Short research report : a comparison of emotional intelligence levels between students in experiential and didactic college programs

Short Research Report: A Comparison of Emotional Intelligence Levels between Students in Experiential and Didactic College Programspeer-reviewe

Sexual Wellness and Rare Disease Considerations: A Behavioral Case Conceptualization and Approach to Counseling Treatment

Sexual wellness is infrequently addressed with individuals with a rare disease. Counselors must be competent in working with sexual wellness issues, especially those related to medical conditions, since clients may not share those concerns with healthcare providers. This article presents a case scenario involving a client living with a rare disease called Hereditary Angioedema, the symptoms of which present challenges to her intimate and sexual relationship with her partner due to unpredictable and painful swelling. A behavioral theoretical lens is used to conceptualize the case scenario and inform treatment. Implications for counselor competency, interdisciplinary collaboration, and client empowerment toward advocacy are discussed

Exercise and heart rate recovery

Purpose: This study examines whether heart rate recovery (HRR) improves as a result of exercise training during cardiac rehabilitation (CR).Methods: A retrospective study was performed that included 100 patients who completed phase II CR and had entry and exit exercise stress tests. HRR was compared for the sample. Improvements in HRR were compared between gender and age groups. Correlation between age and HRR was performed. Results: The total sample improved HRR (P = .020). There was no significant difference in the improvement of HRR based on gender, indicating males and females improve at similar rates (P = .833). Similarly, there was no significant difference in the improvement of HRR based on age, indicating older subjects improve similarly to younger subjects (P = .700). There was no relationship between age and HRR; therefore, as age increases there is no decrease in HRR.Conclusion: HRR improves in patients who complete CR

Nurses’ knowledge of heart failure self-management

Heart failure (HF) is increasing in prevalence. Patient education is essential and is included in both ambulatory and hospital performance measures used to ensure quality care. Nurses are often the primary providers of education to patients with HF. This study assessed nurses’ knowledge of basic principles of HF self-management. The study surveyed 49 nurses who regularly provided care to patients with HF at a hospital in the southeastern United States. A 20-item, true/false survey was administered to participants. Mean HF self-management knowledge score was 15.97 (79.85% correct). Consistent with previous studies, nurses scored lowest on knowledge related to transient dizziness (16.3% answered correctly), daily weight monitoring (36.2% answered correctly), and asymptomatic hypotension (58.3% answered correctly). Findings confirm previous work suggesting that nurses may not be adequately prepared to educate patients with HF about self-management

The Million Hearts initiative: How nurse practitioners can help lead [Editorial]

Every 39 seconds a person in the United States dies from a heart attack or stroke (Roger et al., 2012). Those who survive frequently have residual symptoms or disabilities and poor quality of life. Furthermore, these conditions are expensive for our nation, accounting for nearly $444 billion in healthcare expenditures and lost productivity in 2010 (Heidenriech et al., 2011). Heart attacks and strokes, two of the top four killers of Americans, are largely preventable, regardless of family history. Million Hearts™, launched in September 2011 by the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Centers for Disease Control and Prevention (CDC), aims to prevent 1 million heart attacks and strokes in the United States over the next 5 years. The campaign is focusing entirely on prevention in order to produce, on average, a 10% reduction in the rate of acute cardiovascular (CV) events a year for the next 5 years

Hypertension guidelines: Evidence-based treatments for maintaining blood pressure control

Approximately one in three adults in the United States has hypertension. This article provides an update on the latest JNC-8 guideline for treating hypertension in adults. Emphasis is placed on new and updated information and implications for primary care clinicians to help patients achieve and maintain better blood pressure control

Cardiovascular issues in older adults

Patients who are 65 years and older make up nearly half of intensive care unit (ICU) admissions and approximately 60% of the ICU hospital days in the United States.1 Cardiovascular (CV) conditions are commonly the first or second diagnosis on admission to the ICU. Furthermore, even if an elderly patient is not admitted for a CV condition, the physiologic stress of any acute illness challenges the heart, often producing structural or functional compromise. For example, acute ischemia or dysrhythmias may be the primary condition or a consequence of an initial physiologic insult

Delays in thrombolytic therapy for acute myocardial infarction: Association with mode of transportation to the hospital, age, sex, and race

BACKGROUND: Although increased myocardial salvage and reduced mortality are associated with timely thrombolytic therapy for acute myocardial infarction, some patients still experience delays in treatment. OBJECTIVES: To examine treatment times in patients with acute myocardial infarction treated with thrombolytic therapy and to determine whether delays in treatment are associated with mode of transportation to the hospital, age, sex, or race. METHODS: Medical records of 176 patients with acute myocardial infarction treated with thrombolytic therapy at a community hospital were reviewed and analyzed retrospectively. RESULTS: Median times for the interval between arrival at the hospital and acquisition of a diagnostic electrocardiogram (door-to-electrocardiography time) and the interval between arrival and start of thrombolytic therapy (door-to-drug time) were 6 minutes and 34 minutes, respectively. However, 76.1% of the patients met the recommendation of the American College of Cardiology/American Heart Association of door-to-electrocardiography time of 10 minutes, and 47.2% met the recommendation of door-to-drug time of 30 minutes or less. Door-to-drug times did not differ significantly according to race or mode of transportation to the hospital. Door-to-electrocardiography and electrocardiography-to-drug times were significantly longer for older patients than for younger patients (P = .005 and P < .001, respectively), and electrocardiography-to-drug times were significantly longer for females than for males (P = .01). CONCLUSIONS: With increased emphasis on recognition and rapid treatment of patients with acute myocardial infarction at highest risk for delays in treatment, that is, women and the elderly, benefits of thrombolytic therapy might be maximized

Determining time of onset in patients with acute coronary syndromes: Agreement between medical record and interview data

Background: Prehospital delay, the time of symptom onset until the time of hospital arrival, for patients with symptoms of acute coronary syndrome (ACS) is frequently used to determine the course of care. Total ischemic time (time for symptom onset until the time of first coronary artery balloon inflation) is another criterion for quality of care for patients experiencing ST-segment elevation myocardial infarction. However, obtaining the exact time of symptom onset, the starting point of both time intervals, is challenging. Currently 2 methods are used to obtain the time of symptom onset: abstraction of data from the medical record and structured interviews done after the acute event. It is not clear whether these methods are equally accurate.Purpose: Using identified search terms, PubMed and the Cumulative Index to Nursing and Allied Health Literature were searched for articles published from 1990 to 2014 to identify studies that examined agreement between the 2 data sources to determine prehospital delay in patients with ACS.Conclusions: Five studies examined the accuracy and/or agreement of prehospital delay by medical record review and structured patient interviews. In these studies, the percentage of missing/incomplete data in the medical record was higher compared with interviews (14%-40% vs 12%-13%). Three of the 4 studies that compared the 2 data sources reported more than 50% disagreement, with the time of symptom onset starting sooner when obtained by interview compared with the time recorded in their medical record at hospital presentation.Clinical Implications: There is a need for a consistent, reliable method to assess the time of symptom onset in patients with ACS. To ensure the accuracy of data collected for the medical record, training of emergency and critical care clinicians should (1) emphasize the importance of assessing symptoms broadly, (2) provide tips on interviewing techniques to help patients pinpoint the time of symptom onset, and (3) instill the value of complete documentation

A Qualitative Study of Symptom Experiences of Women With Acute Coronary Syndrome

Background: Most studies show that women with symptoms of acute coronary syndrome (ACS) delay seeking care longer than men do. Contributing factors include women being more likely to experience diverse symptoms, to experience symptoms that do not match preexisting symptom expectations, to interpret symptoms as noncardiac, and to minimize symptoms until they become incapacitating.Objective: The aim of the study is to identify factors influencing women’s ability to recognize and accurately interpret symptoms of suspected ACS.Methods: This qualitative study used in-depth interviews with 18 women diagnosed with ACS to determine how they recognized, interpreted, and acted on symptoms. An interview guide developed from the author’s initial research was used to provide structure for the process.Results: All of the women went through a process of recognizing and interpreting their symptoms. Eight women had symptoms arise abruptly. Most of these women recognized a change immediately, “knew” to go for treatment, and did so quickly. Three women had vague symptoms that started slowly, converting unexpectedly to intense symptoms prompting them to seek care urgently. The remaining 7 women had evolving symptoms, were more likely to interpret symptoms as unrelated to their heart, and avoided disclosing symptoms to others. Despite recognizing that the situation may be serious, women with evolving symptoms adopted a wait-and-see approach.Conclusion: Women with less severe, intermittent, or evolving symptoms are at increased risk for delayed presentation, diagnosis, and treatment for ACS. These women should be targeted for educational and behavioral interventions