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Positive Psychological Experiences in Chronic Heart Failure: A Qualitative Meta‐Synthesis

ABSTRACT

Aims

Determine the positive psychological experience of patients with chronic heart failure through a systematic literature review and to provide a reliable basis for their psychological care.

Design

Qualitative meta-synthesis.

Data Source

A qualitative meta-synthesis was conducted to extract and analyse qualitative research from PubMed, Web of Science, Embase, Cochrane, CINAHL, PsycINFO and Chinese Database, including China National Knowledge Internet, Wanfang Database, China Biology Medicine Disc and VIP database from the inception of the database to 24 March 2024.

Review Methods

Two researchers screened, extracted and cross-checked data. Disputes resolved via discussion or 3rd researcher. Irrelevant titles/abstracts were excluded; full-texts were reviewed for final inclusion.

Results

A total of 17 qualitative studies yielded 58 results, categorised into 10 groups and synthesised into three themes: positive attitudes and emotional responses, positive changes after the disease diagnosis and supportive factors for positive psychology.

Conclusions

Heart failure patients can experience positive psychology post-illness. Care providers should prioritise psychological assessment and support factors to meet needs, foster rehabilitation and improved quality of life.

Patient or Public Contribution

CHF patients crucially contributed to this qualitative meta-synthesis by sharing insights into their positive psychological experiences, resilience and coping strategies.

Safety of penicillamine and trientine in the treatment of Wilson’s disease: An analysis of the FDA Adverse Event Reporting System (FAERS) database

by Wenlong Qian, Kou Xu, Shuo Li, Zhuo Zhang, Xiaoxiao Hou, Bingjie Min, Jia Ling, Xinyu Zhu, Hui Zhou, Wenjuan Xu, Wenming Yang, Shijian Cao, Yonghua Chen

Background

Penicillamine(D-Penicillamine) and trientine are first-line therapies for Wilson’s Disease (WD), yet real-world data on their adverse events (AEs) remain scarce. We analyzed the FDA Adverse Event Reporting System (FAERS) to comprehensively assess the safety of penicillamine and trientine in WD treatment.

Methods

AEs for penicillamine and trientine (2004Q1–2024Q4) were analyzed using Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and Bayesian Confidence Propagation Neural Network (BCPNN).

Results

We found 1,452 and 760 AEs related to penicillamine and trientine, respectively. In all adverse event (AE) reports, the ratio of females to males was approximately 1.3, with the highest proportion of AE reports in the 21–30 age group, and the largest number of AE reports coming from the United States. Signal detection showed that the most commonly reported AEs for penicillamine and trientine were drug hypersensitivity and tremor, respectively, with the highest proportions in the SOC categories of immune system disorders and gastrointestinal disorders. The main AEs for both drugs involved condition aggravated, and identified potential safety signals requiring further validation for the two drugs, such as decreased bone density and brain atrophy for penicillamine, and memory impairment, oesophageal ulcer and starvation for trientine. In addition, we found that women were more likely to experience drug hypersensitivity in penicillamine adverse event reports, while men were more likely to experience cutis laxa.

Conclusion

This study reveals the characteristics of AEs and potential associated risks in the clinical application of penicillamine and trientine, emphasizing individualized medication and vigilant monitoring strategies to provide guidance for safe medication use.

Experiences and Perspectives of Chronic Heart Failure Patients and Caregivers in Advance Care Planning—A Meta‐Synthesis

ABSTRACT

Background

Chronic heart failure (CHF) is a progressive life-limiting condition that necessitates early implementation of advance care planning (ACP). However, patients and caregivers encounter emotional, informational, and cultural barriers to effective ACP engagement. This meta-synthesis consolidates qualitative evidence to deepen our understanding of ACP practices in CHF care.

Aims

This study aimed to explore experiences of CHF patients and their caregivers in ACP, which is defined as a proactive decision-making process to establish future treatment plans based on patients' values. The study also aimed to identify barriers and facilitators influencing ACP decisions and assess the impact of flexible, personalized ACP approaches on care quality.

Methods

Using qualitative meta-synthesis, we analyzed 10 qualitative studies on CHF patients' and caregivers' ACP experiences. Data were thematically synthesized to identify emotional, relational, and practical factors that influence engagement in ACP.

Results

Three themes emerged: (1) heart failure patients and caregivers face difficulties in ACP (difficulties from patients, difficulties from the family, and difficulties from the society), (2) multidimensional drivers and impacts of ACP (advance care planning drivers, acceptance and implementation of ACP, emotions and effects of ACP), (3) flexible, personalized ACP delivers tangible benefits (timing and effectiveness of ACP discussions, patients and caregivers have personalized needs for ACP, and patients and caregivers affirm ACP benefits).

Linking Evidence to Action

ACP plays a critical role in improving end-of-life care quality and reducing emotional and decision-making burdens on caregivers. Flexible and personalized ACP strategies supported by trained healthcare professionals more effectively meet the unique needs of patients and families. To overcome persistent barriers and promote broader ACP adoption, healthcare systems should prioritize provider communication training, ACP education, and support systems tailored to diverse cultural contexts.

Current Status and Factors Influencing Nutrition Literacy in Stroke Patients: A Cross‐Sectional Study

ABSTRACT

Aims

This study investigated the current status of nutrition literacy and related influencing factors in stroke patients, with a view to providing a reference for the development of targeted interventions.

Design

Cross-sectional study.

Methods

A convenience sampling method was used to select 342 stroke patients from June to November 2024 as the study population, and a cross-sectional survey was conducted using the General Information Questionnaire, Nutrition Literacy Scale, Herth Hope Scale, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale. Descriptive analysis, independent samples t-test, one-way ANOVA, Pearson's correlation analysis and multiple linear regression analysis were used for data analysis.

Results

The results showed that the nutrition literacy score of stroke patients was 122.24 ± 16.66, and gender, age, education level, monthly per capita family income, nutrition education, hope level, self-efficacy and social support were the factors affecting the nutrition literacy of stroke patients (all p < 0.05).

Conclusion

According to the study, stroke patients' nutrition literacy has to be raised, and medical practitioners should create focused intervention plans to raise patients' nutrition literacy levels.

Relevance to Clinical Practice

Healthcare professionals should assess the level of nutritional literacy in order to provide targeted interventions. The establishment of a multidisciplinary care team and implementation of long-term nutritional management after stroke are essential to reduce stroke recurrence and mortality.

Reporting Method

The study adhered to the STROBE checklist.

Patient or Public Contribution

No patient or public contribution.

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