More similarities than differences: An international comparison of CVD mortality and risk factors in women

In this article we describe global cardiovascular risk factor trends in women, both physiological and behavioral, in order to improve the understanding of cardiovascular health of women. Our aim in presenting this information is to inform interventions and policies to improve the cardiovascular health of women. Although differences are apparent between developing and developed countries, a range of commonalities exist that allow a global approach to improving women's health. A multifaceted approach considering physiological, social, economic, and political determinants is critical to improve the cardiovascular health outcomes of women

Cardiovascular medication adherence among patients with cardiac disease: a systematic review

© 2016 John Wiley & Sons Ltd Aims: The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications. Background: Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal. Design: A systematic quantitative review of intervention effects. Data Sources: We conducted systematic searches for English-language, peer-reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004–December 2014. Review methods: According to pre-determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers; 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool; and included in the review. Results: Study findings were presented descriptively; due to the heterogeneity of studies meta-analysis was not possible. Included papers described interventions categorized as: (1) multifaceted; and (2) behavioural and educational, comprising: (a) text message and mail message; (b) telephone calls; (c) motivational interviewing and (d) nurse-led counselling and education. Conclusions: Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target individual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review

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

Medication adherence and predictive factors in patients with cardiovascular disease: A cross-sectional study

© 2020 John Wiley & Sons Australia, Ltd Adherence to cardiac medications makes a significant contribution to avoidance of morbidity and premature mortality in patients with cardiovascular disease. This quantitative study used cross-sectional survey design to evaluate medication adherence and contributing factors among patients with cardiovascular disease, comparing patients who were admitted to a cardiac ward (n = 89) and those attending outpatient cardiac rehabilitation (n = 31) in Australia. Data collection was completed between October 2016 and December 2017. Descriptive and regression analyses were conducted to identify medication adherence and determine factors independently predictive of medication adherence. Participants from cardiac rehabilitation had significantly lower adherence to cardiac medications than those recruited from the cardiac ward (58.1 vs 64.0%, respectively). Self-efficacy was significantly associated with participants' medication adherence in both groups. The ability to refill medications and beliefs about cardiac medications were independently significantly predictive of cardiac medication adherence. These findings indicate areas where clinical nurses could expand their role to improve cardiac patients' medication self-management

Behaviour change interventions to improve medication adherence in patients with cardiac disease: Protocol for a mixed methods study including a pilot randomised controlled trial

© 2017 Australian College of Nursing Ltd Background: Suboptimal adherence to medication increases mortality and morbidity; individually tailored supportive interventions can improve patients’ adherence to their medication regimens. Aims: The study aims to use a pilot randomised controlled trial (RCT) to test the hypothesis that a theory-based, nurse-led, multi-faceted intervention comprising motivational interviewing techniques and text message reminders in addition to standard care will better promote medication adherence in cardiac patients compared to standard care alone. The pilot study will assess self-reported adherence or non-adherence to cardiovascular medication in patients referred to a cardiac rehabilitation program following hospital admission for an acute cardiac event and test the feasibility of the intervention. The study will examine the role of individual, behavioural and environmental factors in predicting medication non-adherence in patients with CVD. Methods: This is a mixed- methods study including a nested pilot RCT. Twenty-eight cardiac patients will be recruited; an estimated sample of nine patients in each group will be required for the pilot RCT with 80% power to detect a moderate effect size at 5% significance, and assuming 50% loss to follow-up over the six month intervention. Participants will complete a paper-based survey (Phase one), followed by a brief semi-structured interview (Phase two) to identify their level of adherence to medication and determine factors predictive of non-adherence. Participants identified as ‘non-adherent’ will be eligible for the pilot randomised trial, where they will be randomly allocated to receive either the motivational interview plus text message reminders and standard care, or standard care alone. Discussion: Nurse-led multi-faceted interventions have the potential to enhance adherence to cardiac medications. The results of this study may have relevance for cardiac patients in other settings, and for long-term medication users with other chronic diseases

Examining perceived and actual diabetes knowledge among nurses working in a tertiary hospital

© 2017 Background With the worldwide increase in the incidence and prevalence of diabetes, there has been an increase in the scope and scale of nursing care and education required for patients with diabetes. The high prevalence of diabetes in Saudi Arabia makes this a particular priority for this country. Aim The aim of this study was to examine nurses’ perceived and actual knowledge of diabetes and its care and management in Saudi Arabia. Methods A convenience sample of 423 nurses working in Prince Sultan Medical Military City in Saudi Arabia was surveyed in this descriptive, cross-sectional study. Perceived knowledge was assessed using the Diabetes Self-Report Tool, while the Diabetes Basic Knowledge Tool was used to assess the actual knowledge of participants. Results The nurses generally had a positive view of their diabetes knowledge, with a mean score (SD) of 46.9 (6.1) (of maximum 60) for the Diabetes Self-Report Tool. Their actual knowledge scores ranged from 2 to 35 with a mean (SD) score of 25.4 (6.2) (of maximum of 49). Nurses’ perceived and actual knowledge of diabetes varied according to their demographic and practice details. Perceived competency, current provision of diabetes care, education level and attendance at any diabetes education programs predicted perceived knowledge; these factors, with gender predicted, with actual diabetes knowledge scores. Conclusion In this multi-ethnic workforce, findings indicated a significant gap between participants’ perceived and actual knowledge. Factors predictive of high levels of knowledge provide pointers to ways to improve diabetes knowledge amongst nurses

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