Support of wives of myocardial infarction patients

Seventy-six wives of patients suffering a first myocardial infarction were studied by questionnaire 6 weeks after their husbands went home. Despite the routine provision of support and information to spouses during their husband's stay in hospital, a high proportion reported physical and emotional symptoms of stress. The majority of wives felt they were poorly informed about myocardial infarction, had not had enough opportunity to ask the experts questions, and had received most support from relatives. The reasons for these findings are discussed and suggestions for early and systematic nursing intervention are made in an attempt to reduce stress and prevent the development of unhealthy patterns of behaviour.     

Significance of fellow patients for patients with myocardial infarction

The purpose of the study was to present both positive and negative experiences with respect to the significance of fellow patients for patients with myocardial infarction (MI), both inside and outside the hospital. Five focus group sessions were carried out, each having between four and six participants. A total of 25 patients with MI at an age of 40-71 participated. The analysis was carried out by the moderator and co-moderator of the focus groups. The results, which are elucidated by theories of social support, show a great amount of positive support in the interactions of patients, such as support from others in the same situation, a lot of humour, encountering true understanding and consideration, getting practical assistance, and benefiting from other patients' knowledge and experience as well as experiencing an increase in motivation. The participants also discussed negative experiences such as dramatic situations when fellow patients got worse and sometimes even died. Many patients were bothered by various kinds of noise and other disturbances. Insight into the significance of fellow patients will make health personnel able to encourage a patient environment that will strengthen positive and reduce negative effects of fellow patients on the health of each individual patient. One relevant measure would be involving former patients or starting up physical activity in groups. The findings show that the informal patient community among fellow patients is an important part of their social support system and thereby also may contribute to health and well-being.     

Relocation support groups for corporate wives

Nurses can provide relocation support groups to focus on coping skills, stress management, and peer support for relocated women. Support groups can promote a healthier adjustment to relocation. Although depression and anxiety scores were not statistically decreased by participating in support groups, verbal responses from respondents indicated that the support groups were a valuable intervention.     

Spouse support and myocardial infarction patient compliance

This study investigated the relationship between spouse support and compliance of myocardial infarction patients. Data were obtained from a sample of 60 couples during home interviews with the husband at least three months following his infarction. The hypothesis tested was that there is a positive relationship between spouse support and compliance. Husband's self-reported compliance was obtained for each of 10 aspects of the regimen. A spouse support questionnaire completed by wives estimated the degree to which they engaged in behaviors theorized to be supportive. Demographic and illness variables were also obtained. The hypothesis was not supported. Moreover, compliance was not related to demographic or illness variables, although those subjects still engaged in a cardiac rehabilitation program had significantly higher compliance than those who had stopped attending.     

Predictors of survival in unselected patients with acute myocardial infarction requiring continuous catecholamine support

BACKGROUND: Several predictors of survival have been described in selected subgroups of patients suffering from acute myocardial infarction. However, data on unselected patients with acute myocardial infarction and cardiogenic shock, including patients with out-of hospital cardiac arrest, are missing. We aimed to assess predictors of survival for an unselected cohort of patients representative of clinical practice who experienced acute myocardial infarction and required continuous catecholamine support for circulatory failure. METHODS: The study was performed at a 2000 bed university hospital. All consecutive patients admitted to our emergency department with acute myocardial infarction were prospectively enrolled in a clinical trial from 1993 to 2000. DESIGN: A retrospective cohort study was performed on patients with myocardial infarction requiring catecholamine support within the first 24 h. Primary endpoint was in-hospital mortality. RESULTS: The analysis was carried out on 262 patients, 189 men (72%), median age 65 years (IQR 53-73). Out-of-hospital cardiac arrest was reported in 47% (122/262). In-hospital mortality was 53% (138/262). Survivors as compared to non-survivors exhibited significant differences with respect to age (60 vs. 68 years, P<0.0001), systolic and diastolic blood pressure on admission (110 vs. 102 mmHg, P=0.01 and 64 vs. 58 mmHg, P=0.006, respectively), initial blood serum lactate (6.8 vs. 8.3, P=0.01), peak CKMB level (93 vs. 138 U/l, P=0.005), use of adrenaline (epinephrine) (38 vs. 68%, P<0.0001) and any attempt of revascularisation (76 vs. 63%, P=0.03). In a multivariate model younger age [OR 1.06 (CI 1.03-1.10), P<0.001], no use of adrenaline [OR 2.63 (CI 1.35-5.26) P=0.005] and lower peak CKMB [OR 1.01 (CI 1.01-1.01), P<0.0001] were independently associated with in-hospital survival. CONCLUSION: In unselected patients including CPR survivors with acute myocardial infarction requiring continuous catecholamine support, younger age, the absence of continuous adrenaline administration and a lower peak CKMB were independently associated with increased in-hospital survival.     

An investigation on the family support of discharged acute myocardial infarction patients]

Acute myocardial infarction (AMI) is a kind of diseases. The rehabilitation of AMI patients is affected by many psychosocial factors, the family support is one of these factors. In this research, two groups of patients were interviewed by the author with the Family APGAR Questionnaire, one group was of the patients who discharged 4-6 years ago, the other group was of the patients who discharged 5-7 months ago. The result was that the family support of five-year group was better than that of half-year group. So, the education for patient's family numbers was very important and should be thought highly by nurses.     

急性心肌梗死的院前急诊护理

目的 分析探讨急性心肌梗死患者的院前急诊护理方案.方法 选取本院收治的急性心肌梗死患者60例,其中42例入院前接受急诊护理作为观察组,18例入院前未接受急诊护理作为对照组.对照组18例患者突发急性心肌梗死后马上送医就诊,观察组患者在对照组接受的治疗基础上接受院前急诊护理,比较两组患者抢救成功率、进入重症加强护理病房(ICU)率.结果 观察组42例患者经过院前急诊护理、急诊抢救后38例转入内科普通病房进行治疗,占90.48％,4例转入ICU进行治疗,占9.52％,无死亡,抢救成功率高达100％;对照组18例患者经急诊抢救后,11例转入内科普通病房进行治疗,占61.11％,6例转入ICU继续治疗,占33.33％,1例因抢救无效死亡,占5.55％,两组比较,观察组抢救成功率、进入ICU治疗率均明显低于对照组(P＜0.05).结论 对急性心肌梗死患者进行院前急诊护理能有效提高患者接受入院治疗的临床效果,尽可能的保障患者生命安全,值得临床推广使用.     

心肌梗死患者的颈动脉粥样硬化与脑梗死的关系

目的：探讨心肌梗死（心梗）患者梗死１年内发生脑梗死的心源性病因，并观察颈动脉粥样硬化情况。方法：应用超声心动图和颈动脉超声检测心梗并发脑梗死患者的心功能及颈动脉血流的相应指标。结果：９２．９％的心梗患者合并有颈动脉粥样硬化。脑梗死组（５例）患者中３例存在颈总动脉内膜粗糙，１例存在颈内动脉内膜粗糙；１例有心腔内附壁血栓；无脑梗死组无此现象。心功能指标２组间无显著性差异。结论：对心梗患者应充分了解心功能和颈动脉病变情况，以防止心梗后序发脑梗死。     

急性心肌梗死患者血液动力学监测的护理

目的 总结合并有血液动力学障碍的急性心肌梗死患者进行血液动力学监测护理的特点和注意事项。方法 对42例患者应用Swan-Ganz气囊漂浮导管进行了有创性的血液动力学的监测。结果 通过对患者的护理,配合医师的治疗,38例(90％)患者均取得了满意的治疗效果,治愈后出院,有4例患者死亡。结论 加强急性心肌梗死患者血液动力学监测是为临床提供有效的观察、治疗,对患者的预后有很大的改善。     

Teaching and adaptation of patients with myocardial infarction

The role of teaching in facilitating adaptation were examined in 60 patients with myocardial infarction (MI) of working age (under 65 years). Recovery of three different patient groups were followed for one year at three times: at discharge and three months and one year after it. Data for evaluating the effects of the teaching program on the patients and their close relatives were collected by questionnaires from the patients at discharge and by interviewing the patients three months after discharge. Information on patients' recovery during the first year after MI was collected from patients' records. Impact of teaching was prominent on several outcome measures. Patients' knowledge of illness and care increased, they also perceived having received more information and support. The time devoted to exercise increased after myocardial infarction and amount of butter used on bread decreased in the follow-up state. No impact was observed on the outcome variables measuring patient's use of alcohol and smoking. Some of the impacts at the early stages of the convalescence were not lasting. After one year of MI patients had partly returned to their old life styles, for example some patients had resumed the smoking habit. Teaching of close relatives improved only slightly.     

急性心肌梗死早期病人心肌耗氧量影响因素的分析

目的 分析急性心肌梗死早期病人心肌耗氧量影响因素。方法 对42例AMI病人于入院1～7d进行动态监测，记录病人安静时、活动时的心率、血压及心率、血压变动较大时病人的状态，计算D—P（心率与收缩压二项乘积，用以表示心肌耗氧量）。结果 在排便、进食、探视及做治疗时病人D—P值增大。结论 对急性心肌梗死早期病人加强健康教育及病情监测尤为重要，只有有效控制心肌耗氧量增加的因素，才能减轻心脏负荷，使病人早日康复。     

冠状动脉内支架治疗老年急性心肌梗死的临床研究

目的评价冠状动脉内支架治疗老年急性心肌梗死 (AMI)的临床疗效。方法分析 42例老年AMI患者冠状动脉内支架治疗结果。介入治疗术前及术后观察血压、心率 ,应用心动超声测定心功能变化情况。结果 42例患者置入支架 45枚 ,失败 1例。术后血压明显升高、心率明显下降、心功能明显改善。结论冠脉内支架术是治疗老年AMI的一种十分安全有效的治疗方法     

急性心肌梗死患者绿色通道应用情况效果评价

目的 评价急性心肌梗死患者绿色通道应用情况。 方法 选取2013年1月-2014年1月经过绿色通道收治的228例急性心肌梗死患者,记录各抢救环节时间。 结果 228例急性心肌梗死患者中,221例抢救成功,7例死亡,抢救成功率96.9%。患者急诊停留时间12~54min,平均32.5min;建立静脉通路时间5~12min,平均7.6min;口服给药时间4~10min,平均5.8min;入院到首次球囊扩张时间34~78min,平均52.6min。 结论 急性心肌梗死绿色通道运行状况良好。     

依心电图变化指导急性心肌梗死患者的早期康复护理

对急性心肌梗死(AMI)患者实施有效的早期干预,直接关系着心脏功能,关系着疾病的预后.心电图是反映心肌缺血、损伤、坏死最客观最科学的检查项目.     

Alterations in ultrasonic backscatter during intra-aortic balloon counterpulsation support in patients with acute myocardial infarction

Alterations of ultrasonic backscatter parameters have been evident in humans with myocardial infarction or ischemia. The backscatter variability could be restored in ischemic or stunned myocardium after reperfusion. The aims of this study were to determinate changes in regional myocardial ultrasonic backscatter during intra-aortic balloon counterpulsation (IABP) support in patients with acute myocardial infarction (AMI), and to evaluate whether backscatter imaging could be a functional guide of IABP support. A total of 9 patients with AMI were investigated during IABP support with a two-dimensional (2-D) ultrasonic backscatter imaging approach for parasternal short-axis view. Coronary angiography was performed in 6 of the 9 patients. A total of 21 vessel territories were studied in different modes of IABP support: 1:1, 1:2 and standby. Restoration of cyclic variation of backscatter after IABP support was demonstrated in 10 vessel territories. Failure of restoration of cyclic variation of backscatter after IABP support was noted in 6 vessel territories with severe coronary lesions (total or nearly total occlusion) or scar tissue. No changes of the ultrasonic backscatter were found in nonischemic vessel territories with patent coronary arteries or TIMI III coronary flow. In addition, the wall motion score did not change significantly with different IABP support. These results suggest that IABP could restore the cyclic variation of backscatter in ischemic myocardium. Myocardial anisotropy may play an influential role in the alterations of ultrasonic backscatter. We propose that ultrasonic backscatter could be a noninvasively functional guide of IABP use in patients with AMI.     

Helping patients cope with the stress of myocardial infarction

The victims of myocardial infarction pose a real challenge to nursing. Effective nursing intervention is based on an understanding of human responses to the stress of heart disease and the series of behavioral changes individuals undergo in an attempt to cope with the stress. Cardiac teaching is an essential aspect of this intervention. After a myocardial infarction, patients first go through two stages on the way to recovery--independency and dependency--before they are receptive to teaching. It is during the next two stages--interdependency and self-dependency--that nurses can use specific behavioral changes of the patients to plan health teaching and to negotiate contracts with them to effect learning and permanent behavioral change.     

女性急性心肌梗死患者的临床特点及护理

目的 :通过对已知的急性心肌梗死 (AMI)住院患者临床特点的调查 ,探讨护理干预工作的重点。方法 :对我院 114 3例确诊为AMI的住院患者进行回顾性调查和分析。结果 :女性患者AMI发病率虽低于男性人群 ,但确诊延缓、误诊率高 ,就诊后病死率、猝死率及各种并发症发生率明显高于男性 ,且具有较大的隐蔽性。结论 :护理人员应对就诊的高危冠心病 (CHD)女性患者进行快速识别及分诊 ,并适时地进行有关CHD相关知识的健康教育。     

放松训练在急性心肌梗死病人中的应用

[目的]探寻治疗急性心肌梗死有效的护理措施.[方法]符合条件的急性心肌梗死病人56例,按入院顺序随机分为两组,实验组28例,对照组28例;两组均给予健康教育、心理护理等常规护理,实验组另外进行放松训练.[结果]实验组病人焦虑与抑郁值较对照组低,差异有统计学意义(P<0.05);实验组疼痛程度明显降低,睡眠质量明显改善,与对照组比较,差异有统计学意义(P<0.01).[结论]放松训练是治疗急性心肌梗死有效的护理措施.