published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / abstract / Community Medicine / Doctoral / Doctor of Philosophy

A descriptive design was used in this study to describe the feeding behaviors (as defined by changes in body position) in infants with congestive heart failure secondary to congenital heart disease. In addition, short term physiologic changes associated with the behaviors were measured through the use of pulse oximetry and cardiorespiratory monitors. Nine infants were observed in this study as they were being fed by their nurses. The method chosen was naturalistic observation. Descriptive statistics were used to analyze the demographic data and the measured physiologic variables. A point by serial correlation was conducted to describe any relationships between the position changes and the measured physiologic variables. Statistically significant relationships were found between certain positions and oxygen saturation, heart rate and respiratory rate. The results indicate that infants do experience position changes that are accompanied by changes in physiologic variables during feeding. These position changes can be categorized as infant-mediated or nurse-mediated.

The purpose of this study was to describe the relationships among perceptions of privacy, powerlessness, and subjective sleep characteristics in hospitalized adults with coronary heart disease. Thirty subjects, 48 to 92 years old who were hospitalized for suspected or confirmed coronary heart disease, completed three questionnaires. Negative relationships were found between patient privacy and powerlessness (r = -.44) and between powerlessness and the subjective sleep characteristics of sleep effectiveness (r = -.30). Feelings of powerlessness were negatively related to total number of days of (r = -.50) and number of days in the Coronary Care Unit (CCU) (r = -.41). The number of days in the CCU was positively related to sleep disturbance (r =.30). Age was negatively related to patient privacy (r = -31) but positively related to powerlessness (r =.33) and sleep supplementation (r =.35). A better understanding of the hospital environment enhances the planning of nursing care for hospitalized patients.

M.A. / Please refer to full text to view abstract

published_or_final_version / Medicine / Master / Master of Research in Medicine

Objective: To examine the effect of exercise-based cardiac rehabilitation program for secondary prevention of coronary heart disease on cardiac-related mortality, recurrent cardiovascular event and quality of life. Methods: All studies published between 1990 and 2013 in PubMed, and from 1980 to 2013 in EMBASE, which evaluated the effectiveness of exercise-based cardiac rehabilitation program for coronary heart disease. Using the specific keywords “Cardiac rehabilitation”, “Coronary heart disease” OR “Ischemic heart disease” [MeSH], “Exercise” OR “Physical activities” AND “Quality of life” OR “Mortality” AND Cardiovascular events” were searched. A total of 7randomized controlled trials out of 5,051articles from PubMed and 117 articles from EMBASE were included in this systematic review. The primary outcome measures used in the included seven studies were HRQOL, restenosis, cardiac event, cardiac related mortality. Similar demographic and clinical characteristics of the subjects between the intervention and the control groups were recorded. The studies were from five countries. The average age of the subjects in the seven studies was 61years, the average half of them have history of myocardial infarction. Though there were discrepancies among the results generated in the included studies, the potential benefits of exercise-based cardiac rehabilitation could be seen. Results: Compared with the non-exercise-based cardiac rehabilitation, patients allocated to the exercise-based cardiac rehabilitation program had greater improvement in HRQOL and reduction of cardiac events. The result of reducing restenosis was inconsistent. The cardiac related mortality is not significant difference between exercise-based and non-exercise-based cardiac rehabilitation. / published_or_final_version / Public Health / Master / Master of Public Health

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Coronary Artery Bypass Graft(CABG) Surgery increases blood flow to the endangered myocardium but does not slow the process of atherosclerosis. The only way to slow the process of coronary artery disease is to acknowledge the risk factors present and minimize or totally eliminate them from an individual's lifestyle. Men and women respond differently to stress and lifestyle modifications. The purpose of this study was to determine if there was a difference between genders in compliance to a heart healthy lifestyle pre and post CABG surgery.Thirty men and thirty women who had CABG surgery at least one year earlier were interviewed to assess coronary artery disease risk. The procedure for the protection of human subjects were followed. The instrument used was the RISKO Heart Hazard Appraisal Tool. This instrument was developed in 1985 by the American Heart Association and scored individuals on systolic blood pressure, weight, serum cholesterol level and cigarette smoking habits. Pre-operative records were also reviewed using the same tool to assess individuals preoperative risk. The research design used was 2 x 2 repeated measures. Data were analyzed using 2 x 2 repeated measures analysis of variance (ANOVA).Two findings were discovered. First there was a statistically significant difference between men and women (F=5.82 p=0.019) with men scoring lower RISKO scores than women, indicating lower risk and better compliance to a heart healthy lifestyle, both pre- and postoperatively. Second there was a significant difference between preand postoperative RISKO scores in the total population (F=8.77 p=0.004). Postoperative RISKO scores were lower indicating an improvement in heart healthy lifestyle. There was no statistically significant difference between genders in the difference of pre- and postoperative RISKO scores (F=2.56 p<.115). The significance of this study was that it looked specifically at gender differences and assessed disparities in cardiovascular risk factors and the impact of surgery on men and women.This study found that overall, men had lower RISKO scores than women. Both genders also had improved RISKO scores postoperatively from preoperatively. No statistically significant difference between genders of the RISKO scores from preoperatively to postoperatively was found. Education needs to continue to play a big part in the cardiac rehabilitation process for both genders and specifically women need to become the target of further research and education to improve compliance to a heart healthy lifestyle. / School of Nursing

M.Sc. (Psychology) / Please refer to full text to view abstract