55 research outputs found
Does an Intervention Designed to Improve Self-management, Social Support and Awareness of Palliative-care Address Needs of Persons with Heart Failure, Family Caregivers and Clinicians?
Aims and Objectives
To conduct a formative evaluation of the iPadâEnhanced Shared Care Intervention for Partners (iSCIP) among persons with heart failure (HF), family caregivers and clinicians. Together, persons with HF and family caregivers are referred to as partners. Background
There is growing awareness of the caregiver\u27s contributions to HF selfâmanagement, social support and reciprocal benefits of interventions that involve both partners. The iSCIP engages both partners in a sixâsession psychosocial intervention to address three preventable causes of poor outcomes in a HF population: poor selfâmanagement skills, inadequate social support and underutilisation of palliative care. An iPad app is used to organise the intervention. The goals of the iSCIP are to engage partners in HF selfâmanagement, communication about the HF patient\u27s care values and preferences, and future planning. Design
A qualitative focus group design was used. Methods
Seven clinicians and eight partners participated in focus groups to explore their experiences, needs and reaction to the iSCIP content and technologies employed. Openâended questions and closedâended surveys were used to collect data. Deductive content analysis was used to analyse the qualitative data. NVivo software was used for qualitative data analysis. Bayesian statistical models were used to analyse numeric data. Results
The iSCIP met partnersâ and cliniciansâ needs to improve selfâmanagement, communicate about care values and preferences and plan for the future. Quantitative analysis of numeric data supported our qualitative findings, in that both groups rated the intervention components useful to very useful. Implications for practice
These findings add to the growing evidence of the feasibility and acceptability of programs that address care values and preferences, and care planning. The iSCIP can be used as a guide for developing interventions and software applications, which involve both partners in care and palliativeâcare discussions
Regulation of Coronary Blood Flow
The heart is uniquely responsible for providing its own blood supply through the coronary circulation. Regulation of coronary blood flow is quite complex and, after over 100 years of dedicated research, is understood to be dictated through multiple mechanisms that include extravascular compressive forces (tissue pressure), coronary perfusion pressure, myogenic, local metabolic, endothelial as well as neural and hormonal influences. While each of these determinants can have profound influence over myocardial perfusion, largely through effects on end-effector ion channels, these mechanisms collectively modulate coronary vascular resistance and act to ensure that the myocardial requirements for oxygen and substrates are adequately provided by the coronary circulation. The purpose of this series of Comprehensive Physiology is to highlight current knowledge regarding the physiologic regulation of coronary blood flow, with emphasis on functional anatomy and the interplay between the physical and biological determinants of myocardial oxygen delivery. © 2017 American Physiological Society. Compr Physiol 7:321-382, 2017
Heart failure with preserved left ventricular function (HFpEF) prevalence, clinical presentation, diagnosis, treatment, prognosis
Management of End Stage Heart Failure (Advanced Heart Failure)
Video/audio presentation of Aurora St. Luke\u27s Transplant Grand Rounds on June 27, 2012, presented by Nasir Sulemanjee, MD, Advanced Heart Failure & Transplant Cardiologist. 59 minutes
Remote hemodynamic monitoring program: a single center experience in reducing heart failure admissions
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