Symptom Experience in Acute Coronary Syndrome: Testing a Conceptual Model
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Jul 12, 2023
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Abstract
Introduction: acute coronary syndrome (ACS) is characterized by different symptoms, so the experience varies from person to person. Dodd’s Conceptual Model of Symptom Management addresses this aspect that requires testing within nursing practice. Objective: to test the postulates of the symptom experience dimension of Dodd’s Conceptual Model of Symptom Management in persons with acute coronary syndrome. Methods: theoretical testing by means of structural equations. A total of 256 individuals with a diagnosis of acute coronary syndrome, selected by stratified probability sampling, participated. Clinical and sociodemographic data were collected, and symptom assessment and response were measured with five valid instruments. Statistical analysis was performed with absolute adjustment, incremental adjustment and parsimony adjustment from which a structural equation model was derived. Results: the bidirectional relationship between symptom severity (assessment) and decision making (symptom response) was tested. A model was formed that explains 44% of the variance on decision making. This variable is also influenced by other variables such as cognitive evaluation and personal control. Conclusion: this conceptual model allowed us to understand the dimension of symptom experience in patients with acute coronary syndrome, proving its postulates in practice.
Keywords
structural equation modeling, decision making, symptom assessment, cardiovascular nursing (Descriptors in Health Sciences)modelado de ecuaciones estructurales, toma de decisiones, evaluación de síntomas, enfermería cardiovascular (DeCS)modelagem de equações estruturais, tomada de decisão, avaliação de sintomas, enfermagem cardiovascular (DeCS)
References
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21. Singurdardottir AK, Sigurlasdottir K, Olafsson K, Hronn Svavarsdottir M. Perceived consequences, changeability and personal control of coronary heart disease are associated with health - related quality of Life. J Clin Nurs. 2017;26:3636-45. https://doi.org/10.1111/jocn.13734
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25. Rossello X, Mas-Lladó C, Pocock S, Vicent L, Van de Werf F, Chin CT, et al. Las diferencias por sexo en la mortalidad tras un síndrome coronario agudo se incrementan en los países de menor riqueza y mayor desigualdad de ingresos. Rev Esp Cardiol. 2022;75(5):392-400. https://doi.org/10.1016/j.recesp.2021.05.009
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27. Beedholm K, Andersen LS, Lorentzen V. From Bodily Sensations to Symptoms: Health Care–Seeking Practices Among People Affected by Acute Coronary Syndrome. Qual Health Res. 2019;29(11):1651-60. https://doi.org/10.1177/1049732319857057
28. Si-Min Yao, Pei-Pei Zheng, Yao-Dan Liang, Yu-Hao Wan, Ning Sun, Yao Luo, et al. Predicting non-elective hospital readmission or death using a composite assessment of cognitive and physical frailty in elderly inpatients with cardiovascular disease. BMC Geriatrics. 2020;20(1):1-10. https://doi.org/10.1186/s12877-020-01606-8
29. Lee Y, Kim J, Chon D, Lee KE, Kim JH, Myeong S, Kim S. The effects of frailty and cognitive impairment on 3-year mortality in older adults. Maturitas. 2018;107:50-5. https://doi.org/10.1016/j.maturitas.2017.10.006
30. Miaskowski C, Barsevick A, Berger A, Casagrande R, Grady PA, Jacobsen P, et al. Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations. J. Natl. Cancer. 2017;109(4):253. https://doi.org/10.1093/jnci/djw253
31. Lizcano Álvarez Á, Villar Espejo T, López Köllmer L, Gómez Menor C, Ledesma Rodríguez R, Fernández Zarataín G. The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk. Enferm Clin. 2021;31(5):303-12. https://doi.org/10.1016/j.enfcle.2020.10.009
2. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt D, et al. Guía ESC 2020 sobre el diagnóstico y tratamiento del síndrome coronario agudo sin elevación del segmento ST. Rev Esp Cardiol. 2021;74:482-710. https://doi.org/10.1016/j.recesp.2020.12.024
3. Gomes GLL, Oliveira FMRL, Barbosa KTF, Medeiros ACT, Fernades MGM, Nóbrega MML. Theory of unpleasant symptoms: critical analysis. Texto Contexto Enferm. 2019; 28:e20170222. https://dx.doi.org/10.1590/1980-265X-TCE-2017-0222
4. Armstrong TS. Symptoms Experience: A Concept Analysis. Oncol Nurs Forum. 2003;30(4):601-6. https://doi.org/10.1188/03.ONF.601-606
5. Cioffi D. Beyond attentional strategies: cognitive-perceptual model of somatic interpretation. Psychol Bull. 1991;109(1):25-41. https://doi.org/10.1037/0033-2909.109.1.25
6. Dodd M, Janson S, Facione N, Faucett J, Froelicher E, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs. 2001;33(5):668-76. https://doi.org/10.1046/j.1365-2648.2001.01697.x
7. Céspedes Cuevas VM. Investigación que prueba teoría: una aproximación desde enfermería cardiovascular. Aquichan. 2012;12(2):97-108. https://doi.org/10.5294/aqui.2012.12.2.1
8. Bernal-Cárdenas CY, Céspedes-Cuevas VM, Sanhueza-Alvarado OI. Modelo conceptual del manejo del síntoma: evaluación y crítica. Aquichan. 2018;18(3):311-26. https://doi.org/10.5294/aqui.2018.18.3.6
9. Bernal Cárdenas CY. Predictores cognitivos de la toma de decisiones en la experiencia de los síntomas de Síndrome Coronario Agudo. [Internet]. 2018. Universidad Nacional de Colombia Sede Bogotá Facultad de Enfermería Disponible en: https://repositorio.unal.edu.co/handle/unal/68919
10. Escobedo Portillo T, Hernández Gómez JA, Estebane Ortega V, Martínez Moreno G. Modelos de Ecuaciones Estructurales: Características, Fases, Construcción, Aplicación y Resultados. Cienc Trab. 2016;18(55):16-22. http://dx.doi.org/10.4067/S0718-24492016000100004
11. Saberi F, Adib-Hajbaghery M, Zohrehea J. Predictors of prehospital delay in patients with acute myocardial infarction in Kashan city. Nurs Midwifery Stud. 2014;3(4):e24238. https://doi.org/10.17795/nmsjournal24238
12. Desu MM, Raghavarao D. Sample size Methodology. New York: Academic Press; 1990. https://doi.org/10.1016/C2009-0-22298-7
13. Dracup K, Moser D. Beyond sociodemographics: Factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. Heart Lung. 1997;26(4):253-62. https://doi.org/10.1016/s0147-9563(97)90082-0
14. Céspedes Cuevas M. Atypical nature of coronary artery disease in women: a proposal for measurement and clasification. Av. enferm. 2015;33(1):10-18. https://doi.org/10.15446/av.enferm.v33n1.47855
15. Endler NS, Parker JDA: Assessment of multidimensional coping: task, emotion and avoidance strategies. Psychol Assess. 1994;6:50–60. https://doi.org/10.1037/1040-3590.6.1.50
16. Camara Pacheco J, Vilaca de Brito CS. Tradução, adaptação cultural e validação para português da Control Attitudes Scale-Revised (CAS-R) em pessoas com doença Cardíaca. Revista de Emfermagem. 2014;IV(1):93-101.
17. Sarkar U, Ali S, Whooley M. Self-efficacy as a marker of cardiac function and predictor of heart failure hospitalization and mortality in patients with stable coronary heart disease: Findings from the Heart and Soul Study. Health Phychol. 2009;28(2):166-73. https://doi.org/10.1037/a0013146
18. Consejo de Organizaciones Internacionales de las Ciencias Médicas, y Organización Panamericana de la Salud. Pautas éticas internacionales para la investigación biomédica en seres humanos. Ginebra: Cioms. 2002. Disponble en: http://www.ub.edu/rceue/archivos/Pautas_Eticas_Internac.pdf
19. Asociación Médica Mundial (AMM). Declaración de Helsinki de la AMM – principios éticos para las investigaciones médicas en seres humanos. 64ª Asamblea General, Fortaleza, Brasil, 2013.
20. Kargar L, Khademian Z, Rambod M. Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study. Acute Crit Care. 2021;36(2):118-25. https://doi.org/10.4266/acc.2020.00752
21. Singurdardottir AK, Sigurlasdottir K, Olafsson K, Hronn Svavarsdottir M. Perceived consequences, changeability and personal control of coronary heart disease are associated with health - related quality of Life. J Clin Nurs. 2017;26:3636-45. https://doi.org/10.1111/jocn.13734
22. Andrade Méndez B, Omaira Gómez L, Arias Torres D. Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma. Enferm. glob. 2020;19(60):170-95. https://dx.doi.org/10.6018/eglobal.422331
23. Knight E, Shea K, Rosenfeld A, Schmiege S, Hsieh Hsu C, Devon H. Symptom trajectories after an emergency department visit for potential acute coronary syndrome. Nurs Res. 2016;65(4):268-78. https://doi.org/10.1097/NNR.0000000000000167
24. Nurmeksela A, Pihlainen V, Kettunen T, Laukkanen J, Peltokoski J. Nurse-led counseling for coronary artery disease patients: A 1-year follow-up study. Nurs Health Sci. 2021;0:0. https://doi.org/10.1111/nhs.12852
25. Rossello X, Mas-Lladó C, Pocock S, Vicent L, Van de Werf F, Chin CT, et al. Las diferencias por sexo en la mortalidad tras un síndrome coronario agudo se incrementan en los países de menor riqueza y mayor desigualdad de ingresos. Rev Esp Cardiol. 2022;75(5):392-400. https://doi.org/10.1016/j.recesp.2021.05.009
26. Gayda M, Gremeaux V, Bherer L, Juneau M, Drigny J, Dupuy O, et al. Cognitive function patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses. PLOS ONE. 2017;12(9):1-20. https://doi.org/10.1371/journal.pone.0183791
27. Beedholm K, Andersen LS, Lorentzen V. From Bodily Sensations to Symptoms: Health Care–Seeking Practices Among People Affected by Acute Coronary Syndrome. Qual Health Res. 2019;29(11):1651-60. https://doi.org/10.1177/1049732319857057
28. Si-Min Yao, Pei-Pei Zheng, Yao-Dan Liang, Yu-Hao Wan, Ning Sun, Yao Luo, et al. Predicting non-elective hospital readmission or death using a composite assessment of cognitive and physical frailty in elderly inpatients with cardiovascular disease. BMC Geriatrics. 2020;20(1):1-10. https://doi.org/10.1186/s12877-020-01606-8
29. Lee Y, Kim J, Chon D, Lee KE, Kim JH, Myeong S, Kim S. The effects of frailty and cognitive impairment on 3-year mortality in older adults. Maturitas. 2018;107:50-5. https://doi.org/10.1016/j.maturitas.2017.10.006
30. Miaskowski C, Barsevick A, Berger A, Casagrande R, Grady PA, Jacobsen P, et al. Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations. J. Natl. Cancer. 2017;109(4):253. https://doi.org/10.1093/jnci/djw253
31. Lizcano Álvarez Á, Villar Espejo T, López Köllmer L, Gómez Menor C, Ledesma Rodríguez R, Fernández Zarataín G. The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk. Enferm Clin. 2021;31(5):303-12. https://doi.org/10.1016/j.enfcle.2020.10.009
How to Cite
Bernal Cárdenas, C. Y., Céspedes Cuevas, V. M., & Rojas Reyes, J. (2023). Symptom Experience in Acute Coronary Syndrome: Testing a Conceptual Model. Investigación En Enfermería Imagen Y Desarrollo, 25. https://doi.org/10.11144/Javeriana.ie25.essc
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Original Research Articles
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