Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Feb. 15, 2008). Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Please read the abstract in the section 00front of this document / Dissertation (MA (Psychology))--University of Pretoria, 2005. / Psychology / unrestricted

D.Litt. et Phil. (Psychology) / It has long been known that South Africans are a high risk population for the development of coronary heart disease. Cardiovascular diseases accounted for 8,7% of all deaths in this country in 1988. Despite this distressing situation, rehabilitation facilities for people who have suffered a myocardial infarction or heart attack are relatively scarce. The facilities that exist tend to focus on the biomedical aspects of cardiac rehabilitation such as exercise and diet, and tend to neglect the psychosocial factors. A review of the literature shows, however, that psychosocial factors, and in particular the Type A coronary-prone behaviour pattern are significantly related not only to the development of coronary heart disease, but also to the probability of sUffering and surviving a heart attack. In addition, Type A.behaviour has been shown to be predictive of the risk of a second infarction after an initial attack. For this reason, the proven technology of a treatment programme developed under the auspices of the Recurrent Coronary Prevention Project (Powell & Thoresen, 1986) was applied in an attempt to adapt the programme for the" South African context. The study was aimed at establishing whether the RCPP programme could successfully be employed in this country, and whether the duration could be shortened so as to be more economically viable given the limited economic resources that characterise health care in South Africa. The modified programme was administered to a group of 13 post-myocardial patients at a local cardiac rehabilitation centre. A second group of 11 patients at the same centre served as a no-treatment waiting list control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programme. Results of the study indicate that 'the modified programme is highly successful in modifying Type A behaviour and its components in South African sUbjects. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. It was therefore concluded that the modified programme can be used fruitfully in the local context, but it was cautioned that the present sample needs to be followed up over time to ensure that the treatment gains are maintained.

Acute coronary syndrome (ACS) refers to a group of clinical conditions caused by myocardial ischemia including unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segmcnt elevation myocardial infarction (STEMI). Appropriate and accurate diagnosis has life-saving implications and requires a quick but thorough evaluation of the patient's history, physical examination, electrocardiogram, radiographic studies, and cardiac biomarkers. The management of patients with suspected or confirmed ACS continues to evolve as new evidence from clinical trials is considered and as new technology becomes available to both primary care physicians and cardiologists. Low- and intermediate-risk patients have frequently been managed in a chest pain center or in the emergency department. While stress testing with or without radionuclide imaging is the most common evaluation method, a CT angiogram is sometimes substituted High-risk patients are often managed with an early invasive strategy involving left heart catheterization with a goal of prompt revascularization of at-risk, viable myocardium. With the increased availability of cardiac catheterization facilities, patients with STEMI are more commonly being managed with primary percutaneous coronary intervention, although thrombolysis is still used where such facilities are not immediately available. This article provides primary care physicians with a concise review of the pathophysiology, clinical evaluation, and management of ACS based on the best available evidence in 2008.

This study involved designing an instrument to estimate self care knowledge levels of post myocardial infarction patients. The instrument subscales were diet, smoking, exercise, signs and symptoms of cardiac distress, medications, stress and high blood pressure. Twenty-six subjects were tested following hospital discharge and again two weeks later. Test-retest reliability was performed to establish stability of the instrument. The preset criterion level of.70 for the total scale was not met. The medication subscale did meet the.70 criterion level. Reliability estimates were conducted to establish internal consistency of the instrument. The preset criterion level of.70 was not met for the total scale; however, the stress subscale did meet the.70 criterion level on the retest. Concurrent validity was estimated by comparing subscale knowledge scores with self report behavior. Point biserial coefficients did not meet the preset.70 criterion levels. These results suggest that reliability and validity estimates in the post myocardial infarction patient population were not statistically significant. (Abstract shortened with permission of author.)

Bakgrund: Hjärtinfarkt är den vanligaste dödsorsaken i Sverige och orsakas oftast av en blodpropp som bildas från en plackruptur i något av hjärtats kranskärl. Risken att drabbas av en hjärtinfarkt ökar med åldern, även faktorer som diabetes, ärftliga anlag, stress, rökning, högt blodtryck och övervikt är riskfaktorer för att drabbas av sjukdomen. Män drabbas oftare av sjukdomen än kvinnor och kvinnors symptom vid insjuknandet kan ibland vara diffusa och det kan vara svårt ställa en diagnos. För att sjuksköterskan skall kunna tillgodose grundläggande behov hos personer med hjärtsjukdom så krävs god kompetens. Målet är att främja hälsa och välbefinnande hos patienten samt att förebygga ohälsa och lindra lidande.       Syfte: Syftet med litteraturstudien var att beskriva kvinnors erfarenheter av vardagen efter en hjärtinfarkt. Vidare var syftet att beskriva de inkluderade artiklarnas datainsamlingsmetod.  Metod: En deskriptiv litteraturstudie bestående av tio vetenskapliga artiklar. Huvudresultat: Resultatet speglar hur kvinnorna på ett fysiskt och känslomässigt sätt påverkas efter insjuknandet. Rädslan som finns hos dem att de skall drabbas av en ny hjärtinfarkt samt behovet av att utföra livsstilsförändringar. Betydelsen av stöd och hjälp från närstående samt hur arbetet påverkas efter insjuknandet. Vikten av beröring och intima relationer och dess betydande del i återhämtningen för kvinnorna.  Slutsats: Efter genomgången hjärtinfarkt har närstående en viktig betydande roll för återhämtningsprocessen. För att bibehålla en god egenvård är det viktigt att kvinnorna får hjälp från kompetent sjukvårdspersonal. Som sjuksköterska är det viktigt att besitta kunskap kring kvinnornas erfarenheter samt om sjukdomen / Background: Myocardial infarction is the most common cause of death in Sweden and is usually caused by a blood clot that formed from a plaque rupture in one of the coronary arteries. The risk of suffering a heart attack increases with age, but also factors such as diabetes, hereditary predisposition, stress, smoking, high blood pressure and obesity are risk factors for developing the disease. Men are affected more often by heart diseases than women, and women's symptoms at onset can sometimes be diffuse to make a diagnosis. The nurse need to be able to meet the basic needs of people with heart disease that requires good skills. The goal is to promote health and well-being of the patient and to prevent illness and relieve suffering. Aim: The aim of this study was to describe how women experiences the everyday life after a heart attack. Furthermore, the aim was to describe the articles included data collection method. Method: A descriptive literature of ten scientific articles. Main Results: The results reflect how the women on a physical and emotional way are affected by the myocardial infarction. They feel a fear that they will suffer a heart attack again and they need to do some lifestyle changes. The support and help from the family, is important for them such as touch and intimate relationships and its significant part in the recovery of women. Conclusion: After myocardial infarction have been related to a major significant role in the recovery process. To maintain a good self-care, it is important that women receive help from skilled health professionals. As a nurse, it is important to have knowledge about women's experiences and about the disease

Bakgrund: I Sverige är den vanligaste dödsorsaken kranskärlssjukdom, vilket kan innebära hjärtinfarkt. Riskfaktorer för hjärtinfarkt är låg fysisk aktivitet, höga blodfetter, rökning, låg inkomst och låg utbildning. En hjärtinfarkt uppstår vanligtvis på grund av att ett åderförfettningsplack har brustit och bildat en blodpropp.  Syfte: Syftet med denna litteraturstudie är att undersöka kvinnor och mäns erfarenheter efter en hjärtinfarkt. Metod: Nio kvalitativa vetenskapliga studier analyserades enligt Fribergs modell för litteraturöversikt. Resultat: Resultatet sammanställdes i de tre kategorierna Begränsningar i vardagen, Stöd respektive brist på stöd från omgivningen, Förändrad syn på livet.  Konklusion: De personer som drabbats av en hjärtinfarkt lider ofta av hälsoproblem som fatigue i efterförloppet. Livsstilsförändringar kan vara svåra att genomföra och framförallt att bibehålla. Hälso- och sjukvårdspersonal bör vara väl insatta i vad livet efter en hjärtinfarkt innebär och ge gott stöd till de som drabbats. Livsstilsförändringar bör genomföras några få i taget istället för alla på samma gång för att det ska bli hållbart på lång sikt. / Background: The most common cause of death in Sweden is coronary heart disease, which can imply myocardial infarction. Risk factors for myocardial infarction are low physical activity, high blood lipids, smoking, low income and poor levels of education. A myocardial infarction occurs when a fatty, calcified plaque has ruptured and formed a trombosis. Aim: The aim of this literature study is to examine women and men’s experiences after a myocardial infarction. Method: Nine qualitative scientific studies were analyzed according to Friberg’s model for literature review. Results: The results were complied into three categories named Restrictions in daily life, Support or lack of support from the community, Altered life vision. Conclusion: The people who have suffered a myocardial infarction often sustain health problems such as fatigue in the aftermath. Lifestyle changes may be difficult to adopt and above all to maintain. Healthcare professionals should be well informed of what life after a myocardial infarction can implicate and give good support to those affected. Lifestyle changes should be carried out a few at a time rather than all at once to make them sustainable in the long term.

published_or_final_version / abstract / Anaesthesiology / Master / Master of Philosophy