A Randomised Controlled Trial to Evaluate a Nurse-Led Programme of Support and Lifestyle Management for Patients Awaiting Cardiac Surgery: ‘Fit for Surgery: Fit for Life’ Study

H, Goodman; Parsons, Andrew J.; Davison, June; Preedy, Michael; Peters, E. A.; Shuldham, Caroline; Pepper, John; Cowie, Martin R.

doi:10.1016/j.ejcnurse.2007.11.001

Cited by 54 publications

(114 citation statements)

References 15 publications

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“…An interesting finding was that the preoperative or postoperative endeavors of the healthcare system to improve post‐CABG HRQoL were mainly found to be ineffectual. Enhanced prevention of risk factors, i.e., preoperative counseling, strict control of blood pressure, and medication optimization did not improve postoperative HRQoL 17 . Advanced postoperative support compared with standard postoperative care did not show significant differences in HRQoL, and neither reduced unexpected contacts with the healthcare system nor affected symptom distress between the study groups 26 .…”

Section: Discussionmentioning

confidence: 74%

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Health-Related Quality of Life After Coronary Artery Bypass Grafting: A Review of Randomized Controlled Trials

Jokinen

Hippeläinen²,

Turpeinen³

et al. 2010

Journal of Cardiac Surgery

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Objective outcome measures (i.e., survival, mortality, morbidity, complication rate, symptom recurrence, and need for re-interventions) have long been used as benchmarks for successful cardiac surgery, including coronary artery bypass grafting (CABG). Along with these objectively measurable outcome indicators, acquired improvement by cardiac surgery in subjectively experienced health-related quality of life (HRQoL) has gained importance during the last decade in cardiac surgical research. If an increasing proportion of adult patients referred for CABG are elderly, octogenarians or even nonagenarians, the acquired HRQoL benefit from bypass surgery should be considered to be at least as important an outcome measure as potentially marginal improvement in life expectancy or longevity alone. To achieve the maximal HRQoL benefit and to optimize patient selection, a comprehensive analysis and understanding of contributors that affect pre- and postoperative self-perceived HRQoL is essential. These include patient-related characteristics (e.g., demographics and underlying comorbidities), surgical technique-related factors, and healthcare-related attributes. In this paper we review the randomized controlled trials published during the last ten years to analyze the effect of CABG on HRQoL. Specifically, we focus on the differences between the on-pump and off-pump (OPCAB) bypass techniques, investigate the factors that contribute to post-CABG HRQoL, and study post-CABG HRQoL in elderly patients.

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Section: Discussionmentioning

confidence: 74%

“…Similarly, enhanced prevention of risk factors did not improve post‐CABG HRQoL during the follow‐up at three months and six months. Enhanced intervention appeared to reduce overall healthcare usage 17 …”

Section: Resultsmentioning

confidence: 99%

Health-Related Quality of Life After Coronary Artery Bypass Grafting: A Review of Randomized Controlled Trials

Jokinen

Hippeläinen²,

Turpeinen³

et al. 2010

Journal of Cardiac Surgery

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“…Patients with expected long LOS might benefit from preemptive interventions [34, 35] including geriatric care and pre-procedural rehab [36, 37], nutrition supplementation [38], reducing bleeding risk [39], optimize periprocedural practice [29, 40, 41], and post procedural rehabilitation [42]. …”

Section: Discussionmentioning

confidence: 99%

Factors associated with length of stay following trans-catheter aortic valve replacement - a multicenter study

Arbel

Zivkovic

Mehta

et al. 2017

BMC Cardiovasc Disord

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BackgroundMost patients undergoing Transcatheter aortic valve implantation (TAVR) are elderly with significant co-morbidities and there is limited information available regarding factors that influence length of stay (LOS) post-procedure. The aim of this study was to identify the patient, and procedural factors that affect post-TAVR LOS using a contemporary multinational registry.MethodsWe conducted a retrospective cohort study, with patients recruited from three high volume tertiary institutions. The primary outcome was the LOS post-TAVR procedure. We examined patient and procedural factors in a cause-specific Cox multivariable regression model to elucidate their effect on LOS, accounting for the competing risk of post-procedural death. Hazard ratios (HR) greater than 1 indicate a shorter LOS, while HRs less than 1 indicate a longer LOS.ResultsThe cohort consisted of 809 patients. Patient factors associated with longer LOS were older age, prior atrial fibrillation, and greater patient urgency. Patient factors associated with shorter LOS were lower NYHA class, higher ejection fraction and higher mean aortic valve gradients.Procedural characteristics associated with shorter LOS were conscious sedation (HR = 1.19, 95% CI 1.06–1.35, p = 0.004). Transapical access was associated with prolonged LOS (HR = 0.49, 95% CI 0.41–0.58, p < 0.001).ConclusionThis multicenter study identified potentially modifiable patient and procedural factors associated with a prolonged LOS. Future research is needed to determine if interventions focused on these factors will translate to a shorter LOS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0573-7) contains supplementary material, which is available to authorized users.

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“…19 However, in another randomised controlled trial, Goodman et al found that providing information alone had no significant effect on levels of anxiety among patients scheduled for a coronary artery bypass surgery. 20 In the present study, one of the interventions involved patients watching video footage taken in the surgical environment and an explanation of the actions taken before, during and after the procedure. Tou et al also found a reduction in patients' anxiety levels following a video-based intervention.…”

Section: Discussionmentioning

confidence: 99%

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial

Habibzadeh

Milan

Radfar

et al. 2018

Sultan Qaboos Univ Med J

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abstract:Objectives: Coronary angiography can be stressful for patients and anxiety-caused physiological responses during the procedure increase the risk of dysrhythmia, coronary artery spasms and rupture. This study therefore aimed to investigate the effects of peer, video and combined peer-and-video training on anxiety among patients undergoing coronary angiography. Methods: This single-blinded randomised controlled clinical trial was conducted at two large educational hospitals in Iran between April and July 2016. A total of 120 adult patients undergoing coronary angiography were recruited. Using a block randomisation method, participants were assigned to one of four groups, with those in the control group receiving no training and those in the three intervention groups receiving either peer-facilitated training, video-based training or a combination of both. A Persian-language validated version of the State-Trait Anxiety Inventory was used to measure pre-and post-intervention anxiety. Results: There were no statistically significant differences in mean pre-intervention anxiety scores between the four groups (F = 0.31; P = 0.81). In contrast, there was a significant reduction in post-intervention anxiety among all three intervention groups compared to the control group (F = 27.71; P <0.01); however, there was no significant difference in anxiety level in terms of the type of intervention used. Conclusion: Peer, video and combined peer-and-video education were equally effective in reducing angiography-related patient anxiety. Such techniques are recommended to reduce anxiety amongst patients undergoing coronary angiography in hospitals in Iran. -Peer-facilitated, video-based or peer-and-video training is recommended to reduce anxiety among patients undergoing coronary angiography in Iranian hospitals. Application to Patient Care

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A Randomised Controlled Trial to Evaluate a Nurse-Led Programme of Support and Lifestyle Management for Patients Awaiting Cardiac Surgery: ‘Fit for Surgery: Fit for Life’ Study

Abstract: The nurse-led programme did not appear to reduce risk factors prior to coronary artery bypass surgery. However, the intervention appears to reduce overall healthcare utilization.

Cited by 54 publications

References 15 publications

Health-Related Quality of Life After Coronary Artery Bypass Grafting: A Review of Randomized Controlled Trials

Health-Related Quality of Life After Coronary Artery Bypass Grafting: A Review of Randomized Controlled Trials

Factors associated with length of stay following trans-catheter aortic valve replacement - a multicenter study

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial

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