The 21st – 22nd of March I was invited to be speaker for the Heart Failure Association Training Workshop on Rehabilitation and Long-Term Management of Heart Failure Patients in Pisa Italy, a course of the European Society of Cardiology. This was such an honour, especially because I attended this course myself as a PhD student four years ago.
The first day of the workshop we learned a lot about the guidelines for rehabilitation and prevention and there were presentations on Acute setting/post-acute setting – first steps in initializing cardiac rehabilitation. Additionally, there were two live sessions from the cardiac clinic in the hospital of Pisa (Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica). One live demonstration on early mobilization and physical reconditioning in acute setting and the second on cardiopulmonary exercise testing.
In the evening we visit the Acient Camposanto in Piazza dei Miracoli and had dinner with all the participants and speakers in the course. A perfect ending of an excellent first day.
The second day the presentations were on phase two in rehabilitation, emerging scenarios in heart failure: case presentations and multidisciplinary approach in rehabilitation. I gave a case presentation on tele-rehabilitation and Wii gaming and a presentation on how to deal with vocational, sex and other crucial items in rehabilitation. On sexual counseling in rehabilitation I wrote a blog for the early career blogging of the American Heart Association. There is a very nice online web-seminar of sexual counseling in cardiac patients on the website of the European Society of Cardiology, if you would like to learn more about this subject.
Ghassan Mourad has a collaboration with the research group “Emergency, Cardiovascular and Critical Care Research (ECCCR) Group” led by Professor Tom Quinn at Kingston and St George’s Joint Faculty of Health, Social Care and Education in London. The ECCCR group was launched at the 28th February 2018 and Ghassan Mourad was present at the launch to present his RCT “Patient and societal benefits of guided internet-delivered cognitive behaviour therapy for patients with non-cardiac chest pain”.
The 5th national Swedish conference in Palliative Care was held in Stockholm 21-22 March 2018. The conference is of interest for all health care professionals working in palliative care, regardless of context of care and disease. The theme of the conference this year was ”the palliative approach”.
Two Cesar members presented at the conference. Dr Maria Liljeroos had an oral presentation entitled To live with a person with heart failure, the time before and after the death.
PhD student Lisa Hjelmfors had a poster presentation with the title: Using co-design to develop an intervention to improve communication about prognosis and end-of-life issues in heart failure care. The poster described how co-design was used as a method to develop communication tools, and invited the users: patients, family members and health care professionals to be constructive participants in both the design process and in the testing of the intervention. A Question Prompt List for patients and family members and a communication course for health care professionals were developed and tested, and the communication tools can be valuable in improving communication in HF care about prognosis and end-of-life care.
The next national Swedish Palliative Care conference will be held in 2020.
The first ‘new style’ annual conference of the European Heart Rhythm Association (EHRA) took place 18 – 20 March 2018 in Barcelona – Spain. Previously the conference was called Europace and was organised in collaboration with Cardiostim. The EHRA conference focusses on electrophysiology and the management of cardiac arrhythmias and the relationship with other cardiovascular conditions and risk factors. The conference welcomed approximately 6000 healthcare professionals from 100 countries, and this first edition of the EHRA conference was a great success.
The three days were filled with interesting sessions with a diversity of topics. Oral anticoagulation is an important aspect in the management of cardiac arrhythmias to prevent thromboembolic complications such as a stroke. In a packed room, Professor Heidbuchel (Vice-President EHRA) presented the 2018 EHRA Practical Guide for the use of NOACs in patients with atrial fibrillation. This is an important document to guide health care professionals in e.g. decision making, management and follow-up in anticoagulation management. I very much encourage you to take look at the document (https://www.ncbi.nlm.nih.gov/pubmed/29562325).
Another important topic is cognitive impairment in patients with cardiac arrhythmias. Given that the literature on this topic is scarce and the problem is underestimated and under-recognized in practice, it was very interesting to see the presentation on the EHRA expert consensus document on arrhythmias and cognitive impairment. The document highlights methods of assessments, the role for the health care professionals, as well as the role for imaging. There is still uncertainty as well as limited evidence in this area, but this guide will contribute to awareness and recognition of cognitive impairment in cardiac arrhythmias. For further reading please see the full consensus document: https://www.ncbi.nlm.nih.gov/pubmed/29562326.
At the conference I presented a novel integrated pathway for screening of sleep apnea in patients with atrial fibrillation. We developed this pathway in collaboration with colleagues from Belgium and Australia, and we propose this pathway to increase awareness for (the screening of) sleep apnea which will contribute to improved outcomes in patients with atrial fibrillation (see figure).
In 2019 the EHRA conference will be held 17-19 March in Lisbon – Portugal.
A nice new publication “Preference-based care and research” was recently published in European Journal of Cardiovascular Nursing 2018, Vol. 17(1) 4 –5 by Cesar members Tiny Jaarsma and Leonie Klompstra, and also Chantal F Ski and David R Thompson.
Link to publication here!
Annette Waldemar is a registered nurse who works with cardiac patients at Vrinnevi hospital in Norrköping, Sweden. She also works as a research nurse and cooperates with Professor Tiny Jaarsma, PhD students Lisa Hjelmfors and Emma Säfström (“Continuity of care and patient participation in patients hospitalized due to cardiac condition” and “TALK-HF” studies). Previously, she cooperated with Dr. Leonie Klompstra as a research nurse for many years within the HF-Wii study. Since 2014 she works part-time as a lecturer at Linköping University, at the Department of Social and Welfare studies, and she is a PhD-student at Institution for Medicine and Health. In 2017 Annette became a PhD student and her main supervisor is Associate professor Ingela Thylén and her co-supervisor is Professor Anna Strömberg and Associate professor Anders Bremer.
Her research area for her doctoral thesis is family witnessed cardiopulmonary resuscitation and other research interests concern different aspects of person-centered care. Her first study explored nurses’ and physicians’ experiences and attitudes toward family-witnessed resuscitation in cardiac care units. The next studies will explore how often families are witnessing resuscitations in hospitals, the experiences of patients and their next-of-kin of the resuscitation situation and how it affects their life.
Leonie Klompstra, Lisa Hjelmfors, Tiny Jaarsma and Anna Strömberg got a grant from Linköping forskningsfond and had an nice article about the Wii-study published in Norrköpings newpaper Folkbladet, http://www.folkbladet.se/nyheter/norrkoping/tv-spel-kan-ge-svaga-battre-flas-om4972103.aspx
Congratulations from Cesar Network!
Cesar Network congratulate Johan Lundgren for a great dissertation defense on the 12th of January. The title of the thesis is Behind the Screen -Internet-Based Cognitive Behavioural Therapy to Treat Depressive Symptoms in Persons with Heart Failure.
This year a group of Cesar members attended and presented at American Heart.
Christina Andrea presented a poster about nutrition in HF patients and Lisa Hjelmfors, Anna Strömberg and Tiny Jaarsma presented a poster about palliative care.
Tiny and Anna also gave several speeches, as well as Jeroen Hendriks.
Maria Liljeroos presented in the oral abstract session about the feasibility of a ehealth tool prescribed to patients with HF.
During the whole conferens Leonie Klompstra posted Early career blogs for the AHA, read them here;
Nursing poster sessions
Early career Blog
The 16-26 October 2017, I went on a study visit to Cyprus. The purpose of the study visit was to experience working with another research group and to look in the literature for activity monitors that are used in research in physical activity in patients with heart failure.
During my PhD, we had difficulties finding an appropriate measurement to measure objectively physical activity in this patient group. For this reason I was interested to look in the literature systematically for ways to measure physical activity in an objective way.
Before the visit, a PhD student Martha Kyriakou and I did a systematic literature search in the databases Pubmed, Scopus, CINAHL and Web of Science to search for studies, which objectively measured if their intervention influenced the physical activity in patients with Heart Failure. We worked together with Ekaterini Lambrinou and Nicos Middleton to look at the possibilities to conduct a meta-analysis and the possibilities to write an article together. We presented the 24th of October during a scientific methodology course for master and PhD students.
Furthermore I visit different parts of the University, met researchers with different research interests and made a visit to the American Medical Center in Limassol. For the last visit I would like to thank Vasillis I Barberis to show me around in this beautiful hospital.
I learned a lot working with another research group, got so much motivation, inspiration and the realization that I have a great job.
A big thanks you to Ekaterini Lambinou, for your expertise and hospitality and to Nicos Middleton for your enthusiasm and inspiration!