Abstract P634: The Influence Of Virtual Learning Environment On Therapy Adherence And On The White Coat Effect

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Isabela R Fistarol ◽  
Chao L Wen ◽  
Luiz Bortolotto ◽  
Margarida Vieira ◽  
Miriam Tsunemi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Educational Technology ◽  
Learning Environment ◽  
Statistical Difference ◽  
Virtual Learning Environment ◽  
White Coat ◽  
Study Group ◽  
White Coat Effect

Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a common public health problem. Health education associated with educational technology may be used to encourage patients’ adherence to treatment and enable them to adequately understand how harmful hypertension can be to health, thereby promoting their quality of life. OBJECTIVE: To evaluate the influence of a strategy in an individual orientation program using educational technology associated with virtual learning environment (VLE) of hypertension care on the reduction in the white coat effect and the improvement in blood pressure control to be promoted by a nurse in a hypertension unit in a government state hospital in São Paulo. METHODS AND MATERIALS:This was a randomized clinical education study conducted with two groups, the VLE group (study group, 10 patients) and the control group (16 patients). Both groups were interviewed 6 times by nurses during the 120-day follow-up at 20-day intervals. At baseline (randomization) and at the end of the study, the patients took Spielberg’s State-Trait Anxiety Inventory (STAI), the Morisky test, and the WHOQOL, a quality of life instrument, and had their blood pressure taken (ambulatory blood pressure monitoring [ABPM]). Both groups had their blood pressure, weight, and abdominal circumference measured. Only the study group had remote access to the VLE. This consisted of 6 specific educational modules, each released according to the encounter number. RESULTS: At baseline, there were no statistical differences between the two groups with respect to the sociodemographic and hemodynamic variables. At the end of the study, there was a significant statistical difference between the groups on the Morisky test (p=0.001) and on the WHOQOL with respect to domain 3 social (p=0.001). There was no statistical difference with respect to the white coat effect between the groups. Nor was there any statistical difference between the groups with respect to the association of the anxiety degree measured by STAI and the white coat effect.CONCLUSION: In light of the results, our strategy improved the quality of life in the social domain and changed the adherence behavior of the study group in relation to the forgetfulness of medication schedules.

Abstract P628: The Influence Of Religiosity On The Embracement Vs. Technology Based Distance Learning In Therapy Adherence In Patient Hypertensive

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Grazia M Guerra ◽  
Chao L Wen ◽  
Margarida Vieira ◽  
Isabela Fistarol ◽  
Miriam H Tsunemi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Distance Learning ◽  
Negative Correlation ◽  
Virtual Learning Environment ◽  
Control Group ◽  
Therapy Adherence ◽  
Randomized Clinical Study ◽  
Group A

Introduction: The approach known as ‘ embracement ’ adopts relational strategies or soft technologies which promote bonding and may impact therapy adherence Objectives: To assess the influence of the religiosity in the embracement approach on therapy adherence, quality of life, in hypertensive outpatients. This approach may be associated or not with the use of educational technology in a virtual learning environment(VLE) for distance learning (DL). Methods: This was a prospective randomized clinical study conducted with the following 3 groups of hypertensive patients: Group A (n=16, 12 women, mean age of 55.3±13 years, mean BMI of 32.3±6 kg/m 2 , receiving individual orientation required by an embracement strategy characterized by 7 nursing visits at 20-day intervals, for 4 months); Group VLE (n=10, 7 women, mean age of 51.5±7 years, mean BMI of 29.4±6 kg/m 2 ,using a technological education strategy for DL and making 7 nursing visits at 20-day intervals, for 4 months); Control group (n=10, 5 women, mean age of 57.6±9 years, mean BMI of 29.7±6 kg/m 2 , making 1 nursing visit at baseline and 1 after 120 days.) At baseline and after 120 days, the following tools were applied: the Morisky test, WHOQOL, Religion Index (DUREL), and ambulatory blood pressure monitoring (ABPM). The VLE group had remote access to the ‘ Hypertension E-Care ’ site (6 specific educational modules). Results: At baseline, there were no differences in clinical blood pressure, ABPM, and socio-demographic variables among the 3 groups. At the final assessment, the VLE group (44.4±0.4) showed significant improvement (p<0.05) in the social domain of quality of life when compared to group A (40.8±4) and the controls (41.9±3);groups. In therapy adherence (Morisky test), the VLE group showed significant improvement at the end of the study, which was not the case with the other two groups. The significant correlations were observed between index of religiosity and the differences of BP Office for SBP R = - 0.667 , (p = 0.035 - negative correlation) and for DBP R =-0.666 (p = 0.035 - negative correlation) in VLE Group. Conclusion: This study shows that religious belief can improve blood pressure control, specifically when associated with education technology.

scholarly journals Psychosocial approach: quality of life in young people with elevated blood pressure

2011 ◽  
Vol 10 (2) ◽  
pp. 18-23
Author(s):  
D. I. Sadykova ◽  
I. Ya. Lutfullin
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Psychological Functioning ◽  
Blood Pressure Monitoring ◽  
White Coat ◽  
Clinical Psychologist ◽  
White Coat Hypertension ◽  
Physical Dysfunction ◽  
Essential Arterial Hypertension

Aim. To study quality of life (QoL), as an instrument for standardized assessment and monitoring of patients’ psychosocial status. Psychosocial approach is particularly important in diseases with psychosomatic component, such as essential arterial hypertension (EAH). Material and methods. QoL was assessed in 101 adolescents (62 boys, 39 girls; age 14-17 years) with various EAH forms, as well as in 38 healthy adolescents (comparison group, CG). Based on the results of 24-hour blood pressure monitoring (BPM), all patients were divided into 3 groups: with white-coat hypertension (n=32); with labile AH (n=33); and with stable AH (n=36). QoL was assessed with the MOS SF-36 scale, measuring not only absolute QoL values, but also the “proxy-problem” phenomenon (the discrepancy between QoL reported by the patients themselves and their proxies – parents). Results. Compared to the CG, adolescents with various BP levels demonstrated reduced QoL. QoL reduction was minimal in adolescents with white-coat hypertension, and maximal in patients with labile AH. In the latter group, both physical and psychological functioning parameters were reduced. The parents of EAH adolescents typically overestimated the severity of physical dysfunction of their children, while underestimating the magnitude of psychological dysfunction. Conclusion. The results obtained confirm the important role of psychosomatic mechanisms in AH pathogenesis, and emphasize the need for psychiatrist or clinical psychologist’ participation in the treatment of hypertensive adolescents. In adolescents with stable AH, physical dysfunction was predominant.

scholarly journals Integrated approach in the treatment of metabolic syndrome

2014 ◽  
Vol 11 (1) ◽  
pp. 32-37 ◽  
Author(s):  
V A Uchamprina ◽  
T I Romantsova ◽  
M F Kalashnikova
Keyword(s):  
Quality Of Life ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Clinical Outcomes ◽  
Antihypertensive Therapy ◽  
Standard Therapy ◽  
Integrated Approach ◽  
Study Group

The Goal of this study was to investigate the efficacy of the integrated approach for the treatment of metabolic syndrome (MS) aiming to correct all of its components versus standard therapy using clinical outcomes (BMI, waist circumference, blood pressure, lipid levels), assessment of psychological status (Beck Depression Inventory), and quality of life (SF-36). Methods: A total of 60 patients with MS were included in the study. The study group (30 subjects mean age 41.0±11 years, women - 23 (76.7%), men - 7 (23.3%)) received the complex therapy of MS - pharmacotherapy of obesity (orlistat) and insulin resistance (metformin), lipid-lowering therapy (statins or fibrates), antihypertensive therapy. Control group (30 patients mean age 43.4±9.5 years, women - 26 (86.7%), men - 4 (13.3%)) was treated with statins or fibrates and received antihypertensive therapy when needed. At the inclusion in the study and after 6 months of therapy all patients underwent clinical and laboratory investigation, assessment of depression and quality of life. Results: We found a more significant reduction of all clinical outcomes (body weight, blood pressure, improvement in glucose and lipid metabolism), a significant decrease in the prevalence and severity of the depression, and an improvement in the quality of life in patients of study group compared with standard therapy. Conclusion: Complex treatment of the MS, including pharmacotherapy of obesity (orlistat, Xenical) and insulin resistance (metformin, Glucophage) is characterized by a greater clinical efficacy compared with standard therapy.

The white-coat effect is associated with increased blood pressure reactivity to physical activity

2002 ◽  
Vol 7 (4) ◽  
pp. 209-213 ◽  
Author(s):  
Andrew C. Leary ◽  
Peter T. Donnan ◽  
Thomas M. MacDonald ◽  
Michael B. Murphy
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
White Coat ◽  
Blood Pressure Reactivity ◽  
White Coat Effect ◽  
Pressure Reactivity

scholarly journals Examining the effectiveness of telemonitoring with routinely acquired blood pressure data in primary care: challenges in the statistical analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard A. Parker ◽  
Paul Padfield ◽  
Janet Hanley ◽  
Hilary Pinnock ◽  
John Kennedy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Statistical Analysis ◽  
Propensity Score ◽  
Random Coefficient ◽  
White Coat ◽  
White Coat Effect ◽  
Regression Adjustment ◽  
The Impact

Abstract Background Scale-up BP was a quasi-experimental implementation study, following a successful randomised controlled trial of the roll-out of telemonitoring in primary care across Lothian, Scotland. Our primary objective was to assess the effect of telemonitoring on blood pressure (BP) control using routinely collected data. Telemonitored systolic and diastolic BP were compared with surgery BP measurements from patients not using telemonitoring (comparator patients). The statistical analysis and interpretation of findings was challenging due to the broad range of biases potentially influencing the results, including differences in the frequency of readings, ‘white coat effect’, end digit preference, and missing data. Methods Four different statistical methods were employed in order to minimise the impact of these biases on the comparison between telemonitoring and comparator groups. These methods were “standardisation with stratification”, “standardisation with matching”, “regression adjustment for propensity score” and “random coefficient modelling”. The first three methods standardised the groups so that all participants provided exactly two measurements at baseline and 6–12 months follow-up prior to analysis. The fourth analysis used linear mixed modelling based on all available data. Results The standardisation with stratification analysis showed a significantly lower systolic BP in telemonitoring patients at 6–12 months follow-up (-4.06, 95% CI -6.30 to -1.82, p < 0.001) for patients with systolic BP below 135 at baseline. For the standardisation with matching and regression adjustment for propensity score analyses, systolic BP was significantly lower overall (− 5.96, 95% CI -8.36 to − 3.55 , p < 0.001) and (− 3.73, 95% CI− 5.34 to − 2.13, p < 0.001) respectively, even after assuming that − 5 of the difference was due to ‘white coat effect’. For the random coefficient modelling, the improvement in systolic BP was estimated to be -3.37 (95% CI -5.41 to -1.33 , p < 0.001) after 1 year. Conclusions The four analyses provide additional evidence for the effectiveness of telemonitoring in controlling BP in routine primary care. The random coefficient analysis is particularly recommended due to its ability to utilise all available data. However, adjusting for the complex array of biases was difficult. Researchers should appreciate the potential for bias in implementation studies and seek to acquire a detailed understanding of the study context in order to design appropriate analytical approaches.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

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