scholarly journals Socioeconomic differences in experiences with treatment of coronary heart disease: a qualitative study from the perspective of elderly patients

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024151 ◽  
Author(s):  
Sara Lena Schröder ◽  
Astrid Fink ◽  
Matthias Richter
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Qualitative Study ◽  
Elderly Patients ◽  
Qualitative Content Analysis ◽  
Illness Perception ◽  
University Hospital ◽  
Socioeconomic Differences ◽  
Sources Of Information ◽  
Pathway Of Care

ObjectivesThis qualitative study aims to analyse socioeconomic differences in patients’ experiences along the treatment pathway for coronary heart disease (CHD).DesignA longitudinal qualitative study using in-depth semistructured interviews to explore patients’ experiences with treatment was conducted. We analysed the transcripts of the records according to qualitative content analysis and identified differences between patients with lower and higher socioeconomic status (SES) by comparing and contrasting the narratives.SettingThe University Hospital in Halle (Saale), Germany.Participants41 elderly patients (aged 59–80 years) who suffered from CHD.ResultsFrom various patient’s experiences along the pathway of care which were found to differ according to SES we derived three major themes: (1) information: patients with higher SES had greater knowledge about treatment and could use medical records as sources of information; (2) illness perception: patients with lower SES focused on improving symptoms and survival, while patients with higher SES focused on physical performance and disease management; and (3) perceived role in healthcare: patients with lower SES tended to delegate responsibility to healthcare professionals.ConclusionsDifferences in the patient’s knowledge about treatment, their perceived role in healthcare and illness perception can be the factors and mechanisms that contribute to explain socioeconomic inequalities in the treatment of CHD. These factors should be considered in quantitative studies to better understand the disparities in treatment and mortality. We suggest that improving patient–physician communication and patient knowledge can change the patient’s understanding of CHD and their perceived role in healthcare and reduce inequalities in CHD treatment.Trial registration numberDRKS00007839.

scholarly journals Socioeconomic differences in the pathways to diagnosis of coronary heart disease: a qualitative study

2017 ◽  
Vol 27 (6) ◽  
pp. 1055-1060 ◽  
Author(s):  
Sara Lena Schröder ◽  
Astrid Fink ◽  
Laura Hoffmann ◽  
Nadine Schumann ◽  
Olaf Martin ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Qualitative Study ◽  
Socioeconomic Differences

scholarly journals A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yasunari Yamashita ◽  
Rina Kitajima ◽  
Kiyoshi Matsubara ◽  
Gaku Inoue ◽  
Hajime Matsubara
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Records ◽  
Low Frequency ◽  
University Hospital ◽  
Diabetes Treatment ◽  
C Statistic ◽  
Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

scholarly journals Parental experience of the neuromotor development of children with congenital heart disease: an exploratory qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Mitteregger ◽  
Martina Wehrli ◽  
Manuela Theiler ◽  
Jana Logoteta ◽  
Irina Nast ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Qualitative Study ◽  
Motor Development ◽  
Congenital Heart ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
First Year ◽  
First Year Of Life ◽  
Neuromotor Development

Abstract Background Children with severe congenital heart disease (CHD) are a group of children at risk for neurodevelopmental impairments. Motor development is the first domain to show a delay during the first year of life and may significantly contribute to parental concerns, stress, and difficulties in early child-parent attachment. Thus, the aim of the study was to better understand the wishes and concerns of parents of children with CHD and explore their experience of their children’s neuromotor development in the first year of life. Methods In this qualitative study, fourteen families were recruited. Their children were aged 1–3 years and had undergone open heart surgery within the first 6 months of life. Semi-structured interviews were audio-recorded and transcribed. The data was explored within an expert group, and a qualitative content analysis was conducted using VERBI MAXQDA software 2020. The study was conducted in accordance with the COREQ checklist. Results Parents of children with CHD reported several burdens and needs. Parental burdens concerned the child’s motor development, their own physical and psychological strain, and difficulties in communication with healthcare professionals. The needs, parents reported included supporting their child’s motor development, a medical coordinator, and better communication between healthcare professionals and parents. During the first phase of their children’s illness, parents underwent a dynamic transitional phase and expressed the need to rely on themselves, to trust their children’s abilities, and to regain self-determination in order to strengthen their self-confidence. Conclusions It is essential to involve parents of children with CHD at an early stage of decision-making. Parents are experts in their children and appreciate medical information provided by healthcare professionals. Interprofessional teamwork, partnering with parents, and continuous support are crucial to providing the best possible care for children and their families. Family-centred early motor intervention for CHD children might counteract the effect of parental overprotection and improve children’s motor development and thus strengthen child-parent interaction. In future work, we aim to evaluate a family-centred early motor intervention for children with CHD developed on the basis of this qualitative study. Trial registration Not applicable.

scholarly journals Therapeutic effect of nifedipine combined with enalapril on elderly patients with coronary heart disease complicated with hypertension

2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoye Wang
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
Adverse Reactions ◽  
Effective Rate ◽  
Control Group ◽  
Significant Difference ◽  
Pre Treatment ◽  
Experimental Group

【Abstract】Objective: Toanalyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.METHODS:Sixty-six elderly patients with coronary heart disease and hypertension were enrolled from December 2017 to November 2018. They were randomly divided into two groups, 33 patients in each group. Patients in the experimental group received nifedipine. In combination with enalapril, patients enrolled in the control group received nifedipine monotherapy.RESULTS:Compared with the control group, the total effective rate, Serum Nitric Oxide (Serum NO) after treatment, CRP after treatment, HCY after treatment, and blood pressure after treatment were significantly improved (P<0.05). Serum NO and treatment before treatment in the 2 groups. There was no significant difference in pre-CRP, pre-treatment HCY, pre-treatment blood pressure, and adverse reactions during treatment (P>0.05).Conclusion: Theelderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.

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