The effect of the age on outcomes at a cardiac rehabilitation center in Turkey.

OBJECTIVE: The aim of this study was to assess the effectiveness of a 12-week phase II cardiac rehabilitation (CR) program in Turkish patients aged between ≤65 years and >65 years using psychical parameters, echocardiography measurements, lipid profiles, and psychological parameters. METHODS: A total of 68 patients who completed a phase II CR program were enrolled in this retrospective study. The echocardiography measurements, as well as assessment of physical parameters, psychological state, and serum lipid level of the patients were evaluated before the entry into the program and just after the completion. Patients were divided into 2 groups: those aged 65 years and under and those over the age of 65, and the effects of the CR program were compared. RESULTS: There was a statistically significant difference in the average heart rate (HR), left ventricular ejection fraction (LVEF), Beck Depression Inventory (BDI) score, and State-Trait Anxiety Inventory (STAI) I-II scores of young patients before and after cardiac rehabilitation. The LVEF, high-density lipoprotein (HDL), BDI, STAI-I, and STAI-II parameters of older patients were statistically significant. In the comparison between those who were 65 years and under and those over the age of 65, the change in the mean HR (+11.24±12.62 bpm vs. +3.96±12.50 bpm; p=0.039), LVEF (+21.31±21.37% vs. +9.55±13.50%; p=0.035) and STAI I scores (-11.33±11.51 points vs. -23.25±14.08 points; p=0.025) were significantly different. CONCLUSION: The results of the present study revealed that patients in a Turkish population aged 65 and over benefited from CR as much as younger patients did in terms of physical parameters, echocardiography measurements, lipid profiles, and psychological parameters.

Classification and Regression Tree and Computer Adaptive Testing in Cardiac Rehabilitation: Instrument Validation Study.

BACKGROUND: There is a need for shorter-length assessments that capture patient questionnaire data while attaining high data quality without an undue response burden on patients. Computerized adaptive testing (CAT) and classification and regression tree (CART) methods have the potential to meet these needs and can offer attractive options to shorten questionnaire lengths. OBJECTIVE: The objective of this study was to test whether CAT or CART was best suited to reduce the number of questionnaire items in multiple domains (eg, anxiety, depression, quality of life, and social support) used for a needs assessment procedure (NAP) within the field of cardiac rehabilitation (CR) without the loss of data quality. METHODS: NAP data of 2837 CR patients from a multicenter Cardiac Rehabilitation Decision Support System (CARDSS) Web-based program was used. Patients used a Web-based portal, MyCARDSS, to provide their data. CAT and CART were assessed based on their performances in shortening the NAP procedure and in terms of sensitivity and specificity. RESULTS: With CAT and CART, an overall reduction of 36% and 72% of NAP questionnaire length, respectively, was achieved, with a mean sensitivity and specificity of 0.765 and 0.817 for CAT, 0.777 and 0.877 for classification trees, and 0.743 and 0.40 for regression trees, respectively. CONCLUSIONS: Both CAT and CART can be used to shorten the questionnaires of the NAP used within the field of CR. CART, however, showed the best performance, with a twice as large overall decrease in the number of questionnaire items of the NAP compared to CAT and the highest sensitivity and specificity. To our knowledge, our study is the first to assess the differences in performance between CAT and CART for shortening questionnaire lengths. Future research should consider administering varied assessments of patients over time to monitor their progress in multiple domains. For CR professionals, CART integrated with MyCARDSS would provide a feedback loop that informs the rehabilitation progress of their patients by providing real-time patient measurements.

Use of the North American Nursing Diagnosis Association taxonomies, Nursing Intervention Classification, Nursing Outcomes Classification and NANDA-NIC-NOC linkage in cardiac rehabilitation.

This study aims at creating a standardized language for each patient admitted to Cardiac Rehabilitation Unit (CR) by identifying nursing diagnosis, interventions, results/objectives expected and related correlations. The primary outcome was identifying health needs of all patients admitted to CR. The secondary outcomes were the identification of North American Nursing Diagnosis Association -International diagnoses (NANDA-I), of nursing intervention classification (NIC), of nursing outcomes classification (NOC) and their correlation NANDA-NIC-NOC linkage (NNN linkage) in order to define a standardized language for all nursing staff. This is a retrospective study involving a sample of 168 patients discharged from CR. The NANDA-I, the NIC, the NOC and the most frequently used NNN connections were identified and collected by using structured form including the 11 functional models of Marjory Gordon. Data from 76 patients were analyzed (92.1% male; mean age (± SD) 62.7±9 yrs; IQ range: 42-82). The main NANDA-I nursing diagnosis belongs to psychological sphere, but not to physiological domains. The statement NIC has allowed to put into practice actions of health prevention and education. Nursing care documentation and NNN taxonomic language promotes a wide diffusion of nursing discipline culture and significant qualitative improvement of patient's care, further improving the communication between nurses and other health professionals.