This study aimed to evaluate the relationship between frailty, sociodemographic and clinical characteristics, and disease severity of older adults with acute coronary syndrome (ACS). A total of 57 hospitalized patients ≥60 years with ACS were assessed for frailty through the Tilburg Frailty Indicator. Disease severity was assessed by the Global Registry of Acute Coronary Events, by the maximum troponin level, and by the number of severely obstructed coronary arteries. The relationship between variables was assessed by Mann Whitney’s test, Pearson’s chi-square test, likelihood-ratio test, Fisher’s exact test, or Student’s t test. Analyses were bootstrapped to 1,000 to reduce potential sample bias. About 54.4% were frail. Frailty was associated with ethnicity ( p = .02), marital status ( p = .05), ischemic equivalents ( p = .01), self-perceived health ( p = .002), arthritis/rheumatism/arthrosis ( p = .002), and number of severely obstructed coronary arteries ( p = .05). These relationships can support intensified surveillance planning for the elderly at greatest risk, structuring of transitional care, appropriate nurse-coordinated secondary prevention delivery in primary care, and cardiac rehabilitation following ACS.
This analytical, cross-sectional study aimed to analyze the relationship between depressive symptoms, appetite, and quality of life (QoL) in 86 patients hospitalized with heart failure. Patients were assessed for depressive symptoms, appetite, and QoL using the Beck Depression Inventory-II, the Simplified Nutritional Appetite Questionnaire, and the Minnesota Living with Heart Failure Questionnaire, respectively. Relationships between sociodemographic and clinical variables, depressive symptoms, appetite, and QoL were analyzed using bivariate tests and linear regression models, with p < .05 considered significant. The factors associated with QoL were dependence for four activities of daily living (ADLs) (estimate = 15.4, 95% CI = 0.23 to 30.64, p = .046), minor depressive symptoms (estimate = –20.0, 95% CI = –28.3 to −11.73, p < .001), and appetite (estimate = –11.08, 95% CI = –20.5 to −1.62, p = .022). These results can support multi-professional assessment and development of interventions to promote better QoL, including addressing impaired appetite and food intake, the presence or increased intensity of depressive symptoms, especially in patients dependent for ADLs.
Introdução: A adoção de intervenções adequadas após a síndrome coronariana aguda (SCA) está relacionada à diminuição de readmissões hospitalares. Considerando as possibilidades de intervenções multidisciplinares em diferentes níveis de atendimento à saúde, o objetivo deste estudo foi sumarizar as evidências da literatura acerca das intervenções realizadas por enfermeiros para diminuir a readmissão hospitalar de indivíduos hospitalizados por SCA. Métodos: Trata-se de uma revisão integrativa com buscas no(a) Pubmed, BVS, CINAHL, Web of Science e Scopus, incluindo estudos dos anos 2020 e 2021, cujos pacientes foram internados por SCA e submetidos a intervenções dos profissionais de enfermagem. Resultados: Foram identificados 152 estudos, dos quais cinco foram incluídos na análise (três estudos clínicos randomizados, um estudo clínico não randomizado e uma pesquisa-ação participativa). O número de participantes variou de 31 a 1064, com tempo de acompanhamento de 30 dias a seis meses. As intervenções implementadas eram educativas e/ou de promoção do autogerenciamento de forma presencial, por telefone ou por meio de outros dispositivos. Intervenções longitudinais, iniciadas durante a hospitalização, impactaram as novas internações hospitalares, enquanto intervenções educativas isoladas sem apoio além do plano inicial de alta não impactaram as readmissões hospitalares. Conclusões: Os enfermeiros têm realizado intervenções educativas e/ou de promoção do autogerenciamento junto a pacientes com SCA, objetivando prevenir novas internações. As intervenções iniciadas durante a hospitalização com manutenção do acompanhamento profissional pós-alta, são associadas a menores taxas de readmissão hospitalar. Estudos clínicos randomizados robustos em diferentes contextos são necessários para a melhor compreensão dos componentes efetivos das intervenções, bem como volume de realização e custo-efetividade. Descritores: Avaliação de Eficácia-Efetividade de Intervenções; Enfermeiros; Readmissão do Paciente; Síndrome Coronariana Aguda.
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