Correlates of health-related quality of life in patients with myocardial infarction: A literature review

© 2017 Elsevier Ltd Background By the increasing emphasis on health-related quality of life (HRQoL) in patients with myocardial infarction (MI), it is necessary to explore factors that affect HRQoL in this population. Objectives This study aimed to identify correlates of HRQoL in patients with MI. Design A literature review of the factors that affect HRQoL in patients with MI (1995–2016). Data sources Three main databases—CINAHL, MEDLINE and PsychINFO—were searched to retrieve relevant peer-reviewed articles published in English. Review methods In consultation with a medical librarian, we identified relevant MeSH terms and used them for searching the literature: health-related quality of life/quality of life/HRQoL/QoL, myocardial infarction/heart attack/MI and predict*/factor. Data elements were extracted and narratively described variables synthesised into four categories. Results A total of 48 studies met the inclusion criteria and were included in the review. Correlates of HRQoL in patients with MI were identified in the following categories: demographic, behavioural, disease-related, and psychosocial factors. Specific correlates included age and gender-identity for demographic factors; physical activity and smoking for behavioural factors; severity of MI, symptoms, and comorbidities for disease-related factors; anxiety and depression for psychosocial factors. Conclusions Identifying correlates of HRQoL can help identify patients who are at risk for poor HRQoL in the recovery or rehabilitation stage of post-MI. Future intervention should focus on adjustable correlates such as behavioural and psychosocial factors to promote HRQoL among patients after experiencing MI

Predictors of health-related quality of life in korean patients with myocardial infarction: a longitudinal observational study

© 2018 Elsevier Inc. Background: Experience of myocardial infarction (MI) negatively affects different aspects of health-related quality of life (HRQoL). Objectives: This study aimed to examine trends in HRQoL of MI patients and to identify demographic, clinical and psychosocial predictors of HRQoL at three months. Methods: A total of 150 patients in South Korea were completed the study questionnaires at baseline. After three months from discharge, 136 participants completed follow-up questionnaires, including the Korean version of the MacNew Quality of Life after Myocardial Infarction Questionnaire (MacNew). Results: HRQoL significantly improved over three months. Younger age, ST-elevation MI, and higher LVEF, lower level of depression, better understanding of the illness and higher perceived social support at baseline were associated with better HRQoL at three months. Conclusion: Providing adequate information about the illness and social support as well as reducing negative psychological experiences in early days after MI may improve HRQoL of MI patients

Predicting Return to Work Following Myocardial Infarction: A Prospective Longitudinal Cohort Study.

This study aimed to determine the proportion of patients who returned to work within three months post-myocardial infarction and the factors that predicted return to work. A total of 136 participants with myocardial infarction completed the study questionnaires at baseline and three months post-discharge between August 2015 and February 2016. At the three-month follow-up, 87.5% (n = 49) of the participants who were working pre-infarction had resumed work. Age, gender, education, smoking, readmission after discharge, number of comorbidities, diabetes, social support, anxiety, and depression were significantly associated with returning to work at three months post-discharge. Age, gender, smoking, anxiety, and depression significantly predicted those patients with myocardial infarction that returned to work, using binary logistic regression. The majority of patients in work who experience myocardial infarction have the capacity to achieve a work resumption by three months post-discharge. Interventions that facilitate returning to work should focus on modifiable risk factors, such as improving these patients' mental health, comorbid conditions, risk of readmission, smoking, and social support. Healthcare providers should work in partnership with patients' family members, friends, and employers in developing and implementing interventions to address these modifiable factors to facilitate patients' return to work

Development and optimization of a new suspension system for lower limb prosthesis

The increasing rate of lower limb amputations reinforces the need to develop a new suspension system that provides a better quality of life for the lower limb amputees. This study aimed to present a novel suspension system that improves amputee’s satisfaction in terms of donning and doffing process of the prosthetic lower limb. The design of the proposed suspension system was developed following the design methodology, to establish the amputee’s needs, objectives, functions, requirements and specifications in order to op-timize the final solution. The final solution is a combination of a guiding and fixation mechanisms that improve the donning and doffing process by driv-ing the serrated pin to the fixation system. The proposed suspension system is a good alternative to improve the quality of life of amputees with lower activity level on the daily basis.(undefined

Nutritional care of elderly patients in acute care settings: A qualitative study

© 2016 Japan Geriatrics Society. Aim: Poor nutritional status is common in older adult patients. The present study aimed to explore barriers and facilitators to nutritional care of elderly patients in acute care settings. Methods: Data were collected through individual face-to-face interviews with 12 registered nurses, and analyzed using interpretive description methodology. Results: Two core themes emerged from the analysis of data: (i) neglected care, with three subthemes of "support but also independence," "unsupportive environment" and "responsibility of the family;" and (ii) a humanitarian ethic, with two subthemes of "respect and dignity" and "humanitarian care." Conclusions: As an integral part of holistic care, elderly patient nutrition should be emphasised in health professional education, and promoted through managerial support, multidisciplinary collaborations, and implementation of appropriate monitoring and evaluation systems

Factors Associated with Return to Work Following Myocardial Infarction: A Systematic Review of Observational Studies.

OBJECTIVES:To identify and critically synthesise literature on return to work of patients following a myocardial infarction, and to identify factors that are associated with this. BACKGROUND:Understanding when patients return to work after myocardial infarction and what factors are associated with this may be helpful in designing person-centred treatment plans to facilitate patients' rehabilitation and return to work. DESIGN:A narrative systematic review. REVIEW METHODS:Six databases, MEDLINE, CINAHL, Academic Search Complete, EMBASE, SCOPUS, and ProQuest Health and Medicine, and the search engine Google were searched to retrieve peer-reviewed articles published in English from January 2008 to January 2020. In total 22,217 papers were sourced and screened, with 18 papers retained for quality appraisal using the Joanna Briggs Institute Critical Appraisal Tools. RESULTS:The mean time to return to work varied between 46 and 192 days; about half the participants resumed work by three months. Patients who were male, younger, educated, non-manual workers or owned their own business, and those who evaluated their general and mental health highly, had shorter hospitalisation, fewer comorbidities, complications and mental health issues, were more likely to return to work after myocardial infarction. CONCLUSION & RELEVANCE TO CLINICAL PRACTICE:Findings may help nurses detect patients at increased risk of failure to return to work, and provide appropriate support to facilitate this

Cross-cultural validation of the Cardiac Depression Scale in Iran

Background. The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population. Methods. Translation and back-translation of the 26-item CDS scale was performed using recommended procedures. The Iranian translation of the CDS (I-CDS) was administered to 261 individuals in Iran, concurrently with the Beck Depression Inventory. The factor structure of the I-CDS was examined using exploratory factor analysis procedures to enable comparison with previous psychometric evaluation ofthe CDS. Receiver operating characteristic curves were used to examine the ability of the I-CDS to discriminate between categories of depression. Results. First-order exploratory factor analysis uncovered two robust factors, consistent with the second-order dimensions originally reported by the developers of this instrument. Cronbach's alpha was .88 for the total 26-item I-CDS, indicating satisfactory internal consistency of the I-CDS. Intercorrelation between the total scores for the I-CDS and BDI was .62 (p < .001). For the I-CDS cut-off of 90, the sensitivity was 85%, and specificity was 61% with a computed area under the curve (AUC) of 0.81 (95% CI, 0.76-0.87). For the I-CDS cut-off of 100, the sensitivity was 81%, and specificity was 63% with a computed AUC of 0.81 (95% CI, 0.76-0.87). Conclusion. This validation study of the Iranian version of theCDSdemonstrated that it is an acceptable, reliable, and valid measure of depression in people with heart disease.Copyright © The British Psychological Society

Consequence of habitat specificity: a rising risk of habitat loss for endemic and sub-endemic woody species under climate change in the Hyrcanian ecoregion

Endemic species are more impacted by climate change than other taxa. However, assessing the vulnerability of endemics to these changes in some regions, such as the Hyrcanian forest, is limited, despite its importance for biodiversity and ecosystem function. To address the question of expected habitat shifts under climate change across the Hyrcanian ecoregion, we built an ensemble of species distribution models (SDM) under two emission scenarios (RCP 4.5 and RCP 8.5) for 15 endemic woody taxa. To identify the potential priority conservation areas, we also applied a spatial prioritization approach. Overall, our results suggest that the impacts of climate change are more severe on the eastern parts of the region (Golestan) and the Talysh Mountains (north-western Hyrcanian ecoregion) with over 85% and 34% loss of suitable habitats over the next 80 years. The central part of the Alborz Mountains (Mazandaran) and some areas in the Talysh Mountains could be potential climatic refugia under the future conditions for endemic taxa. The most prominent changes are expected for Ruscus hyrcanus, Gleditsia capsica, Acer velutinum, Frangula grandifolia, and Buxus hyrcana. The worrying predicted loss of suitable habitats for most studied taxa would dramatically affect the stability and resilience of forests, threatening thus biodiversity of the Hyrcanian ecoregion. We present the first estimation of the potential risks involved and provide useful support for regional climate-adaptation strategy, indicating potential conservation priority areas for maintaining and preserving its resources. Notably, only 13.4% of areas designated for conservation and management under climate change will be located within the current Hyrcanian protected areas, yet the majority of these areas are classified as low priority