Effects of Low-to-Moderate Physical Activities On Older Adults With Chronic Diseases

Low-to-moderate levels of regular physical activity could be encouraged among community-dwelling older adults to improve their physical health.

source: J Clin Nurs

Summary

A Systematic Review And Meta-Analysis.

[Posted 26/Jul/2022]

AUDIENCE: Nursing

KEY FINDINGS: Regular physical activity ranging from low-to-moderate intensity should be encouraged among older adults with chronic diseases.

BACKGROUND: Examined the evidence of low-to-moderate-intensity physical activities to assess the effect in managing hypertension, diabetes mellitus and hyperlipidaemia conditions among community-dwelling older adult. Physical activity is recommended for the maintenance and improvement of health. However, high-intensity physical activity may adversely impact exercise adherence by older adults.

DETAILS: This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions. The PRISMA statement was employed to guide the reporting of the systematic review and meta-analyses. This review included randomised controlled trials and cluster-randomised controlled trials on interventions of physical activities with low-to-moderate intensities compared against usual care without physical activities. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was performed using RevMan, with Cochran Q and I2 used for determining heterogeneity. The overall effect was reviewed with z scores. Results Fifteen randomised controlled trials with 940 total participants were evaluated. Low-to-moderate-intensity physical activity significantly improved systolic blood pressure [Z = 3.59, p = .0003], HbA1C [Z = 2.10, p = .04] and high-density lipoprotein (HDL) levels [Z = 3.83, p = .0001], compared to usual care. A further subgroup analysis found no significant difference in systolic blood pressure level after three sessions a week as well as after three months. There were insufficient papers to evaluate for both HbA1C and HDL levels.

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Source: Tan, K. H. L. and Siah, C. J. R. (2022). Effects of Low-to-Moderate Physical Activities On Older Adults With Chronic Diseases: A Systematic Review And Meta-Analysis. Journal of Clinical Nursing. 2022; 31(15-16):2072-2086. Published: August, 2022. DOI: 10.1111/jocn.16087.



Effectiveness of Horticultural Therapy On Physical Functioning and Psychological Health Outcomes For Older Adults

As a safe and promising nonpharmacological intervention, healthcare professionals may consider the HT intervention when caring for older adults with cancer, dementia and frailty.

source: J Clin Nurs

Summary

A Systematic Review and Meta-Analysis.

[Posted 19/Jul/2022]

AUDIENCE: Nursing

KEY FINDINGS: Horticultural therapy has potentially positive effects on the physical functioning and psychological health of older adults. However, more rigorous randomised controlled trials with larger populations are required to confirm the findings.

BACKGROUND: Purpose of this study is to systematically determine the effectiveness of horticultural therapy (HT) on the physical functioning and psychological health of older people. With advancing age and increased chronic diseases, older adults are vulnerable to physical deterioration and psychological problems. There is evidence that horticultural therapy (HT) has positive effect among older adults. However, less attention has been devoted to systematically evaluating the physical functioning and psychological health effects of HT in older adults. Systematic review and meta-analysis were conducted based on the checklist for PRISMA.

DETAILS: The searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, China Network Knowledge Infrastructure, Wan Fang, and China Science and Technology Journal Database, from their inception until June 2021. Randomised controlled trials published in either English or Chinese were reviewed. The Review Manager 5.4 software was used for meta-analyses. The quality of included studies was evaluated using the Cochrane risk of bias tool by two independent researchers. Ten studies involving 884 participants were included. Compared with the control group, HT can significantly improve upper body flexibility and aerobic endurance in older adults with cancer. Besides, HT was found to be more effective for promoting emotional functioning and well-being, subjective social functioning, and quality of life among the elderly. The attendance rate for HT was 66%–100%, and no negative events were found.

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Source: Lin, Y., Lin, R., Liu, W., et al. (2022). Effectiveness of Horticultural Therapy On Physical Functioning and Psychological Health Outcomes For Older Adults: A Systematic Review and Meta-Analysis. J Clin Nurs. 2022; 31(15-16): 2087-2099. Published: August, 2022. DOI: 10.1111/jocn.16095.



Examination of the Effects of 4-Hour Nonvalved Filtering Facepiece Respirator Use on Blood Gas Values of Health Care Professionals

Continuous nonvalved filtering facepiece respirator use for 4 hours was not associated with clinician impairment in blood gas and peripheral SpO2 levels during nonexertional clinical ED work.

source: JEN

Summary

A Before and After Study

[Posted 12/Jul/2022]

AUDIENCE: Nursing

KEY FINDINGS: Continuous nonvalved filtering facepiece respirator use for 4 hours was not associated with clinician impairment in blood gas and peripheral SpO2 levels during nonexertional clinical ED work.

BACKGROUND: The use of personal protective equipment increased rapidly during the COVID-19 pandemic that began in 2019. The purpose of this study was to examine the effects of uninterrupted 4-hour use of internationally certified nonvalved filtering facepiece respirators on venous blood gas in health care workers during the COVID-19 pandemic.

DETAILS: A before-after design included venous blood gas analyses collected at the beginning of shifts before nonvalved filtering facepiece respirator had been put on and after 4-hour uninterrupted use of nonvalved filtering facepiece respirator. In this study, 33 volunteer health care workers took part. In terms of blood gas values, mean pCO2 values were 47.63 (SD = 5.16) before and 47.01 (SD = 5.07) after nonvalved filtering facepiece respirator use, mean HCO3 values were 23.68 (SD = 1.10) in first blood gas analysis and 24.06 (SD = 1.31) in second blood gas analysis, and no significant difference was observed between before and after the use of nonvalved filtering facepiece respirator (t = 0.67, P = .50, t = -2.0, P = .054, respectively). The only significant difference in parameters investigated between the groups was in pH levels, at pH = 7.35 (SD = 0.29) before and pH = 7.36 (SD = 0.20) after nonvalved filtering facepiece respirator use (t = -2.26, P = .03).

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Source: Pasli, S., Imamoglu, M., Beser, M. F., et al. (2022). Examination of the Effects of 4-Hour Nonvalved Filtering Facepiece Respirator Use on Blood Gas Values of Health Care Professionals: A Before and After Study. JEN. Published: July, 2022. DOI: 10.1016/j.jen.2022.03.006.



The Association Of Education Level With Autonomy Support, Self-Efficacy and Health Behaviour

The relationship between autonomy support from healthcare providers and self-efficacy was more evident in the relatively less educated individuals.

source: J Clin Nurs

Summary

The Association Of Education Level With Autonomy Support, Self-Efficacy And Health Behaviour In Patients With Cardiovascular Risk Factors

[Posted 14/Jun/2022]

AUDIENCE: Nursing

KEY FINDINGS: The relationship between autonomy support from healthcare providers and self-efficacy was more evident in the relatively less educated individuals. The associations among autonomy support, self-efficacy and health behaviour differed by patient education level, and the mediating role of self-efficacy on the relationship between autonomy-supportive climate and health behaviour was found only in those less educated.

BACKGROUND: The study aimed to investigate whether the patients' education level affected the mediation effect of self-efficacy on the relationship between the autonomy-supportive healthcare climate and health behaviour among patients with cardiovascular risk factors. Autonomy and self-efficacy are identified as influential factors related to the behaviours of individuals with health problems. However, it is unclear whether autonomy support from healthcare providers affects health behaviour through self-efficacy and if patients' education level affects the association.

DETAILS: A convenience sample of 207 individuals with one or more cardiovascular diseases completed self-administered surveys including the healthcare climate questionnaire, self-efficacy scale and the engagement in health behaviour scale. Data were analysed using descriptive statistics, t test, Pearson's correlation coefficients and hierarchical regression analysis. All procedures of the study adhered to the STROBE guidelines. The influence of autonomy support from healthcare providers on self-efficacy differed by individuals' education level. Self-efficacy in less educated, but not highly educated individuals, tended to depend on the autonomy-supportive climate. Additionally, the autonomy-supportive healthcare climate affected health behaviour through self-efficacy only in less educated individuals.

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Source: Yenom, H. and Lee, J. (2022). The Association Of Education Level With Autonomy Support, Self-Efficacy and Health Behaviour In Patients With Cardiovascular Risk Factors. J Clin Nurs. 2022; 31(11-12): 1547-1556. Published: June, 2022. DOI: 10.1111/jocn.16008.



Understanding Factors That Influence the Decision To Be Vaccinated Against Influenza and Pertussis In Pregnancy

Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices

source: J Clin Nurs

Summary

A Qualitative Study

[Posted 7/Jun/2022]

AUDIENCE: Nursing

KEY FINDINGS: The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women.

BACKGROUND: Aimed to identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated. Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient.

DETAILS: Conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist. During the study carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis. Identified an overarching theme, ‘factors that influenced participants’ decision to be vaccinated or not’, which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants’ decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests.

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Source: Maranon, A. A., Fernandez-Cano, M. I., Montero-Pons, L., et al. (2022). Understanding Factors That Influence The Decision To Be Vaccinated Against Influenza And Pertussis In Pregnancy: A Qualitative Study. J Clin Nurs. Published: May 6, 2022. DOI: 10.1111/jocn.16006.



Pulmonary Congestion During ESE

B-lines identify the pulmonary congestion phenotype at rest, and more frequently, during ESE in ischemic and heart failure patients.

source: AHA Journal

Summary

Pulmonary Congestion During Exercise Stress Echocardiography in Ischemic and Heart Failure Patients

[Posted 2/Jun/2022]

AUDIENCE: Cardiology, Emergency Medicine

KEY FINDINGS: B-lines identify the pulmonary congestion phenotype at rest, and more frequently, during ESE in ischemic and heart failure patients. Stress B-lines may help to refine risk stratification in these patients.

BACKGROUND: Lung ultrasound detects pulmonary congestion as B-lines at rest, and more frequently, during exercise stress echocardiography (ESE).

DETAILS: Performed ESE plus lung ultrasound (4-site simplified scan) in 4392 subjects referred for semi-supine bike ESE in 24 certified centers in 9 countries. B-line score ranged from 0 (normal) to 40 (severely abnormal). Five different populations were evaluated: control subjects (n=103); chronic coronary syndromes (n=3701); heart failure with reduced ejection fraction (n=395); heart failure with preserved ejection fraction (n=70); ischemic mitral regurgitation >= moderate at rest (n=123). In a subset of 2478 patients, follow-up information was available. During ESE, B-lines increased in all study groups except controls. Age, hypertension, abnormal ejection fraction, peak wall motion score index, and abnormal heart rate reserve were associated with B-lines in multivariable regression analysis. Stress B lines (hazard ratio, 2.179 [95% CI, 1.015-4.680]; P=0.046) and ejection fraction <50% (hazard ratio, 2.942 [95% CI, 1.268-6.822]; P=0.012) were independent predictors of all-cause death (n=29 after a median follow-up of 29 months).

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Source: Merli, E., Ciampi, Q., Scali, M. C., et al. (2022). Pulmonary Congestion During Exercise Stress Echocardiography in Ischemic and Heart Failure Patients. Circulation: Cardiovascular Imaging.. 2022; 15(5): e013558. Published: May 17, 2022. DOI: 10.1161/CIRCIMAGING.121.013558.



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