Cardiovascular Risk Factors and Visiting Nurse Intervention – Evaluation of a Croatian Survey and Intervention Model: the CroHort Study (original) (raw)
Collegium antropologicum, 2009
The paper describes a visiting nurse led intervention model for the primary and secondary prevention of cardiovascular diseases (CVD) and specificities of its application. Although CVD burden is high in Croatia, the visiting nurse services have not been specifically focused on CVD prevention in the population until now. The intervention model described here is being implemented alongside the second cycle of the Croatian Adult Health Survey (2008 CAHS). The model includes an objective evaluation of respondents' CVD risk factors through quantitative and qualitative analyses, as well as respondents' self-evaluation of risk factors and motivation to change. At the same time, respondents are educated and intervention is evaluated. A 'health booklet' was specifically designed for documentation during one year's follow-up, where both the user and the visiting nurse keep copies of the negotiated targets and strategies set to achieve them. This intervention model has the ...
Cardiovascular diseases, risk factors and barriers in their prevention in Croatia
Collegium antropologicum, 2009
Cardiovascular diseases are the leading cause of death in Croatia, with significant regional differences. Despite high mortality rates, high prevalence of various cardiovascular risk factors and well organized public health network, comprehensive system for cardiovascular disease monitoring and interventions does not exist. In this study we analyzed legislation framework and responsibilities of stakeholders relevant for cardiovascular disease surveillance and prevention. According to the international experiences we analyzed characteristics of cardiovascular disease prevention in Croatia and causes of the problems appeared in the preventive programs in Croatia. Analysis showed that primary problem is not inefficiency, but the existence of barriers in preventive activities definition, responsibilities distribution and task implementation. Main cause for such situation is incompatibility of the existing practices in clinical medicine and public health with recommendations from other c...
International Journal of Nursing and Health Services (IJNHS)
Health promotion is a method to increase awareness of healthy behavior in public. Unhealthy lifestyles cause increases the risk of cardiovascular disease. Community health nurses have a responsibility to increase the motivation of healthy practice with the health promotion’s method. This research method used a systematic review, using online databases on Cambridge Core, Wiley Online, and Science Direct e-resources when the articles published from 2006-2018. The selection of literature used the Critical Capability Program (CASP) tool and got eight relevant articles. The systematic analysis used the Cochrane Collaboration. The themes of this article are 1) nurses’ knowledge about health promotion, 2) the meaning of health promotion, and 3) the implementation health promotion of cardiovascular disease prevention by nurses. The themes identified some categories, such as nurse responsibilities, the essence of health promotion, support and barriers, and health promotion’s method. The nurs...
BMJ, 2005
Reliable epidemiological data on cardiovascular risk factors in Croatia have been lacking. This new study identifies targets for interventions Cardiovascular disease is the major cause of death in most European transitional countries. 1 Among these countries, standardised mortality from cardiovascular disease is highest in Hungary (508 per 100 000 population) and Croatia (500/100 000) and lowest in Slovenia (295/100 000) and central European countries (238/100 000). In Croatia, cardiovascular disease is the leading cause of death and accounts for more than half the overall mortality. 1 Furthermore, cardiovascular mortality has been constantly rising since the 1970s.
International Journal of Nursing Studies, 2010
Background: Studies have shown that in general patients are positive about cardiovascular prevention delivered by general practitioners. Further, it has been found that care by nurses for the chronically ill leads to even greater patient satisfaction. Objective: The aim of this survey was to answer the following questions: How do patients perceive cardiovascular prevention delivered by the practice nurse? Are patient characteristics and personal health status associated with experiences of received nurse-led care? Design: A cross-sectional survey after completion of a randomised trial. Setting: Six primary health care centres in the Netherlands (25 general practitioners, 6 practice nurses, 30,000 patients). Participants: Included in the randomised trial were 701 patients with at least a 10% risk of fatal cardiovascular disease within 10 years. Patients who visited a cardiovascular specialist more often than once a year and patients with diabetes were excluded from the study. In 90% of the patients it concerned secondary prevention. Half of the patients received nursedelivered care and half received care by the general practitioner. Method: A questionnaire was sent by post to all patients after having received one year of cardiovascular prevention. A dual moderator focus group study was held for the development of the questionnaire. Findings: The response rate was 69%. Patients were more satisfied with nurse-delivered cardiovascular prevention compared to standard care by general practitioners. The majority of patients agreed with positive statements regarding received nurse-led care. Patient characteristics such as age, educational level and gender were significantly associated with patients experiences. Furthermore, a significant association between experiences and personal health status was found. In comparison with patients who did not smoke, smokers would recommend the practice nurse less to others (X 2 = 4.0, p = 0.047), felt more 'rapped on their knuckles' (X 2 = 11.5, p = 0.003), found the consultation more 'awkward' (X 2 = 8.3, p = 0.016) and thought the nurse less understanding of their personal situation (X 2 = 6.4, p = 0.041) and less able to explain clearly (X 2 = 6.5, p = 0.039). Conclusions: The majority of patients responded positively to nurse-delivered cardiovascular prevention. Further improvement could be gained by paying more attention to motivational interviewing. Nurses should approach high risk patients more specifically according to the type of risk factor to be treated. ß
Factors in effectiveness:practice nurses, health promotion and cardiovascular disease
Clinical Effectiveness in Nursing, 1999
Research and Development Executive, to explore the implementation of research-based knowledge by practice nurses in the prevention of cardiovascular disease (CVD) and stroke. Design: the study was designed in two stages. Stage I involved a national survey of practice nurses, focusing upon current practice in relation to the identification and monitoring of the major risk factors for CVD and stroke.This paper relates to stage II of the study, in which semi-structured interviews were undertaken to illuminate issues emerging from the survey data, while also being sensitive to issues raised by respondents. Participants: the interviewees were practice nurses, all female, ranging in age from 27 to 53 years who worked between 18 and 38 hours per week. Findings: a number of factors which appear to influence effective practice and suggest that evidence-based practice is a result of a complex interaction of'organizational', 'patient-centred','personal practice' and 'wider' issues rather than a consequence of the influence of individual elements. Conclusions and recommendations: further research is needed to explore the ways in which the combination of these factors affects changes in nursing practice.