological effects of HIV infection and antiretroviral therapy markedly increase the risk for cardiovascular disease. Further, persons living with HIV are also at high risk for cardiomyopathy. Critical care nurses must recognize the risk factors for cardiovascular disease and the pathophysiology and complex treatment options in order to manage care of these patients and facilitate multidisciplinary collaboration. Two case studies are used to highlight the treatment options and nursing considerations associated with cardiovascular disease among persons living with HIV.


Assuntos
Antirretrovirais/administração & dosagem , Fibrilação Atrial/tratamento farmacológico , Doença das Coronárias/tratamento farmacológico , Enfermagem de Cuidados Críticos/métodos , Gerenciamento Clínico , Infecções por HIV/tratamento farmacológico , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/enfermagem , Fármacos Cardiovasculares/administração & dosagem , Doença das Coronárias/complicações , Doença das Coronárias/diagnóstico , Doença das Coronárias/enfermagem , Quimioterapia Combinada , Seguimentos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/enfermagem , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
8.
Rev. pesqui. cuid. fundam. (Online) ; 8(2): 4460-4471, abr.-jun. 2016. tab
Artigo em Inglês, Português | BDENF - Enfermagem | ID: bde-27730

RESUMO

Objective: assess coronary risk in hospitalized patients the likelihood of developing an acute myocardial infarction over the next decade and discuss the nursing care based on scientific evidence. Method: this is a descriptive cross-sectional study. The sample consisted of 42 hospitalized patients. Data were collected between May and June 2013. This study was approved by the Research Ethics Committee of the University of Bahia (protocol 266.907). Results: it was checked that 42.5% of hospitalized present a high risk of developing myocardial infarction within the next 10 years. Conclusion: The data reveal that there are hospitalized patients in coronary risk becoming clear that the risk was higher with increasing age.(AU)


Objetivo: avaliar o risco coronariano em pacientes hospitalizados a probabilidade de desenvolver um infarto agudo do miocárdio nos próximos dez anos e discutir o cuidado de enfermagem com base nas evidências científicas. Método: trata-se de um estudo descritivo de corte transversal. A amostra foi constituída por 42 pacientes hospitalizados. Os dados foram coletados no período de maio a junho de 2013. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade do Estado da Bahia (protocolo 266.907). Resultados: foi verificado que 42,5% dos hospitalizados apresentam um alto risco para desenvolver infarto agudo do miocárdio nos próximos 10 anos. Conclusão: Os dados revelam que existem pacientes hospitalizados em risco coronariano, ficando evidente que o risco apresentou-se maior com o avanço da idade.(AU)


Objetivo: evaluar el riesgo coronario en pacientes hospitalizados desarrollar infarto agudo de miocardio en los próximos diez años y discutir los cuidados de enfermería basada en la evidencia científica. Método: se trata de un estudio descriptivo de corte transversal. La muestra consistió en 42 pacientes hospitalizados. Los datos fueron recogidos entre mayo y junio de 2013. Este estudio fue aprobado por el Comité de Ética en Investigación de la Universidad de Bahía (protocolo 266 907). Resultados: se encontro que el 42,5% de los hospitalizados presentan un alto riesgo de desarrollar infarto de miocardio en los próximos 10 años. Conclusión: Los datos muestran que no son hospitalizados los pacientes en riesgo coronario es bastante evidente que el riesgo fue mayor con la edad avanzada.(AU)


Assuntos
Humanos , Doença das Coronárias/enfermagem , Fatores de Risco , Pacientes Internados , Brasil
9.
Rev. pesqui. cuid. fundam. (Online) ; 8(2): 4460-4471, abr.-jul.2016. tab
Artigo em Inglês, Português | LILACS | ID: lil-784554

RESUMO

assess coronary risk in hospitalized patients the likelihood of developing an acute myocardial infarction over the next decade and discuss the nursing care based on scientific evidence. Method: this is a descriptive cross-sectional study. The sample consisted of 42 hospitalized patients. Data were collected between May and June 2013. This study was approved by the Research Ethics Committee of the University of Bahia (protocol 266.907). Results: it was checked that 42.5% of hospitalized present a high risk of developing myocardial infarction within the next 10 years. Conclusion: The data reveal that there are hospitalized patients in coronary risk becoming clear that the risk was higher with increasing age...


avaliar o risco coronariano em pacientes hospitalizados a probabilidade de desenvolver um infarto agudo do miocárdio nos próximos dez anos e discutir o cuidado de enfermagem com base nas evidências científicas. Método: trata-se de um estudo descritivo de corte transversal. A amostra foi constituída por 42 pacientes hospitalizados. Os dados foram coletados no período de maio a junho de 2013. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade do Estado da Bahia (protocolo 266.907). Resultados: foi verificado que 42,5% dos hospitalizados apresentam um alto risco para desenvolver infarto agudo do miocárdio nos próximos 10 anos. Conclusão: Os dados revelam que existem pacientes hospitalizados em risco coronariano, ficando evidente que o risco apresentou-se maior com o avanço da idade...


evaluar el riesgo coronario en pacientes hospitalizados desarrollar infarto agudo de miocardio en los próximos diez años y discutir los cuidados de enfermería basada en la evidencia científica. Método: se trata de un estudio descriptivo de corte transversal. La muestra consistió en 42 pacientes hospitalizados. Los datos fueron recogidos entre mayo y junio de 2013. Este estudio fue aprobado por el Comité de Ética en Investigación de la Universidad de Bahía (protocolo 266 907). Resultados: se encontro que el 42,5% de los hospitalizados presentan un alto riesgo de desarrollar infarto de miocardio en los próximos 10 años. Conclusión: Los datos muestran que no son hospitalizados los pacientes en riesgo coronario es bastante evidente que el riesgo fue mayor con la edad avanzada...


Assuntos
Humanos , Doença das Coronárias/enfermagem , Pacientes Internados , Fatores de Risco , Brasil
10.
Heart ; 102(1): 50-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26567234

RESUMO

Current guidelines on secondary prevention of cardiovascular disease recommend nurse-coordinated care (NCC) as an effective intervention. However, NCC programmes differ widely and the efficacy of NCC components has not been studied. To investigate the efficacy of NCC and its components in secondary prevention of coronary heart disease by means of a systematic review and meta-analysis of randomised controlled trials. 18 randomised trials (11 195 patients in total) using 15 components of NCC met the predefined inclusion criteria. These components were placed into three main intervention strategies: (1) risk factor management (13 studies); (2) multidisciplinary consultation (11 studies) and (3) shared decision making (10 studies). Six trials combined NCC components from all three strategies. In total, 30 outcomes were observed. We summarised observed outcomes in four outcome categories: (1) risk factor levels (16 studies); (2) clinical events (7 studies); (3) patient-perceived health (7 studies) and (4) guideline adherence (3 studies). Compared with usual care, NCC lowered systolic blood pressure (weighted mean difference (WMD) 2.96 mm Hg; 95% CI 1.53 to 4.40 mm Hg) and low-density lipoprotein cholesterol (WMD 0.23 mmol/L; 95% CI 0.10 to 0.36 mmol/L). NCC also improved smoking cessation rates by 25% (risk ratio 1.25; 95% CI 1.08 to 1.43). NCC demonstrated to have an effect on a small number of outcomes. NCC that incorporated blood pressure monitoring, cholesterol control and smoking cessation has an impact on the improvement of secondary prevention. Additionally, NCC is a heterogeneous concept. A shared definition of NCC may facilitate better comparisons of NCC content and outcomes.


Assuntos
Doença das Coronárias/enfermagem , Papel do Profissional de Enfermagem , Prevenção Secundária/métodos , Doença das Coronárias/diagnóstico , Fidelidade a Diretrizes , Humanos , Estilo de Vida , Equipe de Assistência ao Paciente , Guias de Prática Clínica como Assunto , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Prevenção Secundária/normas , Resultado do Tratamento
11.
Rev. mex. enferm. cardiol ; 23(3): 103-109, sept-dic. 2015.
Artigo em Espanhol | BDENF - Enfermagem | ID: bde-29401

RESUMO

Antecedentes: las enfermedades cardiovasculares constituyen la primera causa de morbimortalidad a nivel mundial y nacional; sobresale la enfermedad coronaria. Esto ha contribuido para que el tratamiento quirúrgico de revascularización miocárdica sea considerado como un procedimiento de rutina. Éste es uno de los avances más importantes de la medicina durante el siglo XX. En Bogotá, los registros estadísticos muestran que más del 50% del total de cirugías cardiovasculares corresponde a ella. Objetivo: realizar la caracterización de pacientes que se encuentran en posoperatorio temprano de revascularización miocárdica, quienes presentan cambios fisiológicos en su esfera biológica, secundarios al procedimiento, a nivel neurológico, cardiovascular, respiratorio, gastrointestinal, de eliminación y de la piel. Metodología: se realizó un estudio descriptivo, de seguimiento prospectivo. Se observaron y revisaron las historias clínicas de 151 pacientes en posoperatorio de 48 a 96 horas. La revisión de la historia clínica se realizó por el investigador. Se consignó la información en una hoja de registro de información y se procesó mediante métodos de análisis exploratorio multidimensional: análisis factorial de correspondencias múltiples combinado con el Método Cluster de Clasificación. Resultados: estuvieron relacionados con clases de pacientes de acuerdo con los eventos clínicos presentes en cada uno de los sistemas estudiados donde se evidencia que presentan alteración de los sistemas neurológico, cardiovascular, respiratorio y de la piel. Conclusión: la caracterización de los pacientes en posoperatorio de una revascularización miocárdica permite que el cuidado de enfermería sea enfocado hacia la solución de problemas de los sistemas antes mencionados.(AU)


Background: cardiovascular diseases are the leading cause of morbidity and mortality at global and national level; stands out coronary disease. This has contributed to make the surgical treatment of coronary artery bypass grafting being considered a routine procedure. This is one of the most important advances in medicine during the twentieth century. In Bogota, statistical records show that more than 50% of all cardiovascular surgeries corresponds to it. Objective: to characterize patients who are in early postoperative myocardial revascularization, who present physiological changes secondary to procedure, in the biological area at neurological, cardiovascular, respiratory, and gastrointestinal level, elimination system and skin. Methodology: a descriptive study was performed and followed prospectively. The medical records of 151 patients in postoperative 48 to 96 hours were seen and reviewed. The review of the medical history was performed by the researcher. The information was collected on a recording sheet and then recorded and processed by methods of multidimensional exploratory analysis: Multiple correspondence analysis combined with Cluster Classification Method. Results: they were related to the kind of patient according to clinical events present in each of the studied systems where there is evidence of alteration of the neurological, cardiovascular and respiratory systems, and skin. Conclusion: the characterization of patients in postoperative of myocardial revascularization allows nursing care to be focused on solving problems of the aforementioned systems.(AU)


Assuntos
Humanos , Revascularização Miocárdica/efeitos adversos , Revascularização Miocárdica/educação , Revascularização Miocárdica/mortalidade , Revascularização Miocárdica/métodos , Revascularização Miocárdica/enfermagem , Revascularização Miocárdica/reabilitação , Revascularização Miocárdica/estatística & dados numéricos , Doença das Coronárias/complicações , Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Doença das Coronárias/história , Doença das Coronárias/mortalidade , Doença das Coronárias/enfermagem , Doença das Coronárias/patologia , Doença das Coronárias/fisiopatologia , Doença das Coronárias/reabilitação , Doença das Coronárias/cirurgia
13.
Br J Community Nurs ; 20(1): 42, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25559029

RESUMO

Aysha Mendes discusses coronary heart disease, the UK's biggest killer, and describes the range of roles that nurses play in prevention, treatment and support.


Assuntos
Comunicação , Doença das Coronárias/enfermagem , Papel do Profissional de Enfermagem , Qualidade de Vida , Autocuidado , Doença das Coronárias/epidemiologia , Humanos , Reino Unido/epidemiologia
14.
J Clin Nurs ; 24(1-2): 235-43, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25255813

RESUMO

AIMS AND OBJECTIVES: The aim of this study was to evaluate nurses' perceptions of an education programme and screening and referral tool designed for cardiac nurses to facilitate depression screening and referral procedures for patients with coronary heart disease. BACKGROUND: There is a high prevalence of depression in patients with coronary heart disease that is often undetected. It is important therefore that nurses working with cardiac patients are equipped with the knowledge and skills to recognise the signs and symptoms of depression and refer appropriately. DESIGN: A qualitative approach with purposive sampling and semi-structural interviews was implemented within the Donabedian 'Structure-Process-Outcome' evaluation framework. METHODS: Semi-structured interviews were conducted with 14 cardiac nurses working in a major metropolitan hospital six weeks post-attending an education programme on depression and coronary heart disease. Thematic data analysis was implemented, specifically adhering to Halcomb and Davidson's (2006) pragmatic data analysis, to examine nurse knowledge and experience of depression assessment and referral in an acute cardiac ward. RESULTS: The key findings of this study were that the education programme: (1) increased the knowledge base of nurses working with cardiac patients on comorbid depression and coronary heart disease, and (2) assisted in the identification of depression and the referral of 'at risk' patients. CONCLUSIONS: Emphasis was placed on the translational significance of educating cardiac nurses about depression via the introduction of a depression screening and referral instrument designed specifically for use in the cardiac ward. As a result, participants found they were better equipped to identify depressive symptoms and, guided by the screening instrument, to confidently instigate referral procedures. RELEVANCE TO CLINICAL PRACTICE: Much complexity lies in caring for cardiac patients with depression, including issues such as misdiagnosis. Targeted education, including use of appropriate instruments, has the potential to facilitate early recognition of the signs and symptoms of depression in the acute cardiac setting.


Assuntos
Enfermagem Cardiovascular/educação , Doença das Coronárias/psicologia , Transtorno Depressivo/diagnóstico , Adulto , Atitude do Pessoal de Saúde , Comunicação , Doença das Coronárias/enfermagem , Transtorno Depressivo/etiologia , Transtorno Depressivo/enfermagem , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Encaminhamento e Consulta
15.
J Adv Nurs ; 71(4): 895-908, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25400127

RESUMO

AIMS: To test an educational programme with telephone follow-up to improve self-care in Brazilian patients who underwent percutaneous coronary intervention. BACKGROUND: Percutaneous coronary intervention has been established as a treatment for coronary disease. However, additional intervention is needed to improve self-care for individuals who undergo this procedure to reduce further disease. Telephone follow-up is one strategy that has been used to improve chronic disease self-care. DESIGN: Randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01341093. METHODS: Sixty patients who were preparing for their first percutaneous coronary intervention between 2011-2012 were randomly allocated to an educational programme with telephone follow-up (N = 30) or a control group (N = 30). Perceived health status was assessed with the Medical Outcomes Study 36-Item Short Form. Self-efficacy, symptoms of anxiety and depression and medication adherence were also assessed. Measures were collected before intervention (baseline) and 6 months later. RESULTS: Both groups improved from baseline to 6 months in the 'Physical Component Summary' and in the domains of 'Physical Functioning', 'Role-Emotional' and 'Role-Physical'. The educational programme group showed a reduction in anxiety from baseline to 6-month follow-up, while the control group showed a slight increase. No differences in symptoms in depression and self-efficacy were found and both groups reported high levels of medication adherence. CONCLUSION: The educational programme with telephone follow-up is a promising intervention as it led to reduction in anxiety for those receiving the educational programme. Further improvements in timing and focus of the educational programme, such as targeting emotional and social lifestyle changes, might be warranted.


Assuntos
Doença das Coronárias/enfermagem , Educação de Pacientes como Assunto , Intervenção Coronária Percutânea/enfermagem , Autocuidado/métodos , Adulto , Idoso , Brasil , Doença Crônica , Doença das Coronárias/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Telefone
16.
BMC Cardiovasc Disord ; 14: 138, 2014 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-25280578

RESUMO

BACKGROUND: Most people referred to rapid access chest pain clinics have non-cardiac chest pain, and in those diagnosed with stable coronary heart disease, guidance recommends that first-line treatment is usually medication rather than revascularisation. Consequently, many patients are not reassured they have the correct diagnosis or treatment. A previous trial reported that, in people with non-cardiac chest pain, a brief discussion with a health psychologist before the tests about the meaning of potential results led to people being significantly more reassured. The aim of this pilot was to test study procedures and inform sample size for a future multi-centre trial and to gain initial estimates of effectiveness of the discussion intervention. METHODS: This was a two-arm pilot randomised controlled trial in outpatient rapid access chest pain clinic in 120 people undergoing investigation for new onset, non-urgent chest pain. Eligible participants were randomised to receive either: a discussion about the meaning and implication of test results, delivered by a nurse before tests in clinic, plus a pre-test pamphlet covering the same information (Discussion arm) or the pre-test pamphlet alone (Pamphlet arm). Main outcome measures were recruitment rate and feasibility for a future multi-centre trial, with an estimate of reassurance in the groups at month 1 and 6 using a 5-item patient-reported scale. RESULTS: Two hundred and seventy people attended rapid access chest pain clinic during recruitment and 120/270 participants (44%) were randomised, 60 to each arm. There was no evidence of a difference between the Discussion and Pamphlet arms in the mean reassurance score at month 1 (34.2 vs 33.7) or at month 6 (35.3 vs 35.9). Patient-reported chest pain and use of heart medications were also similar between the two arms. CONCLUSIONS: A larger trial of the discussion intervention in the UK would not be warranted. Patients reported high levels of reassurance which were similar in patients receiving the discussion with a nurse and in those receiving a pamphlet alone. TRIAL REGISTRATION: Current Controlled Trials ISRCTN60618114 (assigned 27.05.2011).


Assuntos
Angina Pectoris/diagnóstico , Doença das Coronárias/diagnóstico , Conhecimentos, Atitudes e Prática em Saúde , Ambulatório Hospitalar , Educação de Pacientes como Assunto , Satisfação do Paciente , Pacientes/psicologia , Adulto , Idoso , Angina Pectoris/etiologia , Angina Pectoris/enfermagem , Angina Pectoris/psicologia , Comunicação , Doença das Coronárias/complicações , Doença das Coronárias/enfermagem , Doença das Coronárias/psicologia , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Folhetos , Projetos Piloto , Valor Preditivo dos Testes , Prognóstico , Fatores de Tempo
17.
Nurs Health Sci ; 16(4): 476-82, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25040805

RESUMO

The purpose of this study was to develop a comprehensive cardiac rehabilitation program that considered patients' learning needs and cultural context, and to identify the impact of this program on patients with coronary heart disease in Korea. We employed a quasi-experimental design to evaluate the effects of the developed program in 61 patients with coronary heart disease. The experimental group received education, counseling, educational materials, and telephone follow-ups by cardiac nurses for six months. Results showed that participants of the program exhibited reduced body mass index and waist circumference as well as improved left ventricular diastolic function and cardiac disease-related quality of life. There was no significant difference between the groups with the rate of recurring symptoms or cardiac events. This comprehensive cardiac rehabilitation program safely and effectively improved body composition, cardiac function, and quality of life in patients with coronary heart disease.


Assuntos
Doença das Coronárias/reabilitação , Adulto , Idoso , Índice de Massa Corporal , Doença das Coronárias/enfermagem , Aconselhamento , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Qualidade de Vida , República da Coreia , Resultado do Tratamento
18.
J Adv Nurs ; 70(12): 2932-41, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24684662

RESUMO

AIM: To develop and examine the effectiveness of a home-based self-help psychoeducation programme on health-related quality of life, stress level, anxiety and depression symptoms, self-efficacy, cardiac risk factors and health service use of outpatients with coronary heart disease. BACKGROUND: Hospital-based cardiac rehabilitation programmes have been shown to improve, effectively, the quality of life of patients with coronary heart disease. However, a majority of these patients do not participate in these programmes, while those who do enrol in these programmes fail to complete the programmes. DESIGN: Randomized controlled trial with repeated measures. METHODS: This study was approved and received the grant in July 2013. A convenience sample of 128 coronary heart disease outpatients will be recruited from a tertiary hospital in Singapore. Participants are randomly assigned to the 4-week experimental group and will participate in the programme or the control group who will not participate in the programme. The outcome measures include the: 12-item Short Form Health Survey, Perceived Stress Scale, Hospital Anxiety and Depression Scale and General Self-Efficacy Scale. Data will be collected at baseline, then 4 and 16 weeks from baseline. At the end, a process evaluation will be conducted to assess the acceptability, strengths and weaknesses of our programme based on the participants' perspectives. DISCUSSION: Our programme offers coronary heart disease patients an additional option to the existing cardiac rehabilitative services in Singapore hospitals. It aims to help them manage their disease effectively by reducing cardiac risk factors and improve their health-related quality of life and psychological well-being.


Assuntos
Doença das Coronárias/enfermagem , Doença das Coronárias/psicologia , Pacientes Ambulatoriais/educação , Pacientes Ambulatoriais/psicologia , Educação de Pacientes como Assunto , Qualidade de Vida , Autocuidado/psicologia , Feminino , Assistência Domiciliar/educação , Humanos , Masculino , Modelos Educacionais , Singapura , Resultado do Tratamento
19.
J Cardiopulm Rehabil Prev ; 34(6): 396-405, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24667664

RESUMO

PURPOSE: To investigate the effectiveness of an intensive nursing care electronic followup system for cardiovascular risk management after percutaneous coronary intervention (PCI). METHODS: In total, 840 subjects who underwent PCI in a single hospital in Beijing between January 2010 and January 2012 were enrolled. All subjects were randomized into the control and intensive nursing care groups (n = 420 each group). Both groups received standard secondary prevention according to guidelines. The control group received regular followup while the intensive nursing care group was closely monitored and followed by specific nursing staff with the electronic followup system. RESULTS: In total, 807 subjects were followed up for 1 year. Compared with subjects in the control group, those in the intensive group had decreased levels of total cholesterol (3.99 ± 1.08 vs 3.76 ± 0.98; P < .05), systolic blood pressure (142.41 ± 11.53 vs 135.71 ± 14.57 mm Hg; P < .05), low-density lipoprotein cholesterol (LDL-C) (2.72 ± 1.01 vs 2.42 ± 0.81; P < .05), and body mass index (25.13 ± 5.12 vs 24.23 ± 6.22; P < .05); a higher percentage with target LDL-C < 2.6 mmol/L (66.99% vs 47.88%; P < .05); increased use of medication including aspirin (96.51% vs 99.26%; P < .05), clopidogrel (87.53% vs 98.77%; P < .05), statins (52.62% vs 93.10%; P < .05), ß-blockers (48.63% vs 61.33%; P < .05), and angiotensin-converting enzyme inhibitors (32.92% vs 61.82%; P < .05); and better dietary control and physical exercise (55.66% vs 26.18%, P < .05; 62.56% vs 38.65%, P < .05). CONCLUSIONS: Intensive nursing care by the electronic followup system may lead to an improvement in quality of secondary prevention after PCI, including risk factor control, the use of medication, and self-management abilities.


Assuntos
Doença das Coronárias/enfermagem , Doença das Coronárias/cirurgia , Enfermagem de Cuidados Críticos/métodos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Intervenção Coronária Percutânea/métodos , Prevenção Secundária/métodos , Idoso , Pressão Sanguínea , Índice de Massa Corporal , China , LDL-Colesterol , Doença das Coronárias/reabilitação , Técnica Delfos , Exercício , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Gestão de Riscos/métodos , Autocuidado/métodos
20.
Eur J Cardiovasc Nurs ; 13(1): 48-54, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23382534

RESUMO

AIM: This study aimed to explore and identify the relationship between health-related quality of life (HRQoL) and perceived social support among Chinese patients with coronary heart disease (CHD) in mainland China. METHODS: A descriptive correlational study was conducted with a convenience sample of 200 Chinese patients with CHD recruited from the cardiac outpatient departments of two university-affiliated hospitals in Xi'an, China. The Chinese Mandarin versions of the Short-form 36-item health survey (CM:SF-36) and the Medical Outcomes Study Social Support Survey (CM:MOS-SSS) were administered to assess HRQoL and perceived social support. RESULTS: The results indicated that Chinese patients with CHD reported a poorer HRQoL and lower social support compared with their Western and Hong Kong counterparts. Multiple regression analyses identified four significant predictors of deteriorated physical health (increasing age, co-morbidity with heart failure or hypertension, and smoking status) and two significant predictors of poor mental health (co-morbidity with heart failure and perceived social support). CONCLUSIONS: Health status and social support in Chinese people with CHD should be routinely assessed and, where feasible, addressed through appropriate individually tailored interventions.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Doença das Coronárias/etnologia , Doença das Coronárias/psicologia , Qualidade de Vida/psicologia , Apoio Social , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Enfermagem Cardiovascular , China/epidemiologia , Comorbidade , Doença das Coronárias/enfermagem , Inquéritos Epidemiológicos , Humanos , Hipercolesterolemia/etnologia , Hipercolesterolemia/enfermagem , Hipercolesterolemia/psicologia , Hipertensão/etnologia , Hipertensão/enfermagem , Hipertensão/psicologia , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Análise de Regressão , Fumar/etnologia , Fumar/psicologia , Inquéritos e Questionários
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