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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Age differences in long-term adjustment and psychosocial outcomes in a large multi-site sample 5-10 years after heart transplant

Shamaskin, Andrea 01 April 2011 (has links)
Research on age differences in heart transplant patients has focused primarily on medical outcomes, with mixed findings regarding mortality and morbidity rates and limited research regarding age differences in psychosocial and quality of life outcomes. To gain a more complete understanding of psychosocial adjustment after heart transplant, this study examined age differences in: satisfaction with quality of life, satisfaction with social support, depressive symptoms, negative affect, symptom distress, stress related to heart transplant, overall health functioning, coping strategies, and aspects of adherence. Results indicate that older patients, compared to younger patients, report better adjustment and quality of life across numerous outcomes 5-10 years after heart transplant. These findings are consistent with previous literature examining age differences in developmental changes with emotion regulation and coping. This study hopes to contribute to the discussion of age and heart transplant, highlighting the importance of considering quality of life in addition to medical outcomes.
12

Livet med ett nytt hjärta : Patienters upplevelser och copingstrategier

Johansson, Emmelie, Larsson, Jennifer, Thuresson, Emelie January 2010 (has links)
Background: For patients with severe heart disease, may heart transplantation be the only opportunity for survival. Previous research highlights the importance of the nurse's role as supporters and knowledge brokers. People who has undergone heart transplant may be changed forever. Having to undergo a heart transplant can lead to that patients end up in a traumatic crisis. People's perception of herself and her perception of the world is also changing when the body is injured or suffers a disease. Aim: The aim of this study is to elucidate patients' experiences of living with a new heart, and to focus on the coping strategies used by patients to manage their new situation. Method: A literature review was chosen as the method. The 12 items used in the study have been based on studies of seven qualitative and five quantitative approaches. Articles were published after year 1995. Results: Two main categories emerged from the analysis: Patients' experiences of living with someone else's heart, and patients' coping strategies to deal with the new heart. The most important results were about emotional turmoil, changes in health, psychological adjustment and defense mechanisms. Conclusion: To have received a new heart gives different experiences. It is important that the nurse has knowledge and understanding of these individual experiences that patients can feel.
13

Implementing a healthy eating strategy after heart and lung transplantation : a randomised controlled feasibility study

Entwistle, Timothy January 2017 (has links)
Background: Studies evaluating the possible health-promoting effects of sound nutrition in heart and lung transplant recipients are currently lacking. Despite advances in drug treatment and patient monitoring, lifestyle-associated complications such as obesity, diabetes and cardiovascular disease occur frequently. Following transplantation, a low-fat eating pattern is currently viewed as best standard care. However, a Mediterranean diet based on a varied range of fresh unprocessed foods and supplemented with extra virgin olive oil has demonstrated clinical benefit in various non-transplant populations. The aim of this study was to evaluate the feasibility and acceptability of a Mediterranean vs a low-fat diet intervention in heart and lung transplant recipients, and to assess clinical and biochemical outcomes. Methods: This was a randomised controlled feasibility trial to evaluate a Mediterranean diet supplemented with extra-virgin olive oil, vs a modified low-fat diet in heart and lung transplant recipients at a single centre. In total, 41 clinically stable male and female (median age 55 years) transplant recipients were randomly assigned (1:1) in two separate 12-month waves (n=24 and n=17) to one of these diet interventions. A range of validated food frequency and adherence questionnaires captured changes in participants' reported eating habits to 6 weeks post-study. Clinical and biochemical analysis was conducted at baseline, 25 and 52 weeks. Telephone and outpatient contact provided a support mechanism to reinforce dietary behavioural change. Caloric intake and physical exercise awareness were discussed, but not promoted. Results: Thirty nine participants completed the trial (95%). Adherence to both interventions improved significantly at week 25, and was maintained at 52 and 58 weeks. Compared with baseline, waist circumference decreased in both groups at week 25 (p=0.024). A decrease in blood pressure and heart rate occurred at 52 weeks in the low-fat group only. At 52 weeks, higher adherence resulted in significant improvements in fasting glucose in the Mediterranean (< 4.8%) and low-fat (< 5%) groups. This respective pattern was also observed with total cholesterol (≤ 9% and ≤ 7%), triglycerides (≤ 9% and ≤ 20%) and IGF-1 (≤ 9% and ≤ 15%). A significant decrease in the LDL/HDL ratio (≤ 12%) occurred in the Mediterranean group only. Moreover, clinically relevant lipid and glucose regulation changes were observed in each intervention. Conclusions: The implementation of a prospective 12-month Mediterranean or low-fat diet is feasible and acceptable in a heart and lung transplant outpatient setting. Both interventions were positively associated with improvements in lipid and blood glucose regulation and circulating IGF-1. As part of a multidisciplinary framework, these findings offer an additional therapeutic strategy to optimise outpatient care.
14

Avaliação ecocardiografica da função ventricular de pacientes transplantados e sua correlação com rejeição cardiaca imunologica / Echocardiographic assessment of ventricular function of transplanted patients and its correlation with heart immune rejection

Miguel, Gabriel Antonio Stanisci, 1978- 15 August 2018 (has links)
Orientador: Salomon Soriano Ordinola Rojas / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T00:59:13Z (GMT). No. of bitstreams: 1 Miguel_GabrielAntonioStanisci_M.pdf: 2975905 bytes, checksum: c45b885c0ebe455da2be8fded7817e46 (MD5) Previous issue date: 2009 / Resumo: Introdução: O transplante (TX) cardíaco é uma alternativa para os indivíduos com doença cardíaca terminal. Na evolução pós-TX, a ocorrência de episódios de rejeição é um evento frequente, sendo responsável pelo aumento da morbimortalidade. Uma alternativa relevante seria o emprego de um exame não invasivo que tivesse uma boa acurácia na detecção das alterações da função sisto-diastólica do coração transplantado, pois a biópsia endomiocárdica (BEM) não é um procedimento isento de complicações. Objetivo: Comparar a função ventricular esquerda entre os pacientes transplantados com rejeição cardíaca e os pacientes transplantados sem rejeição; utilizando como referência o grupo controle e correlaciona-la com rejeição cardíaca imunológica. Métodos: Foram realizados ecocardiogramas transtorácicos no período de janeiro de 2006 a janeiro de 2008, para a avaliação prospectiva de 47 pacientes; sendo 17 pacientes (36,2 %) pertencentes ao grupo controle (grupo GC), 18 (38,3%) pertencentes ao grupo de pacientes transplantados sem rejeição (TX0) e 12 (25,5%) pertencentes ao grupo de pacientes transplantados com rejeição (TX1). Comparou-se a função sisto-diastólica entre os três grupos (GC, TX0, TX1). Para o estudo da homogeneidade entre proporções foi utilizado o teste exato de Fisher. Para a análise da hipótese de igualdade entre os grupos em relação às medianas, utilizou-se o teste não-paramétrico de Kruskal-Wallis seguido do teste de comparações múltiplas. O nível de significância utilizado para os testes foi de 5%. Resultados: Os grupos não diferiram em relação à idade [34,0 (29,5 - 44,0) X 46,0 (33,5 - 51,5) X 39,0 (32,5 - 54,5) p = 0,354], ao peso [70,0 (57,5 - 85,0) X 66,5 (57,5 - 88,0) X 61,0 (57,5 - 73,5) p = 0,661], altura [1,65 (1,59 - 1,73) X 1,66 (1,64 - 1,70) X 1,69 (1,64 - 1,72) p = 0,821] e superfície corpórea [1,84 (1,58 - 1,98) X 1,75 (1,62 - 2,03) X 1,69 (1,63 - 1,88) p = 0,758]. O grupo GC quando comparado com o grupo TX0, apresentou alteração da função sisto-diastólica do ventrículo esquerdo, expressa através do aumento do Índice de Performance Miocádica (IPM), sendo esta mais significativa nos pacientes do grupo TX1 [0,38 (0,29 - 0,44) X 0,47 (0,43 - 0,56) X 0,58 (0,52 - 0,74) p <0,001]. Conclusão: Foi evidenciado que o Índice de Performance Miocárdica encontra-se aumentado nos pacientes transplantados, em relação ao grupo controle e não houve diferença significativa entre os dois grupos de pacientes transplantados; portanto, o ecocardiograma mostrou-se como exame de boa acurácia na detecção das alterações da função sisto-diastólica do coração transplantado e não foi confiável como método substituto da biópsia endomiocárdica para o diagnóstico seguro de rejeição cardíaca. / Abstract: Introduction: The transplant (TX) cardiac is an alternative for the individuals with terminal cardiac illness. In the evolution after TX, the occurrence of rejection episodes is a frequent event, being responsible for the increase of morbi-mortality. An excellent alternative would be the job of a not invasive examination that had a good acurácia in the detention of the alterations of the diastolic function of the transplantated heart, therefore the endomyocardial biopsy (BEM) is not an exempt procedure of complications. Objective: Compare the left ventricular function between patients transplated with rejection and cardiac transplant patients without rejection, using as reference the control group and correlated it with immunological rejection rate. Methods: Transthoracic echocardiograms in the period of January of 2006 had been carried through the January of 2008, for the prospective evaluation of 47 patients; being 17 patients (36,2 %) pertaining to the group it has controlled (group GC), 18 (38,3%) pertaining to the group of patients transplantated without rejection (TX0) and 12 (25,5%) pertaining ones to the group of patients transplantated with rejection (TX1). It was compared sisto-diastolic function between the three groups (GC, TX0, TX1). To study the homogeneity of proportions was used Fisher's exact test. For the analysis the hypothesis of equality between the groups in relation to the medians, we used the nonparametric Kruskal-Wallis test followed by multiple comparisons. The significance level used for the tests was 5%. Results: The groups did not differ in age [34.0 (29.5 to 44.0) X 46.0 (33.5 - 51.5) X 39.0 (32.5 - 54.5) p = 0.354 ], weight [70.0 (57.5 to 85.0) X 66.5 (57.5 to 88.0) X 61.0 (57.5 to 73.5) p = 0.661], height [ 1.65 (1.59 to 1.73) X 1.66 (1.64 - 1.70) X 1.69 (1.64 - 1.72) p = 0.821] and body surface area [1.84 ( 1.58 to 1.98) X 1.75 (1.62 - 2.03) X 1.69 (1.63 to 1.88) p = 0.758]. The GC group compared with the group TX0, had an alteration of the systolic-diastolic function of left ventricle, expressed by increasing the Miocardic Performance Index (IPM), which is more significant for patients in group TX1 [0.38 (0, 29 to 0.44) X 0.47 (0.43 to 0.56) X 0.58 (0.52 to 0.74) p <0.001]. Conclusion: It was shown that the myocardial performance index is increased in transplant patients in the control group and no significant difference between the two groups of transplant patients, so the echocardiogram showed to be taking good accuracy in the detection of systolic-diastolic function of the transplanted heart and was not a reliable method of biopsy substitute for the confident diagnosis of cardiac rejection. / Mestrado / Cirurgia / Mestre em Cirurgia
15

Efter hjärttransplantation : Patientens känslor och upplevelser / After hearttransplantation : Patients emotions and experiences

Persson, Jannice, Arvidsson, Sara January 2021 (has links)
Bakgrund: Allt fler lever idag med ett transplanterat hjärta. En hjärttransplantation kan vara en omställning både kroppsligt och känslomässigt. I väntan på ett nytt hjärta är det vanligt att patienten upplever stor rädsla och oro inför framtiden. De känslor patienten erfar innan hjärttransplantationen kan höra ihop med hur patienten erfar situationen efteråt, här kan sjuksköterskans roll vara betydelsefull. Syfte: Syftet med studien var att belysa patienters känslor och upplevelser efter hjärttransplantation.  Metod: En litteraturstudie innehållande kvalitativa och kvantitativa artiklar analyserades och sammanställdes. Resultatet: Resultatet bestod av tre Huvudkategorier: Komplexa känslor, Upplevelser av stöd och Det nya livet. Patienterna upplevde en tacksamhet gentemot donatorn. Flera av de hjärttransplanterade kände rädsla, oro och skuld. Vissa av patienterna upplevde en period av nedstämdhet efter hjärttransplantationen. Upplevelsen av stöd var betydelsefullt. Det nya livet bestod av olika känslor och upplevelser kring den nya situationen och en kamp med självidentiteten. Slutsats: Litteraturstudiens resultat visade på att det är en omfattande process för patienten att genomgå en hjärttransplantation, både fysiskt och psykiskt. Patienterna genomgår många komplexa känslor som kan liknas vid en berg- och dalbana där önskan och hopp blandas med sorg, nedstämdhet och rädsla. Det är grundläggande att sjuksköterskan har kunskap och förståelse för patientens livsvärld för att kunna stödja patienten i den situationen.
16

Cuidados de Enfermagem ao transplantado cardíaco: perspectiva do enfermeiro e do paciente / Nursing care to the transplanted heart patients: the perspective of nurse and patient.

Daniel, Leticia de Carvalho Zanatta 17 December 2012 (has links)
Introdução e Objetivos: O cuidado de Enfermagem à pessoa póstransplante cardíaco é um tema pouco investigado no Brasil. Este estudo teve como objetivos: Identificar os cuidados de Enfermagem prestados ao paciente transplantado cardíaco mediato em unidade de terapia intensiva e na unidade de internação de um hospital especializado em cardiologia; apreender os cuidados que o paciente transplantado cardíaco espera receber do enfermeiro em unidade de terapia intensiva e na unidade de internação, na perspectiva do enfermeiro e na perspectiva do paciente. Metodologia: Trata-se de uma pesquisa qualitativa. Foram entrevistados nove enfermeiros e três pacientes que atenderam aos critérios de inclusão, utilizando-se um questionário semiestruturado, cujos dados foram analisados por meio da análise temática, conforme Minayo. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da USP e autorizada a coleta de dados pelo Instituto do Coração do HCFMUSP, local onde foi realizada a pesquisa. Resultados: A relação dos enfermeiros e dos pacientes está mediada pelo cuidado, que se expressa por um cuidado realizado que é o cuidado prestado e um cuidado desejado ou um cuidado esperado, que evidenciam as expectativas tanto dos enfermeiros quanto dos sujeitos entrevistados. Da análise temática das entrevistas emergiram três dimensões de cuidados: biológica, emocional e psicossocial. A dimensão biológica é apreendida pelos enfermeiros e pelos pacientes na mesma perspectiva e se refere aos cuidados relativos à administração de medicamentos, à alimentação, aos curativos, à detecção de sinais de rejeição, aos drenos e cateter, à higiene, à prevenção de infecção e à realização de biópsia. A dimensão emocional, na perspectiva dos enfermeiros, está relacionada à revolta com a doença e ao longo tempo de internação, enquanto na dos pacientes se refere ao apoio, à atenção e ao vínculo afetivo. Na dimensão psicossocial os enfermeiros abordam o acolhimento da família e a orientação para o cuidado e os pacientes a orientação para o cuidado. Considerações finais: Os enfermeiros citam e realizam predominantemente cuidados na dimensão biológica e é assim que os pacientes os apreendem e os reproduzem. As outras dimensões do cuidado foram pouco mencionadas, o que sugere a necessidade de ressignificar o cuidado ao transplantado cardíaco de modo a que as condições objetivas de trabalho e as crenças sejam analisadas e investigadas visando à ampliação e à efetivação do cuidado que se deseja ser multidimensional. / Introduction and Objectives: The nursing care to an individual after cardiac transplantation is poorly investigated in Brazil. This study aimed to: Identify the nursing care provided to mediate postoperative cardiac transplant patient in the intensive care unit and inpatient unit of a hospital specialized in cardiology; apprehend the nursing care that heart transplant patient hopes to receive from the nurse in the intensive care unit and inpatient unit, from the perspective of the nurse and the patient. Methods: This was a qualitative research. Was interviewed nine nurses and three patients who fulfilled the inclusion criteria, using a semi-structured questionnaire whose data were analyzed using thematic analysis according to Minayo. The research project was approved by the EEUSP Ethics Commission and the collection of data were authorized by HCFMUSP, where the research was conducted. Results: The ratio of nurses and patients is mediated by nursing care, which is expressed by a realized care that is the provided care and a desired nursing care or expected care, which showed both the expectations of nurses as the interviewed subjects. The thematic analysis of the interviews revealed three dimensions of care: biological, psychosocial and emotional. The biological dimension is apprehended by nurses and patients in the same perspective and refers to the care of the administration of medicines, to food, to bandages, to detection the signs of rejection, to the drains and catheters, to hygiene, to the prevention of infections and to the biopsy. The emotional dimension, from the perspective of nurses, is related to the anger with illness and hospitalization time, while the patients perspective referred to the support, attention and affective link. In psychosocial dimension the nurses approach the hosting of family and the orientation related to the care and the patients referred the orientation related to the care. Final considerations: The nurses cite and realize predominantly biological dimension care and that is how the patients reproduce them. Other dimensions of care were just little mentioned, which suggests the need to resignify the transplanted heart care so that the objective conditions of work and beliefs are examined and investigated aiming to increase and to effective the care that is wanted to be multidimensional.
17

Organmottagares upplevelse av att ha genomgått en hjärttransplantation : En litteraturbaserad studie / The organ recipient’s experience after having a heart transplant : A literature-based study

Evertsson, Elvira, Dunder, Åsa January 2019 (has links)
Bakgrund: I Sverige utfördes den första hjärttransplantationen år 1984 i Göteborg. En ökande trend har identifierats genom åren och Sverige är det land som utför flest hjärttransplantationer i Skandinavien. Det är vid svår hjärtsvikt som den drabbade kan bli kandidat för eventuell hjärttransplantation och sjuksköterskan har en nyckelroll i omvårdnaden av dessa patienter. Omvårdnadens syfte är att förbättra patientens chans för överlevnad och livskvalitet. Syfte: Beskriva organmottagares upplevelser av att ha genomgått en hjärttransplantation. Metod: En litteraturbaserad metod för att bidra till evidensbaserad omvårdnad med grund i analys av kvalitativ forskning. Resultat: Fyra kategorier identifierades; En ny livssituation, förändrad syn på livet, ta del av andra erfarenheter och nya tankar inför framtiden, med tio underkategorier. Konklusion: Resultatet visar att patienter som genomgått en hjärttransplantation upplever en förändrad vardag och livssyn. Nya insikter om livet och upplevelse av att fått en ny chans skapas. Detta väcker känsla av tacksamhet och skyldighet gentemot sin donator. Majoriteten av patienterna upplevde att stödet från sjukvården var bristfälligt, både inför och efter operationen och att det är bristen på information som upplevs som central. / Background: The first heart transplant performed in Sweden took place in 1984 in Gothenburg. An increasing trend has been identified over the years and Sweden is the country that performs most heart transplants in Scandinavia. It is in case of severe heart failure that the affected person can become a candidate for any heart transplant and the nurse has a key role in the care of these patients. The purpose of nursing is to improve the patient's chance of survival and quality of life. Aim: The aim was to describe the organ recipient’ experience after having a heart transplant. Method: A literature-based study where the data consisted of qualitative articles. Result: Four categories were identified; A new life situation, changed view of life, influence from others and new thoughts about the future with ten subcategories. Conclusion: The result shows that patients who have undergone a heart transplant experience a changed everyday life and belief. New insights about life and the experience of having a new chance created. This arouses a sense of gratitude and obligation towards their donor. The majority of the patients felt that the support from the health service was inadequate, both before and after the surgery and that it is the lack of information that is perceived as central.
18

Cuidados de Enfermagem ao transplantado cardíaco: perspectiva do enfermeiro e do paciente / Nursing care to the transplanted heart patients: the perspective of nurse and patient.

Leticia de Carvalho Zanatta Daniel 17 December 2012 (has links)
Introdução e Objetivos: O cuidado de Enfermagem à pessoa póstransplante cardíaco é um tema pouco investigado no Brasil. Este estudo teve como objetivos: Identificar os cuidados de Enfermagem prestados ao paciente transplantado cardíaco mediato em unidade de terapia intensiva e na unidade de internação de um hospital especializado em cardiologia; apreender os cuidados que o paciente transplantado cardíaco espera receber do enfermeiro em unidade de terapia intensiva e na unidade de internação, na perspectiva do enfermeiro e na perspectiva do paciente. Metodologia: Trata-se de uma pesquisa qualitativa. Foram entrevistados nove enfermeiros e três pacientes que atenderam aos critérios de inclusão, utilizando-se um questionário semiestruturado, cujos dados foram analisados por meio da análise temática, conforme Minayo. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da USP e autorizada a coleta de dados pelo Instituto do Coração do HCFMUSP, local onde foi realizada a pesquisa. Resultados: A relação dos enfermeiros e dos pacientes está mediada pelo cuidado, que se expressa por um cuidado realizado que é o cuidado prestado e um cuidado desejado ou um cuidado esperado, que evidenciam as expectativas tanto dos enfermeiros quanto dos sujeitos entrevistados. Da análise temática das entrevistas emergiram três dimensões de cuidados: biológica, emocional e psicossocial. A dimensão biológica é apreendida pelos enfermeiros e pelos pacientes na mesma perspectiva e se refere aos cuidados relativos à administração de medicamentos, à alimentação, aos curativos, à detecção de sinais de rejeição, aos drenos e cateter, à higiene, à prevenção de infecção e à realização de biópsia. A dimensão emocional, na perspectiva dos enfermeiros, está relacionada à revolta com a doença e ao longo tempo de internação, enquanto na dos pacientes se refere ao apoio, à atenção e ao vínculo afetivo. Na dimensão psicossocial os enfermeiros abordam o acolhimento da família e a orientação para o cuidado e os pacientes a orientação para o cuidado. Considerações finais: Os enfermeiros citam e realizam predominantemente cuidados na dimensão biológica e é assim que os pacientes os apreendem e os reproduzem. As outras dimensões do cuidado foram pouco mencionadas, o que sugere a necessidade de ressignificar o cuidado ao transplantado cardíaco de modo a que as condições objetivas de trabalho e as crenças sejam analisadas e investigadas visando à ampliação e à efetivação do cuidado que se deseja ser multidimensional. / Introduction and Objectives: The nursing care to an individual after cardiac transplantation is poorly investigated in Brazil. This study aimed to: Identify the nursing care provided to mediate postoperative cardiac transplant patient in the intensive care unit and inpatient unit of a hospital specialized in cardiology; apprehend the nursing care that heart transplant patient hopes to receive from the nurse in the intensive care unit and inpatient unit, from the perspective of the nurse and the patient. Methods: This was a qualitative research. Was interviewed nine nurses and three patients who fulfilled the inclusion criteria, using a semi-structured questionnaire whose data were analyzed using thematic analysis according to Minayo. The research project was approved by the EEUSP Ethics Commission and the collection of data were authorized by HCFMUSP, where the research was conducted. Results: The ratio of nurses and patients is mediated by nursing care, which is expressed by a realized care that is the provided care and a desired nursing care or expected care, which showed both the expectations of nurses as the interviewed subjects. The thematic analysis of the interviews revealed three dimensions of care: biological, psychosocial and emotional. The biological dimension is apprehended by nurses and patients in the same perspective and refers to the care of the administration of medicines, to food, to bandages, to detection the signs of rejection, to the drains and catheters, to hygiene, to the prevention of infections and to the biopsy. The emotional dimension, from the perspective of nurses, is related to the anger with illness and hospitalization time, while the patients perspective referred to the support, attention and affective link. In psychosocial dimension the nurses approach the hosting of family and the orientation related to the care and the patients referred the orientation related to the care. Final considerations: The nurses cite and realize predominantly biological dimension care and that is how the patients reproduce them. Other dimensions of care were just little mentioned, which suggests the need to resignify the transplanted heart care so that the objective conditions of work and beliefs are examined and investigated aiming to increase and to effective the care that is wanted to be multidimensional.
19

Race/Ethnicity: Is it an Outcome Predictor in Patients with Heart Failure?

Bhatt, Digant V 28 January 2009 (has links)
Objective: The aim of this study was to determine the role of race as a significant risk factor for prediction of outcomes in heart failure (HF). Methods: The data was collected on demographics, detailed history of HF, family history, vital signs, medication and laboratory profile for 585 patients from Heart failure Treatment Center of Emory University after year of 2000. Outcome of HF was defined as combination of death, placement of left ventricular assisted devise, heart transplant or emergency transplant. The independent relationship between race and outcomes of HF was evaluated by univariate and multivariate logistic regression analyses. The survival analysis was done by Cox regression modeling. Results: Among 585 HF patients, 58.1% were whites and 41.9% were blacks and 28.2% HF patients had positive outcomes. Although Whites tended to have a more positive outcome (34.6%) than blacks (28.9%), the difference was not statistically significant. Factors predicting the outcome in whites were male gender (OR 5.02), history of hypertension (OR 2.3), ventricular arrhythmias (OR 2.4), placement of AICD(OR 0.09), low EF% (OR 0.95), high NYHA class (OR 3.25), use of beta blockers (OR 0.12), aldosterone blockers (OR 2.19), furosemide (2.18); while in blacks they were age in years (OR 0.96), history of PTCA (OR 7.04), dislipidemia (OR 3.90), depression (OR 0.01), placement of AICD (OR 0.14), low EF% (OR 0.92), systolic blood pressure (OR 0.96), high NYHA class (OR 4.01), use of beta blockers (OR 0.14), torsemide (OR 2.86), and digoxin (OR 4.91) etc. Blacks had higher survival than whites (p < 0.001). Conclusion: There is no significant difference in combined outcome (death, transplant, emergency transplant, and Left Ventricular Assisted Devise placement) of HF between whites and blacks. There are differences regarding the risk factors, which are more prominent in each race. Further exploration is required to evaluate the race as significant risk factor for predicting the outcome in HF.
20

”Hinner jag få ett nytt hjärta i tid?” : - Unga kvinnors bloggar kring upplevelser av att vänta på en hjärttransplantation / ”Will I get a new heart in time?” : - Young women blogs about experiences of waiting for a heart transplant

Almsand, Jessica, Duell, Sara January 2014 (has links)
Bakgrund: Antalet utförda hjärttransplantationer i Sverige ökar och uppgår nu till omkring femtio transplantationer per år. Främsta orsaken till en hjärttransplantation är grav hjärtsvikt. Att drabbas av hjärtsvikt som ung är ovanligt och mycket påfrestande. Om hjärttransplantation blir aktuellt sätts patienten upp på väntelista där medianväntetiden är tre månader. Tidigare forskning visar att sjuksköterskan har en viktig roll i patientens upplevelse under denna tid. Syfte: Studiens syfte är att analysera och beskriva unga kvinnors upplevelser inför en hjärttransplantation. Metod: Kvalitativ innehållsanalys används som analysmetod. Data består av fem bloggar publicerade på internet. Resultat: Unga kvinnor som väntar på en hjärttransplantation upplever fysiska begränsningar i vardagen. Närstående, sjukvårdspersonal och omgivningen är viktiga för att ge stöd och fungera som drivkraft i situationen. Den ovissa väntan präglas av oro och rädsla för den egna döden. Väntan innebär att unga kvinnor får en ny syn på livet. Slutsats: Unga kvinnors livsvärld förändras drastiskt i väntan på hjärttransplantation och det är av stor vikt att sjuksköterskan uppmärksammar denna förändring och utformar omvårdnaden därefter. / Background: The number of performed heart transplants in Sweden is increasing and is now about fifty transplants per year. The primary reason for a heart transplant is severe heart failure. To suffer from heart failure as young is rare and trying. If heart transplantation becomes necessary the patient is placed on a waiting list where the median waiting time is three months. Previous research shows that nurses have an important role in the patient's experience during this time. Aim: The study aims to analyze and describe the experiences of young women facing a heart transplant.  Method: Qualitative content analysis is used as analytical method. Data consists of five blogs published on the Internet. Results: Young women waiting for a heart transplant experience physical limitations in daily life. Relatives, professionals and the environment are important to provide support and act as motivation in the situation. The uncertain waiting is incused by anxiety and fear of their own death. The waiting means that young women will have a new outlook on life. Conclusion: The lifeworld of young women drastically changed awaiting heart transplantation and it´s important for the nurse to recognize this change and frame the care thereafter.

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