Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A theoretical model that specifies relationships among depression, ADL impairment, and social support components was tested using 147 patients age 55 and older undergoing open heart surgery for angina pectoris or aortic stenosis. Patients completed interviews and self-reports before surgery and one and 6 months after surgery. The longitudinal data were analyzed using covariance structure modeling techniques. Consistent with an initially theorized structural model, the number of close network members seen regularly before surgery was associated with perceived adequacy of support one month after surgery. In turn, perceived adequacy of support one month after surgery predicted less depression and less ADL impairment at 6 months. The number of close network members seen regularly was also directly associated with less ADL at one month and less depression at 6 months after surgery.
 ...
PMID:Social support, depression, and activities of daily living in older heart surgery patients. 900 71

The impact of coronary heart disease (CHD) on elderly patients' functional abilities is of growing interest because of the increasing number of people that survive the disease. The aim of our study was, firstly, to describe functional abilities among elderly CHD patients and, secondly, to analyze the relationships between physical disability and the severity of chest pain or dyspnea. The third aim was to assess whether there is an independent association between physical disability and CHD. The study was carried out at the health center of the municipality of Lieto, southwestern Finland. From a population of 1196 community-dwelling persons aged > or = 64 years, 89 men and 73 women with CHD (angina pectoris and/or a past myocardial infarction) were selected along with 178 male and 146 female sex- and age-matched controls without CHD. Physical functioning was assessed by means of interviewer-based questionnaires, compared between patients and controls and described in relation to the severity of chest pain and dyspnea among patients. The associations between dependence or difficulties in mobility, ADL (activities of daily living) and IADL (instrumental activities of daily living) and CHD, age, smoking, comorbidities, drug therapy and clinical characteristics were assessed by logistic regression analyses. On items representing mobility and managing in IADL, patients reported more difficulties or dependence than controls. Among female patients, more severe chest pain was associated with poor managing in IADL and tended to be associated with poor mobility. More severe dyspnea was associated with poor mobility among both male and female patients, and with poor managing in IADL among male patients. Logistic regression analyses failed to show that CHD was associated independently with physical disability among the elderly. However, physical disability was associated with the use of cardiovascular drugs in the models among both genders, which probably indirectly indicated an association between physical disability and CHD. Several confounding factors, such as higher age, depression, cancer and the use of psychotropic drugs, contributed to the decline in functional abilities even among persons with CHD. In conclusion, elderly CHD patients have greater limitations in their functional ability than matched controls, which may depend on the severity of the disease. Especially male patients' limitations in physical abilities may be influenced by the fact that men with CHD are more likely to be depressed. Although an independent association between physical disability and CHD was not found, the associations found between physical disability and the use of cardiovascular drugs probably indicate a causal relationship between CHD and physical disability.
 ...
PMID:Functional abilities of elderly coronary heart disease patients. 966 93

In addition to the visiting nursing service conventionally provided, the Department of Long-term Care Insurance Service of this hospital inaugurated the home care supporting service in April 2000. Senior citizens rated higher in the degree of necessity of care in the initial accreditation and in the renewal accreditation of the Long-term Care Insurance tend to have fewer changes in the services for the last two years. At present, care managers of various professions are involved in the home care supporting services and have no choice but to provide care in non-specialty areas. Under the situation, care management by the visiting nurse helped an elderly increase ADL and live on his own, and the case is introduced in this article. Mr. K.T. developed angina pectoris at the age of 76, had recurrences of complications and repeated transfers of hospitals and was eventually admitted to the hospital. Though he had declined muscular strength and ADL because of the long bed-ridden life, he was discharged from the hospital. Nursing services centered on visiting nursing were provided as the home care supporting service when home medical care for the patient was started. Since Mr. K.T. required medical management, he and his family members were not sure whether it is possible to provide care for him at home and required guidance about health/life and mental supports. Therefore, visiting nursing care was provided by a nurse to assess needs or condition of the person, which reduced anxiety and encouraged the person. As a result, ADL increased and the degree of necessity of care decreased from 4 to 2. This success is attributed to the visiting nurse's appropriate care management based on the medical expertise from the perspective of nursing and the introduction of necessary services at the necessary time based on the appropriate assessment of changes in the physical condition or willingness and the nursing condition of family members. Coordination with the staffs engaged in each service also contributed to the success. As shown by this case, it may be necessary for care managers who can exercise their specialty to be engaged in the service or to change care managers depending on the condition of the care service receiver or considering the specialty of care managers for the benefit of the care service receiver and for the improvement of the efficiency of the operations.
 ...
PMID:[Discussion on care management operation of a visiting nurse--a case of increased ADL by the support of independent life]. 1253 30