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1
Dal-Santo, Mary Gail. "Evaluation of an early discharge service for cardiac rehabilitation at home." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26198.
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This study evaluates the outcomes of a hospital-based cardiac rehabilitation program designed to deliver the first phase of cardiac rehabilitation services at home. The program was established in a community hospital in 1985, operating under the administration of the hospital's Medical Day Centre. Patients suffering from acute myocardial infarction (MI) are referred to the program by their physician and receive services from a cardiac nurse specialist immediately upon discharge. The services continue for a period of 6 weeks. The outcomes of importance in the study are the effects of the program on hospital services in the initial 10 month period and on patient's health related behaviour 3 months post infarction. Results of the study indicate that program goals were achieved during the initial 10 months of the study. Physicians referred 92% of the eligible patients and the average length of stay (ALOS) in hospital was satisfactorily reduced. For patients with uncomplicated MI the ALOS was 8.6 days by the tenth month. At 3 month follow up, patients reported significant improvements over their pre infarction health related behaviour. There were significant increases in the frequency of light exercise (p<-0005), in the regular use of low fat dairy products (p=.0003) and in the practice of restricting calories (p=.003) while significant decreases were reported in the frequency of consuming fried foods (p<.0005), salted foods (p<.0005) and rich foods (p<.005) and in the regular use of table salt (p=.00003). Smoking cessation was reported by 50% of the smokers at follow up. Patients reported a high level of satisfaction with the program, describing the service as well timed, informative, practical and valuable in restoring their self confidence. While these results were satisfactory with regards to the program goals, the evaluation was based on a single group design and further investigation is desirable with comparisons between hospitals and between patients with and without exposure to the program.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Green, Kerrie L. "A descriptive analysis of cardiac rehabilitation education programs." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1177976.
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The purpose of this research was to obtain information on the content of education within cardiac rehabilitation programs, methods of administering education, what the barriers are to providing education and which professionals administer education.To reach this goal, a questionnaire was modified from a previous study and a pilot study was undertaken to establish reliability of the questionnaire. The questionnaire was then sent to a sample of 100 directors of cardiac rehabilitation programs belonging to The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). The questionnaire focused on 13 established areas of education within cardiac rehabilitation programs.Once the questionnaires were completed, the information was transferred to a table format based upon the 13 content areas. The following conclusions were drawn from the research and the data gathered: 11 of the 13 content areas are offered at least 84% of the time, the major barriers for the 13 content areas were lack of time and lack of interest on the patient's behalf, the most frequent methods of education for all 13 content areas were individual education, print materials, and group education, and the primary educator overall for all 13 content areas was the nurse followed by the exercise physiologist and dietitian/nutritionist.Department of Physiology and Health Science
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Retzner, Rebecca J. "Examination of the registered dietitian's role in the implementation of dietary interventions to patients in cardiovascular rehabilitation phase II programs." Virtual Press, 2004. http://liblink.bsu.edu/uhtbin/catkey/1286763.
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The purpose of this research study was to examine the nature and scope of nutrition counseling and/or education available to cardiac patients and the role of the Registered Dietitian (RD) in Cardiac Rehab Phase II Programs. One hundred and fifty programs were surveyed in regards to their program and the programs elements in regards to nutrition topics. To our knowledge, this is the first study to systematically examine the nature and scope of nutrition counseling and/or education and the role of the Registered Dietitian in Cardiac Rehab Phase II Programs.The results indicated that almost 75% of the programs surveyed offered nutrition counseling and/or education, regardless of the region examined. Also the majority of the programs were identified to have a Registered Dietitian on staff, but less than half reported a Registered Dietitian employment as full-time. There were also significant differences in regards to nutrition education topics among the regions. The results also uncovered a discrepancy between the perceived importance of having a Registered Dietitian on staff and their role as the primary provider of nutrition counseling and/or education.Department of Family and Consumer Sciences
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Kotb, Ahmed. "The Impact of Telemedicine in the Rehabilitation of Patients with Heart Diseases." Thèse, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30490.
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The potential that telemedicine interventions may have in effectively delivering remote specialized cardiovascular care to large numbers of patients with heart diseases has recently come under question. In the first phase of this thesis, a systematic review and meta-analysis was conducted to compare the impact of a basic form of telemedicine that is regular patient follow-up by telephone, with usual care for individuals with coronary artery disease following their discharge. In the second phase of this thesis, a network meta-analysis, using Bayesian methods for multiple treatment comparisons, was conducted to compare the more complex forms of telemedicine for patients with heart failure. In the third and final phase of this thesis, a randomized controlled trial was designed to compare the impact of two forms of telemedicine, identified in the earlier two phases as being the most promising, on clinical outcomes, cardiac risk factors and patient reported outcomes.
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Austin, Jacky. "A comparison of cardiac rehabilitation versus standard care in elderly patients with heart failure." Thesis, University of South Wales, 2003. https://pure.southwales.ac.uk/en/studentthesis/a-comparison-of-cardiac-rehabilitation-versus-standard-care-in-elderly-patients-with-heart-failure(c61f6019-a868-46dc-a828-6fac2ba27b8d).html.
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Heart failure, a condition predominantly affecting the elderly, represents an ever increasing clinical and financial burden for the NHS. Patients with symptomatic heart failure have a poor prognosis and a high degree of morbidity. Current research findings suggest that enhancement of self-care through education, optimisation of pharmacological therapy, exercise training, lifestyle modification and counselling improves patient outcomes and reduces hospitalization. Cardiac rehabilitation, a service that incorporates all the aforementioned components, has yet to be evaluated in heart failure management. Set in a district general hospital with a primary catchment area of 500,000 inhabitants, this study is among the first of its type in the U.K. The study evaluates the effects of a cardiac rehabilitation programme on a range of outcome measures: mortality, health related quality of life, functional change, health care utilisation and clinical status. The design is a randomised controlled trial, comparing cardiac rehabilitation to standard care. Two hundred patients (60 - 89 years, 66% male) were recruited from hospital clinics, wards, and general practice. Patients with NYHAII or in heart failure confirmed, by echocardiography, were randomly allocated to control or experimental groups. Both patient groups attended out patient appointments to see the specialist nurse and cardiologist every eight weeks. In addition, patients in the experimental group attended cardiac rehabilitation classes twice weekly for eight weeks, followed by weekly exercise sessions for 16 weeks. Intervention consisted of exercise prescription, education, dietetics, occupational therapy and psychosocial counselling. A selection of measures were used to collect data over six months: Minnesota Living with Heart Failure (MLHF), New York Heart Association (NYHA) functional classification, EuroQol (EQ-5D), the six-minute walk test, Borg's rating of perceived exertion (RPE), medication compliance monitored by ACE inhibition, routine biochemisty, prescribed medication, coronary risk factor status, medical records and patient diaries. Results show statistically significant improvements for the experimental group in comparison to control patients. Improvements were identified in health related quality of life, functional status, metrs walked and patient cost utility; a reduction in hospital admissions attributable to heart disease was evident. No statistical difference between patient groups was evident in mortality, contact with primary health care professionals, compliance and clinical status. The findings are discussed in terms of previous rehabilitation studies. In conclusion, this study describes the necessary infrastructure and provides an evidence base for implementing a successful multidisciplinary cardiac rehabilitation programme in a district general hospital.
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Valentine, Cassandra E. "The relationship of proxy-efficacy and self-efficacy on the intention to continue cardiac rehabilitation." Virtual Press, 2008. http://liblink.bsu.edu/uhtbin/catkey/1399197.
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Cardiac rehabilitation is profoundly effective at improving physical activity and reducing morbidity and mortality of heart patients. Despite its effectiveness, it is highly underutilized. Research indicates proxy-efficacy and self efficacy positively correlate and predict exercise adherence after Phase II cardiac rehabilitation (Bray & Cowan, 2004; Bray, Brawley, & Millen, 2006). The purpose of the current study aims to investigate the relationship of Phase I patients' proxy-efficacy and self efficacy and their intention to enroll in Phase II cardiac rehabilitation. Thirty participants completed measurements of self-efficacy and proxy-efficacy, a demographic questionnaire, and asked to indicate intent to enroll. Results revealed proxy-efficacy does not predict intention to enroll into Phase II cardiac rehabilitation. Even though patients generally had high confidence in their cardiac rehabilitation specialists, proxy-efficacy was an insufficient predictor of intention to enroll in subsequent cardiac rehabilitation services. Moreover, results indicate proxy-efficacy and self efficacy for exercise are not related.School of Physical Education, Sport, and Exercise Science
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Luk, Ting-hin, and 陸庭軒. "Effect of cardiac rehabilitation on vascular function in patients withcoronary artery disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45153000.
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Lahm, Marjorie. "Operationalizing the coronary care patient's concept of hope." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/447238.
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The purpose of this study was to operationalize the coronary care patient's concept of hope. Analysis of 25 subjects' responses to an open interview format suggested that the sample's definition of hope revolved around five categories. These categories were: 1) theistic beliefs: 2) knowledge that they would not die, require surgery, or experience pain; 3) a wish not to die; 4) a wish to get better; and, 5) confidence that they would get better. Furthermore, significant differences in: 1) the sample's definition of hope: 2) the feelings associated with admission to the coronary care unit: and, 3) the factors that positively influenced the sample's level of hope were directly related to the subject's age.
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Shieh, Shew-Fang. "Self-care of patients following a nurse-coordinated cardiac rehabilitation program." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277098.
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A descriptive design was utilized to identify the relationship between perceived cardiac rehabilitation at the time of discharge and perceived self-care three months later. Perceived cardiac rehabilitation was indicated by perceived quality of the cardiac rehabilitation program, perceived understanding of self-care, and satisfaction with hospital care. Perceived self-care was indicated by self-reported self-care related exercise, stress management, and medication. Fifty-three patients from a community hospital voluntarily participated in the study by responding to four questionnaires. A low positive relationship was found between (a) perceived quality of the cardiac rehabilitation program and self-reported stress management, (b) perceived understanding of self-care and self-reported exercise and stress management, and (c) satisfaction with hospital care and self-reported exercise and medication administration. These findings of post-hospital care are useful in the evaluation of the effectiveness of one nurse-coordinated cardiac rehabilitation program.
10
Jones, Jason L. "Pedometer intervention to increase physical activity of patients entering a maintenance cardiac rehabilitation program." Muncie, IN : Ball State University, 2009. http://cardinalscholar.bsu.edu/654.
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Bailey, Barry D. "Physiological responses, perceptual responses and target heart rate compliance of coronary heart disease patients during walk-jog exercise." Thesis, Virginia Polytechnic Institute and State University, 1987. http://hdl.handle.net/10919/91082.
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Nine male CHD patients volunteered for testing to determine variations in heart rate response (HR), walk-jog velocity (W) and compliance to the target heart rate zone under three monitoring conditions. Determination of variations in W, peripheral perceived exertion (RPEL) chest perceived exertion (RPEC) and post-exercise lactate accumulation (La) during exercise which was held constant between 60-80% maximum HR reserve were also made. Procedures consisted of three 20 min walk-jog exercise conditions. First, two baseline condition (BC) trials were performed on separate days with exercise intensity regulated through intermittent defibrillator-ECG HR checks and radial/carotid artery palpation. Next, continuous telemetry monitoring of HR by staff was added during a single exercise trial (TC). Finally, two ExersentryRcondition (EC) trials were performed on separate days with continuous feedback concerning HR response provided to the patient via ExersentryR devices. Evaluation of HR and W revealed no significant variation between conditions. However, % target HR reserve attained was significantly (p>0.05) lower during early and late BC, as compared to TC. Furthermore, "frequency in" vs "frequency out" of target HR zone was significantly (p>0.05) greater during EC, as compared to TC. During EC, no significant variations in HR, W, La, RPEL and RPEC were noted. Correlation coefficient values between 0.76-0.95 and 0.58-0.80 were reported for RPEL and RPEC, respectively. This data suggested that continuous feedback concerning HR response resulted in the greatest compliance to the target HR zone. With the exception of the first five min of EC, only RPEL reliably mirrored HR and W.
Index terms: Intermittent heart rate monitoring, continuous heart rate monitoring, heart rate response, walk-jog velocity, target heart rate compliance, peripheral perceived exertion, chest perceived exertion, post-exercise lactate accumulation.M.S.
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Hui, Tze-shau, and 許子修. "A systematic review on quality of life for patients underwent cardiac rehabilitation programs." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012064.
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Jarkowski, Nancy Lee 1955. "THE EFFECTS OF THERMAL BIOFEEDBACK THERAPY ON PATIENTS IN A CARDIAC REHABILITATION PROGRAM." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276379.
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Pangallo, Georgianne. "Effect of a supportive and informational telephone call on threat appraisal in the newly discharged surgical cardiac patient." Virtual Press, 1990. http://liblink.bsu.edu/uhtbin/catkey/722461.
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The purpose of the present study was to test the theoretical relationship of the concepts of informational support and threat appraisal with a sample of surgical cardiac patients twenty-four hours after discharge from the hospital. These discharged patients were adjusting to the transition of hospital to home environment while still recovering from a life threatening illness. They may need varying informational supports to reduce their threat perception of the magnitude of the illness. A convenience sample of thirty-six surgical cardiac patients was assigned to three groups. The groups received the standard discharge preparation as stated by the hospitals' policy and procedure manual. The experimental group received a supportive and informational telephone call approximately twenty-four hours after discharge. The second group was the placebo group, these participants were given a telephone call at the end of the twenty-four hours to remind them to return the questionnaire. The third group was the control group, received no telephone call and were instructed to complete the questionnaire at the specified time. All groups were instructed at the time of initial contact to complete the questionnaire at approximately the end of the first twenty-four hours after discharge. The placebo group and control group were then pooled for data analysis due to the low return rate of the two groups. The two groups were compared with a t-test. The demographic data compared age and educational level to the perceived level of threat. Reliability of the tool was determined using a Cronbach's Alpha.School of Nursing
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Royce-Richmond, Judy Elaine. "The effects of knowledge and attitude toward computer assisted instruction on patient education of cardiac risk factors." Virtual Press, 1990. http://liblink.bsu.edu/uhtbin/catkey/722462.
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This study assessed differences in the knowledge of cardiac risk factors and the attitude toward computer assisted instruction (CAI) in cardiac rehabilitation patients instructed by lecture and transparencies or CAI. The quasi-experimental two-group posttest design used a convenience sample of 30 volunteers enrolled in a cardiac rehabilitation program. After randomization, cardiac risk factor instruction was conducted via lecture or the investigator developed CAI. The subjects completed a knowledge instrument which demonstrated content validity and a Kuder-Richardson formula 20 reliability coefficient of .0 and the Attitude Toward CAI scale which demonstrated content validity and a Cronbach's alpha .853 and .759. The data were analyzed by the two-sample t-test utilizing the .05 probability level. The results indicated a nonsignificant t value of .00 (df 28, p = 1.00) in the knowledge scores and a nonsignificant t value of 2.00 (df 28, p = .05) in attitude scores therefore the results failed to reject both null hypotheses. The conclusions drawn from this study are that CAI was as effective as lecture for patient education and that attitudes toward CAI were favorable.School of Nursing
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Pasvogel, Alice Eleanor. "The relationship between health expectations and compliance among cardiac rehabilitation participants." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276879.
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The purpose of this study was to describe the relationship between health expectations and compliance in persons who were attending a cardiac rehabilitation program. Three subscales of the Olivas Health Motivation Scale were administered to a convenience sample of 23 subjects at two points in time: at the beginning and at the completion of the prescribed sessions. A significant relationship was found between Stimulus Outcome Expectations and the duration of exercise at the beginning of the cardiac rehabilitation sessions (r = -.51, p =.02). The relationship between Regimen Efficacy Expectations and the duration of exercise was also found to be significant at the beginning of the sessions (r = -.40, p =.05). There was no significant relationship between health expectations and compliance at the completion of the sessions. One measure of health expectations, Stimulus Outcome Expectations (F = 10.11, p =.01), and two measures of compliance, duration of exercise (F = 406.45, p =.00) and metabolic equivalents (F = 74.14, p =.00), were significantly different between the beginning and the completion of cardiac rehabilitation.
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Taylor, Kelly A. "Benefits of cardiac rehabilitation." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/251.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Haghshenas, Abbas Public Health & Community Medicine Faculty of Medicine UNSW. "Negotiating norms, navigating care: the practice of culturally competent care in cardiac rehabilitation." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/32280.
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BACKGROUND Increasingly, it is recognised that the unique needs of people from culturally and linguistically diverse backgrounds (CaLDB) should be addressed within a framework of cultural competence. To date, there are limited data on the issues facing CaLDB patients in the Cardiac Rehabilitation (CR) setting. Appreciation of an individual???s values, attitudes and beliefs underpins negotiation of behaviour change in the CR setting. Therefore an understanding of patient and professional interactions is of key importance. OBJECTIVES The focus of this study has been to undertake an exploration of CR service delivery to people from culturally and linguistically diverse backgrounds, using Arabic speaking people as an exemplar of a CaLDB group. More broadly, this research project has sought to identify factors, which influence the practice of health professionals towards CaLDB patients, and to develop a model for evaluation of culturally competent health care in the CR setting. The study sought to achieve these aims by addressing the following research questions: 1. In what way do health practitioners in CR adjust their treatment and support to accommodate the perceived needs of CaLDB communities? 2. In what way do factors (such as individual and organisation perspectives) influence the adjustment of clinical practice and service delivery of CR practitioners; and what are practitioners??? and patients??? perception of barriers and facilitators to service delivery? 3. To what level are CaLDB patients satisfied with CR services? This study design is comprised of the following elements: (1) interviews with health practitioners and Arabic speaking background patients as an exemplar of CaLDB patients; (2) review of policy and procedure documents and medical records; and (3) field observation. METHOD This thesis embraces a qualitative approach as the primary method of investigation to align with the exploratory and descriptive nature of the study. The main methods used in the study were: in depth interviews with health professionals and patients; field observations; appraisal of relevant documents and consultation with expert panels. Study samples were selected through a purposive sampling strategy.Data were analysed using the method of content analysis, guided by the research questions. FINDINGS In total, 25 health professionals (20 female and 5 male) and 32 patients (21 male and 11 female) were interviewed. The method of qualitative content analysis was used for data analysis. Data analysis revealed four major themes: 1) The challenging context; 2) Tuning practices; 3) Influencing factors; and 4) Goodness of fit. The study demonstrated a challenging context for CR delivery, both from the perspective of patients and health professionals. Data reveal a process of reflection, negotiation, and navigation of care by CR health professionals in an effort to understand and meet the diverse needs of CALDB patients. CONCLUSION On the basis of the study findings, a process-oriented model of tuning practice to achieve cultural competence in CR delivery is proposed to inform policy, research and clinical practice.
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Nuzzo, Tracye A. Williams (Tracye Adel Williams). "The effects of coronary heart disease, beta-blockade medications and stage duration on graded exercise testing." Thesis, Virginia Tech, 1987. http://hdl.handle.net/10919/45824.
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Controversy exists regarding the effects of beta-blocker medications on functional capacity in cardiac patients and in the effects of disease-related impairments on cardiorespiratory dynamics during exercise testing. Therefore, this study was conducted to examine the exercise responses of 26 subjects (ages 37-66 years) to a graded exercise test. Subjects were divided into three groups based on clinical status: apparently healthy (AH; N=8); cardiacs receiving beta-blockers (C-BB; N=8); cardiacs not receiving betaâ blockers (Câ NBB; N=lO).
Master of Science
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Willmann, Chantel Shroyer. "Comparison of the effects of programmed instruction versus lecture on knowledge acquisition among post myocardial infarction patients." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/834614.
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The purpose of the study was to determine the effects of either a programmed instruction booklet or group lecture on knowledge of post myocardial infarction patients. A convenience sample of 30 post myocardial infarction patients enrolled in Cardiac Rehabilitation at a midwestern hospital were asked to participate.Subjects were assigned either to the experimental group or the lecture group. The pretest was administered to both groups. The experimental group received the self instruction booklet and the lecture group received a posttest was immediately completed by the participants. A nonequivalent pretest-posttest repeated measure design was utilized in the study.The results of the study showed a mean improvement in knowledge scores for both the booklet group and lecture group, with the booklet group having the larger gain in knowledge scores. The knowledge gain however, was not significant at the 0.05 level.School of Nursing
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Cunningham, Margaret. "Psychological factors associated with walking in patients with Peripheral Arterial Disease." Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/3040.
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Objectives This thesis aimed to explore psychological factors associated with walking behaviour in patients with Peripheral Arterial Disease, within the framework of Leventhal et al’s (1998) Common-sense Model of Self-regulation of Health and Illness. The objective was to identify psychological factors which could be modified to increase walking behaviour in these patients. Method A series of three studies were conducted to achieve these aims. The first study was an exploratory qualitative study, to explore the illness and treatment beliefs and walking behaviour of patients with intermittent claudication. The second study was a cross-sectional postal questionnaire to a cohort of patients with intermittent claudication, which tested the influence of the psychological factors identified in the qualitative study, in a larger sample. The final study was a randomised controlled trial of a brief psychological intervention designed to modify the illness and walking beliefs of patients with intermittent claudication, in order to increase walking behaviour. Results Beliefs about intermittent claudication, and beliefs about walking were both found to be associated with walking behaviour in the qualitative study. The results from the cross-sectional postal questionnaire confirmed this relationship – taken as a set, illness and walking beliefs accurately predicted adherence to minimum walking levels for 93.4% of the sample. The brief psychological intervention successfully modified illness and treatment beliefs and increased walking behaviour in patients newly diagnosed with intermittent claudication. Conclusion This thesis highlights the importance of illness and walking beliefs to the walking behaviour of patients with intermittent claudication. The thesis has added to the body of knowledge about intermittent claudication, and the findings of this thesis have implications for the treatment of patients with intermittent claudication within the health service. Theoretical and clinical implications of this research are discussed.
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Tarassova, Inna. "Factors associated with recovery from cardiac surgery in female patients." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/254.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Rice, Thomas H. "Prediction of oxygen consumption during exercise testing in apparently healthy subjects and coronary artery disease patients." Thesis, Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/91143.
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The American College of Sports Medicine has published formulae that are widely used to predict functional aerobic capacity for any treadmill speed and grade combination. However, it has been demonstrated that these formulae overpredict oxygen consumption (V̇O₂) for patients with coronary artery disease as well as for apparently healthy individuals. To study this, we measured V̇O₂, ventilation (V̇E), and respiratory exchange ratio (R) responses in 21 apparently healthy subjects (AH) and 16 coronary artery diseased subjects (CAD) during a modified Balke protocol. Modification of the protocol consisted of extending the stage time from two minutes to three minutes at the higher intensities to allow a greater time for a physiological steady-state to occur. The attainment of a steady-state may lead to the reduction of or the elimination of prediction errors. No differences were observed between two and three minute VO₂ responses at maximal and submaximal exercise for either group. At peak exercise, the AH group was significantly (P≤.05) different from the CAD group when compared for heart rate (164±2.6 vs 140±4.8 bts•min⁻¹ ), V̇O₂ (33.3±1.1 vs 26.7±2.3 ml•kg⁻¹•min⁻¹), and total treadmill time (9.9±.33 vs 8.1±.54 min). At submaximal exercise, V̇O₂ responses were also significantly (p≤.05) greater for the AH group when compared to the CAD group (26.6±.95 vs 21.9±1.8 ml•kg⁻¹•min⁻¹). No significant differences were observed for RPE and blood lactate at peak exercise and V̇E and R responses at submaximal or peak exercise between the two groups. Predicted values for peak V̇O₂ were significantly (p≤.05) higher than measured values (33.3±1.1 vs 38.8±1.1 ml•kg⁻¹•min⁻¹) and (26.7±2.3 vs 34.1±1.7 ml•kg⁻¹•min⁻¹) for the AH and CAD groups, respectively. However, no significant differences were noted between predicted and measured V̇O₂ responses at submaximal exercise for either group. Individuals classified as Type A were not significantly different from classified Type B individuals when compared for the cardio-respiratory variables measured. These data demonstrate that the ACSM prediction formulae significantly overpredict V̇O₂ for both AH and CAD subjects at maximal treadmill intensities. However, at submaximal intensities, these prediction formulae are acceptable for both groups of subjects. Furthermore, these data suggest that two minutes per stage allows sufficient time for physiological steady-state to occur at clearly submaximal intensities. Although at the higher intensities, extending the stage time beyond two minutes may be indicated.M.S.
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Chau, June, and 周宗欣. "Application of cost-effectiveness concepts to cardiac rehabilitation and secondary prevention in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31225755.
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Derenowski, Julie Margaret. "The qualitative generation of wellness motivation theory." Diss., The University of Arizona, 1990. http://hdl.handle.net/10150/565532.
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McKay, Janet A. "A feasibility and exploratory study of cardiac rehabilitation in acute coronary syndrome." Thesis, University of Stirling, 2013. http://hdl.handle.net/1893/20346.
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Background: Cardiac Rehabilitation (CR) has been shown to be effective in reducing mortality and morbidity in Coronary Heart Disease (CHD). There is a limited amount of research that evaluates the impact of menu-based CR, in patients with Acute Coronary Syndrome with Low Troponin levels (ACSLT). Aim: This thesis contains a feasibility study and an exploratory study. The feasibility study aimed to examine the feasibility of a Randomised Controlled Trial (RCT) which would test the impact of a menu-based CR programme, on individuals diagnosed with ACSLT, against standard care. This feasibility study included staff views. The exploratory study aimed to explore the impact that ACSLT and CR can have on this client group. Method: The feasibility study was a repeated measures case-control trial of menu-based CR based on the theoretical framework of the Common Sense Model of Self-Regulation (CSM), using a range of health assessments. The areas assessed included misconceptions, symptoms, anxiety, depression and Health Related Quality of Life (HRQoL). In addition, focus groups were held with both ward and specialist CR staff to seek their views on the feasibility of a RCT of menu-based CR for ACSLT. The exploratory study consisted of description and analysis of the data that had been collected from the participants over the two year period as above. In addition it included qualitative data that had been collected during interviews with the participants. Findings: Participants (n=33) were recruited from cardiology wards following an admission with ACSLT. They were assessed at baseline (T1), nine months (T3) and 24 months (T4). Twenty-five participants completed the studies. The feasibility study was successful in its aim of testing the CR intervention and protocols for a further RCT. The intervention was acceptable to the participants and to the specialist staff, although the ward staff did not see the need for a RCT. The measures used, with the exception of the self-reporting measures, were suitable and provided a wide range of data that could be utilised in a RCT. However the changes to diagnostic categories meant that a RCT would no longer be feasible. The exploratory study found that both groups were similar on a range of baseline demographic and clinical factors. There was a tendency to benefit within the exploratory study which favoured the intervention. An additional finding from the exploratory study was the degree of uncertainty experienced by the participants, within the context of a changing political and clinical landscape. Discussion and conclusions: The studies presented in this thesis add to our knowledge by highlighting some of the difficulties in designing a RCT of menu-based CR in a specific subgroup of CHD and by presenting outcome data for a small group of participants that have not previously been studied within the literature. This data suggests that there was a tendency to benefit for the intervention that requires further study. Implications for practice: Patients with ACSLT are now being included in CR programmes due to the changes within the diagnostic criteria. Clinicians have little understanding of the impact of CR on this group of patients, or what type of interventions would work best. Large RCT’s will however be problematic and this thesis has highlighted that further work is required to explore how CR can best improve the well-being of individuals with ACSLT.
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Roberts, Sherri. "Exercise leader interaction analysis of ACSM rehabilitative exercise specialist candidates." Thesis, Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/101462.
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Twenty subjects were audio and video taped during their exercise leadership examination. The tapes were used to code the interactions that occurred between the exercise leaders and the participants in the simulated cardiac rehabilitation exercise session using an interaction analysis system developed specifically for this physical activity setting group. The system identified interactions that could occur during the warm-up, stimulus, and cool-down phases of the session. The tapes were coded using the Datamyte 801 Observational Recorder. The phases of the sessions were coded individually. A frequency count was made as the interaction categories occurred. The frequencies were converted into rates of interaction (f•min⁻¹) for comparison. The mean rates of interaction were low for the phases and overall (warm-up= .38/min; stimulus= .59/min; cool-down= .29/min; total= .46/min). The individual subject's rates of interaction were all less than 1 interaction per minute (minimum= .28/min; maximum= .72/min). Related t-tests across category facets between phases showed the instruction and explanation facets in the warm-up phase differed significantly from the same facets in the stimulus phase. The compliance facet differed significantly in the stimulus phase from the compliance facet in the other two phases. The monitor facet in the stimulus phase differed significantly from the monitor facet in the cool-down phase. There was no significant differences across facets between the warm-up and cool-down phases. Higher rates of interaction occurred more frequently in the stimulus phase. The coding showed the differences in the interactions of the exercise leaders in the different phases in the simulated exercise session. The low rates of interaction suggest that the exercise leaders may have been reactive to the specific examination situation in which these data were collected.M.S.
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Lamotte, Michel. "Contribution à l'étude de la réponse hémodynamique lors d'exercices de renforcement musculaire: sujets sains et patients de réadaptation cardio-vasculaire." Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209825.
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Northrup-Snyder, Kathlynn. "Factors influencing women's enrollment in cardiac rehabilitation : patient and support person perspectives." Thesis, 2002. http://hdl.handle.net/1957/32471.
Full textAbstract:
Coronary Heart Disease (CHD) accounts for almost 20% of all deaths in the
United States and is a leading cause of premature death and disability. The cost for
this disease includes not only lost work years, but billions of health care dollars.
Women account for almost half of the deaths from CHD and rates for the death of
young women have risen 30% from 1988 to 1998. For the two-thirds of women
who survive the initial coronary event, the risk of future events and disability
increases. Cardiac rehabilitation (CR) is a multi-disciplinary program designed to
reduce this risk. Unfortunately, only 25% of eligible women attend the program.
Few studies have analyzed the factors that influence women's CR enrollment
choices making a careful examination of these factors particularly relevant.
The purpose of this study was to qualitatively explore the factors associated
with a woman's decision to enroll, or not enroll, in CR from the perspectives of the
patient and her support person.
Twenty-five women (15 enrolled in CR, 10 not enrolled in CR) and 24
matched support persons (one person's supporters refused to participate) were
interviewed using a semi-structured format from September, 1999 to January, 2001.
Questions addressed the beliefs, affect, social referents, past experiences/habits,
and facilitating/constraining conditions related to CR enrollment choices. Support
persons were asked to respond to these questions from their perception of their
loved one's attitudes, beliefs and health care seeking behaviors.
Information from the interviews was transcribed verbatim, entered into
NUD*IST, and coded using the components of the Expanded Theory of Reasoned
Action (Triandis, 1977) as a framework. Descriptive analyses was done on basic
demographic information, including perceptions of health and depression.
There were specific factors identified in each of the primary categories of
affect, beliefs, facilitating/constraining factors, and social referents and
information. The key findings indicated that a lack of information on CR, feelings
related to the perceived necessity of CR, transportation, finances, and accessibility
were primary factors in enrollment behavior. Overall agreement between the
cardiac female and her support person existed in most categories, except affect,
where a minimum number of emotions was stated by the supporter.
Cardiologists are a preferred source for CR information and they and
primary care physicians need to increase the amount of positive support they
provide to post-coronary event women. Emphasis on the necessity of attending CR
as well as solutions for transportation and finances may increase enrollment. More
research should be completed on the context of depression related to CR,
importance of factors identified as having an impact on CR decision making, and
the role of support persons in the enrollment choices of women.Graduation date: 2002
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Rinzema, Sonya Maria Catherine. "Relational caring in cardiac rehabilitation : how case management service affects clients' recovery and risk factor modification." 2004. http://hdl.handle.net/1828/488.
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Ogimoto, Kayoko. "Cortisol, abdominal obesity, and reductions in inflammation after cardiac rehabilitation in non-diabetic coronary patients." Thesis, 2000. http://hdl.handle.net/1957/32661.
Full textAbstract:
Abdominal obesity is a part of insulin resistance syndrome that is closely
linked to increased risk of coronary artery disease (CAD). Because fat tissue acts as
an endocrine target and source of hormone production, increased metabolism or
production of chemical messengers in fat tissue may result in metabolic perturbations
that contribute to occurrence and recurrence of coronary events. This dissertation
research entails two separate approaches. The first study, a cross-sectional analysis,
sought to determine whether serum cortisol responses to oral glucose loading are
associated with abdominal obesity, non-esterified fatty acid (NEFA) suppression, and
self-reported symptoms of depression in 26 non-diabetic coronary patients. We
conclude that lower cortisol responses to oral glucose loading are associated with
abdominal obesity, reduced NEFA suppression, and fewer symptoms of depression
(P���0.028). Future prospective studies should determine whether psychosocial risk
factors, such as depression and anxiety, increase cortisol production, whether increases
in cortisol production act synergistically with a positive energy balance in the
development of abdominal obesity, and whether increases in abdominal obesity lead to
increases in cortisol metabolism and insulin resistance.
C-reactive protein (CRP) is a marker of low-grade inflammation that is
associated with increased risk for recurrent events in coronary patients. Fat tissue also
secretes proinflammatory cytokines that stimulate hepatic production of CRP. Thus,
the second study, an intervention study, sought to determine whether the first three
months of cardiac rehabilitation could reduce serum concentrations of CRP and the
proinflammatory cytokine, tumor necrosis factor-�� (TNF-��), in our non-diabetic
coronary patients (N=26). Results from the intervention study showed significant
reductions in serum CRP levels (P=0.012) that were associated with reductions in
waist circumferences after cardiac rehabilitation (r=0.39, P=0.049). However,
changes in serum TNF-�� levels after cardiac rehabilitation were nonsignificant
(P=0.869). Thus, we conclude that cardiac rehabilitation may reduce the severity of
low-grade inflammatory conditions, in part, through reductions in waist circumference
in non-diabetic coronary patients.Graduation date: 2001
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Feldner-Busztin, Adrienne. "Predicting the psychological and physiological prognosis of cardiac rehabilitation patients." Thesis, 1995. http://hdl.handle.net/10539/23011.
Full textAbstract:
Thesis submitted to the Faculty of Arts, University of the Witwatersrand, for the degree of Doctor of Philosophy
Johannesburg 1995The large percentage of deaths attributed to recurrent Coronary Heart Disease (CHD) has generated a search for behavioural and psychological factors which mitigate the consequences of CHD. An aim of the present thesis is to extend this search by identifying factors which predict prognosis fer recovery from CHD. Two key factors seen to influence prognosis are aerobic exercise and Type A behaviour. Extant research into the role of exercise has been hindered by methodological weaknesses. As a consequence, the precise means by which exercise influences CHD patients' psychological and physiological strain remains unclear. Similarly, the Type A literature has been flawed by the inaccurate conceptualisation and measurement of Type A behaviour as a global, and 110t a multidimensional, construct. Research which has examined the multidimensional nature of Type A behaviour has been restricted to low risk samples. Thus, a further aim. of the present research is to examine ; prognostic role of exercise and Type A components within the context of cardiac rehabilitation. In achieving this aim, three studies are conducted. [Abbreviated Abstract. Open document to view full version]
MT2017
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Rabilal, Melisha. "A survey to determine the need and scope for a cardiac rehabilitation programme at Grey's Hospital in KwaZulu-Natal : a multi disciplinary perspective." Thesis, 2012. http://hdl.handle.net/10413/11191.
Full textAbstract:
Aim : The study was explored within the context of a survey to determine the need and scope for a cardiac rehabilitation programme at Grey’s Hospital in Kwa Zulu-Natal. A multi-disciplinary perspective was sought as a cardiac rehabilitation programme with a multi-disciplinary approach is holistic. Also it is an effective intervention as secondary prevention in the care of the cardiac patient.
Design : Exploratory survey in a “case-study”.
Setting : a provincial, tertiary hospital in Kwa-Zulu Natal
Participants : Permanent healthcare workers employed by the Department of health and working in the various units at Grey’s Hospital with more than 3 years experience. Staff included nurses and doctors in the coronary care unit, medical ward D1, catheterization unit and the cardiac clinic. Allied staff such as occupational therapists, dieticians, psychologists and physiotherapists also participated in this study. Staff not satisfying the above criteria and those not consenting to be part of the study were excluded. 58 questionnaires were distributed and 35 were returned completed.
Intervention : A self developed questionnaire was used and information was obtained about the demographics of the healthcare workers, relevant interaction with cardiac patients and aspects of training related to cardiac conditions. Questions were directed to professionals as pertained to their respective scope of practice. Some questions were “open” ended and required responses with descriptions and/ or explanations. Admission records were perused in various cardiac units to determine the number of cardiac patients accessing services at Grey’s Hospital.
Results : The total number of cardiac patients that attended Grey’s Hospital from January 2007 to December 2011 was 19983. The cardiac clinic showed an increase annually in the number of patients each year from 2495 in 2007 to 3569 in 2011 with a total number of 15928 over 5 years. All professionals assisted patients with achieving cardiac rehabilitation goals. There was a need demonstrated for the implementation of written resources for patient education; and training of staff in cardiac rehabilitation according to international guidelines. Basic life support (CPR) training is present among some professionals. A structured referral of patients for cardiac rehabilitation is not present and a phase I-IV cardiac rehabilitation programme with updated protocols is not present at Grey’s Hospital. Health professionals listed the scope of practice for current and potential interventions with cardiac patients. Healthcare workers also expressed their views on the value of a multi-disciplinary cardiac rehabilitation programme at Grey’s Hospital. Benefits for a multi-disciplinary cardiac rehabilitation programme at referral hospitals were listed by the multi-disciplinary healthcare workers. It was found there is a strong agreement to have a cardiac rehabilitation programme at Grey’s Hospital across all disciplines. An overall agreement of 32/35 for rehabilitation programme is statistically significant with p < 0.001.
Conclusion : There is a need for a multi-disciplinary cardiac rehabilitation programme at Grey’s Hospital.Thesis (M.Physio.)-University of KwaZulu-Natal, Durban 2012.
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Venter, Hendrik J. "The effect of a self-directed lifestyle change programme on cardiac patients." Thesis, 2014. http://hdl.handle.net/10210/9130.
Full textAbstract:
D.Litt. et Phil. (Psychology)Over the past four decades we have witnessed the emergence of amazingly sophisticated means of cardiovascular diagnosis and therapy. For the first time in many years, some Western countries could report a decline in cardiovascular deaths. During this same span of years we have witnessed the remarkable development of an array of technological achievements that include the means for invasive diagnostic procedure such as cardiac catherization, and non-invasive methods of echocardiography, magnetic, radio-isotopic and positron imagery which provide detailed diagnostic and prognostic information. This innovations along with synthetic grafts have permitted surgical interventions that would not have been conceivable at the outset of this cardiovascular odyssey. Another major advance has been the appearance of new pharmacological modalities; the diuretics, the beta-adrenergic receptors and angiotension converting enzyme inhibitors, the calcium antagonists and other anti-hypersensitive agents, a spectrum of antiarrhythmic compounds, anticoagulants and fibrinolytic therapy, and the promise of still more innovative and novel modes of therapy which will appear via genetic engineering. Over the past years there has been equally significant development in the area of cardiovascular epidemiology. These advances include the demonstration of validity and the efficacy of various therapeutic programmes by the unique development of complex multi-center trials, as well as long-term population-based studies. Through this endeavours specific risk factors that impart independent risk ofpremature cardiovascular morbidity and mortality has been identified. Some of these risk factors are clearly not modifiable such as advancing years, male gender and race. Others are at least partly modifiable: predisposition to diabetes myelitis and increased body mass. By virtue of multi-center trials we have clear evidence that cigarette smoking, rising systolic and diastolic arterial pressures, serum cholesterol levels, and diabetes are modifiable. It is a known fact that not all individuals with coronary artery disease are cured by medication or by means of a surgical intervention. In addition to this, the reduction of traditional biomedical risk factors have been shown to be insufficient in averting the reocclusion and the further occlusion of coronary arteries in patient populations.
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Heckman, Jenna L. "The effectiveness of a pedometer feedback intervention for increasing physical activity in cardiac rehabilitation patients." 2011. http://liblink.bsu.edu/uhtbin/catkey/1656585.
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Access to abstract permanently restricted to Ball State community onlyAccess to thesis permanently restricted to Ball State community only
School of Physical Education, Sport, and Exercise Science
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Liebenberg, Anna Maria Magrieta. "Ondersteuningstelsels vir koronêre vaatomleidingspasiente." Thesis, 2014. http://hdl.handle.net/10210/11808.
Full textAbstract:
M.Cur. (Intensive General Nursing)The rehabilitation of the coronary artery bypass patient should be a continuation of the contact which exists during the hospitalisation phase, with specific reference to the pre-dismissal phase. As a member of the health team, the nurse makes the most important inputs during this phase because she is the one who is in constant contact with the patient and his family. The purpose of this study is to determine, by means of set criteria and within a nursing perspective, the contributions that are made by various support groups to the rehabilitation of persons who have undergone coronary artery bypass surgery.
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Hoeksema, Stacy L. "The long-term effectiveness of short-term physical activity interventions in cardiac patients." 2012. http://liblink.bsu.edu/uhtbin/catkey/1670052.
Full textAbstract:
While many short-term physical activity (PA) interventions in cardiac rehabilitation (CR) patients have proven to be successful at increasing PA levels, little is known about the long-term impact these interventions have. The purpose of the current study was to determine if the Increased Physical Activity in Cardiac Patients (IPAC) study utilizing pedometer feedback, motivational messages, and a combination of both were successful at increasing PA levels and improving cardiovascular disease (CVD) risk factors after 12 months. The results of the study indicated that none of the IPAC interventions were successful at increasing PA levels after 12 months compared to the usual care group and all groups reverted back to baseline levels. Additionally, no significant differences were seen across time or between groups in most CVD risk factors. Further research is needed to develop PA interventions in CR patients that foster long-term PA maintenance.School of Physical Education, Sport, and Exercise Science
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"Holistic aspects of rehabilitation post cardiac surgery in the Bonny method of guided imagery and music." University of Technology, Sydney. Faculty of Nursing, Midwifery & Health, 2003. http://hdl.handle.net/2100/238.
Full textAbstract:
This thesis has set out to investigate the role of music therapy in the form of the specialist Bonny Method of Guided Imagery and Music (GIM) with a view to exploring how meanings related to adjustment from a health crisis (such as cardiac surgery) are depicted in music-supported imagery. Factors shaping clinical interpretations of verbal and musical responses in music therapy practice are often unclear or undelineated. A systematic interpretive process relevant to clinical health care was developed using the Bonny Method of Guide Imagery and Music (GIM), providing a means for exploring the emotional difficulties of coronary bypass patients, who typically recover quickly from physical surgery but often experience residual symptoms such as depression, pain, and anxiety. The interpretive process accessed both verbal and non-verbal texts, playing them against each other in order to find significance for music therapy practice in rehabilitation. A Bonny Method of Guided Imagery and Music (GIM) series was undertaken by patients recovering from coronary artery bypass grafting (CABG), with each session audiotaped and transcribed. This narrative data was analyzed thematically, and grand themes were used to focus further intertextual (semiotic) and Jungian perspectives, in the process of deriving substantial clinical meanings. Results suggested that participants used a wide range of personal, cultural and archetypal texts to convey meanings about their health care situation, including images of the music during the therapeutic process. Clinical change in the rehabilitative process was suggested by grand themes comprising 'Looking through the frame', 'Feeling the impact', 'Spiralling into the unexpected', 'Sublime plateau', and 'Rehearsing new steps' and the further music-related grand theme of 'Sounding the changes'. This project highlights the value of GIM as a vehicle to track clinical change with cardiac patients, based on a systematic interpretive process sensitive to the interweaving verbal and nonverbal texts evident in the music therapy context.
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Murray, Barbara June. "Feng shui: implications of selected principles for holistic nursing care of the open heart patient." Diss., 2001. http://hdl.handle.net/10500/1047.
Full textAbstract:
This qualitative study sought to explore the Hong Kong Chinese patient's perceptions of an Intensive Care experience and their views on the introduction of feng shui principles focussing on sleep orientations, dietary management and exercise regimes. The study explored the background of feng shui as an authentic traditional Chinese belief. It also explores if incorporating these feng shui principles into the health care setting would provide a positive effect for open-heart patients in an Intensive Care Unit at the Hong Kong Adventist Hospital in Hong Kong.
The major inference drawn from this study is that Chinese patients seek culturally related experiences from the health care setting. The Chinese informants showed strong belief patterns in traditional practices of feng shui, however, practiced these within the confines of their homes as these experiences were denied to them in the hospital setting.Health Studies
M.A. (Nursing Science)