Home About us Contact
|
Home About us Contact | ||
|
|
||
Exercise Counseling (exercise + counseling)
Selected AbstractsNurse practitioner practice patterns for exercise counselingJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2009ARNP (Nurse Practitioner), Tawnya Horsley Tompkins MN Abstract Purpose:, To describe nurse practitioner (NP) practice patterns for exercise counseling for adults. Data sources:, Using a cross-sectional design, participants completed a self-administered questionnaire that ascertained barriers and facilitators encountered when providing exercise counseling. Participants included 398 NPs, who averaged 11 years in practice (SD = 7.9) and worked in a variety of practice areas. Conclusions:, In a given week, about half (48%) of the NPs counseled more than 50% of their patients for exercise. The majority of participants (84%) agreed that exercise counseling is as valuable an intervention as prescribed medication. More than half (59%) of the participants exercised regularly. Barriers and facilitators to exercise counseling were predominately a patient's lack of interest and the length of the patient visit. Specific strategies were identified for older adults and individuals residing in rural areas who may require more tailored exercise counseling. Participants demonstrated strong values about exercise counseling and observed that exercise had clear benefits for their patients. NP respondents offered recommendations focused on safety and adherence that can be used to improve exercise counseling. Clinical implications:, Exercise is a crucial component of preventative health care. Studies have shown that healthcare provider recommendations can be effective in helping patients increase their exercise and activity. [source] Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart FailureCLINICAL CARDIOLOGY, Issue 11 2008Gautam V. Ramani MD Abstract Background Morbid obesity (MO) is a risk factor for congestive heart failure (CHF). The presence of MO impairs functional status and disqualifies patients for cardiac transplantation. Bariatric surgery (BAS) is a frontline, durable treatment for MO; however, the safety and efficacy of BAS in advanced CHF is unknown. Hypothesis We hypothesized that by utilizing a coordinated approach between an experienced surgical team and heart failure specialists, BAS is safe in patients with advanced systolic CHF and results in favorable outcomes. Methods We performed a retrospective chart review of 12 patients with MO (body mass index [BMI] 53 ± 7 kg/m2) and systolic CHF (left ventricular ejection fraction [LVEF] 22 ± 7%, New York Heart Association [NYHA] class 2.9 ± 0.7) who underwent BAS, and then compared outcomes with 10 matched controls (BMI 47.2 ± 3.6 kg/m2, LVEF 24 ± 7%, and NYHA class 2.4 ± 0.7) who were given diet and exercise counseling. Results At 1 y, hospital readmission in BAS patients was significantly lower than controls (0.4 ± 0.8 versus 2.5 ± 2.6, p = 0.04); LVEF improved significantly in BAS patients (35 ± 15%, p = 0.005), but not in controls (29 ± 14%, p = not significant [NS]). The NYHA class improved in BAS patients (2.3 ± 0.5, p = 0.02), but deteriorated in controls (3.3 ± 0.9, p = 0.02). One BAS patient was successfully transplanted, and another listed for transplantation. Conclusions Bariatric surgery is safe and effective in patients with MO and severe systolic CHF, and should be considered in patients who have failed conventional therapy to improve clinical status. Copyright © 2008 Wiley Periodicals, Inc. [source] | ||||||||||