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A Comparison of the NYHA Classification and the Duke Treadmill Score in Patients with Cardiovascular Disease

Open Journal of Nursing 2014年第11期4卷 774-783页

作者： Sandra L. Carroll Karen Harkness michael Hugh mcgillion McMaster University Hamilton Canada Hamilton Health Sciences Hamilton Canada

Aim: A discussion of the measurement of functional status in cardiovascular research. Background: Selection of appropriate outcome measures and instrumentation is vital for nurse researchers to ensure that outcomes align conceptually and are measured using reliable and valid tools. Functional status is a well-known outcome in cardiovascular research—however attention to underlying conceptual differences that may influence choices of whether to include subjective or objective measures is needed. Design: This work is a discussion paper: seminal research reporting the development, validation, and reliability testing of the NYHA classification system and the Duke Treadmill Score. Implications for nursing: Conceptually clarity and comprehensive appraisal of the reliability and validity of outcome measures in nursing research are essential to ensure high level of quality outcomes that will benefit patients.

关键词： Nursing Practice Function Measurement Cardiovascular Disease Framework

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Nociceptive and Neuropathic Pain Qualities in Men and Women with Acute Coronary Syndromes: A Complex Pain Presentation

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Open Journal of Nursing 2017年第3期7卷 331-344页

作者： Sheila O’Keefe-McCarthy michael mcgillion Charles J. Victor Sheila Rizza Judith McFetridge-Durdle Brock University St. Catharines Ontario Canada Heart and Stroke Foundation/michael G. De Groote Endowed Chair in Cardiovascular Nursing Research School of Nursing Faculty of Health Sciences Hamilton Ontario Canada University of Toronto Toronto Ontario Canada Nurse Practitioner Heart Failure Clinic Trillium Health Partners-Credit Valley Site Mississauga Ontario Canada Florida State University College of Nursing Tallahassee Florida US

Background: Cardiac pain arising from acute coronary syndrome (ACS) is a multi-factorial phenomenon. Historically, episodes of cardiac pain have been captured using a one-dimensional numeric pain rating scale. Lacking in clinical practice are acute pain assessments that employ a comprehensive evaluation of an emergent ACS episode. Aim: To examine the sensory-discriminative, motivational-affective and cognitive-evaluative dimensions of ACS-related pain. Methods: A descriptive-correlational, repeated-measure design was used to collect data on 121 ACS patients of their cardiac pain intensity. The (numeric rating scale-NRS 0-10 scale) measured chest pain “Now” and “Worst pain in the previous 2 hours over 8 hours” and the McGill Pain Questionnaire Short-Form (MPQ-SF) measured pain at 4 hours. Results: Mean age was 67.6 ± 13, 50% were male, 60% had unstable angina and 40% had Non-ST-elevation myocardial infarction. Cardiac pain intensity scores remained in the mild range from 1.1 ± 2.2 to 2.4 ± 2.7. MPQ-SF: 66% described pain as distressing and 26% reported pain was horrible or excruciating. Participants described ACS pain quality as acute injury (nociceptive pain: heavy, cramping, stabbing), as nerve damage (neuropathic: gnawing, hot-burning, shooting) and as a mixture of acute and chronic pain qualities (aching, tender and throbbing). Conclusions: Patients reported both nociceptive and neuropathic cardiac pain. It is unclear if pain perceptions are due to: i) pathophysiology of clot formation, ii) occurrence of a first or repeated ACS episode, or iii) complex co-morbidities. Pain arising from ACS requires an understanding of the interplay of ischemic, metabolic and neuropathophysiological mechanisms that contribute to complex cardiac pain experiences.

关键词： Acute Coronary Syndromes Nociceptive Pain Neuropathic Pain Pain Descriptors Emergency Department

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