[PDF] Factors Influencing Uncertainty And Health Status Outcomes In Coronary Artery Bypass Graft Surgery Patients eBook

Author : Friederike Kendel
Publisher : Springer Science & Business Media
Page : 106 pages
File Size : 20,49 MB
Release : 2009-01-24
Category : Medical
ISBN : 3798518564

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Progress in coronary artery bypass graft surgery has irrefutably improved the quality of life of many patients. However, we are confronted with the finding that women - hibit a higher mortality rate than men. In part, this difference can be explained by clinical parameters such as age, disease severity, or comorbidity – factors that have been well studied, but which do not fully explain the observed differences. This is one reason why, in recent years, psychosocial variables have attracted special atten- on in this context. In fact, women and men having undergone a bypass operation - ry a great deal with respect to, e. g. , depression, partner status, and socio-economic status. Moreover, psychological well-being, on the one hand, and social isolation, on the other hand, definitely influence the recovery process, particularly when consi- red under the gender aspect. The Deutsches Herzzentrum Berlin has been actively supporting gender-specific research for many years. In this context, a large prospective study on gender dif- rences in recovery after bypass surgery, carried out by the Competence Network of Heart Failure, was started at our Department for Cardiothoracic and Vascular Sur- ry. From the beginning of the study, psychosocial variables were included as being substantial contributors. The starting point of the study presented here* by psychologist Dr. Friederike Kendel are recent empirical investigations about gender differences in coronary heart disease and the course of recovery after bypass surgery.

Author : Patricia Thomson
Publisher :
Page : pages
File Size : 32,32 MB
Release : 2008
Category :
ISBN :

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Background: Coronary heart disease (CHD) remains a major cause of death and ill-health in Scotland. Coronary artery bypass grafting (CABG) aims to relieve CHD symptoms, improve quality of life and increase life expectancy in high-risk groups. Partners may positively or negatively influence patient outcome, and they too may be adversely affected by the experience of CABG. Health care is currently organised around the patient. The partner is seen as merely assisting patient recovery. Their health and well-being is neglected despite them being at an increased risk of CHD. Research has been limited in the partner variables that have been examined. Their health needs and concerns and the influence of the patient on partner outcome have seldom been examined and the effects of CABG on the dyad. The dyad has not previously been examined as an outcome variable of interest. Aim: To explore the complex factors that influence patient and partner and dyad outcome 4 months after CABG surgery. Design and methods: A multifactorial exploratory, prospective study was carried out. A consecutive sample of 80 patient-partner/family pairs were recruited and data were collected on a number of physical and psychosocial variables 2-3 months prior to elective CABG and 4 months after surgery. The outcome measures were perceived health status, quality of life and CHD risk factors. Findings: The patients' CHD risk factors and physical and mental health (SF-12) improved significantly from pre- to post-operatively, but there was no corresponding improvement in the partners. Most patients were free from angina following CABG. Though the partners' quality of life improved it remained sub-optimum post-operatively. The patients' self efficacy beliefs and partners' efficacy judgements about the patient's cardiac capabilities improved significantly at 4 months; treatment beliefs were unchanged. The patients' perceived social support improved post-operatively, but not the partners. Patients' and partners' total number of important need met increased significantly post-operatively, and the number of important needs unmet decreased. There were significant differences between the patient and partner groups over the two time periods (pre- and post-operatively) for CHD risk factors, physical health (SF-12), self-efficacy for maintaining function, affectionate support, positive social interaction and important needs met and unmet. Overall, the recovery patterns indicated a move towards concordance. The patients' poorer pre-operative physical and mental health (SF-12) significantly predicted their poorer post-operative physical health, and lower pre-operative importance need met predicted poorer mental health. Greater pre-operative CHD risk factors and being female predicted higher post-operative risk factors. Partners' poorer pre-operative physical and mental health (SF-12) significantly predicted their poorer post-operative physical and mental health; low pre-operative affectionate support predicted poorer physical and social health (QL-SP); and a greater number of pre-operative CHD risk factors predicted higher post-operative risk factors. The patients' pre-operative beliefs about CABG - mortality risk reduction predicted the partners' poorer post-operative physical health (SF-12) and emotional health (QL-SP); and patients' poorer pre-operative mental health (SF-12) and greater physical limitation (SAQ) predicted the partners' poorer physical and social health (QL-SP). Only the partners' poorer pre-operative physical health predicted patients' poorer post-operative physical health (SF-12). This unidirectional relationship in which the patients' pre-operative factors predominantly influenced partner outcome(s) was also evident when the physical and mental health and CHD risk factors of the dyad (outcomes) were examined. Results highlight the potential that pre-operative rehabilitation and use of interventions, which target the dyad have for the primary and secondary prevention of CHD. Nurses are heavily involved in the pre-operative preparation for CABG and in the post-operative care of patients and could contribute further to improving the outcomes of surgery for patients and partners.

Author : David P. Taggart
Publisher : Oxford University Press, USA
Page : 521 pages
File Size : 37,43 MB
Release : 2021
Category : Medical
ISBN : 0198758782

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This is the most authoritative textbook ever dedicated to the art and science of surgical coronary revascularization, with 71 chapters, organized in 9 sections, and written by over 100 recognized world experts. It covers every aspect of the surgical management of coronary artery pathology and ischaemic heart disease.

Author : Vasken Dilsizian
Publisher : Wiley-Blackwell
Page : 448 pages
File Size : 48,78 MB
Release : 2000-02-10
Category : Medical
ISBN : 9780879934378

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Despite remarkable advances in the understanding and management of impaired left ventricular function (LVF) and related coronary disease, the prevalence of heart failure in the U.S. and the resulting death rates have almost tripled in the past 3 decades. New understanding of the relationships between the myocardium and LVF demonstrate a direct correlation between myocardial viability and improved patient survival. Because of this, myocardial viability is now a major investigative area in contemporary cardiology, one that holds significant clinical and prognostic relevance. Authored by physicians of international renown, the book brings together various disciplines affecting myocardial viability, with five main sections providing an introduction and comprehensive review of: basic concepts and mechanisms; vascular biology and cellular physiology; advances in functional imaging; and perfusion, metabolism and cell membrane integrity. New concepts, such as stunning and hibernation, are clarified, and subsequent novel diagnostic and therapeutic strategies are described. New and sophisticated examination techniques are also presented, as well as advances in instrumentation and imaging techniques, which may result in improved use of resources and enhanced efficiency of health care delivery. This monograph will serve as a reference source for those interested in the field of myocardial viability, and hopefully improve understanding between investigators from various disciplines. Clinical cardiologists, physicians, and nurses in the field, as well as radiologists, vascular surgeons, reperfusionists, cellular biologists and physiologists, and students will all find material of interest in this book.

Author : Joep Perk
Publisher : Springer Science & Business Media
Page : 540 pages
File Size : 47,14 MB
Release : 2007-09-18
Category : Medical
ISBN : 9781846289934

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The aim of this textbook is to give guidance in prevention, lifestyle counselling and rehabilitation for cardiologists, other physicians and many different categories of health professionals in cardiac rehabilitation teams.

Author : Institute of Medicine
Publisher : National Academies Press
Page : 781 pages
File Size : 40,79 MB
Release : 2009-02-06
Category : Medical
ISBN : 030908265X

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Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Author : Corrado Tamburino
Publisher : Springer Science & Business Media
Page : 137 pages
File Size : 36,89 MB
Release : 2009-08-29
Category : Medical
ISBN : 8847014301

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Recent developments in the field of percutaneous coronary intervention and encouraging data relating to feasibility and safety have led to a renewed interest in left main angioplasty. Interventional cardiologists are faced with the challenge represented by this complex subset of lesions. The first part of this practical handbook specifically deals with the development of the anatomical classification and gives an overview of the frequency of different anatomic phenotypes. The second part provides a comprehensive knowledge on the techniques and approach to left main coronary artery disease and discuss the potential complications. The authors draw on their practical experience to look at expected or potential morbidity from percutaneous coronary intervention. The aim of this book is to provide interventional cardiologists with useful tips and tricks for percutaneous coronary intervention of the left main coronary artery.