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Sabina De Geest

Publications and source records attributed to Sabina De Geest.

At least 55 records · Page 3Linked to original sources
PubMed2003

Health professionals' perceptions of health status after renal transplantation: a comparison with transplantation candidates' expectations.

BACKGROUND: Renal transplantation is frequently considered superior to other renal replacement therapy in terms of survival and quality-of-life outcome. In this study, it was examined whether physicians and nurses have accurate perceptions of health status after renal transplantation (RTX) and whether renal transplant candidates have realistic expectations about posttransplant quality of life. METHODS: A comparative descriptive design was used for the comparison of physicians' and nurses' perceived and patients' expected and actual health status after RTX. Health status perceptions were measured by means of the EQ-5D self-report questionnaire. RTX candidates (n=107) were followed longitudinally from November 1999 until July 2001. Transplant patients (n=29) were surveyed 14 days and 4, 8, and 12 months after discharge from hospital. All physicians and nurses (n=123) had regular contact with dialysis or RTX patients. RESULTS: Physicians' and nurses' perceptions of health status after RTX were significantly lower than patients' expectations. Transplant nurses' and physicians' valuations were closer to patients' actual health status after transplantation than valuations of nurses on the dialysis or nephrology ward or at the outpatient clinic. CONCLUSIONS: RTX candidates frequently have higher expectations about their quality of life after transplantation than physicians and nurses who have regular contact with renal transplant patients. Physicians' and nurses' perceptions are closer to the actual health state after transplantation than patients' expectations. Thus, physicians and nurses are a reliable source of information for patients about the health state they can expect after transplantation.

Comorbidity↗
PubMed2003

Health-related quality of life and symptom experience in tacrolimus-based regimens after renal transplantation: a multicentre study.

Tacrolimus is increasingly used as a baseline immunosuppressant after renal transplantation. This multicentre study assessed health-related quality of life and symptom experience in renal transplant patients on tacrolimus-based therapy, using the SF-36 and Euroqol 5 dimensions (EQ-5D) and the 'modified transplant symptom occurrence and symptom distress scale', respectively. Symptoms of depression were assessed with the short form of the Beck Depression Inventory and physical activity with the Baecke questionnaire. Overall, 350 patients with a median post-transplant status of 16.7 months were enrolled. Results revealed that patients experienced lower SF-36 scores than the general population, except in terms of bodily pain. Univariate and multivariate analyses demonstrated that a higher degree of depressive symptoms and female gender were consistently related to a health status perceived as being worse and a higher rate of symptom experience. These findings are in accordance with previous quality-of-life reports that assessed patients under various immunosuppressive therapies. Therefore, interventions, including the screening and treatment for depression and the addressing of gender-specific issues, can enhance quality of life.

Adult↗
PubMed2003

Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards.

BACKGROUND: Heart failure represents a growing epidemic, primarily in the elderly. Development and implementation of management programs designed for use in daily clinical practice remains a major challenge. AIMS: This study aimed at profiling a hospitalized heart failure population in view of medical, behavioral, educational, psychosocial and health resources utilization parameters stratified by admission to cardiology and geriatric wards. METHODS AND RESULTS: Using a descriptive comparative design, 109 European heart failure patients admitted to cardiology (42%) and geriatric wards (58%) were included. Significant differences (all P<0.0001) were identified between the two groups. Patients admitted to cardiology had a mean age of 68.5, 33% were women, and the mean ejection fraction was 38%. Patients admitted to geriatrics had a mean age of 85, 68% were women, and the mean ejection fraction was 56%. Sixty-six percent were admitted for cardiac reasons. Medical, educational, behavioral, psychosocial and health resources utilization data were retrieved from medical files as well as by patient and family interviews. Results showed significant differences between groups. Patients admitted to geriatric wards received significantly less ACE inhibition and beta-blockers. Moreover, these patients were significantly less knowledgeable, showed poorer self-management, poorer hearing, more cognitive impairment, a higher degree of depressive symptomatology, more problems with ADL and IADL, and used significantly more home health care services compared to patients admitted to cardiology wards. CONCLUSION: The characteristics of the heart failure population at large are quite different from those of populations included in large-scale therapeutic trials. Findings from this study provide options for tailored management strategies for both profiled subgroups.

Activities of Daily Living↗
PubMed2003

Building bridges: the American Heart Association-European Society of Cardiology's International Nursing Collaboration.

This paper described the formal collaboration between the American Heart Association's Council on Cardiovascular Nursing and the European Society of Cardiology's Working Group on Cardiovascular Nursing. This collaboration comprises following dimensions: (1). further expansion on collaboration on annual conferences; (2). development of mentoring initiatives; (3). initiation of research collaboration; (4). development of joint guidelines; and (5). appointment of liaison persons of AHA to ESC and vice versa.

American Heart Association↗
PubMed2003

Validity testing of the Long-Term Medication Behavior Self-Efficacy Scale.

Self-efficacy is an important determinant of health behavior that can be targeted for intervention. Little effort has been given to the development of valid measures for self-efficacy with medication taking for adherence research. The purpose of this study was to determine the criterion validity of the Long-Term Medication Behavior Self-Efficacy Scale (LTMBSES). Individual patient data from 6 existing adherence studies in transplant, hyperlipidemia, and AIDS/HIV patients (n = 1021) were pooled. Validity was determined by assessing the relation between the LTMBSES score and medication adherence--both self-reported and electronically monitored. A weak relationship was found between the LTMBSES score and adherence, which can possibly be attributed to a ceiling effect, caused by a too homogeneous population and/or a failure of the scale to challenge patients. Generalized Estimating Equations revealed that the total average self-efficacy score predicted reported medication adherence (p < .0001). The Receiver Operating Characteristic curve revealed the area under the curve was 0.67, indicating a significant (p < .0001), but poor predictive capability. Evidence for criterion validity of the Long-Term Medication Behavior Self-Efficacy Scale is not yet convincing. Future research should focus on: (1) validation in a population with a more heterogenous level of adherence, and (2) making the scale more challenging by referring to "always taking the medication without exception."

Adolescent↗
PubMed2002

Nonadherence to highly active antiretroviral therapy: clinically relevant patient categorization based on electronic event monitoring.

Adherence to highly active antiretroviral therapy (HAART) is crucial, but which aspects of drug-taking behavior are important remain largely unknown. In a prospective observational study, 43 HIV-1-infected patients taking HAART underwent electronic event monitoring (EEM). Taking adherence was defined as the percentage of doses taken compared with the number prescribed, dosing adherence was defined as the percentage of days on which all doses were taken, and timing adherence was defined as the percentage of doses taken within 1 hr of the time prescribed. Drug holidays were defined as periods of no drug intake for >24 hr. Cluster analysis, including the four EEM parameters, was used and refined to construct an algorithm to discriminate patients. Patients were categorized as nonadherent if they had a taking adherence of <90%, or a dosing adherence of <75% and at least 1 drug holiday, or a timing adherence of <80% and at least 1 drug holiday, or >6 drug holidays per 100 days. All four EEM parameters differed significantly (p < 0.0001) between the two groups. Adherent patients had a better outcome, as shown by a larger drop in viral load (p = 0.011) and rise in CD4+ cell count (p = 0.035), showing that the algorithm-based categorization is clinically relevant.

Adult↗
PubMed2002

Depression and the heart: a systematic overview of definition, measurement, consequences and treatment of depression in cardiovascular disease.

Depression is an independent risk factor in the pathogenesis of cardiovascular disease and it is a prevalent disorder after cardiovascular disease associated with negative outcome in terms of mortality and morbidity. It is a dangerous condition requiring adequate screening and treatment, however, it often remains undiagnosed and thus untreated. Non-psychiatric healthcare workers, like nurses, general practitioners, physiotherapists and cardiologists are the health providers most closely involved in the management of patients with cardiovascular disease. They can play an important role in screening cardiovascular patients for depressive symptoms and in referring them for treatment. The purpose of this article therefore is to provide an evidence-based framework, aiming to educate non-psychiatric healthcare providers on depressive disorder in the context of chronic cardiovascular disease. In this paper, an overview of the definition, prevalence and consequences of depression will be discussed. Moreover, an overview of measurement methods and treatment modalities for depression will be provided. In addition, a step-by-step guide is provided in order to help non-psychiatric healthcare providers in dealing with depressed patients.

Algorithms↗
PubMed2002

Comprehensive care for adults with congenital heart disease: expanding roles for nurses.

Adults with congenital heart disease constitute a growing patient population. Although life expectancy of these patients is increasing, they may be confronted with specific medical, psychosocial and behavioural problems throughout their life span. Special attention needs to be given to patients' illness experiences; knowledge and health behaviour; employability and insurability. Hence, comprehensive care by specialised health care professionals, addressing the multidimensional problems experienced by the patients is required. Interdisciplinary teams in which nurses guarantee the management beyond typical medical issues are promising. Key elements of nurses' involvement are facilitation of the transition process from paediatric to adult cardiology, identification of patient needs, screening and referral for psychosocial problems, and education and counselling of patients and families. In particular, an advanced practice nurse seems to be pre-eminent to optimise illness management of adult patients with congenital heart disease.

Adaptation, Psychological↗
PubMed2002

A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure.

The relationship between adherence, virological response to highly active antiretroviral therapy (HAART) and the presence and development of genotypic resistance was assessed in 41 HIV-infected patients on HAART. Four adherence parameters (drug taking adherence, dosing adherence, timing adherence and drug holidays) were scored prospectively using electronic event monitoring. Genotypic resistance at baseline and after therapy failure was scored retrospectively and a genotype-based susceptibility score was calculated. Overall median adherence rates were high. All adherence parameters were better in virological responders (n=31) compared to non-responders (n=10), drug taking adherence and number of drug holidays being significantly different. Responders had a significantly higher susceptibility score. Stepwise logistic regression showed that the number of drug holidays and a low susceptibility score were highly predictive for therapy failure. Despite the presence of a limited number of baseline resistance mutations, perfectly adherent patients can control virus replication for a prolonged period.

Adult↗
PubMedDate not supplied

Adherence to the therapeutic regimen in heart, lung, and heart-lung transplant recipients.

Optimal outcome after heart, lung, and heart-lung transplantation can only be obtained if patients are supported in adhering to a lifelong therapeutic regimen. The transplant patient's therapeutic regimen consists of a lifelong medication regimen, including immunosuppressive drugs; monitoring for signs and symptoms related to complications; avoidance of risk factors for cardiovascular disease and cancer (ie, diet and exercise prescriptions, nonsmoking); avoidance of abuse/dependence of alcohol or illegal drugs, as well as attending regular clinical checkups. Nonadherence to all aspects of this regimen is substantial. Nonadherence has been related to negative clinical outcome in view of acute rejections, graft vasculopathy, higher costs, and mortality. This review focuses on the prevalence, correlates, and consequences of nonadherence to the therapeutic regimen in heart, lung, and heart-lung transplantation. The current state of the-art on adherence-enhancing interventions is reported. Priorities for future research are outlined.

Aftercare↗
PubMedDate not supplied

Symptom management in HIV/AIDS: advancing the conceptualization.

For people living with HIV, symptoms related to the disease, comorbidities, and treatment side effects make symptom management essential. Poorly managed symptoms result in reduced medication adherence, disease progression, and lower quality of life. The Self-regulatory HIV/AIDS Symptom Management Model is a conceptual model that describes how persons living with HIV/AIDS manage their symptoms. The model links symptom experience, symptom management, social support, adherence, and health-related quality of life. It can assist nurses, through a multidimensional approach to illness management, to enhance symptom assessment, better understand factors influencing symptom experience, and to improve symptom management among people living with HIV/AIDS.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Prevalence, severity and correlates of alcohol use in adult renal transplant recipients.

BACKGROUND: Severe alcohol use is recognized as a major public health concern, even though light to moderate alcohol use might have beneficial effects on health. Alcohol use has been studied to some extent in solid organ transplant populations, yet evidence is lacking on alcohol use and its correlates in the renal transplant population. The aim of this study was therefore to determine the prevalence, severity and correlates of alcohol use in renal transplant recipients. METHODS: This cross-sectional study is a secondary analysis of the Supporting Medication Adherence in Renal Transplantation (SMART) study. Alcohol use was assessed by patient's self-report. At risk and binge drinkers were classified using World Health Organization criteria. The following correlates of alcohol use were explored: adherence with immunosuppression (Siegal questionnaire; electronic monitoring), smoking, coping style (UCL), depressive symptomatology (BDI) and busyness/routine in life style (ACQ Busyness Scale). RESULTS: Two hundred and eighty-four patients were included in this analysis, 58.1% male, with a mean age of 54 yr (range 20-84) and a median of seven (interquartile ranges [IQR] 8) yr post-transplantation. A total of 52.8% of study participants reported to drink alcohol at least once a week. Two hundred and eighty of 284 subjects (98.5%) were drinking at low risk, four at moderate risk (1.5%). None of the participants were drinking severely. Correlates of alcohol use were male gender and being professionally active. CONCLUSION: Alcohol use is less prevalent in renal transplant recipients than in the general population. Severe alcohol use does not seem to represent a serious problem in renal transplant patients.

Adaptation, Psychological↗