Cardiac rehabilitation: The quest for quality

Stokes, Helen

doi:10.1016/s1362-3265(99)80040-6

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…taking advantage of the group dynamic process, which is in line with Dusseldorp et al [10] as well as Wieslander and Fridlund [11]. A common task performed on a daily basis by the cardiac rehabilitation nurse is to provide education regarding lifestyle, the purpose of which is to give the women the insight and motivation to make the necessary lifestyle changes, as documented by studies, in order to prevent recurrence of the MI [23,26]. Studies have shown that patients’ level of knowledge increased after implementation of a structured health education programme but that it did not necessarily lead to the required changes in lifestyle [8].…”

Section: Discussionmentioning

confidence: 84%

Self-Reported Behavioural and Medical Changes in Women after Their First Myocardial Infarction: A 4-Year Comparison Between Participation and Non-Participation in a Cardiac Rehabilitation Programme

Winberg

Fridlund

2002

European Journal of Cardiovascular Nursing

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Background: Women's recovery following a myocardial infarction (MI) has not yet been studied in a thorough manner. Aim: Therefore, the aim of this study was to compare women's self-reported behavioural and medical changes, both in those women who voluntarily participated and those women who did not participate in a cardiac rehabilitation programme (CRP). Methods: A non-randomised comparative study design, including pre- (baseline) and post-tests (1 and 4 years after), was implemented in 18 hospitals in Sweden. Consecutively chosen women suffering their first MI ( N=240) completed a questionnaire regarding behavioural and medical factors. Results: At baseline, significant differences existed between the groups regarding time stress (increased in the CRP group) and hypertension (increased in the non-CRP group). The behavioural factors improved, irrespective of CRP participation or not, with the exception of time stress, which was consistently high in the CRP group both 1- and 4-years after the MI. Regarding the medical factors, the significant difference in hypertension disappeared after 1 year. Four years after the MI, the CRP group reported significantly less rehospitalisation and more interventive cardiology compared to the non-CRP group. Conclusion: The women benefited from CRP participation in relation to medical factors, but not at all in relation to behavioural factors. Accordingly, randomised clinical trials are necessary to perform in order to determine the effects of a long-term individual-based supportive CRP, performed by well-educated healthcare professionals.

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Section: Discussionmentioning

confidence: 84%

Self-Reported Behavioural and Medical Changes in Women after Their First Myocardial Infarction: A 4-Year Comparison Between Participation and Non-Participation in a Cardiac Rehabilitation Programme

Winberg

Fridlund

2002

European Journal of Cardiovascular Nursing

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“…The need to evaluate the quality of the phase-one cardiac rehabilitation program from the consumer perspective has been considered by other health services as an outstanding area yet to be fully examined (Stokes 1999). Other limitations of this study include the lack of random sampling, small sample size and possible bias of the staff involved in the delivery of the phase-one CR program.…”

Section: Discussionmentioning

confidence: 99%

Concordance with phase‑one cardiac rehabilitation guidelines in the inpatient setting

Murphy,

George,

Driscoll

2007

Aust J Adv Nurs

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Objective: To examine concordance with phase‑one cardiac rehabilitation (CR) guidelines, undertake an intervention that might optimise adherence to the guidelines, and establish a benchmark for practice in the coronary care unit (CCU) setting. Design: Pre‑post intervention medical record review. Setting: Level 1, university-affiliated coronary care unit (CCU), Melbourne, Australia. Subjects: Inpatients of the CCU with a discharge diagnosis of acute coronary syndrome, ischaemic‑induced acute pulmonary oedema, myocardial infarction, arrhythmia, or cardiac arrest, and patients for elective coronary interventions (eg. angioplasty). Interventions: Medical record review of concordance with phase‑one CR guidelines and staff in‑services to communicate the results; distribution of a questionnaire post-in-service to collate staff perceptions of barriers to undertaking phase‑one CR; and repeated medical chart audit to re‑assess concordance. Main outcome measures: Concordance with the guidelines for phase‑one CR. Results: Data was complete for 89 cases. Concordance rates ranged from 5 to 100%. Good concordance with guidelines was recorded in advising the patient of their medical diagnosis (98‑100%); and in assessing the patient and their family’s psychological adjustment to their condition and the impact it had on their well-being (80‑83%). The only significant improvement post-intervention was a written invitation to a phase two CR program (5 vs. 14%). Conclusions: The audit raised awareness of barriers to undertaking phase‑one CR but did not appreciably alter the concordance rates. This suggests other strategies and resources to increase the delivery of phase‑one CR need to be considered

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“…Although clinical effectiveness has been described as ‘Doing the right thing to the right person at the right time’, this definition may be lacking two further elements: ‘Who is it being done by?’ and ‘Are they competent to do it?’ (Stokes, 1999). Evaluation of cardiac rehabilitation services has tended to focus on clinical and cost effectiveness, as measured by a variety of patient outcomes including mortality, risk factor reduction, quality of life and return to work.…”

Section: Effective Practice and Training Needs In Rehabilitationmentioning

confidence: 99%

Education and training towards competency for cardiac rehabilitation nurses in the United Kingdom

Stokes

2000

Journal of Clinical Nursing

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The development of cardiac rehabilitation in the UK, the evolution of the nursing role as a speciality, and the nursing role within the multidisciplinary team are briefly outlined. The potential impact of different professional backgrounds on the effectiveness of patient care is discussed, with particular reference to the differences between acute cardiac care and rehabilitation. Issues of professional competency are discussed, and core competencies for cardiac rehabilitation as specified by various professional associations are described. Current opportunities for preparation for practice in this field in the UK are outlined. Conclusions point towards the need for clearly specified competencies and an accredited programme of education and training to meet proposed standards for the management and rehabilitation of coronary heart disease (CHD) in the UK.

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Cardiac rehabilitation: The quest for quality

Cited by 7 publications

References 27 publications

Self-Reported Behavioural and Medical Changes in Women after Their First Myocardial Infarction: A 4-Year Comparison Between Participation and Non-Participation in a Cardiac Rehabilitation Programme

Self-Reported Behavioural and Medical Changes in Women after Their First Myocardial Infarction: A 4-Year Comparison Between Participation and Non-Participation in a Cardiac Rehabilitation Programme

Concordance with phase‑one cardiac rehabilitation guidelines in the inpatient setting

Education and training towards competency for cardiac rehabilitation nurses in the United Kingdom

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