摘要:

The purpose of this study was to determine the significance and patient profiles of nonadherence with immunosuppressive therapy in the etiology of late acute rejections (LARs), more than 1 year after heart transplantation. Nonadherence was assessed in 101 heart transplant recipients (14 females, 87 males) with a median age of 56 (Q1 = 50; Q3 = 61) and a median posttransplant status of 3 (range, 1-6) years, using electronic event monitoring and self-report. The influence of depression, perceived self-efficacy, knowledge, perceived health, symptom frequency and distress, perceived social support, and adherence with outpatient appointments on medication nonadherence was examined. Ten LARs occurring in six patients were observed. Nine of the rejections, emerging in five patients, appeared to be caused by medication nonadherence. Nonadherence with immunosuppressive therapy is a major risk factor in the etiology of LAR. Patient profiles allow the identification of patients at risk.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

During the last three decades, community education programs have been initiated with the purpose of teaching community citizens cardiopulmonary resuscitation (CPR). Millions of people have learned the technique. However, the frequency of bystander initiated CPR prior to emergency medicine service (EMS) arrival is still very low. This can lead one to ask if CPR training is optimal. Perhaps motivational aspects and psychological inhibitors to starting CPR should be included in CPR training. So far, CPR training has been skills oriented and has assumed that a bystander competent in CPR will intervene when required. However, this does not seem to be the case, as there are indications in recent research, for example, that the will to help and the courage to intervene are also needed. Bystanders who intervene in a cardiac arrest event improve the victim's chance of survival. However, there is little knowledge regarding the rescuers' reactions concerning their performance and whether they will overcome the trauma of the event and be prepared to do it again.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The aim of this article is to provide an overview of the available scientific evidence to support decisions to withhold cardiopulmonary resuscitation in hospitals. The decision to perform resuscitation or not is a complex one that requires consideration of a number of factors, including patient preference and patient clinical status. The three fundamental questions that must be answered in making an informed decision about whether to attempt resuscitation are discussed and the evidence used to answer them is presented.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This article provides an overview of the key concepts and methodological issues in the measurement of health-related quality of life in patients with coronary heart disease. It then outlines the approach adopted in a British study to develop and test a new disease-specific health-related quality of life instrument for use with individuals with myocardial infarction.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was (1) to determine the coping strategies employed by spouses of patients with AMI in the early phase of the crisis, (2) to define the role of age, gender, health perception, time since infarction, spouses' fears, and negative life events in the choice of coping strategies applied, and (3) to test the effect of coping strategies on physical and psychological strain. Fifty-seven spouses participated in the study, 47 were female and 10 were male. Data were collected by structured questionnaires, which were distributed to the spouses from 2 weeks-4 months after the patient's AMI. The researchers found that age, negative life event during the last 12 months, time since infarction, and the spouse's fears influenced the choice of strategies. In the early stage of the crisis, positive reappraisal seems to be a strategy that increased physical strain. Spouses' need for social support in the early stage of the crisis is a factor for health care providers to bear in mind. Besides giving information, empathy, and understanding, health care personnel can try to assist spouses in their efforts to reappraise their situation.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to examine whether cognitive dysfunction was associated with poor participation in an outpatient treatment program for patients with chronic heart failure and if it was related to specific patient characteristics. Cognitive function was measured with the Mini Mental State Examination (MMSE). Twenty-three of 78 (29%) patients randomized to structured care did not participate in this program and nonparticipation during 6-month follow-up was associated with an MMSE score below the median and a low calculated creatinine clearance (CrCl) (R2= 0.15,p= 0.0025) at entry. In the entire group long duration of heart failure and low blood hemoglobin concentration were independently associated with an MMSE score below the median at entry (R2= 0.14,p< 0.0001). Among elderly patients hospitalized with moderate-severe chronic heart failure, judged to be eligible for a nurse-directed outpatient program after discharge, a low MMSE score predicted nonparticipation in such a program. Cognitive dysfunction, which was related to the duration of heart failure, should be evaluated in the treatment of patients with chronic heart failure.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The growing burden of heart failure (HF) challenges health practitioners to implement and evaluate models of care to facilitate optimal health related outcomes. Australia supports a publicly funded universal health insurance system with a strong emphasis on primary care provided by general practitioners. The burden of chronic HF, and a social and political framework favoring community-based, noninstitutionalized care, represents an ideal environment in which home-based HF programs can be implemented successfully. Cardiovascular nurses are well positioned to champion and mentor implementation of evidence-based, patient-centered programs in Australian communities. This paper describes the facilitators and barriers to implementation of best practice models in the Australian context. These include the challenge of providing care in a diverse, multicultural society and the need for clinical governance structures to ensure equal access to the most effective models of care.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This article describes the efforts of a recent initiative of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. The Undertaking Nursing Interventions Throughout Europe (UNITE) Research Group represents a truly international team of nurses who collaborate on a number of research studies. The major focus of the group is to provide better care to patients in whom modern day treatment has proven to be ineffectual such as patients with chronic, intractable angina.

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0889-4655    

出版商:OVID    

年代:2001

数据来源: OVID