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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

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

The purpose of this study was to examine the relationship between training heart rate (THR) and the HR occurring at the Aerobic Threshold (AerTHR), and to examine the AerT as an index of training intensity in selected coronary artery disease (CAD), post-myocardial infarction (MI), and post-coronary artery bypass surgery (CABS) patients. Twenty male subjects (age=54.9; wt=73.7 kg; %body fat=25.8) were recruited on the basis of regular participation in a cardiac rehabilitation program (CRP) (3/week at 70 - 85% HRmax) for 6 months; no beta-adrenergic medication; and symptom-free during exercise. Field measurements of THR during the aerobic phase at CRP was carried out by computer-assisted portable telemetry with mean THR computed from each 30 minute value per subject. A maximal treadmill test starting at 2.5 mph at 0% grade with speed increasing 0.5 mph each minute was carried out using a Beckman MMC for 30 second determinations of respiratory gas values. The AerT was determined by visual inspection of the first departure from linearity of Ve and excess CO₂. VO₂max was 35.6 ±5.6 ml/kg/min⁻¹, with HRmax 166.2 ±11.8 bpm. Paired t-tests were performed; AerTHR was 124.8 ±15.3 bpm with THR 133.7 ±13.4 bpm (p < .03). Percent HRmaxAerT was 75.1 ±8.05 and %HRmaxTHR was 80.6 ±8.3 (p < .03). Mean %VO₂maxAerT (54.4 ±6.7) is consistent with other reported data showing .lower values in less trained individuals. Stepwise correlations were performed, and a regression equation was produced to predict AerT grom HRmax, height, and weight with a multiple r = .74 (p < .01). These data suggest that in this population, THR, as calculated by the relative percentage of maximum method, produces training intensities above the AerT expressed as absolute or relative percents of HRmax. This finding may have implications for optimal body fat reductions, patient compliance to the exercise program, and safety in CRP's. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

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Thesis submitted to the Faculty of Arts, University of the Witwatersrand, for the degree of Doctor of Philosophy Johannesburg 1995 / The 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

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.

published_or_final_version / Medicine / Master / Master of Research in Medicine

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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.