Individual quality of life in adults with congenital heart disease: a paradigm shift

Aims During the last decade, a paradigm shift has emerged in the measurement of quality of life, from the use of standard questionnaires towards a more individualized approach. Therefore, this study examined individual quality of life in adults with congenital heart disease and explored potential differences with those reported by matched, healthy control subjects. Methods and results We examined 579 adults with congenital heart disease. A subsample of 514 of these patients was matched for age, gender, educational level, and employment status with 446 healthy counterparts. Individual quality of life was assessed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW). Twelve domains affecting patients' quality of life were identified. Family, job/education, friends, health, and leisure time were the most prominent quality of life domains. Significantly fewer patients than control subjects considered financial means and material well-being and future to be important determinants of quality of life. Conclusion Assessment of quality of life in adults with congenital heart disease that focusses on the individual is appropriate for obtaining in-depth information on issues relevant for patients' quality of life. This represents a paradigm shift in the measurement of this concep

The comparative biology of New Zealand oystercatchers

Oystercatchers comprise a distinctive group of mollusc-eating shorebirds. They form an extremely uniform monogeneric family which has not undergone any major adaptive radiations into a diversity of ecological niches, but rather has dispersed from original centres of distribution to occupy identical niches in new geographical localities. The uniformity of structure and habit displayed within the group has been attributed by Larson (1957) to a high ecobiotic specialisation with centripetal selection involved. Throughout their range, oystercatchers exploit identical ecological niches which require specialised habits for successful utilisation. The specialised feeding habits of oystercatchers are well documented (Murphy, 1925; Dewar, 1940; Larson, 1957; Tinbergen and Norton-Griffiths, 1964; Dare, 1966), and a natural consequence of this specialisation is that it is restrictive to adaptive radiation

Gluren bij de buren: Cardiovasculaire verpleegkunde in België

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The NYHA classification, employment, and physical activities are poor indicators of quality of life after congenital cardiac surgery

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Cardiovascular nursing in Belgium: at the crossroad

This article presents considerations for the design and testing of electronic interventions to improve recovery outcomes in cardiac patients. A brief description of the design and testing of 2 telehealth interventions for cardiac patients is provided: HeartCare and E-CHANGE. The HeartCare project was a randomized trial of a home support program for patients after coronary artery bypass graft surgery. E-CHANGE is an Internet-based home support program designed to increase lifestyle exercise after a cardiac event. Lessons learned from these 2 projects regarding design considerations, system use, effectiveness, and research challenges are discussed. Methods to promote the preservation of nursing values in electronic systems are described, as well nursing roles in the use of computer-assisted care.status: publishe

Implementation of transition programs can prevent another lost generation of patients with congenital heart disease

Congenital heart disease is the most frequently occurring birth defect. To date, more than 90% of the children born with a heart defect reach adulthood. Since many patients are prone to residua and sequelae, lifelong specialized care is required. However, studies indicate that about one-half to three-quarters of the patients are lost to follow-up when they have grown up. This has resulted in a virtual lost generation. Lapse of care is associated with significant morbidity. Therefore, implementation of strategies to prevent patients from failing to continue regular follow-up is critical. It is argued that transition programs that inform patients about the rationale for ongoing follow-up and that teach them how to navigate the medical system can avoid another lost generation.status: publishe

Patent foramen ovale closure and migraine: Are we following the wrong pathway?

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