BACKGROUND: A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits. OBJECTIVE: The study aimed to explore the experiences of patients who participated in the NeCR program. METHODS: A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile, >35th percentile, and > 70% percentile) in the improvement of health-promoting behaviors. RESULTS: Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers. CONCLUSIONS: Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.
- MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc * rehabilitace MeSH
- lidé MeSH
- následná péče MeSH
- propuštění pacienta MeSH
- reprodukovatelnost výsledků MeSH
- role ošetřovatelky MeSH
- telemedicína * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits. OBJECTIVE: The study aimed to explore the experiences of patients who participated in the NeCR program. METHODS: A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile, >35th percentile, and > 70% percentile) in the improvement of health-promoting behaviors. RESULTS: Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers. CONCLUSIONS: Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.
- MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc * rehabilitace MeSH
- lidé MeSH
- následná péče MeSH
- propuštění pacienta MeSH
- reprodukovatelnost výsledků MeSH
- role ošetřovatelky MeSH
- telemedicína * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: The two most common symptoms associated with COVID-19 are dyspnea and fatigue. One possible cause of such symptoms may be inspiratory muscle weakness. OBJECTIVES: The purpose of this study was to examine inspiratory muscle performance (IMP) from intensive care unit discharge (ICUD) to hospital discharge (HD) in patients with COVID-19 hypothesizing that IMP would be markedly depressed at both ICUD and HD. METHODS: IMP was examined at ICUD and HD via the PrO2 device (PrO2 Health, Smithfield, RI) which provided the maximal inspiratory pressure (MIP), sustained MIP (SMIP), inspiratory duration (ID), and fatigue index test (FIT). Patient symptoms were assessed at ICUD, HD, and 1-month post-HD. RESULTS: 30 patients (19 men, 11 women) with COVID-19 were included. The mean±SD age, BMI, and length of ICU and hospital stay was 71±11 yrs, 27.9 ± 6.3 kg/m, 9 ± 6 days, and 26±16 days, respectively. The mean±SD MIP, SMIP, ID, and FIT of the entire cohort at ICUD vs HD were 36±21 vs 40±20 cm H2O, 231±157 vs 297±182 PTU, 8.8 ± 4.2 vs 9.5 ± 4.6 s, and 9.0 ± 9.4 vs 13.1 ± 12.3, respectively, with only SMIP and FIT significantly greater at HD (p=.006 and 0.03, respectively). SMIP at HD was significantly related to resting dyspnea at HD (r=-0.40; p=.02). The SMIP and FIT of men were found to increase significantly from ICUD to HD, but no measure of IMP in the women increased significantly from ICUD to HD. At least one COVID-19-related symptom was present 1 month after HD with the most persistent symptoms being fatigue, cough, and dyspnea in 47%, 40%, and 37% of the patients, respectively. CONCLUSIONS: A significant reduction in IMP exists in patients with COVID-19 at both ICUD and HD and no measure of IMP in women was observed to increase significantly from ICUD to HD. Impaired inspiratory muscle endurance rather than strength was associated with greater dyspnea at HD.
- MeSH
- COVID-19 * komplikace MeSH
- dechová cvičení škodlivé účinky MeSH
- dýchací svaly * fyziologie MeSH
- dyspnoe etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- svalová síla fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The response to cardiac resynchronization therapy (CRT) is suboptimal in one-third of patients. OBJECTIVES: The study aimed to evaluate the impact of sleep-disordered breathing (SDB) on the CRT-induced left ventricular (LV) reverse remodeling and response for CRT in patients with ischemic congestive heart failure (CHF). METHODS: A total of 37 patients aged 65.43 years (SD 6.05), seven of whom were females, were treated with CRT according to class I European Society of Cardiology recommendations. Clinical evaluation, polysomnography, and contrast echocardiography were performed twice during the six-month follow-up (6M-FU) to assess the effect of CRT. RESULTS: In 33 patients (89.1%), sleep-disordered breathing (SDB), predominantly central sleep apnea (70.3%) was observed. This include nine patients (24.3%) with an apnea-hypopnea index (AHI) of >30 events/hour. During the 6M-FU, 16 patients (47.1%) responded to CRT by reducing LV end-systolic volume index (LVESVi) by ≥15%. We stated a directly proportional linear relationship between AHI value and LV volume: LVESVi p = 0.004, and LV end-diastolic volume index p = 0.006. CONCLUSIONS: Pre-existing severe SDB can impair the LV volumetric response to CRT even in an optimally selected group with class I indications for resynchronization, which may have an impact on long-term prognosis.
- MeSH
- echokardiografie MeSH
- lidé MeSH
- prognóza MeSH
- remodelace komor MeSH
- srdeční resynchronizační terapie * MeSH
- srdeční selhání * komplikace terapie MeSH
- syndromy spánkové apnoe * terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Cardiac rehabilitation is an evidence-based intervention that aims to improve health outcomes in cardiovascular disease patients, but it is largely underutilized. One strategy for improving utilization is home-based cardiac rehabilitation (HBCR). Previous research has shown that HBCR programs are feasible and effective. However, there is a lack of evidence on safety issues in different cardiac populations. This systematic review aimed to provide an evidence-based overview of the safety of HBCR. OBJECTIVES: To examine the incidence and severity of adverse events of HBCR. METHODS: The following databases were searched: CINAHL, The Cochrane Library, Embase, MEDLINE, PubMed, Web of Science, Global Health, and Chinese BioMedical Literature Database for randomized controlled trials. The included trials were written in English and analyzed the incidence of adverse events (AEs) as a primary or secondary intervention outcome. RESULTS: Five studies showed AEs incidence, of which only one study reported severe AE associated with HBCR exercise. The incidence rate of severe AEs from the sample (n = 808) was estimated as 1 per 23,823 patient-hour of HBCR exercise. More than half patients included were stratified into a high-risk group. In the studies were found no deaths or hospitalizations related to HBCR exercise. CONCLUSION: The risk of AEs during HBCR seems very low. Our results concerning the safety of HBCR should induce cardiac patients to be more active in their environment and practice physical exercise regularly.
- MeSH
- cvičení MeSH
- kardiovaskulární nemoci * MeSH
- kardiovaskulární rehabilitace * metody MeSH
- lidé MeSH
- terapie cvičením metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: Targeted temperature management (TTM) in comatose survivors of out-of-hospital cardiac arrest has been associated with improved neurological outcomes. However, the optimal temperature target for TTM remains unclear. OBJECTIVES: To compare a TTM protocol targeted at 34-36 °C with a protocol targeted at 32-34 °C with reference to both clinical outcomes and acute complications. METHODS: We analyzed a prospective registry of consecutive out-of-hospital cardiac arrest survivors who underwent TTM. We compared patients on a TTM protocol targeted at 34-36 °C (n = 59) with a historical cohort of patients treated at 32-34 °C (n = 116) according to the following parameters: six-month survival, cerebral performance category (CPC) scores, and acute complications. RESULTS: Survival and favorable neurological outcomes (CPC ≤ 2) at six months were 56% and 49%, respectively, in the higher target temperature group vs. 66% and 61%, respectively, in the lower target temperature group (p = 0.18 and 0.13). Acute clinical complications occurred in 1.5% vs. 12% of patients treated at the higher vs. the lower temperature range (p = 0.02). CONCLUSIONS: Patients treated with TTM at 34-36 °C had similar mid-term survival and neurological outcomes as patients treated with TTM at 32-34 °C. However, patients treated within the higher temperature range had fewer acute complications.
- MeSH
- časové faktory MeSH
- kardiopulmonální resuscitace metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- prospektivní studie MeSH
- registrace * MeSH
- tělesná teplota fyziologie MeSH
- terapeutická hypotermie metody MeSH
- výsledek terapie MeSH
- zástava srdce mimo nemocnici patofyziologie terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Leptin modulates ventilation and circulating levels are higher in normal women than men. OBJECTIVES: The aim of this study was to compare exercise ventilation and gas exchange in men and women with heart failure (HF) and their relation to circulating leptin concentration. METHODS: Consecutive HF patients were studied by cardiopulmonary exercise testing and assay of circulating leptin concentration. RESULTS: Fifty-seven men and 20 women were similar with respect to age, BMI, NYHA class, left ventricular ejection fraction, and peak oxygen consumption (all p > 0.05). Leptin concentration was lower (10.3 ± 10 vs. 25.3 ± 16 ng/mL; p < 0.01) and peak exercise ventilatory efficiency (VE/VCO2) was higher (43 ± 10 vs. 36 ± 5; p < 0.01) in men. Leptin concentration was associated with peak exercise VE/VCO2 (b = -0.35; F = 5.6; p = 0.02). CONCLUSION: Men have significantly lower circulating leptin concentration and increased ventilatory drive during exercise than women with comparable HF. In men with HF, lower leptin concentration may account for an increased ventilatory drive.
- MeSH
- biologické markery krev MeSH
- cvičení fyziologie MeSH
- funkce levé komory srdeční fyziologie MeSH
- leptin krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- plicní ventilace fyziologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- sexuální faktory MeSH
- spotřeba kyslíku MeSH
- srdeční selhání krev patofyziologie MeSH
- zátěžový test metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
