State of the Science: The Relevance of Symptoms in Cardiovascular Disease and Research: A Scientific Statement From the American Heart Association

Nguyễn

et al. 2022

IJERPH

This study aimed to assess the symptom burden among older patients hospitalised for heart failure. This hospital-based, cross-sectional study was conducted at the National Geriatric Hospital, Hanoi, Vietnam, from June 2019 to August 2020. Face-to-face interviews were performed to gather the following information: socio-demographic characteristics, heart failure classification, and clinical characteristics (comorbidities, polypharmacy, pro–B-type natriuretic peptide, left ventricular ejection fraction (LVEF), symptom burden, and depression). Symptom burden was assessed using the Edmonton Symptom Assessment Scale (ESAS), and depression was measured using the Patient Health Questionnaire. A total of 314 patients participated in the study. The mean participant age was 72.67 (SD = 9.42) years. The most frequently reported symptoms on the ESAS were shortness of breath (95.5%), fatigue (94.8%), and anxiety (81.2%). In univariate analyses, depression was significantly associated with heart failure class (p < 0.05). Multivariate linear regression revealed that major depression was significantly associated with total symptom burden score (Beta: 11.74; 95% CI: 9.24–14.23) and LVEF (Beta: −0.09; 95% CI: −0.17–(−0.007)). Patients hospitalised for heart failure experienced a high burden of symptoms. Further studies addressing adverse outcomes and expanding to community-dwelling older people are essential. Palliative care approaches that target symptom reduction should be considered in patients with heart failure.

Section: Discussionsupporting

confidence: 90%

Symptom Burden among Hospitalised Older Patients with Heart Failure in Hanoi, Vietnam

Nguyễn

et al. 2022

IJERPH

CIN: Computers, Informatics, Nursing

“…The ratio by E-SNT was critical (IR = 0.850), whereas the ratio by E-SM was unnecessary (IR = 0.563). In the second round, the four indicators rated as supplemental did not make a consensus among respondents (ranks 37,38,39,40). More than 60% considered monitor effects of stimulants as unnecessary (Table 6).…”

Section: Self-management: Cardiac Diseasementioning

confidence: 99%

“…The understanding natural course of cardiac disease may be hard for patients because of difficult pathology; however, knowing signs, symptoms, and disease process is helpful to adherent treatments and medication. 38 Among 45 self-management indicators, monitors effects of stimulants and Uses diary to monitor symptoms over time ranked the lowest, and they were rated as unnecessary by a few respondents in both rounds. They may have thought that these two indicators are redundant because there are some indicators for symptom and medication management.…”

Section: Indicatorsmentioning

confidence: 99%

Validation of Nursing Outcomes Classification: Knowledge and Self-management for Cardiac Disease

Moorhead

Chae

2023

The Nursing Outcomes Classification provides two outcomes, Knowledge: Cardiac Disease and Self-management: Cardiac Disease, to assess knowledge and self-management behaviors of adults with cardiac disease. The purpose of this study was to validate the two nursing-sensitive outcomes to establish content validity. A methodological design was used using the Delphi technique. A total of 13 nurse experts in two domains participated in this study: five in standardized nursing terminologies and eight in self-management. Descriptive statistics and the Nurse-Patient Outcome Content Validity method were used to validate four aspects: definition adequacy of each outcome, clinical usefulness of measurement scales, importance of outcome indicators, and content similarity between the two outcomes. The definition adequacy, clinical usefulness, and content similarity of both outcomes were acceptable. A total of 81 indicators from the two outcomes were validated, and 60 were designated as critical. Nurses can evaluate cardiac patient outcomes effectively and accurately using these validated outcomes. The validated Nursing Outcomes Classification outcomes will also support the clinical decision-making of nursing students when they learn about patients with cardiac disease.

“…Given that some acute stroke symptoms including fatigue, anxiety and dizziness may overlap with other cardiovascular and general medical conditions 38 it is important to identify patients who are experiencing stroke 'mimics', and to avoid unnecessary and expensive investigations and inappropriate long-term prevention treatments. Patients presenting with stroke symptoms may ultimately be diagnosed with other conditions such as migraine headache, vertigo, metabolic disturbances, brain tumours, or presyncope/syncope.…”

Section: Section 4: Emergency Department Evaluationmentioning

confidence: 99%

Canadian Stroke Best Practice Recommendations: Acute Stroke Management, 7^th Edition Practice Guidelines Update, 2022

Heran¹,

Lindsay²,

Gubitz³

et al. 2022

Can. J. Neurol. Sci.

The 2022 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Acute Stroke Management, 7 th Edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by an interdisciplinary team of healthcare providers and system planners caring for persons with an acute stroke or transient ischemic attack. These recommendations are a timely opportunity to reassess current processes to ensure efficient access to acute stroke diagnostics, treatments and management strategies, proven to reduce mortality and morbidity. The topics covered include prehospital care, emergency department care, intravenous thrombolysis and endovascular thrombectomy, prevention and management of inhospital complications, vascular risk factor reduction, early rehabilitation and end of life care. These recommendations pertain primarily to an acute ischemic vascular event. Notable changes in the 7 th edition include recommendations pertaining the use of tenecteplase, thrombolysis as a bridging therapy prior to mechanical thrombectomy, dual antiplatelet therapy for stroke prevention, 1 the management of symptomatic intracerebral hemorrhage following thrombolysis, acute stroke imaging, care of patients undergoing endovascular thrombectomy, medical assistance in dying (MAiD) and virtual stroke care. An explicit effort was made to address sex and gender differences wherever possible. The theme of the 7 th Edition of the CSBPR is building connections to optimize individual outcomes, recognizing that many people who present with acute stroke often also have multiple comorbid conditions, are medically more complex, and require a coordinated interdisciplinary approach for optimal recovery. Additional materials to support timely implementation and quality monitoring of these recommendations are available at www.strokebestpractices.ca.