The Journal of cardiovascular nursing
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Heart failure (HF) places a disproportionate burden on ethnic minority populations, including blacks, who have the highest risk of developing HF and experience poorer outcomes. Self-care, which encompasses adherence to diet, medication, and symptom management, can significantly improve outcomes. However, HF self-care is notoriously poor in ethnic minority black populations. ⋯ Research to develop and test culturally sensitive interventions is needed. Community-based interventions that provide culturally acceptable resources to facilitate self-care should be explored.
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Informal (family) caregivers are integrally involved in chronic heart failure (HF) care. Few studies have examined HF patients and their informal caregiver as a unit in a relationship, or a dyad. Dyad congruence, or consistency in perspective, is relevant to numerous aspects of living with HF and HF care. Incongruence or lack of communication could impair disease management and advance care planning. ⋯ Several areas of HF clinical and research relevance, including self-care, advance care planning, and communication, were affected by congruence. Further research is needed to define how congruence is related to other relationship characteristics, such as relationship quality, how congruence can best be measured quantitatively, and to what degree modifying congruence will lead to improved HF patient and caregiver outcomes.
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Patient decision delay continues to be a major factor of delay along the pathway of care for patients with myocardial infarction (MI). Although potentially modifiable, efforts to reduce these delays through educational and media interventions have been relatively unsuccessful. This failure has been due, in part, to the lack of understanding about the complex sociopsychological and clinical dimensions associated with the phenomenon of help-seeking behavior. ⋯ Definitions of MI and the educational information provided to the public need to be reviewed. Slow-onset MI and fast-onset MI provide plausible definition alternatives and, possibly, a more authentic version of real MI events than what is currently used. They also provide a unique "delay" perspective, which may inform future educational initiatives targeted at decision delay reduction.
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Family-centered care (FCC) has been cited as important to patient care; however, little is known about nurses' perspectives toward FCC. Family presence during resuscitation (FPDR) is an example of the implementation of FCC; however, nurses do not necessarily agree with FPDR, especially those from non-Western countries. It is also unknown whether there is an association between FPDR and FCC. ⋯ Although FCC has moderate support, objection still remains to FPDR. Family presence during resuscitation has been used as an example of FCC, but at least in certain populations, this example might not be applicable. Increased education and policy changes should be encouraged to promote FCC and FPDR.