Tuesday, 29 September 2015

World Heart Day 2015 Tuesday 29 September 2015

David R Thompson PhD FRCN FAAN
Professor and Director, Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia

To mark World Heart Day, we asked Professor David Thompson to select some recent relevant papers from JAN.
David Thompson
Heart disease not only remains the world’s leading cause of death but also results in significant disability and distress, which impose a major human and economic burden. Two key areas where nurses have made major research contributions to the care of people with heart disease are in cardiac rehabilitation and heart failure self-care. I have therefore selected two very recent papers, both from Canada, that address these topics.

The first paper by Angus et al. (2015) addresses the issue of gender and access to cardiac rehabilitation. It is well recognized that access to, and uptake and completion of, cardiac rehabilitation is poor, especially for women, older people, ethnic minority groups and rural and remote communities. Why women, for example, are less likely to attend cardiac rehabilitation is unclear and there is a need to understand the barriers to uptake that exist. This meta-synthesis of 69 qualitative studies found that only four of them had specified a definition or theoretical position on gender. The authors argue that conceptual clarity about the social origins of gender is needed in order to work towards understanding the social determinants of access disparities.


The other paper by Spaling et al. (2015) addresses the issue of heart failure patients’ self-care. It is well recognized that there is inconsistency in patients’ knowledge and practices around self-care and interventions to improve it. Thus, patient-focused recommendations are needed to improve this care. This systematic review and qualitative interpretive synthesis of 37 studies found, for instance, that while patients could often recall health professionals’ self-care advice, they were unable to integrate this knowledge into daily life. The authors argue that merely providing patients with more sophisticated knowledge of heart failure is unlikely to improve heart failure self-care. What are also needed are strategies with patients and family members to promote mastery and self-efficacy, learning and adaptation/application. 

Both of these papers make important contributions to the nursing literature and will, hopefully, influence the provision of better care to people with heart disease.


References

Angus JE., King-Schier KM., Spaling MA., Duncan AS., Jaglal SB., Stone JA. & Clark AM. (2015) A secondary meta-synthesis of qualitative studies of gender and accessto cardiac rehabilitation. Journal of Advanced Nursing doi: 10.1111/jan.12620

Spaling MA., Currie K., Strachan PH., Harkness K. & Clark AM. (2015) Improving supportfor heart failure patients: a systematic review to understand patients’ perspectiveson self-care. Journal of Advanced Nursing doi: 10.1111/jan.12712



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