Background. Shared decision making (SDM) is becoming more and more important for the patient-physician interaction. There has not been a study in Romania evaluating patients’ point of view in the SDM process yet. Therefore, the present study aims to evaluate the psychometric parameters of the translated Romanian version of SDM-Q-9. Material and methods. A multicentric cross-sectional study was performed comprising eight recruitment centers. The sample consisted of in- and outpatients who referred to Hospital Units for treatment for atrial fibrillation or collagen diseases. Furthermore, patients who were members of Autoimmune Disease Patient Society were able to participate via an online survey. All participants completed the Romanian translated SDM-Q-9. Results. Altogether, 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The Romanian version had good internal consistency (Cronbach α coefficient of 0.96.) Corrected item correlations were good ranging from 0.64 to 0.89 with low corrected item correlations for item 1 and item 7. PCA found a one-factorial solution (similar with previous reports) but the first item had the lowest loading. Conclusion. SDM-Q-9 is a useful tool for evaluation and improvement in health care that was validated in Romania and can be used in clinical setting in this country.

Background Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. Material and methods A cross‐sectional multicentric study comprising eight recruitment centres was performed. Inpatients and outpatients who referred to Hospital Units treating autoimmune diseases or atrial fibrillation were included. Another sample consisted of members of the Autoimmune Disease Patient Society, who completed an online anonymous questionnaire. All participants completed the Romanian translated version of the 9‐item Shared Decision Making Questionnaire (SDM‐Q‐9), as these samples were used for the validation of this questionnaire, too. Patients had to refer to the visit in which the decision concerning the antithrombotic treatment was taken (atrial fibrillation patients), or the immunosuppressive treatment was last time changed (autoimmune disease patients). Ordinal regression having the total SDM score as dependent variable was used. Results A total of 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The median score for SDM was 34 of 45, but it differed between hospital completion –39/45 and online completion (anonymous) –20/45 (P < .001). Patients with higher education were influenced most by the setting, giving the best marks in hospital and low marks online, while those with lower education gave lower marks in both settings. In ordinal regression with SDM score as dependent variable, hospital completion of the questionnaire (OR = 9.5, 95% confidence interval, 5.69‐16), collagen disease diagnosis (OR = 2.4, 95% confidence interval, 1.39‐4.14), and immunosuppressive treatment (OR = 2.16, 95% confidence interval, 1.43‐3.26) were independent predictors. Conclusion In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical.

No abstract

Cardiovascular rehabilitation (CR) is part of cardiovascular prevention and the objectives are the improvement of functional capacity, control of cardiovascular risk factors, adoption of a healthy lifestyle, education and adherence to the recommended therapies, aiming the reduction of the risk of adverse events, disability, cardiovascular mortality and the increase in quality of life. In Romania, CR is delivered only in a in hospital basis, at 2nd phase of rehabilitation in patients, in five dedicated centers that have the necessary equipment and a multidisciplinary team, but an insufficient number of beds compared to a great number of patients with an indication for rehabilitation. Issues related to addressability, adherence, incomplete legislation regarding ambulatory rehabilitation, and lack of recognition of CR as a part of cardiology or internal medicine are still unsolved.

Cardiovascular rehabilitation represents a very important measure in post myocardial infarction patients for both, improving their quality of life and preventing other acute cardiovascular events. It is important to accurately assess functional capacity of patients after acute coronary events, in order to optimize the results of cardiac rehabilitation program. Cardiopulmonary exercise testing (CPET) represents the gold standard in functional capacity assessment. We present 3 clinical cases of post STEMI patients, with coronary revascularization interventions, addressed to cardiovascular rehabilitation. They underwent CPET evaluation at baseline and during rehabilitation program. This method proved important utility for individualization of cardiovascular rehabilitation program, as well as for monitoring the long term evolution after myocardial infarction.