Kathleen Dracup

..Exercise training improves exercise capacity in patients with heart failure (HF) but the long-term effects on clinical outcomes remain unknown...

..To compare delay and circumstances of decisions to seek care in patients with acute myocardial infarction (AMI) in the United States (US), England, Australia, South Korea, and Japan...

..Researchers need to develop expertise in the use of biomarkers and secure appropriate funding for their use. Missing links may be missing no longer...

..Therefore, we conducted a clinical randomized trial to test whether an intervention tailored specifically for patients with ACS and delivered one-on-one would reduce prehospital delay time...

..Patients are being followed for 2 years from the time of enrollment. The purpose of this article is to describe the intervention and its theoretical framework, and to outline the design of this randomized controlled trial...

..We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease...

..This approach may be potentially beneficial in delivering educational and behavioral support to this high-risk group in ways that are affordable and accessible...

..This study sought to identify characteristics that distinguish men from women with both conditions...

..These findings suggest the need for multiple risk factor intervention strategies that improve physical and emotional health to decrease fatigue. Patients with depression warrant particular scrutiny...

....

..The time interval from symptom onset to hospital arrival can guide the decision to start reperfusion for patients with acute myocardial infarction (AMI)...

..03) accounted for lower C-QLI scores (R2=0.33, P=.03). Compared with physical functioning, emotional functioning and younger age have a stronger relationship to QOL in men with HF...

..39-10.25), but not severity of chest pain. As opposed to men, severe chest pain may not be a cue for women to interpret their symptom as cardiac in origin. Education and counseling must take sex differences into account to be effective...

..In conclusion, cultural variation within this Japanese group was observed and was associated with prehospital delay time...

..This study sought to describe depressive symptoms, types of performed care tasks, social support, and the impact of caregiving among family caregivers of patients with PAH...

..Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work...

..Younger spouses are particularly at risk for decreased emotional well-being and may require special intervention...

..Given the association between physical activity and overall QOL and relevant health indicators, measures to enhance physical activity need to be developed and tested; these strategies may be beneficial in improving overall outcomes...

..This exploratory study was done to describe levels of hope, mood states and QOL; examine relationships between these variables and demographic characteristics; and identify predictors of QOL in female heart transplant recipients...

..It is known that sex and ethnicity influence rehospitalization rates. Several measures easily and conveniently obtained before discharge are arterial oxygen saturation (SaO2) and distance walked during the 6-minute walk test (6MWT)...

..63 +/- 0.94 vs 1.07 +/- 0.95, p <0.05). In conclusion, the findings demonstrate the beneficial effects of a low-level, home-based walking program on weight loss in overweight and obese patients with advanced HF...

....

..Heart transplant recipients and candidates equally need special attention and follow-up because they both seem to have emotional and psychologic repercussions...

..Our findings suggest the need for aggressive screening and risk factor interventions to promote smoking cessation before and after HTX in this unique population of female HTX recipients...

..We sought to identify which ACS symptoms are related-symptom clusters-and to determine if sample characteristics, response times, and outcomes differ among symptom cluster groups...

..Their sense of meaning and life purpose is relatively high and is positively informed by several motivating factors that serve as coping resources throughout the recovery process...

..We therefore examined the relationship between obesity, HRQOL, and depression in 358 patients with HF...

....

..Scale scores were significantly correlated but without evidence of multicolinearity. Initial tests of reliability and validity support further testing of this new instrument...

..The authors found that elderly persons with limited computer skills can and will use Web resources to obtain information when given adequate instructions on how to access the Web pages...

..We investigated the relationship between the S-TOFHLA total score at the recommended 7-minute limit and with no time limit (NTL)...

..Little is known regarding the effects of index angiograms on health-related quality of life related to angiographic outcome, that is, positive or negative for coronary heart disease (CHD)...

..Moreover, Japanese physicians should be aware that admitting patients directly to the hospital and bypassing the Emergency Department might increase delay to treatment...

..The aims of the study were to compare the kind and amount of care provided by partners of HF patients and partners of healthy individuals and to examine the associations between gender and the performance of caregiving tasks...

..The results of this study suggest that they may be a valid indicator of exercise adherence in heart failure patients who participate in a home-based walking program...

..Assumptions about older age being related to noncompliance appear invalid in patients with HF...

..To identify gender differences in delay time and the reasons why African Americans delay in seeking medical care for symptoms of acute myocardial infarction (AMI)...

..Our findings suggest the need to focus on supporting caregivers and providing them with the strategies they need to support their loved ones with HF...

..Education and counseling of patients and their families should be a major strategy in optimizing patients' outcomes and decreasing the time to definitive treatment...

..Ultimately, BNP testing may improve the accuracy of the diagnosis of HF and guide best treatment practices...

....

..Communication with heart failure (HF) patients about their condition and wishes for end-of-life care is recommended in all HF guidelines...

..In addition, social support and positive aspects of caregiving have received little attention...

..05). CONCLUSIONS: Effective education and counseling of patients after an AMI must be coupled with their view of what factors put them at risk for future AMIs...

..Evaluation for support services is needed to prevent rehospitalization, especially in women and nonwhites...

..The current study was conducted to: 1) examine the prevalence of pain in cohort of patients with chronic HF (New York Heart Association class I-IV); and 2) determine the relationship between pain and QOL...

..An earlier return to work might be promoted by interventions focused on reducing psychological job demand, increasing perceived job control, and treating depressive symptoms...

..CONCLUSIONS: More studies are needed to determine extent of biologic variability. The further use of BNP as a potential discharge marker is promising but awaits additional randomized study that reflects use in a broad-based population...

....

..Interventions designed to increase perceived control may be an important aspect of HF care, but require testing in randomized trials...

..The purpose of the study was to examine the association between working hours, job strain, and duration of prehospital delay in seeking care by employed patients with acute coronary syndrome (ACS) in the United States and Japan...

..Finally, we question whether the DNP will create confusion among colleagues and consumers. We recommend that the adoption of the DNP only occur after thoughtful discussion both within and outside the profession...

..The benefits and challenges of each format to doctoral students and faculty are discussed. The discussion reflects changing trends in the nursing profession as an academic discipline...

....

....

..However, the attributes of vital exhaustion following coronary artery bypass (CABG) surgery are poorly understood...

....

..This partnership is an innovative solution to the current nursing crisis...

....

..The findings of the current study require replication but may be used to identify patients with heart failure who are potentially at risk for reduced HRQOL...

..Recommendations to ensure continuing development of advanced nursing practice that serves the interests and needs of the public now and in the future are presented within the context of a national workforce perspective...

..CONCLUSIONS: Collaborative structures (eg, weaning boards, flow sheets) are useful in decreasing duration of mechanical ventilation for patients receiving long-term ventilation...

..Issues for refinement of acute and critical care nursing practice and research priorities are identified to create a synergy between these philosophical perspectives...

..However, factors influencing noncompliance to exercise have not been evaluated. We assessed clinical factors, functional status, and emotional predictors of noncompliance to a 12-week home walking exercise program...

....

....

..Finally, we offer suggestions for clinical practice and future research...

..Even though various cultures were represented in this study, culture itself did not account for variations in anxiety after AMI. It appears that anxiety after AMI is a universal phenomenon...

....

..This condition has outcomes worse than many cancers; however, patients are often denied the benefits of palliative care with its important emphasis on symptom management, spirituality, and emotional health and focus on family issues...

..Thus, we sought to evaluate the effects of a 12-week home walking exercise program on functional status and symptoms in patients with heart failure...

..We developed a tool to identify self-assessment of skills for advanced HF assessment and management and knowledge of HF care...

..Prehospital delay in response to acute myocardial infarction (AMI) symptoms is well documented in the US and Europe, but little is known about it in Asian countries where cardiovascular disease is increasing...

..Such information will assist clinicians to tailor health care service delivery and ensure the delivery of appropriate, quality care. This manuscript provides the background, rationale and methods for this study...

..The purpose of this paper is to describe strategies used to administer an international multicenter trial to assess the effectiveness of a nursing educational intervention...

..Therefore, we conducted a study of patients and spouses to compare their levels of depression and health-related quality of life (HRQOL), and to identify factors that contribute to depression and HRQOL in patient-spouse pairs...

..There were no group differences in exercise performance, physical functioning, mental functioning or general health perceptions...

....

..Clinicians who counsel patients with heart disease often focus on enhancing coping skills to reduce negative emotions...

..Women were likely to adhere to smoking, medication, and stress modification guidelines but unlikely to adhere to modification guidelines for diet and exercise...

..08 versus 3.10 h), but there are important gender differences in the reasons patients delay and in their patterns of decision-making that may assist clinicians trying to tailor interventions...

....

..The results of the study suggest a need for nurses to be equipped on both an intellectual and a practical level about the concept of palliative care in nonmalignant disease...

..Consequently, home use of an automated external defibrillator (AED) might offer an opportunity to improve survival for patients at risk...