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Relational caring in cardiac rehabilitation : how case management service affects clients' recovery and risk factor modificationRinzema, Sonya Maria Catherine. 10 April 2008 (has links)
No description available.
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Factors influencing women's enrollment in cardiac rehabilitation : patient and support person perspectivesNorthrup-Snyder, Kathlynn 02 May 2002 (has links)
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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Evaluation of an early discharge service for cardiac rehabilitation at homeDal-Santo, Mary Gail January 1987 (has links)
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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The epidemiology of cardiovascular diseases in the ethnic groups in SingaporeHughes, Kenneth January 1988 (has links)
No description available.
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Cardio-metabolic disease and associated risk factors in the Johannesburg Health DistrictMoodley, Nishila 17 January 2012 (has links)
Introduction: The global burden of non-communicable diseases (NCDs) has long been neglected, with the omission of NCDs from the Millennium Development Goals (MDGs) bearing testament to this. The growing prevalence of chronic cardio-metabolic diseases in South Africa places huge demands on the health system. This study sought to determine the community prevalence of these cardio-metabolic diseases and associated risk factors in Chiawelo, Soweto – a township undergoing rapid urbanization in the Johannesburg Health District.
Methods: The study comprised 337 participants: 124 male and 213 female. This was a community based cross sectional survey using questionnaires, anthropometric and biochemical measurement of HbA1c. Cluster sampling techniques identified eligible adult participants. Regression models were performed to identify factors associated with disease. Ethical approval to conduct the study was obtained from the University of the Witwatersrand and written informed consent was obtained from the participants.
Results: The study population was black with middle to higher socio-economic status and education levels below Grade 12 mostly. The prevalence of diabetes mellitus (DM) in this study population was 14%, with many undiagnosed and those with disease poorly controlled. More than half the study population had hypertension (HPT) (58%) and most were poorly controlled. This was a markedly obese population (39%) with 54% of women having a body mass index (BMI) categorised as obese (BMI ≥ 30 kg/m2). Conclusions: The burden of chronic cardio-metabolic diseases in the Johannesburg Health District has been grossly underestimated. The prevalence of HPT and DM was high and both diseases were poorly controlled with obesity reaching epidemic proportions. Countering the burden of disease involves targeting females as a high risk priority group, engaging the community in health promotion and developing a NCD surveillance system. Clinically, it is the findings of this study to support the screening of cardio-metabolic diseases from as early as 30 years of age in males and 40 years of age in females.
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Describe cardio-metabolic diseases and the associated cost in a district hospital in the North West ProvinceMoalosi, Derrick Meriting 10 1900 (has links)
A research report submitted to the Faculty of Health Sciences, University of
the Witwatersrand, in partial fulfilment of the requirements for the degree of
Master of Public Health in the field of Hospital Management
OCTOBER 2014 / BACKGROUND: Gelukspan District Hospital is situated in the Ngaka Modiri
Molema District in the North West Province. The majority of patients admitted
in the adult medical wards of this Hospital are due to two conditions namely
(a) HIV/ AIDS and (b) Cardio-metabolic diseases. The Hospital regularly
analyse data related to the HIV/ AIDS patients for HIV/ AIDS conditional grant.
The information related to cardio-metabolic diseases are seldom analysed by
the Hospital management, although there is a belief within the Hospital that
more than one thirds of the patients admitted in these two wards are due to
cardio–metabolic diseases. This study was planned against this background
to systematically analyse the routinely collected data from the Hospital
information system. The results of the study would hopefully provide the
estimation of the prevalence of these diseases at a health facility level and the
cost for managing these conditions.
AIM: To describe the profiles of patients admitted of cardio–metabolic
diseases in the Gelukspan District Hospital in the North West Province during
one year study period (from 01 April 2010 to 31 March 2011).
METHODOLOGY: This was a cross-sectional study based on retrospective
review of routinely collected data from the Adult Medical Wards of the
Gelukspan District Hospital during the one year study period (1 April 2010 to
31 March 2011). No primary data was collected for this study. The study
variables included: the number of subjects with cardio-metabolic diseases
among the subjects who were admitted in the Medical wards of the Hospital
during one year study period; their profiles and the type and cost of laboratory
tests performed for these patients at the time of admission. Permission to
conduct the research at the Hospital was obtained from the North West
Department of the Health and the University of the Witwatersrand ‘Human
Research Ethics Committee (Medical) before commencement of the study.
RESULTS: Number of admissions in male and female medical wards for noncommunicable
diseases was 558. There were almost same number of female
(n= 287) and male (271) admissions. The result showed that both males and
females suffer equally from cardio-metabolic diseases. The age – group
8805634J DM Moalosi
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analysis showed almost a third of the subjects were below 50 years age and
another third was above 65 years of age. More than 20% of the population
were pensioners representing the age distribution of the study cohort. The
majority of the subjects were black (97.8%) and unemployed (98%)
representing the demographics of the catchment population. The majority of
the women were single (55.4%). There was no significant difference between
male and female patients in terms of primary clinical diagnoses. Thirty-nine
percent of the males (n=108) and 56% (163) females stayed more than 3
days (the norms of average length of stay for District hospitals. The case
fatality rate was 19.5% probably high in a district hospital setting, this implies
that probably these patients were not managed properly at the PHC level and
or at this The laboratory tests done at the time of admission included random
and fasting blood glucose, and creatinine. No HbA1C, lipogram and other
renal function tests were done at the time of admission contrary to the norms
and guidelines for management of cardio-metabolic diseases. The laboratory
test result showed the possibility of significant comorbidity among the patients.
Fourteen percent of the subject probably had nephropathy.
CONCLUSION: This was the first study conducted in this Hospital to
systematically evaluate management of a particular group of patients.
Hopefully, this study would assist the Hospital management to improve the
management of patients admitted in this Hospital.
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An analysis of myocardial deformation with speckle tracking echocardiography in black patients on haemodialysisYip, Anthony 10 February 2014 (has links)
Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of the Master of Science in Medicine, Johannesburg, 2013 / Cardiac disease is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD). Accurate evaluation of cardiac function is therefore important but difficult with commonly used imaging modalities such as echocardiography being subject to variable load changes in haemodialysis.
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The hydrodynamics of idiopathic hypertrophic subaortic stenosisSimons, Dianne Margaret 08 1900 (has links)
No description available.
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SPECT myocardial perfusion scans : a left ventricular defect size estimation algorithm and a three dimensional computer simulationBoyers, Albert S. 05 1900 (has links)
No description available.
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A comparison of cardiac rehabilitation versus standard care in elderly patients with heart failureAustin, Jacky January 2003 (has links)
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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