Dorthe Overgaard

Background: The positive effects of cardiac rehabilitation (CR) are well established; however, among older and vulnerable patients, nonattendance and dropout are prevalent problems. Aim: The objective of this study is to explore if a 24-week peer-mentor intervention increases initial and long-term CR attendance. Secondary aims are whether peer-mentor intervention improves lifestyle (diet and physical activity) and psychological outcomes (self-efficacy, anxiety, depression, and quality of life) among older vulnerable patients with ischemic heart disease. Methods: The study was designed as a 2-arm, single-center, parallel, 24-week, randomized controlled trial (RCT) with follow-up at 12 and 24 weeks. Patients were randomized at a ratio of 1:1 to receive either the peer-mentor intervention (in addition to standard CR) or standard CR along (control arm). Results: Between August 2021 and March 2023, 117 older, vulnerable patients were enrolled and randomized (59 randomized to peer-mentor intervention and 58 to usual care). The peer-mentor intervention significantly increased CR attendance. This applies to both initial participation in 1 CR session of physical training or dietary advice (78.0% vs 58.6%; P = .03), and long-term attendance in ≥50% dietary advice sessions (50.8% vs 27.6%; P = .01) and completed ≥50% (64.4% vs 41.4% P = .01) or ≥75% of the physical training sessions (59.3% vs 37.9%; P = .02). The study found no statistically significant effect on secondary outcomes. Conclusions: Low CR attendance is a well-known problem, especially among older, vulnerable patients; however, we tested a low-cost, peer-mentor intervention that significantly increased both initial CR participation and long-term attendance in CR sessions in this group of patients.

Denne artikel præsenterer følgende argument: kvaliteten af sygeplejeforskning med kvalitative data forbedres gennem brug af softwareprogrammer så som NVivo. Studerende eller sygeplejersker skal lære at analysere kvalitative data med elektronisk software. I forskningsprocessen er den videnskabelige tænkemåde vigtig fx i form af verifikations- og valideringsteknikker. Den stigende mængde af data genereret i klinisk praksis nødvendiggør et overblik over data i alle faser af analysen. I denne artikel beskrives, hvordan NVivo kan benyttes i alle forskningsaktiviteter i faser af projektet og henviser til et eksempel på et hierarki af kodninger, der førte frem til de analytiske temaer. Denne artikel beskriver nogle fordele og ulemper ved brugen af elektroniske softwareprogrammer til kvalitativ analyse. Især fokuseres på, hvordan NVivo stimulerer en kreativ forskningsproces, og hvordan NVivo hjælper med at holde styr på et komplekst projekts mange aspekter, mange data og mange tanker. Endelig beskæftiger artiklen sig med spørgsmålet om gyldigheden og hvordan brugen af NVivo giver anledning til fænomenologiske-, hermeneutiske- og kritisk teoretiske forståelser af gyldighed. This article presents the following argument: the quality of nursing research with qualitative data is improved through the use of software programs such as NVivo. Students or nurses should learn how to analyze qualitative data with electronic software. In the process ordinary scientific ways of thinking are important such as verification- and validation techniques. The increasing amount of data generated in clinical practice calls for an overview of data in all stages of the analysis. This article discusses how NVivo can be used in all research phases of the project and refers to an example of a hierarchy of coding that led to the analytical themes. This article outlines some advantages and disadvantages in the use of electronic software programs for qualitative analysis. In particular, we consider how NVivo stimulates a creative research process and how NVivo helps to keep track of a project's many aspects, much data and many thoughts that accompanies the research process. Finally, the article deals with the question of validity and how the use of NVivo gives rise to phenomenological, hermeneutic and critical theoretical understandings of validity.

The study aims to describe substance use, dental hygiene, and physical activity in adult survivors with single ventricle physiology (SVP) and to compare the behaviors with matched controls, while the patients are particularly at risk for general health problems. The present study is part of a larger research project on long-term outcomes in adult patients with SVP. A cross-sectional, case-control study including 59 patients out of 83 eligible patients participated in the study (response rate 71%). The patients were matched to 172 healthy controls. A questionnaire was mailed to the patients. Nonresponders did not differ significantly from the included participants on age, gender, or physical function. The study was conducted at the Heart Center of Copenhagen University Hospital or the Department of Cardiology, Aarhus University Hospital. In these patients, 85% report alcohol consumption (92% in controls; odds ratio [OR] = 0.91; P = 0.575); 26% admit "binge drinking" (41% in controls; OR = 0.56; P = 0.041); 20% are cigarette smokers (36% in controls; OR = 0.59; P = 0.100); 12% have used cannabis over the past year (15% in controls; OR = 0.80; P = 0.596); 20% have had no dental visits during the last year (25% in controls; OR = 1.07; P = 0.684); 46% are not flossing their teeth (32% in controls; OR = 1.32; P = 0.239); and 39% are not physically active (24% in controls; OR = 1.63; P = 0.069). While in general there was no significant differences in overall health behaviors between SVP patients and controls, SVP patients are less physically active and are less likely to binge drink.

Approximately 3% of children with congenital heart disease born in Denmark have single ventricle physiology (SVP). In previous decades, these children did not survive into adulthood. However, because of new surgical techniques and improved medical care, they now have a 90% survival rate. Several studies have described the somatic status of SVP patients using clinical parameters; however, only a few studies have researched the life perspectives and coping skills in this patient group. The aim of this study was to investigate how young adults with an SVP diagnosis are coping with adulthood and the emotional experiences of daily life. Semistructured, qualitative interviews were held with 11 SVP respondents, selected by physical and psychological parameters identified in an earlier quantitative study. Data from the interviews were analyzed by a research group using a phenomenological methodology. The goal for SVP patients is to gain control over their disease to live normal lives. Patients require special support from their core network to overcome physical and psychological challenges. Respondents underscored the need for friends and resource persons outside the family to help lift them out of their role as disabled cardiac patients and provide them with "normal" life experiences.

The Ability Index was developed to classify patients with congenital heart disease into four functional classes. Functional class is typically determined by the cardiologist, based on data from a clinical interview. The validity of the Ability Index as assessed by the patient has never been scrutinized. We tested the agreement between cardiologists and patients in assessing functional status using the Ability Index and compared the accuracy of the two assessments in explaining patient-reported outcomes (PRO). The Ability Index Scale was completed for 57 patients, independently by cardiologists and patients. Cohen's Kappa coefficient with quadratic weighting (K(w)) was calculated. The area under the receiver operating characteristic (ROC) curve (AUC) (=C-index) was used to test the accuracy of the Ability Index in explaining PRO, as assessed by the cardiologist or the patient. Agreement was observed in 61.4% of the patients. The K(w) was 0.55, showing a moderate agreement; and the R(2) was 0.29, displaying a limited shared variance. The AUC for cardiologists' assessments of the Ability Index in explaining PRO was consistently lower than the AUC for patients' assessments. The appraisal of the patients was more accurate. When cardiologists and patients are assessing functional status using the Ability Index, two different constructs are measured. These assessments cannot be interchanged, but should be used complementarily. Because the assessment of the patients regarding the Ability Index is more precise in terms of explaining PRO, it could be valuable as a simple crude marker to identify patients at risk for poor functional and psychosocial outcomes.

Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs across functional classes, and (3) to compare PROs between patients and controls. Methods: A case-control study in two adult congenital heart programmes with 62 adult survivors with SVP were matched to 172 healthy controls. A wide range of PROs were measured using validated questionnaires. The treating physician classified patients according to the Ability Index. Results: Patients with SVP have a good functional status. Patients in Ability Index class I consistently reported the best scores, similar to those of healthy controls. Negative associations were found between functional class and outcomes of perceived health and quality of life. For patients in Ability Index class II and III, PROs were poorer. Conclusions: PROs in patients with SVP are generally good.

Nurses play a key role in ensuring that nutritional needs of cancer patients are met and is enabling patients to manage rehabilitation. Most patients with colorectal cancer are malnourished. The objective was to examine how patients' experiences of information, support, and involvement concerning nutrition during hospitalization are associated with rehabilitation. Furthermore, to investigate how patients' experiences of admission- and discharge consultations, as well as having a primary contact person are associated with rehabilitation. Patients who had undergone surgery according to the ICD-10 codes (International Classification of Diseases) with the diagnostic criteria C18-C21 in Denmark were included. Two self-administered questionnaires were sent to the patients' home address. Outcome measures were constructed as reduction in physical, mental and social conditions in order to reveal potentials of improvement in nursing. The experiences of guidance and practical help, as well as the experiences of having a primary contact person (nurse/physician) and admission — and discharge consultations were related to physical, mental and social rehabilitation. Patients' experiences of care were associated with rehabilitation following colorectal surgery.

High job demands and low job influence may be associated with subsequent weight gain. Predisposition to obesity may further modify such associations. The purpose of the study was to determine whether familial predisposition to obesity modified associations between psychological workload and 6-year weight changes among nurses. A total of 6404 Danish nurses 45 to 65 years old, who belonged to the workforce in both 1993 and 1999, answered a questionnaire on psychological workload, body weight, and familial obesity. Women were considered to be predisposed to obesity if they were overweight and had at least one obese parent. Parents' body shape was reported using pictograms. An increased psychological workload, reflected by high job demands and low influence in job, was associated with an increased body weight. This was particularly the case for nurses being predisposed to obesity, suggesting a synergy between familial obesity predisposition and the psychological workload environment. An interaction test among job demands, familial predisposition to obesity, and weight gain on adjusted data was made. The test showed p = 0.05. The adjusted interaction test among influence in job, familial predisposition to obesity, and weight gain showed p = 0.02. Predisposed nurses who were busy in their job gained 4.4 kg, whereas other nurses gained only 3.2 kg during the 6 years. Similarly, nurses predisposed to obesity with low influence in job had a higher body weight gain (5.4 vs. 3.2 kg) compared with other nurses. High psychological workload due to high job demands and low influence in job seems to predict weight gain in general and, in particular, among those nurses with a familial predisposition to obesity.