Bernice C. Yates

Sedative music reduces anxiety and pain during chair rest after open-heart surgery

Abstract Open‐heart surgery patients report anxiety and pain with chair rest despite opioid analgesic use. The effectiveness of non‐pharmacological complementary methods (sedative music and scheduled rest) in reducing anxiety and pain during chair rest was tested using a three‐group pretest–posttest experimental design with 61 adult postoperative open‐heart surgery patients. Patients were randomly assigned to receive 30 min of sedative music (N=19), scheduled rest (N=21), or treatment as usual (N=21) during chair rest. Anxiety, pain sensation, and pain distress were measured with visual analogue scales at chair rest initiation and 30 min later. Repeated measures MANOVA indicated significant group differences in anxiety, pain sensation, and pain distress from pretest to posttest, P<0.001. Univariate repeated measures ANOVA (P≤0.001) and post hoc dependent t‐tests indicated that in the sedative music and scheduled rest groups, anxiety, pain sensation, and pain distress all decreased significantly, P<0.001–0.015; while in the treatment as usual group, no significant differences occurred. Further, independent t‐tests indicated significantly less posttest anxiety, pain sensation, and pain distress in the sedative music group than in the scheduled rest or treatment as usual groups (P<0.001–0.006). Thus, in this randomized control trial, sedative music was more effective than scheduled rest and treatment as usual in decreasing anxiety and pain in open‐heart surgery patients during first time chair rest. Patients should be encouraged to use sedative music as an adjuvant to medication during chair rest.

Effects of a Physical Activity Intervention for Women

Physical activity is associated with health and reduced mortality risk, yet only15% ofU.S. adults achieve adequate activity. This study is an experimental repeated measures nested design randomizing two similar rural communities to investigate the effectiveness of the Heart and Soul Physical Activity Program (HSPAP) (Peterson, 2002) in promoting physical activity in midlife women (n =42) aged 35 to 65 years. The HSPAP, an innovative church-based health promotion intervention, is conceptualized in social support and designed to increase physical activity, energy expenditure (EE), and cardiorespiratory fitness (VO2 max), measured over time. A significant interaction (p < .001) was found for EE in one HSPAP group increasing their EE by 1,010 kcals/week. HSPAP participants increased their VO2 max level by 75% (p < .001) and 10%; comparison groups stayed the same or declined 16%. Study results provide preliminary support for the HSPAP intervention as an effective treatment to improve physical activity levels in sedentary, rural, midlife women.

Translating the Pittsburgh Sleep Quality Index Into Arabic

This descriptive correlational study describes the translation process and the psychometric testing of the Pittsburgh Sleep Quality Index (PSQI). The PSQI has been successfully translated into Arabic and back-translated into English by 10 Arabic bilingual translators. Then the PSQI is tested in a sample of 35 healthy Arabic bilinguals.The internal consistency reliability for the Global PSQI demonstrates borderline acceptability (Cronbach’s alpha = .65). The reliability is further supported by moderate to high correlations between five PSQI components and the global PSQI score (r = .53 to .82, p < .01). Convergent validity is supported by the global PSQI correlating strongly with the Insomnia Severity Index (r = .76) and moderately with the related construct of the Medical Outcome Study Short Form—36 vitality subscale (r = —.33). Further testing of the PSQI is needed in a larger Arabic population, both clinical and healthy populations, living in their native countries.

Effects of an Internet Physical Activity Intervention in Adults With Metabolic Syndrome

The Internet is a relatively new method of delivering strategies for health behavior change. The purpose of this study was to determine the feasibility of delivering a physical activity intervention by the Internet to improve outcomes in adults with the metabolic syndrome. Twenty-two participants (16 males; 6 females) were recruited from a cardiology clinic database, age range 32-66 years. Participants were randomly assigned to the Internet intervention (n = 12) or the usual care ( n = 10) group. The mean total dose, in terms of the time the intervention Web site was accessed was 2 hours over 6 weeks, which was greater than the time spent delivering usual care. Overall, participants_ evaluations of the Internet intervention were positive. The costs of development and delivery of the Internet intervention were less than that of a consultation and follow-up in the cardiology clinic for this sample. The Internet intervention appears feasible for testing in a larger study.

Development and content validity testing of the Cardiac Symptom Survey in patients after coronary artery bypass grafting

BACKGROUND Patients who have undergone coronary artery bypass grafting often experience numerous symptoms after surgery. There is a need for a symptom tool for this population that is disease-specific, comprehensive, and responsive to change. AIMS The aims of this study were to describe the development and preliminary content validity testing of the Cardiac Symptom Survey (CSS), assess further content validity of the CSS through an expert panel, and assess responsiveness of the CSS to change. METHODS The original development of the CSS is described. An expert panel of four judges was used to rate the clarity of the items (content validity) and the relevance of the symptoms and items to the domain. Responsiveness to change of the CSS was assessed in a sample of 90 subjects who underwent coronary artery bypass grafting. RESULTS Percent agreement and content validity index coefficients ranged from .90 to 1.00. Repeated measures analyses of variance showed significant changes over time as hypothesized in some of the symptom evaluation and symptom response scores. CONCLUSION Support is documented for both content validity and responsiveness of the CSS.

American heart association: Council on cardiovascular nursing

According to the American Heart Association (AHA), physical inactivity is an important independent risk factor for coronary heart disease. In 2007, only 30.8% of persons engaged in 30 minutes or more of moderate physical activity per weekVthe level sufficient to lower the risk of coronary heart disease. Similarly, only 21.9% of men and 17.5% of women reported strength training twice or more often per week. In children aged 6 to 11 years, 42% met the recommendation to accumulate at least 1 hour of physical activity on most days of the week. Physical activity levels among adolescents dropped to 12% for boys and 3% for girls in those aged 12 to 15 years. In reality, physical activity declines substantially throughout the entire life span. These declines underscore the need for additional programs to increase the physical activity levels among all age groups. Several organizations have recently published guidelines for physical activity (Table 1). Several strategies proposed by the AHA in meeting these guidelines and treating physical inactivity are lifestyle modification through counseling, education, and outreach efforts. Studies of the beneficial effects of healthy lifestyles on cardiovascular outcomes highlight the need for intensive primary and secondary prevention efforts in middle age and beyond to improve healthy longevity and quality of life. People who adhere to the physical activity guidelines should be able to improve their physical functioning within 3 to 6 months and achieve the health benefits of physical activity. Health benefits include (http:// www.americanheart.org):

Theoretical perspectives on the nature of social support in cardiovascular illness.

In light of the minimal follow-up care that cardiovascular patients typically receive and the few patients who enter cardiac rehabilitation programs, it is evident that these patients need more support resources to improve their health outcomes. A better understanding is needed of the basic support processes that occur after a cardiac event so that the different sources and types of support can be tapped for the desired outcome. This article highlights the research findings on social support for cardiovascular patients in light of various theoretical perspectives and provides implications for practice and future research.

Implementing common data elements across studies to advance research

Challenges arise in building the knowledge needed for evidence-based practice partially because obtaining clinical research data is expensive and complicated, and many studies have small sample sizes. Combining data from several studies may have the advantage of increasing the impact of the findings or expanding the population to which findings may be generalized. The use of common data elements will allow this combining and, in turn, create big data, which is an important approach that may accelerate knowledge development. This article discusses the philosophy of using common data elements across research studies and illustrates their use by the processes in a developmental center grant funded by the National Institutes of Health. The researchers identified a set of data elements and used them across several pilot studies. Issues that need to be considered in the adoption and implementation of common data elements across pilot studies include theoretical framework, purpose of the common measures, respondent burden, teamwork, managing large data sets, grant writing, and unintended consequences. We describe these challenges and solutions that can be implemented to manage them.

Caregiving demand and difficulty in older adult spousal caregivers after coronary artery bypass surgery

The purpose of this study was to describe the caregiving demands and difficulties for older adult spousal caregivers of coronary artery bypass (CAB) surgery patients. Caregiving demands and difficulties were measured by the Caregiving Burden Scale. The sample size was 35 caregivers of CAB surgery patients who were, on average, 60 years old and 19 days since hospital discharge. Descriptive analysis revealed that the top four most demanding caregiving activities perceived by spousal caregivers were providing transportation, additional household tasks, providing emotional support, and two tied for fourth: monitoring symptoms and additional tasks outside the home. The top four most difficult caregiving tasks were additional household tasks, providing transportation, and two tied for third: additional tasks outside home and managing behavior problems. Also, caregivers reported experiencing more demands than difficulties. Examining the demanding and difficult caregiving tasks provides information from which to develop and test tailored interventions for caregivers of this population.

The impact of marital status and quality on family functioning in maternal chronic illness

Married individuals tend to enjoy greater health and well-being than nonmarried. However, investigators disagree about whether this is related to the quality of the marriage or to participation in the socially accepted role of marriage. In the present study, we examined the roles of marital quality and marital status as predictors of the familys adjustment processes in the context of maternal chronic illness. We found that the family functioning of single women and unhappily married women was similar and that happily married women enjoyed higher levels of family functioning and family coping. Unhappily married women reported more illness demands, particularly on their time and energy, than did happily married or single women. We suggest it is the quality of the marital interaction, and not the role benefits of marriage, that facilitates family adjustment under conditions of maternal chronic illness.