The effect of ambulation after cardiac catheterization on patient outcomes.
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Adult↗
Biomedical subjects
David R Thompson
Publications and source records attributed to David R Thompson.
Cardiovascular risk estimation by professionally active cardiovascular nurses: results from the Basel 2005 Nurses Cohort.
BACKGROUND: Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. METHODS: Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (kappa(w)). RESULTS: Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (> or =5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of <1%, while 13% reported having a risk > or =5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was <1% for 96% of responders: only 2% had a > or =5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (kappa(w)=0.27). CONCLUSION: Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.
Adult↗
Migratory shearwaters integrate oceanic resources across the Pacific Ocean in an endless summer.
Electronic tracking tags have revolutionized our understanding of broad-scale movements and habitat use of highly mobile marine animals, but a large gap in our knowledge still remains for a wide range of small species. Here, we report the extraordinary transequatorial postbreeding migrations of a small seabird, the sooty shearwater, obtained with miniature archival tags that log data for estimating position, dive depth, and ambient temperature. Tracks (262+/-23 days) reveal that shearwaters fly across the entire Pacific Ocean in a figure-eight pattern while traveling 64,037+/-9,779 km roundtrip, the longest animal migration ever recorded electronically. Each shearwater made a prolonged stopover in one of three discrete regions off Japan, Alaska, or California before returning to New Zealand through a relatively narrow corridor in the central Pacific Ocean. Transit rates as high as 910+/-186 km.day-1 were recorded, and shearwaters accessed prey resources in both the Northern and Southern Hemisphere's most productive waters from the surface to 68.2 m depth. Our results indicate that sooty shearwaters integrate oceanic resources throughout the Pacific Basin on a yearly scale. Sooty shearwater populations today are declining, and because they operate on a global scale, they may serve as an important indicator of climate change and ocean health.
Animal Identification Systems↗
Handmaiden or right-hand man: is the relationship between doctors and nurses still therapeutic?
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Attitude of Health Personnel↗
The psychometric properties of the Chinese version of the SF-36 health survey in patients with myocardial infarction in mainland China.
OBJECTIVE: To test the reliability and validity of the Chinese Mandarin version of the SF-36 health survey (CM:SF-36) in patients with myocardial infarction (MI) in mainland China. METHODS: Single group, cross-sectional design to test the measurement performance on a convenience sample of 180 Chinese patients with MI, 30 of whom were retested after 2 weeks to establish reliability. FINDINGS: Cronbach's alpha coefficients exceeded the 0.70 criterion for all subscales except General Health, indicating good internal consistency. Test-retest reliability was adequate (intraclass correlation coefficient >0.70) for all subscales. The significant differences were detected by the presence or absence of co-morbidities and the number of risk factors in most physical subscales indicating good discriminative validity. Principal components factor analysis with varimax rotation confirmed the presence of the eight factors, though the item loadings of the Vitality and Mental Health subscales were found to differ from the original ones of the SF-36. CONCLUSION: The CM:SF-36 is a psychometrically acceptable instrument for assessing the health status of Chinese patients with myocardial infarction.
Adult↗
Prolonged effects of a home-based intervention in patients with chronic illness.
BACKGROUND: Data on the long-term benefits of nonspecific disease management programs are limited. We performed a long-term follow-up of a previously published randomized trial. METHODS: We compared all-cause mortality and recurrent hospitalization during median follow-up of 7.5 years in a heterogeneous cohort of patients with chronic illness initially exposed to a multidisciplinary, home-based intervention (HBI) (n = 260) or to usual postdischarge care (n = 268). RESULTS: During follow-up, HBI had no impact on all-cause mortality (relative risk, 1.04; 95% confidence interval, 0.80-1.35) or event-free survival from death or unplanned hospitalization (relative risk, 1.03; 95% confidence interval, 0.86-1.24). Initial analysis suggested that HBI had only a marginal impact in reducing unplanned hospitalization, with 677 readmissions vs 824 for the usual care group (mean +/- SD rate, 0.72 +/- 0.96 vs 0.84 +/- 1.20 readmissions/patient per year; P = .08). When accounting for increased hospital activity in HBI patients with chronic obstructive pulmonary disease during follow-up for 2 years, post hoc analyses showed that HBI reduced readmissions by 14% within 2 years in patients without this condition (mean +/- SD rate, 0.54 +/- 0.72 vs 0.63 +/- 0.88 readmission/patient per year; P = .04) and by 21% in all surviving patients within 3 to 8 years (mean +/- SD rate, 0.64 +/- 1.26 vs 0.81 +/- 1.61 readmissions/patient per year; P = .03). Overall, recurrent hospital costs were significantly lower (14%) in the HBI group (mean +/- SD, 823 dollars +/- 1642 dollars vs 960 dollars +/- 1376 dollars per patient per year; P = .045). CONCLUSION: This unique study suggests that a nonspecific HBI provides long-term cost benefits in a range of chronic illnesses, except for chronic obstructive pulmonary disease.
Accidental Falls↗
Pharmacological treatment and perceived health status during 1-year follow up in patients diagnosed with coronary artery disease, but ineligible for revascularization. Results from the Euro Heart Survey on Coronary Revascularization.
BACKGROUND: It has been recognized that a clinically significant portion of patients with coronary artery disease (CAD) continue to experience anginal and other related symptoms that are refractory to the combination of medical therapy and revascularization. The Euro Heart Survey on Revascularization (EHSCR) provided an opportunity to assess pharmacological treatment and outcome in patients with proven CAD who were ineligible for revascularization. METHODS: We performed a secondary analysis of EHS-CR data. After excluding patients with ST-elevation myocardial infarction and those in whom revascularization was not indicated, 4409 patients remained in the analyses. We selected two groups: (1) patients in whom revascularization was the preferred treatment option (n = 3777, 86%), and (2) patients who were considered ineligible for revascularization (n = 632, 14%). RESULTS: Patient ineligible for revascularization had a worse risk profile, more often had a total occlusion (59% vs. 37%, p < 0.001), were treated more often with ACE-inhibitors (65% vs. 55%, p < 0.001) but less likely with aspirin (83% vs. 88%, p < 0.001). Overall, they had higher case-fatality at 1-year (7.0% vs. 3.7%, p < 0.001). Regarding self-perceived health status, measured via the EuroQol 5D (EQ-5D) questionnaire, these same patients reported more problems on all dimensions of the EQ-5D. Furthermore, in the revascularization group we observed an increase between discharge and 1-year follow up (utility score from 0.85 to 1.00) whereas patients ineligible for revascularization did not improve over time (utility score remained 0.80) CONCLUSION: In this large cohort of European patients with CAD, those considered ineligible for revascularization had more co-morbidities and risk factors, and scored worse on self-perceived health status as compared to revascularized patients in the revascularization group. With the exception of ACE-inhibitors and aspirin, there were no major differences regarding drug treatment between the two groups. Given these clinically significant observations, there appears to be a role for nurse-led, multidisciplinary, rehabilitation teams that target clinically vulnerable patients whose symptoms remain refractory to standard medical care.
Activities of Daily Living↗
Quality of life in Chinese elderly people with depression.
BACKGROUND: Depression is the most prevalent functional mental disorder of later life. It is estimated that about 5% of the elderly population of Hong Kong are suffering from depression. AIM: To investigate the self-rated quality of life of community-dwelling elderly people diagnosed with depression, and to examine the relationships between quality of life and mental, physical health, functional status and social support. METHODS AND RESULTS: A cross-sectional descriptive survey was conducted in psychiatric outpatient clinics. A convenience sample of 80 Chinese elderly people with a diagnosis of depressive disorder was recruited. Perception of quality of life was measured by the Hong Kong Chinese World Health Organization Quality of Life Scale-Brief Version. Participants' mental status, functional abilities, physical health condition, and social support status were assessed. Sixty-one (76.3%) participants were female. They were least satisfied with 'meaningfulness of life', 'life enjoyment', 'concentration and thinking', 'energy' and 'work capacity'. Functional abilities had a positive association with participants' perceived quality of life, level of depression and number of physical health conditions had a negative association. Participants had low ratings of quality of life when compared with healthy persons and persons with chronic physical problems. Findings are discussed in light of the socio-cultural environment in Hong Kong. CONCLUSION: Comprehensive treatment and better control of depression, including different modes of medical and psychosocial intervention, could help to improve participants' perception of quality of life. A longitudinal study with a larger sample with various levels of depression and socio-demographic characteristics is recommended.
Activities of Daily Living↗
A cross-sectional study on the health related quality of life of depressed Chinese older people in Shanghai.
BACKGROUND: With an increasing life expectancy, there is a rapidly growing sector that is aging. Depression is the most prevalent functional mental disorder of older population. It is estimated that about 21% of the older population in Shanghai are suffering from depression. AIM: This study investigated the self-rated health related quality of life of community-dwelling older people diagnosed with depression in Shanghai, and to examine the relationships between this and mental and physical health, functional status and social support. METHODS: A cross-sectional survey was conducted in two community centres with a convenience sample of 71 participants. Measures included subjective perception of health related quality of life, level of depression, cognitive function, number of medical conditions, activities of daily living, functional abilities, and social support. The majority of the participants were female (n=52, 73.23%), and married (n=51, 71.8%). RESULTS: A higher level of depression was related to a poorer health related quality of life. Participants were least satisfied with their physical health. The level of depression, activities of daily living and satisfaction with social support were predictors of health related quality of life ratings. CONCLUSION: The study identified how depression affects the bio-psychosocial status of Chinese older people. Findings are discussed in light of the socio-cultural environment in Shanghai.
Activities of Daily Living↗
Quality of life measures for depressed and non-depressed Chinese older people.
AIM: To compare the perception of quality of life (QoL) between depressed and non-depressed Chinese older people in Hong Kong and examined the factors that influence this perception. METHODS: A cross-sectional study was conducted with a convenience sample of 80 older people with a diagnosis of depression and 179 non-depressed controls. RESULTS: The depressed group had a lower rating in perceived QoL in all aspects than the non-depressed group. Level of depression and functional abilities were predictors of quality of life ratings for the both groups and activities of daily living was the predictor of quality of life for the depressed group only. The study identified the subjective perception of QoL amongst depressed older people is significantly lower than that amongst non-depressed older people. Depression affects the bio-psychosocial status of Chinese older people. This study provides insight for healthcare professionals in planning innovative services to meet their health needs.
Activities of Daily Living↗
Factors influencing Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction.
The purpose of this study was to identify, through in-depth interview, factors that influenced 27 Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction (AMI). The median delay time from the onset of symptoms to arrival at the hospital was 15.6 hours for men and 53.7 hours for women. Three major categories emerged from the data: (a) becoming aware of the threat, (b) maintaining a sense of normality, and (c) struggling to mobilize resources. A variety of decisions were made by patients from the onset of chest pain to seeking help. These decisions were heavily influenced by healthcare factors (access to emergency medical service (EMS) and treatment), personal factors (cognitive interpretations of symptoms), sociocultural factors (family situation, cultural beliefs, and practices), and coping strategies.
Adaptation, Psychological↗
Depression in cardiac patients: what can nurses do about it?
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Depressive Disorder↗
Factor structure of the Chinese version of the Geriatric Depression Scale.
Depression is common in patients following stroke and has been found to be related to the degree of functional disability, recovery and engagement in rehabilitation. Consequently, screening for depression is crucial in this group in order to facilitate the delivery of appropriate psychological support. The current study sought to determine key psychometric properties of the Chinese version of the Geriatric Depression Scale (GDS) in this group. Three versions of the GDS were evaluated, these being the 30-item original measure (GDS-30), the short-form version comprising 15 items (GDS-SF) and a recently developed innovative four-item version (GDS-4). Confirmatory factor analysis revealed the GDS-30 and GDS-SF to offer an acceptable fit to data suggesting utility of these measures for screening. However, the GDS-4 offered a poor fit to the data, suggesting this measure was an inadequate measure of depression in this clinical group. Further, though GDS-30 and GDS-SF measures revealed good internal consistency, the performance of the GDS-4 was marginal. However, all GDS-derived measures demonstrated excellent convergent and divergent validity. It is concluded that the GDS-30 is a useful and appropriate screening instrument in this group. Further, the GDS-SF shows promise in terms of development as a multidimensional measure of depression that may have predictive and outcome monitoring potential. The psychometric shortcomings of the GDS-4 strongly suggest that this measure is unsuitable for screening in this clinical group.
Aged↗
Psychometric properties of the Chinese version of the diabetes empowerment scale.
Metabolic control is central to positive clinical outcome in patients with diabetes. Empowerment has been linked to metabolic control in this clinical group. The current study sought to determine key psychometric properties of the Chinese version of the Diabetes Empowerment Scale (C-DES) and to explore the relationship of the C-DES sub-scales to metabolic control in 189 patients with a diagnosis of diabetes. Confirmatory factor analysis established that the five sub-scales of the C-DES offered a highly satisfactory fit to the data. Furthermore, C-DES sub-scales were found to have generally acceptable internal consistency and divergent reliability. However, convergent reliability of C-DES sub-scales could not be established against metabolic control. It is concluded that future research needs to address ambiguities in the relationship between empowerment and metabolic control in order to afford patients an evidenced-based treatment package to assure optimal metabolic control.
Asian People↗
An examination of the psychometric properties of the Rosenberg Self-Esteem Scale (RSES) in Chinese acute coronary syndrome (ACS) patients.
The psychometric properties of the Rosenberg Self-Esteem Scale (RSES) as a clinical research instrument for acute coronary syndrome (ACS) patients were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis was conducted on the RSES to establish its psychometric properties in 128 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test-retest reliability of the RSES-TOT (all-items) and RSES-POS sub-scale (positively valenced items) were found to be acceptable. The RSES-NEG sub-scale (negatively valenced items) lacked acceptable internal reliability. The underlying factor structure of the RSES comprised two distinct but related factors, though there was inconsistency in best model fit indices at the 1-week observation point. The use of the RSES as two sub-scales (RSES-POS and RSES-NEG) may be clinically useful in evaluating the influence of this important psychological construct on the health outcomes of patients with ACS. Directions for future research are indicated.
Acute Disease↗
Use of factor analysis in Journal of Advanced Nursing: literature review.
AIM: This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing. BACKGROUND: Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable. METHOD: Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study. RESULTS: One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis; Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used. CONCLUSIONS: Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.
Bibliometrics↗
Commentary on Chung BPM, Wong TKS, Suen ESB & Chung JWY (2005) SARS: caring for patients in Hong Kong. Journal of Clinical Nursing 14, 510-517.
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Hong Kong↗
Translation and validation of the Chinese version of the Charing Cross Venous Ulcer Questionnaire.
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Activities of Daily Living↗