Should cardiopulmonary resuscitation be performed on patients with heart failure? The role of the patient in the decision-making process

Situation-specific theories provide nurses with a vehicle to interpret situations, guide their decisions or make assumptions about factors influencing a health problem. In this article, we used meta-synthesis techniques to integrate statements of findings pertaining to barriers and facilitators to heart failure self-care that were derived previously through meta-summary techniques leading to a new situation-specific theory. According to our proposed theory, self-care behavior is the result of a patient’s naturalistic decision-making process. This process is influenced by two key concepts: “self-efficacy” and the “patient’s disease concept of heart failure.” Numerous facilitative and inhibitive factors have been identified influencing these two key concepts as well as the decision-making process, thereby either enabling or hampering the execution of effective heart failure self-care. Further research is needed to validate the model through empirical testing. Once fully matured, the model may be useful in developing behavioral interventions aiming at enhancing adherence to self-care recommendations.

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Self-care behavior: a new insight of the role of impulsivity into decision making process in persons with heart failure

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01617-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mohammed Munther Al-Hammouri ◽

Jehad A. Rababah ◽

Lynne A. Hall ◽

Debra K. Moser ◽

Zainab Dawood ◽

...

Keyword(s):

Heart Failure ◽

Decision Making ◽

Self Care ◽

Decision Making Process ◽

Care Behavior

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The Prognostic Role of the Right Ventricle in Patients With Heart Failure or Congenital Heart Disease

Case Medical Research ◽

10.31525/ct1-nct03969394 ◽

2019 ◽

Author(s):

Keyword(s):

Heart Failure ◽

Congenital Heart Disease ◽

Heart Disease ◽

Right Ventricle ◽

Congenital Heart ◽

Prognostic Role ◽

Patients With Heart Failure ◽

The Right

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The role of perceived ethics in the decision-making process for responsible tourism using an extended model of goal-directed behavior

International Journal of Tourism and Hospitality Research ◽

10.21298/ijthr.2017.4.31.4.5 ◽

2017 ◽

Vol 31 (4) ◽

pp. 5-25 ◽

Cited By ~ 4

Author(s):

Myung Ja Kim ◽

Joo Yeon Park ◽

Choong-Ki Lee ◽

Jin Young Chung

Keyword(s):

Decision Making ◽

Decision Making Process ◽

Extended Model ◽

Goal Directed Behavior ◽

Responsible Tourism

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How Nudge Theory Explains the Magical Role of Emotions in the Decision-Making Process of Different Economic Participants During Financial Crisis

SSRN Electronic Journal ◽

10.2139/ssrn.3496252 ◽

2019 ◽

Author(s):

Nargiz Mammadova

Keyword(s):

Decision Making ◽

Financial Crisis ◽

Decision Making Process

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Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan

European Heart Journal ◽

10.1093/ehjci/ehaa946.0040 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Galli ◽

Y Bouali ◽

C Laurin ◽

A Gallard ◽

A Hubert ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Rank Test ◽

Reduced Ejection Fraction ◽

Non Invasive ◽

Patients With Heart Failure ◽

Increase Risk ◽

Echocardiographic Examination ◽

Constructive Work

Abstract Background The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs). Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients. Methods 79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan. Results Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B). Conclusions In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs. Funding Acknowledgement Type of funding source: None

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Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach

JDR Clinical & Translational Research ◽

10.1177/23800844211014440 ◽

2021 ◽

pp. 238008442110144

Author(s):

N.R. Paul ◽

S.R. Baker ◽

B.J. Gibson

Keyword(s):

Decision Making ◽

Grounded Theory ◽

Treatment Options ◽

Study Data ◽

Primary Objective ◽

Major Surgery ◽

Future Research ◽

Decision Making Process ◽

Theory Approach

Introduction: Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision. Objectives: The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment. Methods: This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding. Results: The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face. Conclusion: The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies. Knowledge Transfer Statement: The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.

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Interleukin-6 Could Be a Potential Prognostic Factor in Ambulatory Elderly Patients with Stable Heart Failure: Results from a Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10030504 ◽

2021 ◽

Vol 10 (3) ◽

pp. 504

Author(s):

Marina Povar-Echeverría ◽

Pablo Esteban Auquilla-Clavijo ◽

Emmanuel Andrès ◽

Francisco Javier Martin-Sánchez ◽

María Victoria Laguna-Calle ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Renal Failure ◽

Interleukin 6 ◽

Kaplan Meier ◽

Patients With Heart Failure ◽

Potential Prognostic Factor ◽

Fundamental Phenomenon ◽

Group 2

Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.

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Evolution of EC Institutions and Role of France (1990–2000)

World Economy and International Relations ◽

10.20542/0131-2227-2011-7-58-70 ◽

2011 ◽

pp. 58-70

Author(s):

P. Timofeev

Keyword(s):

Decision Making ◽

Decision Making Process ◽

The Eu

The gradual enlargement of the EEC has necessitated an adaptation of European supranational structures established in the 1950-1970s to the needs of the time. Under these circumstances one of the key priorities of France's participation in the EU is he struggle for preserving her influence on the EU decision-making process. The article is devoted to the interaction of France with its partners in the EU institutions. This implies not only the implementation of its own interests, but also the search for compromise more or less satisfactory to all participants.

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