Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach

The radial approach (RA) is the most common in invasive cardiology, but depending on the clinical situation, the femoral approach (FA) and brachial approach (BA) are also used. The BA is associated with the highest odds of complications so it is used mainly if a first-choice approach fails. The aim of the study was to assess clinical outcomes after invasive cardiology procedures stratified by the use of the RA, FA, and BA, with a focus on access site-related complications, quality of life (QoL), and patients’ perspective. A total of 250 procedures (RA: 98; FA: 99; BA: 53) performed between 2013 and 2020 were retrospectively analyzed. Puncture site-related complications, vascular events, patient preferences, and QoL were assessed by the analysis of medical records and telephone follow-up using a proprietary questionnaire and the modified EQ-5D-3L questionnaire. Patients from the RA group received the smallest volume of contrast during a percutaneous coronary interventions (PCI) procedure (RA vs. FA vs. BA: 180 (150–240) ml vs. 200 (180–270) ml vs. 190 (100–200) ml, p = 0.045). The access site was changed most frequently in the procedures initiated from the RA (p < 0.04). Overall puncture site-related complications, especially local hematomas, occurred most commonly in the BA group (7.1, 14.1, and 24.5% for RA, FA, and BA, respectively, p = 0.01). During the index procedure, the access site was changed most frequently in procedures initiated from the RA (19.7, 8.5 and 0%, p = 0.04). The RA was indicated as an approach preferred by the patient for a hypothetical next procedure (87.9, 55.4, and 70.0% for subjects preferring the same approach out of patients who underwent a procedure by the RA, FA, and BA, respectively, p < 0.001). For the RA and FA, the prevalence of moderate or extreme access site-related problems in self-care decreased significantly (RA: p < 0.01, FA: p < 0.05) within 1 month after the index procedure (RA: 18.1, 4.2, and 1.4%; FA: 20.7, 11.1, and 9.6% periprocedurally, after 1 and 6 months, respectively). In contrast, for the BA these percentages were higher and a significant improvement (p < 0.05) was delayed until 6 months (54.6, 36.4, and 18.2% periprocedurally, after 1 and 6 months, respectively). In conclusion, compared to the BA and FA, the RA appears to be not only the safest, mainly due to the lowest risk of puncture site-related complications after coronary procedures but also represents a preferable approach from the patient’s perspective. Although overall post-procedural QoL outcomes did not differ significantly according to the access site, nevertheless, the BA was associated with more frequent self-care problems whose improvement was delayed until more than one month after the index procedure.

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Quality of Life and Self-Care of College Students With Type I Diabetes

PsycEXTRA Dataset ◽

10.1037/e509052008-001 ◽

2008 ◽

Author(s):

Avery E. Block ◽

Joan C. Chrisler

Keyword(s):

Quality Of Life ◽

College Students ◽

Type I Diabetes ◽

Self Care ◽

Type I

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Prophylaxis in people with haemophilia

Thrombosis and Haemostasis ◽

10.1160/th08-07-0483 ◽

2009 ◽

Vol 101 (04) ◽

pp. 674-681 ◽

Cited By ~ 36

Author(s):

Massimo Franchini ◽

Annarita Tagliaferri ◽

Antonio Coppola

Keyword(s):

Quality Of Life ◽

Cost Benefit ◽

Primary Prophylaxis ◽

Secondary Prophylaxis ◽

Severe Haemophilia ◽

Duration Of Treatment ◽

First Choice ◽

Long Term Treatment

SummaryA four-decade clinical experience and recent evidence from randomised controlled studies definitively recognised primary prophylaxis, i.e. the regular infusion of factor concentrates started after the first haemarthrosis and/or before the age of two years, as the first-choice treatment in children with severe haemophilia. The available data clearly show that preventing bleeding since an early age enables to avoid or reduce the clinical impact of muscle-skeletal impairment from haemophilic arthropathy and the related consequences in psycho-social development and quality of life of these patients. In this respect, the aim of secondary prophylaxis, defined as regular long-term treatment started after the age of two years or after two or more joint bleeds, is to avoid (or delay) the progression of arthropathy. The clinical benefits of secondary prophylaxis have been less extensively studied, especially in adolescents and adults; also in the latter better outcomes and quality of life for earlier treatment have been reported. This review summarises evidence from literature and current clinical strategies for prophylactic treatment in patients with severe haemophilia, also focusing on challenges and open issues (optimal regimen and implementation, duration of treatment, long-term adherence and outcomes, cost-benefit ratios) in this setting.

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Quality of life and self-care in elderly patients with cardiovascular diseases: The effect of a Traditional Chinese Medicine health educational intervention

Applied Nursing Research ◽

10.1016/j.apnr.2017.10.003 ◽

2017 ◽

Vol 38 ◽

pp. 134-140 ◽

Cited By ~ 4

Author(s):

Yi-Qin Sun ◽

An-Li Jiang ◽

San-Mei Chen ◽

Hui Li ◽

Hai-Yan Xing ◽

...

Keyword(s):

Quality Of Life ◽

Chinese Medicine ◽

Cardiovascular Diseases ◽

Traditional Chinese Medicine ◽

Elderly Patients ◽

Educational Intervention ◽

Self Care ◽

Health Educational Intervention

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AB0912-HPR AMIGOS DE FIBRO (FIBRO FRIENDS): EDUCATIONAL PROGRAM TO PROMOTE THE HEALTH OF PEOPLE WITH FIBROMYALGIA IN BRAZIL

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2598 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1478.1-1478

Author(s):

M. Antunes ◽

A. Schmitt ◽

A. Pasqual Marques

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Content Analysis ◽

Health Education ◽

Health Professionals ◽

Educational Program ◽

Self Care ◽

Link Type ◽

Primary Health

Background:Health education is pointed out as the front line in non-pharmacological approaches in fibromyalgia.Objectives:To develop an interdisciplinary educational program to promote the health of individuals with fibromyalgia in Brazil.Methods:This is a qualitative study, through a focus group, carried out in a Basic Health Unit in the city of São Paulo, SP. The guiding questions were about the needs and demands exposed by patients with fibromyalgia and health professionals who work in primary health care. 12 individuals with fibromyalgia and 10 health professionals participated. The data were analyzed using the content analysis method proposed by Bardin, specifically the thematic content analysis.Results:Amigos de Fibro (Fibro Friends) should be conducted through lectures, dynamics and conversation circles. The educational program must include 15 meetings with weekly frequency. The meetings are: 1st to present the program and socialization activities. 2nd: Doctor presents the concepts of fibromyalgia. 3rd: Nurse informs about practices and environments that favor self-care. 4th: Social Worker shows the importance of support. 5th: Physiotherapist shows the main body practices and physical activity. 6th: Nutritionist presents an adequate and healthy diet. 7: Psychologist shows mental health practices. 8th: Pharmacist informs about medicines. 9, 11 and 13: participants perform activities at home. 10: Naturologist presents integrative and complementary practices. 12th: Occupational Therapist encourages methods to save energy. Day 14: Speech therapist helps in the quality of sleep. 15: closing activity.Conclusion:Amigos de Fibro is a program that presents interdisciplinary educational information for individuals with fibromyalgia, being considered a trend of care for the future. The next step is to conduct a clinical trial to verify the effect of this intervention and then implement it in the health service in Brazil. Fibro Friends was created from the conjunct action of patients and healthcare professionals, it can be an effective educational tool to be implemented at primary health attention centers, promoting the self-care, life quality and the promotion of health in individuals with Fibromyalgia. Fibro Friends is an excellent tool for patient education and counseling in Brazil.References:[1]Antunes M, Ferreira A, Oliveira D, Júnior JN, Bertolini S, Marques AP. There is association between the level of physical activity and quality of life of women with fibromyalgia?. Annals of rheumatic diseases. 2019;78(2)650-1. http://dx.doi.org/10.1136/annrheumdis-2019-eular.2835.[2]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301-13. https://doi.org/10.23736/S1973-9087.19.05524-2.[3]Oliveira DV, Ferreira AAM, Oliveira DCD, Leme DEDC, Antunes MD, Nascimento Júnior JRAD. Association of the practice of physical activity and of health status on the quality of life of women with fibromyalgia. Journal of Physical Education. 2019;30(1): e3027. https://doi.org/10.4025/jphyseduc.v30i1.3027.[4]Stuifbergen AK, Blozis SA, Becker H, Phillips L, Timmerman G, Kullberg V, et al. A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome. Clinical Rehabilitation. 2010;24(4):305-18. https://doi.org/10.1177/0269215509343247.Acknowledgements:This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.Disclosure of Interests:None declared

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Serving Students Takes a Toll: Self-Care, Health, and Professional Quality of Life

Journal of Student Affairs Research and Practice ◽

10.1080/19496591.2020.1853558 ◽

2021 ◽

pp. 1-16

Author(s):

Portia Jackson Preston ◽

Hannah Peterson ◽

Delia Sanchez ◽

Athena Corral Carlos ◽

Aaliyah Reed

Keyword(s):

Quality Of Life ◽

Self Care ◽

Professional Quality Of Life ◽

Professional Quality ◽

Care Health

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The impact of e-Health interventions on promoting Self-Care in Chronic Patients: an Umbrella Review

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1104 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Renzi ◽

G Gasperini ◽

V Baccolini ◽

C Marzuillo ◽

C De Vito ◽

...

Keyword(s):

Public Health ◽

Quality Of Life ◽

Chronic Conditions ◽

Self Care ◽

Health Interventions ◽

Self Management ◽

Improve Quality ◽

Umbrella Review ◽

Copd Patients

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.

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Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial

Nursing Reports ◽

10.3390/nursrep11020040 ◽

2021 ◽

Vol 11 (2) ◽

pp. 418-429

Author(s):

Joana Pereira Sousa ◽

Hugo Neves ◽

Miguel Pais-Vieira

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Care Management ◽

Controlled Trial ◽

Self Care ◽

Fluid Restriction ◽

Symptom Recognition ◽

Patients With Heart Failure ◽

Randomised Controlled

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).

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