Dr. Gabrielle Mc Kee

Summary

Physical activity in the older adult: The aim of MOVEAGE-ACT project aims to empower older people in Europe to adopt healthy lifestyles which include activity and mobility. It aims to identify and address the motivators and barriers to physical activity and develop possible age-appropriate solutions based on these findings. It will organize and high-level public events to promote active ageing events in a number of sites across France and Ireland. to further empower the older adults it will develop and evaluate brief interventions at these events and an behavioural change web based app to motivate maintenance of physical activity.

Funding Agency

EIT

Programme

Health campus programme

Project Type

Intervention

Person Months

12

Summary

This study is a follow on from the successful survey by Irish Nurses Cardiac Association (INCA) of the members of CCNAP ( 2015)and their barriers to guideline use and a small study funded by Irish Heart Foundation (2007). In collaboration with the The Irish Nurses Cardiac This study is a small study with the Irish Nurses Cardiac Association (INCA). This follow on study utilised the reminder of the funds. This all Ireland project seeks to identify nurses knowledge of European society of cardiology guidelines and barriers to guideline use in all hospitals that have nurses caring for cardiac patients and practice nurses. 2017-2019 team members: G. Mckee1, M. Hayes2, N. Caples3, A. Lowry4, M. Shine4, B. Hannon4, E. Cronin3, E. Lodge4, L. Hill5, M. Tuohy6, N. Gillen7, S. Teehan4 (1) Trinity College, Dublin, Ireland (2) Blackrock Clinic, Dublin, Ireland (3) Waterford Regional Hospital, Waterford, Ireland (4) St James Hospital, Dublin, Ireland (5) Queen's University of Belfast, Belfast, United Kingdom (6) Naas General Hospital , Naas, Ireland (7) Galway Clinic, Galway, Ireland

Funding Agency

Irish Heart Foundation ( Phase 1)

Programme

Noel Hickey Bursary ( Phase 1)

Project Type

Survey

Person Months

36

Summary

Patients with peripheral arterial disease (PAD) (lower limb) have a 6 fold increased risk of mortality from cardiovascular disease (CVD) compared to the general population. Risk factors for PAD are similar to those for CVD. Exercise limitations and claudication pain compound these risk factors and accentuate their impact on CVD. Given the very high CVD risk associated with PAD, patients need interventions to protect their overall arterial tree. The aim of this project was to evaluate a PAD risk assessment and rehabilitation programme. A prospective observational study on one site from 2015 -2019. Team members: N. Fallon, C. Edgeworth, P. McGeary, N.Flynn N, R. O Mahony, V.Jones, S.Tierney, B. Egan, Maher V, ( Tallaght Hopstial) Mary Quirke (TCPHI) G. McKee ,

Funding Agency

The Meath Foundation

Project Type

Observational study following intervention

Person Months

24

Summary

The European Society of Cardiology create new guidelines for practice on a regular basis. Implementation of these guidelines is not always optimal. The aims of the research is three fold to: Ascertain the current use of and the factors that influence the use of guidelines and to identify the perceived barriers to the use of guidelines in nurses across Europe.

Project Type

Survey

Person Months

12

Summary

To evaluative the effectiveness of attendance at a Phase III specialised Heart Failure Cardiac rehabilitation programme (CRHFP) on patient's cardiovascular risk factor profile. Purpose: The European Society of Cardiology (ESC) recommend exercise as one of the core components for patients with chronic heart failure, with reported benefits in skeletal, muscle, respiratory, cardiovascular and physiological responses. Exercise training reduces debilitating symptoms, improves functional capacity, quality of life, and significantly improves survival time, while reducing all cause and HF specific cause of hospital admissions. Methods: This is a retrospective longitudinal study that examined profile factors of patients' pre and post the CRHFP. Patients were recruited through a specialised heart failure service to a 10 week exercise and education program. The following data was examined to ascertain if there was any significant changes in the profile factors following attendance at the programme: Quality of life (Minnesota), levels of anxiety and depression (HADS), functional capacity (6Minute walk test and DASI) and anthropometric measurements (Weight, BMI, WC), and Blood Pressure. Results: Data was collected, pertaining to 100 patients. The mean age was 64.5 years (SD=11.1) with half of patients falling within the 67-83 years age group (range 33-83 years). 80% (n=80) were male. 15% (n=15) of patients did not achieve a compliance rate of ≥60%. The reasons for non-completion included Illness/injury 47% (7), no reason 27% (4), return to work 13% (2), domestic issues 7% (1) and lack of motivation7% (1). There was a significant change in four of the ten examined variables. Post CRHFP, patients showed significant improvements in 6 minute walk score: 426 to 466 meters, p<0.001, systolic blood pressure 122mmHg to 115mmHg p <0.005. The Minnesota Living with Heart Failure score improved: 30.5 to 25 p <0.005. The categories of the anxiety and depression scales were merged dichotomously (Normal/Mild & Moderate/Severe). McNemar analysis revealed a significant decrease in the proportion of participants who scored within the moderate/severe range on the HADS Anxiety scale following the programme (5%) when compared with the proportion prior to the programme (18%; n=78, p<0.01). No significant changes were observed on the HADS Depression score. Conclusions: In-hospital and out of hospital HF care has developed significantly, especially in acute symptom control. More recently, emphasis has been put on the long term control of other risk factors. This study adds to this body of literature indicating that attendance at a hospital based Phase III CR programme that provides supervised tailored exercise, with intensive education and support, is effective in reducing risk factors in patients with the lower grades of heart failure. In addition, this study highlighted the positive effects of exercise training on quality of life and exercise capacity.

Funding Agency

The Meath Foundation

Project Type

Intervention evaluation

Person Months

36