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Access to cardiac rehabilitation among South-Asian patients by referral method: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature143716
Source
Rehabil Nurs. 2010 May-Jun;35(3):106-12
Publication Type
Article
Author
Keerat Grewal
Yvonne W Leung
Parissa Safai
Donna E Stewart
Sonia Anand
Milan Gupta
Cynthia Parsons
Sherry L Grace
Author Affiliation
University of Toronto, ON. keerat.grewal@utoronto.ca
Source
Rehabil Nurs. 2010 May-Jun;35(3):106-12
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - ethnology - rehabilitation
Asia, Western - ethnology
Asian Continental Ancestry Group
Automation
Continuity of Patient Care
Emigrants and Immigrants
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
India - ethnology
Male
Middle Aged
Ontario
Referral and Consultation
Abstract
People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowledge and access varied among South-Asian patients. Participants were South-Asian cardiac patients receiving treatment at hospitals in Ontario, Canada. Each hospital refers to CR via one offour methods: automatically through paper or electronically, through discussion with allied health professionals (liaison referral), or through referral at the physician's discretion. Data were collected via interviews and analyzed using interpretive-descriptive analysis. Four themes emerged: the importance of predischarge CR discussions with healthcare providers, limited knowledge of CR, ease of the referral process for facilitators of CR attendance, and participants'needs for personal autonomy regarding their decision to attend CR. Liaison referral was perceived to be the most suitable referral method for participants. It facilitated communication between patients and providers, ensuring improved understanding of CR. Automatic referral may not be as well suited to this population because of reduced patient-provider communication.
PubMed ID
20450019 View in PubMed
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Differences in social support and illness perceptions among South Asian and Caucasian patients with coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature143670
Source
Heart Lung. 2010 May-Jun;39(3):180-7
Publication Type
Article
Author
Keerat Grewal
Donna E Stewart
Sherry L Grace
Author Affiliation
Kinesiology and Health Sciences, York University, Toronto, Ontario.
Source
Heart Lung. 2010 May-Jun;39(3):180-7
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Asia - ethnology
Attitude to Death
Coronary Artery Disease - epidemiology - ethnology - psychology
Cross-Sectional Studies
Cultural Diversity
Ethnic Groups
Female
Humans
Inpatients
Male
Middle Aged
Ontario - epidemiology
Prognosis
Questionnaires
Social Perception
Social Support
Stress, Psychological
Abstract
Social support and illness perceptions may affect recovery from a cardiac event or procedure. Previous research has found that patients of South Asian origin with coronary artery disease (CAD) have lower levels of social support and may perceive different causes of their condition. The purpose of this study was to quantitatively investigate differences in social support and illness perceptions between Caucasian and South Asian patients with CAD.
A total of 562 inpatients with CAD (53 [9%] South Asian) were recruited from 2 hospitals. The Medical Outcomes Study social support scale and Illness Perception Questionnaire were administered to examine ethnocultural differences in total social support and subscales, and in illness perceptions subscales, including causes of illness.
South Asian participants had significantly lower levels of tangible (P=.001) and emotional/informational support (P
PubMed ID
20457337 View in PubMed
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Factors affecting cardiac rehabilitation referral by physician specialty.

https://arctichealth.org/en/permalink/ahliterature156142
Source
J Cardiopulm Rehabil Prev. 2008 Jul-Aug;28(4):248-52
Publication Type
Article
Author
Sherry L Grace
Keerat Grewal
Donna E Stewart
Author Affiliation
Bethune College, York University, Toronto, Ontario, Canada. sgrace@yorku.ca
Source
J Cardiopulm Rehabil Prev. 2008 Jul-Aug;28(4):248-52
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - rehabilitation
Clinical Competence
Cross-Sectional Studies
Female
Humans
Male
Ontario
Physicians, Family
Questionnaires
Referral and Consultation - statistics & numerical data
Abstract
Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists.
A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral.
Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P
PubMed ID
18628655 View in PubMed
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A prospective, controlled multisite study of psychosocial and behavioral change following women's cardiac rehabilitation participation.

https://arctichealth.org/en/permalink/ahliterature158457
Source
J Womens Health (Larchmt). 2008 Mar;17(2):241-8
Publication Type
Article
Date
Mar-2008
Author
Sherry L Grace
Keerat Grewal
Heather M Arthur
Beth L Abramson
Donna E Stewart
Author Affiliation
York University, Toronto, ON, Canada.
Source
J Womens Health (Larchmt). 2008 Mar;17(2):241-8
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Anxiety - epidemiology
Comorbidity
Coronary Disease - epidemiology - psychology - rehabilitation
Depression - epidemiology
Exercise Therapy - methods
Female
Health Knowledge, Attitudes, Practice
Humans
Middle Aged
Ontario
Prospective Studies
Quality of Life
Questionnaires
Sickness Impact Profile
Social Support
Treatment Outcome
Women's health
Abstract
Despite its proven benefits and need, women are significantly less likely than men to participate in and complete cardiac rehabilitation (CR). Thus, there are few reports of CR outcomes among women, particularly when compared with women who do not participate in CR. The purpose of this study was to prospectively assess psychosocial and behavioral changes, comparing women who participated in CR with those who did not.
One hundred fifty-seven female cardiac inpatients from three hospitals consented to participate in a prospective study, and 110 (79%) were retained 18 months postdischarge. A mailed survey discerned CR participation 9 months postdischarge. Quality of life (Short-Form Health Survey Physical and Mental Component Summary [SF-12 PCS and MCS]), exercise behavior (Health-Promoting Lifestyle Profile II [HPLPII]), Exercise Benefits and Barriers Scale (EBBS), and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale [HADS]) were assessed in hospital and 18 months postdischarge.
Fifty-one (45.1%) women self-reported participating in CR at 1 of 18 sites, and site-verified participation was 82.43% +/- 29.97% of prescribed sessions. For CR participants, paired t tests assessing change from hospitalization to 18 months postdischarge revealed significant improvements in physical quality of life (p
Notes
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PubMed ID
18321175 View in PubMed
Less detail

Quality of life following participation in cardiac rehabilitation programs of longer or shorter than 6 months: does duration matter?

https://arctichealth.org/en/permalink/ahliterature137858
Source
Popul Health Manag. 2011 Aug;14(4):181-8
Publication Type
Article
Date
Aug-2011
Author
Yvonne W Leung
Keerat Grewal
Shannon Gravely-Witte
Neville Suskin
Donna E Stewart
Sherry L Grace
Author Affiliation
Kinesiology & Health Science, York University, Toronto, Ontario, Canada.
Source
Popul Health Manag. 2011 Aug;14(4):181-8
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Diseases - rehabilitation
Female
Humans
Male
Middle Aged
Ontario
Outcome Assessment (Health Care)
Program Evaluation
Prospective Studies
Quality of Life
Questionnaires
Secondary Prevention - organization & administration
Time Factors
Abstract
Cardiac rehabilitation (CR) participation results in significant health benefits. However, there is wide variation in program duration, and little is known about the optimal duration of CR for patient outcomes. The objective of this study was to compare quality of life (QoL) of patients who participated in CR programs of??0.0001), and PTGI (P?=?0.007) were significantly greater regardless of CR duration when compared to those who did not attend CR. There were no significant differences in outcomes when comparing patients attending CR programs of?
PubMed ID
21241185 View in PubMed
Less detail

A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients.

https://arctichealth.org/en/permalink/ahliterature137552
Source
Anxiety Stress Coping. 2011 Jul;24(4):463-75
Publication Type
Article
Date
Jul-2011
Author
Keerat Grewal
Shannon Gravely-Witte
Donna E Stewart
Sherry L Grace
Author Affiliation
Faculty of Health, Kinesiology & Health Science, York University, Toronto, Ontario, Canada.
Source
Anxiety Stress Coping. 2011 Jul;24(4):463-75
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Aged
Angina Pectoris - psychology - rehabilitation
Anxiety Disorders - diagnosis - psychology
Coronary Artery Disease - psychology - rehabilitation
Depressive Disorder - diagnosis - psychology
Female
Hostility
Humans
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction - psychology - rehabilitation
Myocardial Revascularization - psychology
Ontario
Patient Readmission
Personality Inventory - statistics & numerical data
Prognosis
Psychometrics - statistics & numerical data
Recurrence
Reproducibility of Results
Risk factors
Social Support
Stress, Psychological - complications
Abstract
Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.
PubMed ID
21271407 View in PubMed
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Smoking and physical activity: a systematic review.

https://arctichealth.org/en/permalink/ahliterature160275
Source
Am J Health Behav. 2008 Jan-Feb;32(1):93-110
Publication Type
Article
Author
Andrew T Kaczynski
Stephen R Manske
Roger C Mannell
Keerat Grewal
Author Affiliation
Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada. atkaczyn@ahsmail.uwaterloo.ca
Source
Am J Health Behav. 2008 Jan-Feb;32(1):93-110
Language
English
Publication Type
Article
Keywords
Exercise
Humans
Ontario
Smoking
Abstract
To better understand the co-occurrence of smoking and physical inactivity.
A review of 5 databases identified 50 articles reporting empirical relationships between smoking and physical activity (PA).
Almost 60% of the articles reported a definitely negative association, but this relationship was often attenuated or reversed among adolescents and males and for moderate (vs vigorous) exercise. Stages of change for smoking and PA were relatively unrelated.
Smoking and PA are largely incongruent behaviors. Potential explanations for the observed relationships are described. These ranged from physiological (eg, lung function) to psychological (eg, depression) to socio-demographic (eg, education) factors.
PubMed ID
18021037 View in PubMed
Less detail

Timing of depressive symptom onset and in-hospital complications among acute coronary syndrome inpatients.

https://arctichealth.org/en/permalink/ahliterature142524
Source
Psychosomatics. 2010 Jul-Aug;51(4):283-8
Publication Type
Article
Author
Keerat Grewal
Donna E Stewart
Susan E Abbey
Yvonne W Leung
Jane Irvine
Sherry L Grace
Author Affiliation
York University, 4700 Keele St., Toronto, ON, Canada.
Source
Psychosomatics. 2010 Jul-Aug;51(4):283-8
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - epidemiology - psychology
Comorbidity
Cross-Sectional Studies
Depressive Disorder - epidemiology - psychology
Female
Heart Arrest - epidemiology - psychology
Hospitalization
Humans
Inpatients - psychology - statistics & numerical data
Longitudinal Studies
Male
Middle Aged
Myocardial Ischemia - epidemiology - psychology
Ontario - epidemiology
Prospective Studies
Recurrence
Risk factors
Abstract
Recent research has reported an association between in-hospital depression and poorer long-term prognosis and a greater risk of in-hospital complications.
The purpose of the current study was to examine the relationship between past and incident depressive symptoms and in-hospital complications in acute coronary syndrome (ACS) inpatients.
A group of 906 ACS inpatients from 12 coronary-care units participated in the study. Incident depressive symptoms were assessed through the Beck Depression Inventory, and participants' were asked about past history of prolonged depressed mood. In-hospital complications were noted as present or absent by nurses, and authors conducted logistic-regression analyses.
A subset of 492 patients (58.4%) experienced an in-hospital complication, the most common being ischemia (48.8%) and cardiac arrest (7.2%). After adjusting for prognostic indicators, incident and past-combined-with-incident depressive symptoms were significantly associated with an increased risk of experiencing an in-hospital complication.
Incident symptoms, in particular, seem to be prognostic. This finding suggests that acute emotions may be triggering cardiac complications, and early identification of emotional symptoms is warranted.
PubMed ID
20587755 View in PubMed
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8 records – page 1 of 1.