Background: Despite exercise capacity and quality-of-life benefits, pulmonary rehabilitation (PR) and cardiac rehabilitation (CR) programmes are not easily accessed because of several barriers. A solution may be telerehabilitation (TR), in which patients exercise in their communities while they are monitored via teletechnology. However, the benefits of TR for the purposes of PR and CR have not been systematically reviewed. Objective: To determine whether the benefits of the exercise component of PR and CR using TR are comparable to usual-care (UC) programmes. Methods: A comprehensive literature search was performed of the Medline, Embase, and CINAHL databases up to July 13, 2015. Meta-analyses were performed for peak oxygen consumption, peak workload, exercise test duration, and 6-minute walk test (6MWT) distance using the I2 statistic and forest plots displaying standardized mean difference (SMD). Results: Of 1,431 citations found, 8 CR studies met the inclusion criteria. No differences were found in exercise outcomes between UC and TR groups for CR studies, except in exercise test duration, which slightly favoured UC (SMD 0.268, 95% CI: 0.002, 0.534, p<0.05). Only 1 PR study was included, and it showed similar improvements on the 6MWT between the UC and TR groups. Conclusion: TR for patients with cardiac conditions provided benefits similar to UC with no adverse effects reported. Similar studies of TR for patients with pulmonary conditions need to be conducted.
Simple diaphragmatic breathing instructions can significantly increase the recruitment of the diaphragm during IMT compared with a bout of IMT where individuals are free to choose their own inspiratory muscle recruitment strategy.
Context:Studies have documented that nurses and other health care professionals are inadequately prepared to care for patients in palliative care. Several reasons have been identified including inadequacies in nursing education, absence of curriculum content related to pain management, and knowledge related to pain and palliative care.Aims:The objective of this paper was to assess the knowledge about palliative care amongst nursing professionals using the palliative care knowledge test (PCKT).Settings and Design:Cross-sectional survey of 363 nurses in a multispecialty hospital.Materials and Methods:The study utilized a self-report questionnaire- PCKT developed by Nakazawa et al., which had 20 items (statements about palliative care) for each of which the person had to indicate ‘correct’, ‘incorrect’, or ‘unsure.’ The PCKT had 5 subscales (philosophy- 2 items, pain- 6 items, dyspnea- 4 items, psychiatric problems- 4 items, and gastro-intestinal problems- 4 items).Statistical Analysis Used:Comparison across individual and professional variables for both dimensions were done using one-way ANOVA, and correlations were done using Karl-Pearson's co-efficient using SPSS version 16.0 for Windows.Results:The overall total score of PCKT was 7.16 ± 2.69 (35.8%). The philosophy score was 73 ± .65 (36.5%), pain score was 2.09 ± 1.19 (34.83%), dyspnea score was 1.13 ± .95 (28.25%), psychiatric problems score was 1.83 ± 1.02 (45.75%), and gastro-intestinal problems score was 1.36 ± .97 (34%). (P = .00). The female nurses scored higher than their male counterparts, but the difference was not significant (P > .05).Conclusions:Overall level of knowledge about palliative care was poor, and nurses had a greater knowledge about psychiatric problems and philosophy than the other aspects indicated in PCKT.
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