Effects of home-based cardiac exercise program on the exercise tolerance, serum lipid values and self-efficacy of coronary patients

Exercise-based cardiac rehabilitation improves exercise capacity and reduces cardiac risk factors. The purpose of this pilot study was to examine the effects of a home-based cardiac exercise program (HBCEP) on exercise tolerance, serum lipids, and self-efficacy in coronary heart disease patients in Turkey. Self-efficacy theory provided the framework for this study's intervention. The study design was a pre-test and post-test experimental, randomized assignment. The study included 30 participants in a home-based cardiac exercise program (HBCEP; mean age = 54.7 ± 7.8) and 30 in control (C; mean age = 52.7 ± 6.5). The Phase II cardiac exercise program included three 45-60-min sessions per week for 12 weeks, and the enhancement of self-efficacy through educational sessions and the use of goal setting, modelling, and physiological feedback strategies. Both groups were comparable in their medical regimen, exercise capacity, and other measured variables pre-intervention. At baseline and after 12 weeks, exercise capacity was evaluated by exercise testing using the Bruce Protocol, self-efficacy was measured with the Cardiac Exercise Self Efficacy Index, and serum lipid values were measured. At the completion of the 12-week exercise program, the exercise capacity (P<0.001), total cholesterol (P =0.004), triglycerides (P = 0.048), high-density lipoprotein-cholesterol (P = 0.001), low-density lipoprotein-cholesterol (P = 0.039), and self-efficacy (P<0.001) of the HBCEP Group were significantly improved compared to the control group. These results suggest that a first-time HBCEP in Turkey can be successful in having patients adhere to a prescribed exercise program and reduce risk factors. Enhanced self-efficacy may have mediated the improved behavioural outcomes. © 2006, European Society of Cardiology. All rights reserved

Attitudes toward the elderly among the health care providers: Reliability and validity of Turkish version of the UCLA Geriatrics Attitudes (UCLA-GA) scale

PubMed ID: 21937128The population of above 65 years of age is increasing fast in societies, as the life expectancy is increasing and it leads to high demands for health care service. Health care service for the elderly should be provided by trained team in this field. Success of health care service to be rendered is related to knowledge, skill and attitudes of team members in different profession group (doctor, nurse, social worker, psychologist, etc.) about health of elderly. The aim of this study is to establish the Turkish validity and reliability of 14-question UCLA-GA scale, validity and reliability of which was proven and used the most frequently among the scales that assess attitudes of health care providers toward elderly. A total 256 people, 150 of them were post-graduates, 106 of them were pre-graduates were involved in the study at Ege University, medical faculty between the dates of December 2010 and February 2011. Majority of the participants (63.67%) were women and in the age group of 18-29 (58.3%). The ratio of the ones undergoing geriatric education is 38.2%. It was found out that the Kaiser-Meyer-Olkin (KMO) sampling adequacy test presented high correlation among the items in both single adult households of 14 items of the scale was 0.72. Cronbach alpha value of the scale was found as 0.67 and satisfying. As a result of examination with Tukey's test of additivity, it was seen that items of the scale have additive quality (F=. 85.25, p< 0.0001). When we calculated the correlation of each item with total score, it was found that correlation coefficient varied between 0.32 and 0.68. Test-retest reliability was defined by use of Pearson correlation analysis. It was determined that test-retest consistency of correlation scale between two measurements was r=. 0.51. As a result of test-retest application, the correlation between the first and second application scores of each item was analyzed to determine the internal consistency of each item of the scale. Based on this analysis it was found as p< 0.01 between r=. 0.22 and 0.65. As a conclusion, Turkish validity and reliability of UCLA-GA scale was demonstrated in this study. Since Turkish version of UCLA-GA scale is short and clear, it is recommended to use it for determining attitudes of health care providers toward elderly in geriatrics. © 2011 Elsevier Ireland Ltd

The effect of web-based education on disease activity, symptom management, and quality of life on patients with inflammatory bowel disease

WOS: 00042731890230

Evaluation of the shortened cholesterol-lowering diet self-efficacy scale

Specificity in the self-efficacy construct requires that instruments assess domain-specific behaviors. The objectives of the study were to (1) reexamine and shorten the original 57-item Cholesterol-Lowering Diet Self-Efficacy Scale (CLDSES), (2) estimate reliability and validity of the short form CLDSES (CLDSES-SF), (3) examine the dimensionality of the CLDSES-SF, (4) examine discriminant validity of the scale by its ability to differentiate between adherence and nonadherence to saturated fat intake guidelines, and (5) examine the CLDSES-SF's sensitivity and specificity. A sample of 238 patients being treated for hypercholesterolemia completed three instruments: the CLDSES, the Connor Diet Habit Survey (DHS) and a Three-Day Food Record. Internal consistency for the CLDSES-SF was .95. The inter-correlation coefficients among the seven sub-scales ranged from .28 to .62, and for the total to sub-scales .58 - .87, significant at p < .001. Evidence for criterion validity was shown in the correlations between the CLDSES-SF and the Connor DHS scores and between the CLDSES-SF and the Three-Day Food Record. Factor analysis showed a one-factor model that fits the data with a sufficient amount of total variance explained among the seven subscale items in each subscale, providing evidence of the uni-dimensionality of each subscale. Sensitivity (76%) and specificity (63%) for the CLDSES-SF were good with 88% positive predictive value for adherence. The shortened CLDSES retained its good psychometric properties and remains comprehensive in its assessment of self-efficacy for adherence to a cholesterol-lowering diet. © 2006 European Society of Cardiology

Attitudes of Turkish nursing students toward elderly people

WOS: 000355558900013Purpose: This study was conducted to determine the attitudes of nursing students towards elderly people. Methods: The study was carried out in a cross-sectional and descriptive design. The Turkish version of UCLA-GA Scale was used to evaluate attitudes towards older people among 931 students attending four schools of nursing located in Aegean, Mediterranean, Marmara regions and Istanbul in Turkey. Results: Mean score of UCLA-GA scale was 48.64 +/- 5.51 (min: 22, max: 64). Female students were found to have more positive attitudes than male students (t = 2.709, P < 0.05), those who have an elderly relative than those who do not (t = 2.671, P < 0.05), those who want to live with an elderly family member than those who do not (t = 6.374, P < 0.05), and those who want to work at a unit offering care to the elderly after graduation than those who do not (t = 5.259, P < 0.05). Conclusion: Positive attitudes towards ageism were affected by variables such as: sex, willingness to live with aged parents after starting a family, work with older people after graduation and whether they had previously or currently lived with an aged relative. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved

Association of physical inactivity with increased cardiovascular risk in patients with rheumatoid arthritis.

OBJECTIVE: Patients with rheumatoid arthritis (RA) are characterized by reduced physical activity and increased morbidity and mortality from cardiovascular disease (CVD). The aim of this study was to investigate associations between levels of physical activity and CVD risk profile in RA patients. METHODS: Levels of physical activity were assessed in 65 RA patients (43 females). Using the International Physical Activity Questionnaire, patients were allocated into three groups: active, moderately active and inactive. Anthropometric characteristics, RA activity/severity, multiple classical and novel CVD risk factors and 10-year CVD event probability were assessed and compared among the three groups. RESULTS: Significant differences were detected among groups in systolic blood pressure (P=0.006), cholesterol (P<0.001), low-density lipoprotein (P=0.01), homeostasis model assessment (P=0.001), type-I plasminogen activator inhibitor antigen (P<0.001), tissue-type plasminogen activator antigen (P=0.019), homocysteine (P=0.027), fibrinogen (P=0.001), apolipoprotein B (P=0.002) and von Willebrand Factor (P=0.001), with a consistent deterioration from the physically active to the physically inactive group. Multivariate analysis of variance revealed that levels of physical activity were significantly associated with the differences in all of the above variables (P<0.05) after adjustment for age, weight, sex, smoking status, as well as RA disease activity and severity. CONCLUSION: This cross-sectional study suggests that physically inactive RA patients have significantly worse CVD risk profile compared with physically active patients. The possible beneficial impact of increased physical activity, including structured exercise, to the CVD risk of RA patients needs to be accurately assessed in prospective studies