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Biomedical subjects

H Sherrard

Publications and source records attributed to H Sherrard.

10 recordsLinked to original sources

Determination of the burden of care in families of cardiac surgery patients.

"Burden of care" is a term that describes the effects of the multifaceted stressors associated with providing care to an ill family member. Descriptions of burden of care in acute care populations, such as families of patients who have had coronary artery bypass grafting, are very limited. The three purposes of this study were to describe the burden of care in families of coronary artery bypass grafting surgery patients, to compare the burden of care in families grouped by length of stay, and to provide evidence for the validity of the Caregiving Burden Scale in acute care populations. A survey was done using a longitudinal design over the first six weeks following coronary artery bypass grafting surgery. The 124 spouses of coronary artery bypass grafting surgery patients who participated reported a moderate degree of burden in caring for post cardiac surgery family members. Providing emotional support, taking over household tasks, and monitoring patients' conditions created the greatest burden for the participants. Length of stay in hospital did not have an impact on burden of care. The analysis of the data supports the validity of the Care-giving Burden Scale when used in the cardiac surgery population. (Prog Cardiovasc).

Adult↗

The Ottawa telehealth project.

OBJECTIVE: To examine the telehealth system as a means of improving access to cardiac consultations and specialized health services in remote areas of Ontario. METHODS: The University of Ottawa Heart Institute has set up a telehealth test program, Healthcare and Education Access for Remote Residents by Telecommunications (HEARRT), in collaboration with industry and the provincial and federal government, as well as several remote clinical test sites. The program makes off-site cardiology consultations possible. History taking and physical examinations are conducted by video and electronic stethoscope. Laboratory results and echocardiograms are transmitted by document camera and VCR. The technology is being tested in both stable outpatient and emergency situations. Various telecommunications bandwidths and encoding systems are being evaluated, including satellite and terrestrial-based asynchronous transfer-mode circuits. Patient satisfaction and cost-effectiveness are also being assessed. RESULTS: Bandwidths from as low as 384 kbps using H.320 encoders to 40 Mbps using digital transport of NTSC video signals have been evaluated. Although lower bandwidths are sufficient for sending echocardiographic and electrocardiogram data, bandwidths with transport speeds of 4 to 6 Mbps appear necessary to capture the nuances of the cardiac physical examination. A preliminary satisfaction survey of 19 patients noted that all felt that they could communicate effectively with the cardiologist by video, and each had confidence in the advice offered. None reported that he or she would rather have traveled to the doctor in person. Initial and projected examination of the costs suggested that telehealth will effectively reduce overall health care spending while decreasing travel expenses for rural patients. CONCLUSION: Telehealth technology is sufficiently sophisticated to allow off-site cardiology assessments. Preliminary results suggest there is a sound business case for the implementation of telehealth technology to meet the needs of remote residents in northern Ontario. Working closely with government and industry, we will develop a marketing and commercialization plan to support the use of this technology throughout Ontario and expand application to patient education and continuing medical education.

Cardiology↗

Early release following cardiac surgery.

Early release following cardiac surgery can be facilitated by the implementation of a standard protocol for pre- and postoperative care. This protocol involves aggressive pharmacologic therapy together with education and support. Accelerated recovery and release is inherently attractive because the duration of intensive care unit stay and hospital stay are the most important determinants of costs. However, in the desire for reduced costs, patients must clearly benefit from earlier rehabilitation and release. Retrospective studies have shown no significant differences in mortality or morbidity in patients who have undergone conventional versus "fast-tracked" care following cardiac surgery, and follow-up surveys have shown a high level of patient satisfaction with the care. Some centers report that, without exception, all cardiac surgery patients are now fast-tracked.

Cardiac Surgical Procedures↗

Cardiac nurses' perceptions of nursing research.

Nurses' perception of nursing research is an important variable affecting the successful development of a clinical nursing research program. The objectives of this study were to: examine the perceived value, role, interest, support and experience of cardiac nurses in nursing research; to determine the effects of age and level of education on their perceptions; and to analyze the reliability of Alcock et al.'s questionnaire. The survey was administered to 313 nurses with a response rate of 46%. Frequency distributions were obtained on individual survey items. MANOVAs were performed as a function of age group and education level, followed by post hoc ANOVAs. Findings showed nurses valued nursing research particularly as it related to clinical practice decisions and solutions to patient care problems. They saw a participatory role in the first stages of the research process. Age was not a factor in nurses' perceptions of nursing research with the exception of perceived support. Diploma nurses indicated higher levels of perceived value (p = 0.000), role (p = 0.034), interest (p = 0.000) and support (p = 0.017) for nursing research than baccalaureate nurses. The Cronbach reliability coefficient of each area indicated high internal consistency (> 0.72). When 5 items in the questionnaire are deleted, the tool exhibits high level of reliability and evidence of construct and discriminant validity.

Adult↗

Educational and support needs of patients and their families awaiting cardiac surgery.

OBJECTIVE: To identify and explore the learning and support needs of patients and families during the waiting period before cardiac surgery. DESIGN: Prospective, cross-sectional cohort survey design. SETTING: University-affiliated tertiary cardiovascular care center in mideastern Canada. SUBJECTS: One hundred forty-seven patients currently on the cardiac surgery waiting list, and 125 family members of these patients. OUTCOME MEASURES: Needs Inventory for Patients who Wait. INTERVENTION: All patients were sent a survey for themselves and one for a family member that included: a demographic profile, subjective questionnaire, and the Needs Inventory for Patients who Wait. The survey was to be completed and returned to the investigators. RESULTS: The return rates were 77% (113) for patients, and 70% (87) for family members. For patients and their family members, item rankings were highly correlated for areas in which they wanted information (r = 0.84), and for areas that caused them the most concern (r = 0.91). Family members were also concerned about caring for the patient before and after surgery. The number of weeks on the waiting list (< 1 month to > 6 months) did not change the concerns of patients and family. CONCLUSIONS: This survey identifies some of the educational and support needs of patients undergoing cardiac surgery and their family members. Patients are concerned about their health and survival until the surgical procedure, as well as about the success of the procedure. Families share patients' concerns and have an additional concern regarding how to support the patient during the perioperative stage. The needs identified by patients and their families in this survey were found to be stable over time, and within the realm of nursing practice to address.

Adult↗

Early release after cardiac surgery.

Early release after cardiac surgery can be facilitated by the implementation of a standard protocol for pre- and postoperative care. This protocol involves aggressive pharmacological therapy, in combination with education and support. Accelerated recovery and release is inherently attractive because the duration of intensive care unit stay and of total hospital stay are the most important determinants of costs. However, in addition to the desire for reduced costs, the patients must be clearly seen to benefit from earlier rehabilitation and release. Retrospective studies have shown no significant differences in mortality or morbidity between patients who have received conventional care and those given 'fast-tracked' care after cardiac surgery, and follow-up surveys have shown a high level of patient satisfaction with the care. Some centres report that all cardiac surgery patients are now fast-tracked.

Cardiac Surgical Procedures↗

Supply and demand for cardiac nurses in Ontario: perceptions of CNOs.

This article presents the results of a nursing survey of cardiac care hospitals undertaken by a Cardiac Care Network of Ontario Consensus Panel on Cardiovascular Human Resources. The focus of the Panel was to identify areas of current or pending shortages in human resources and make recommendations to the Ministry of Health and Long-Term Care about human resource management in adult cardiac care in Ontario. The article presents the number and mix of full-time, part-time and casual nursing staff, the age distribution of RNs, and the number of vacant Registered Nurse (RN) positions for a sample of cardiac care hospitals in Ontario. Next a sample of Chief Nursing Officer opinions about factors contributing to current difficulties in recruiting RNs and the outlook for future shortages are presented. Implications for nurse managers are offered, including development of new recruitment and retention strategies, identification of further efficiencies in care provision, and a need for nurse manager involvement in debates about the future of how health care is provided in Canada.

Cardiac Care Facilities↗