Heart failure (HF) is a syndrome associated with high mortality and morbidity. HF patients tend to be at a high risk of poor clinical and psychosocial outcomes. This study aimed to capture patients' and carers perspectives of HF, the impact on their health reported QoL, and the factors associated with their poor health outcomes. To explore HF patients' and carers' views on their QoL since diagnosis. This study used a cross-sectional, qualitative design with semistructured interviews conducted with participating patients and carers. Thirteen adults (> 18 years) with HF and 21 carers were interviewed over the telephone, following a semi-structured interview schedule. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Three main themes were identified, with an overarching theme . Themes included impact on patients' lifestyle including diet, smoking and inability to part-take in social activities, adjusting to HF diagnosis and co-morbidity management, and psychological/mental health issues such as anxiety and depression. Patients with HF are at high-risk of various issues which can negatively impact their QoL. Additionally, Carers play a vital role in the management of HF patients. Effective patient centred care and better communication between patients, carers and healthcare professionals is vital in HF management.
Advanced clinical practitioners increasingly provide patient care in a variety of settings across the world. This paper reports a qualitative study exploring the training and education needs of these healthcare professionals in England. Four focus group discussions and one individual interview were conducted with a total sample of 17 people. Participants were adults enrolled on an Advanced Practice Masters programme at one Higher Education Institution or advanced clinical practitioners from across two large London National Health Service hospitals. Data collection took place March-April 2017. Following transcription, audio-recorded data were imported into Nvivo11 and subjected to a standard process of inductive thematic analysis. Three key themes were identified: Recognising advanced practice; Education for Advanced Practice; Programme delivery. Findings highlight the huge variation in titles, practice responsibilities and management structure, which make the development of a generic education programme challenging and the importance of flexibility key to success. At a time when public services are experiencing significant financial constraints, the need for improved collaborative practices, shared resources and a practice focus is considered vital for educating future advanced clinical practitioners worldwide.
Heart failure is a complex condition where the heart is unable to pump blood effectively because of a structural or functional abnormality. This condition is associated with a substantial human and economic burden, with a particularly high impact on patients' quality of life. However, previous research suggests that patient education, which is often delivered by nurses, can help to reduce the burden of heart failure, both for patients and healthcare services. This review aimed to assess the impact of nurse-led patient education programmes on the quality of life among patients with heart failure. Key electronic databases (MEDLINE, CINAHL, PsycINFO and Web of Science) were searched from inception to February 2022. Studies of adults with heart failure who received in-person nurse-led patient education using a quality of life assessment tool were included. Of the 2225 studies retrieved in the initial search, 18 were included in the final review, including a total of 2413 participants. Physical health was assessed across all studies, with some variation in the findings, particularly in relation to the impact of patient education on mortality rates. However, positive mental health outcomes were reported in intervention groups across selected studies, with one study reporting significant improvement at 12 months compared to a control group (P=0.038). This indicates that nurse-led patient education can improve some aspects of patients' quality of life, reinforcing the importance of this aspect of nursing care in heart failure management, while also highlighting areas in need of further research.
Aim: This article provides a literature review on the post-procedural outcomes of patients who have undergone transfemoral transcatheter aortic valve implantation (TAVI). Background: TAVI is a less invasive treatment option than surgical aortic valve replacement (SAVR) for aortic stenosis. Aortic stenosis in the UK has a prevalence rate of 5% in people aged 75 and over. Access sites used for TAVI procedures include trans-aortic, subclavian, carotid, apical (TA) and femoral (TF) ( National Institute for Health and Care Excellence (NICE), 2012 ). Transfemoral TAVI access sites were previously closed using an open surgical access technique (closure of the skin using sutures). However, over the years, the use of percutaneous access closure devices such as Perclose Proglide has increased. Nevertheless, there is a gap in the literature that assesses the postoperative vascular complications in patients who undergo TAVI. Conclusion: This review highlights the importance of measuring patients' post-procedural outcomes, as well as the need for increased confidence and competence in all health professionals in their provision of care to patients, and more evidence-based care. Relevance to clinical practice: Nurses can improve patient care by observing the patient and ensuring their safety following the TAVI procedure. They should therefore be competent in recognising any major or minor vascular complications after transfemoral TAVI and assessing their significance.
Aim: A clinical audit of the post-procedural outcomes in patients having transfemoral transcatheter aortic valve implantation (TAVI), comparing the impact of percutaneous and open surgical access closure of the femoral artery. Method: Using data collected from an NHS hospital database, a retrospective audit was undertaken in February 2014 on all patients who had a transfemoral TAVI between October 2011 and October 2013. Descriptive statistics were used to summarise patient data. Results: Data from 62 patients were included; 31 had open surgical access closure of the femoral artery while the remaining 31 had percutaneous access closure. Median age and interquartile range was 84(8), with 33.8% male and 67.7% female. The median Euroscore was 20. Conclusion: Vascular complications occur after TAVI. However, in this study the incidence was slightly lower with the use of percutaneous access closure compared with open surgical access closure. Patient health outcomes post TAVI are better with percutaneous access closure.
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