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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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Posttraumatic growth in coronary artery disease outpatients: relationship to degree of trauma and health service use.

https://arctichealth.org/en/permalink/ahliterature126272
Source
J Psychosom Res. 2012 Apr;72(4):293-9
Publication Type
Article
Date
Apr-2012
Author
Yvonne W Leung
David A Alter
Peter L Prior
Donna E Stewart
Jane Irvine
Sherry L Grace
Author Affiliation
York University, Canada. yvonnewleung@gmail.com
Source
J Psychosom Res. 2012 Apr;72(4):293-9
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Ambulatory Care
Cohort Studies
Continuity of Patient Care
Coronary Artery Disease - prevention & control - psychology - rehabilitation
Female
Health Services - utilization
Humans
Male
Middle Aged
Ontario
Personality Development
Prospective Studies
Recurrence - prevention & control
Sick Role
Stress Disorders, Post-Traumatic - diagnosis - psychology
Utilization Review
Abstract
Posttraumatic growth (PTG) is frequently reported after the strike of a serious medical illness. The current study sought to: 1) assess the relationship between degree of cardiac "threat" and PTG one-year post-hospitalization; and 2) to explore the association between PTG and healthcare utilization.
In a cohort study, 2636 cardiac inpatients from 11 Ontario hospitals completed a sociodemographic survey; clinical data were extracted from charts. One year later, 1717 of these outpatients completed a postal survey, which assessed PTG and healthcare utilization. Morbidity data were obtained retrospectively through probabilistic linkage to administrative data. The predicted risk of recurrent events for each participant was calculated using a logistic regression model, based on participants' sociodemographic and clinical characteristics. The relationship among PTG, trauma and health service use was examined with multiple regression models.
Greater PTG was significantly related to greater predicted risk of recurrent events (p
PubMed ID
22405224 View in PubMed
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The prevalence and correlates of mind-body therapy practices in patients with acute coronary syndrome.

https://arctichealth.org/en/permalink/ahliterature152839
Source
Complement Ther Med. 2008 Oct;16(5):254-61
Publication Type
Article
Date
Oct-2008
Author
Yvonne W Leung
Hala Tamim
Donna E Stewart
Heather M Arthur
Sherry L Grace
Author Affiliation
222A Bethune College, York University, Toronto, Ont, Canada. yleung@yorku.ca
Source
Complement Ther Med. 2008 Oct;16(5):254-61
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - therapy
Aged
Canada
Comorbidity
Female
Humans
Logistic Models
Male
Middle Aged
Mind-Body Therapies - methods - utilization
Prevalence
Questionnaires
Relaxation Therapy - statistics & numerical data
Social Class
Abstract
While the benefits of mind-body therapy (MBT) for cardiac secondary prevention continues to be investigated, the prevalence of such practices by cardiac patients is not well known. The aim of this study was to quantitatively examine the prevalence of MBT practice and its sociodemographic, clinical, psychosocial and behavioral correlates among patients with acute coronary syndrome (ACS).
Six hundred and sixty-one ACS in-patients (75% response rate) recruited from three hospitals completed a demographic survey, and clinical data were extracted from charts. Four hundred and sixty five patients (81% retention rate; 110 (23.7%) female) responded to an 18-month post-discharge survey that queried about MBT use and its correlates.
One hundred and sixty-three (35.1%) ACS patients practised MBT in their lifetime, and 118 (25.4%) were currently practising. MBT users were more often women (OR = 2.98), nonwhite (OR = 2.17), had higher levels of education (OR = 2.22), past smokers (OR = 3.33), reported poorer mental health (OR = 2.15), and engaged in more exercise (OR = 1.65).
One-third of ACS patients practised some form of MBT. The greater MBT practice among female ACS patients is noteworthy, given their generally lower physical activity and lower receipt of evidence-based treatments including cardiac rehabilitation. In addition, there is some evidence that MBT can promote mental well-being, and thus such practice might reduce risk related to negative affect in cardiac patients.
Notes
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PubMed ID
19186341 View in PubMed
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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
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The role of systematic inpatient cardiac rehabilitation referral in increasing equitable access and utilization.

https://arctichealth.org/en/permalink/ahliterature128525
Source
J Cardiopulm Rehabil Prev. 2012 Jan-Feb;32(1):41-7
Publication Type
Article
Author
Sherry L Grace
Yvonne W Leung
Robert Reid
Paul Oh
Gilbert Wu
David A Alter
CRCARE Investigators
Author Affiliation
Kinesiology and Health Science, 368 Bethune College, York University, Toronto, Ontario, Canada. sgrace@yorku.ca
Source
J Cardiopulm Rehabil Prev. 2012 Jan-Feb;32(1):41-7
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Chi-Square Distribution
Coronary Artery Disease - rehabilitation
Female
Health Resources - statistics & numerical data - utilization
Health Services Accessibility
Health services needs and demand
Health Status Indicators
Health Surveys
Humans
Inpatients
Male
Marital status
Middle Aged
Ontario
Prospective Studies
Referral and Consultation - statistics & numerical data - utilization
Risk assessment
Self Report
Socioeconomic Factors
Abstract
While systematic referral strategies have been shown to significantly increase cardiac rehabilitation (CR) enrollment to approximately 70%, whether utilization rates increase among patient groups who are traditionally underrepresented has yet to be established. This study compared CR utilization based on age, marital status, rurality, socioeconomic indicators, clinical risk, and comorbidities following systematic versus nonsystematic CR referral.
Coronary artery disease inpatients (N = 2635) from 11 Ontario hospitals, utilizing either systematic (n = 8 wards) or nonsystematic referral strategies (n = 8 wards), completed a survey including sociodemographics and activity status. Clinical data were extracted from charts. At 1 year, 1680 participants completed a mailed survey that assessed CR utilization. The association of patient characteristics and referral strategy on CR utilization was tested using ?.
When compared to nonsystematic referral, systematic strategies resulted in significantly greater CR referral and enrollment among obese (32 vs 27% referred, P = .044; 33 vs 26% enrolled, P = .047) patients of lower socioeconomic status (41 vs 34% referred, P = .026; 42 vs 32% enrolled, P = .005); and lower activity status (63 vs 54% referred, P = .005; 62 vs 51% enrolled, P = .002). There was significantly greater enrollment among those of lower education (P = .04) when systematically referred; however, no significant differences in degree of CR participation based on referral strategy.
Up to 11% more socioeconomically disadvantaged patients and those with more risk factors utilized CR where systematic processes were in place. They participated in CR to the same high degree as their nonsystematically referred counterparts. These referral strategies should be implemented to promote equitable access.
PubMed ID
22193933 View in PubMed
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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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6 records – page 1 of 1.