BACKGROUND:The past 2 decades have witnessed a number of studies and reviews reporting on the development, implementation, and evaluation of nurse-based models of cardiovascular disease (CVD) prevention, which are contributing to the growing evidence base of their effectiveness. Teams comprising healthcare professionals with expertise in nursing, dietetics, physical activity, and behavioral skills have shown high levels of success in preventive efforts, particularly in high-risk and vulnerable populations. PURPOSE:The purpose of this article is to highlight the research and successful models of nurse-based care in clinical practice including the main outcomes, challenges, and dissemination of these models. Highlights include the role of nurses in CVD prevention and the lessons learned from implementation. CONCLUSIONS:Used appropriately, collaborative, team-based, nurse-led models have the potential to effect positive change in both primary and secondary prevention of CVDs. Technology also has an increasingly important role to play. Considerations regarding the effectiveness of contemporary nurse-based models include their design features and content, and methods of implementation and dissemination, with the aim of organizing and delivering flexible CVD preventive healthcare, including training and administrative oversight, which is responsive to contemporary patient need, choice, and preferences. CLINICAL IMPLICATIONS:The nurse's role in CVD prevention shows promise for enhancing both primary and secondary prevention of CVD worldwide. The research and dissemination of models shown to be effective in clinical practice will enhance the capability of individuals to ensure that appropriate methods are used to implement and extend these models in numerous settings from primary to tertiary care.

ABSTRACT Objectives: to determine the acceptability and feasibility of a health-related program planning educational intervention delivered to nursing faculty in Brazil, comparing preand post-learning knowledge. Methods: a feasibility study conducted at two Brazilian universities. Sixteen professors were recruited and underwent a multi-component intervention that addressed the content in two phases: ten pre-recorded sessions and readings; five live interactive online sessions. Knowledge and acceptability data were analyzed descriptively, and t-test analyzes were also calculated to determine the difference in knowledge and ability scores. Results: the findings indicate that participants considered the educational intervention both acceptable and feasible. However, they also expressed concerns regarding insufficient time to fully engage with the intervention due to work-related responsibilities, emphasizing the need for an extra question-and-answer session to enhance support for content practical application. Conclusions: our findings suggest the intervention is acceptable and feasible, and will support expanding assessment tests through a large-scale clinical trial.

Patient and public involvement (PPI) plays a pivotal role in enhancing the management and prevention of cardiovascular disease (CVD), at multiple levels. The partnership with patients and the public, those who are directly affected by CVD, is central to delivering personalized care, and may contribute to decreasing the burden of CVD and reducing health inequalities. This statement describes the concept of PPI and highlights the role of PPI across different settings including: clinical practice, research, regulatory processes, and policy and clinical guideline development. Recognition of the value of PPI and how to create environments and infrastructure to embed PPI into these areas requires further attention, specifically for under-represented communities. Therefore, considerations for good practice as well as future directions for improvement are provided. Whilst the content of this paper focusses on CVD, the insights provided can be applied to other conditions.

ABSTRACT:As people living with HIV (PLWH) experience greater longevity with antiretroviral therapy, they face increasing rates of chronic comorbidities, including cardiovascular disease (CVD). Nurses are well-positioned to lead prevention efforts, yet a comprehensive mapping of nonpharmacological strategies is limited. This scoping review, guided by the PRISMA-ScR framework, mapped interventions to reduce CVD risk among PLWH. Twenty-seven studies met inclusion criteria, most focusing on physical activity, dietary change, and cardiovascular education. Interventions were delivered in-person, home-based, or digitally, with nurses frequently central to implementation. Most studies demonstrated improvements in at least one outcome, such as blood pressure, lipid profiles, or activity levels, although theoretical frameworks were inconsistently applied. Barriers included participant retention, technology access, and resource limitations, particularly in underserved populations. Findings suggest nurse-led, behaviorally focused interventions are promising. Future research should emphasize theory-informed, community-engaged, and culturally responsive strategies that address structural determinants to strengthen cardiovascular outcomes among diverse PLWH populations.

AIMS:The primary aim of this systematic review was to identify nurse-led clinical interventions evaluated in randomized controlled trials (RCTs) for adults who had undergone cardiac surgery. The secondary aim was to assess the effectiveness of these interventions on post-operative clinical and patient-reported outcomes during the acute inpatient phase. METHODS AND RESULTS:A systematic review was undertaken according to an a priori protocol using Joanna Briggs Institute (JBI) methodology and PRISMA guideline for reporting. Eligible studies were RCTs of adult (≥18 years) cardiac surgery, nurse-led inpatient interventions implemented immediately post-surgery and prior to discharge. Six databases were searched from inception to June 2025. Of 2690 records, 19 RCTs were eligible, representing 13 countries, and 3142 participants. Risk of bias varied, with only two low-risk trials. Interventions were grouped into seven domains: behavioural support; temperature management and comfort strategies; pain and symptom management; wound care; infection prevention; respiratory and pulmonary function; and post-operative recovery, mobilization, and hydration. Across these domains, nurse-led interventions were generally feasible, safe, and positively affected patient comfort, physiological stability, symptom relief, and aspects of functional recovery. CONCLUSION:Nurse-led inpatient interventions contribute meaningfully to inpatient post-operative recovery in cardiac surgery, although the broader cardiac surgical nursing scope is underrepresented in RCTs. This review provides a foundation for developing further high-quality research, peer-reviewed interdisciplinary practice guidelines, and strengthening the scope and recognition of cardiac surgical nursing as a distinct specialty. REGISTRATION:PROSPERO-CRD420251063851.

A rapidly ageing population implies an increasing demand for informal caregivers. Caregiver-reported outcomes (CROs) can provide valuable insights into caregivers' experiences of their own health, the burden of tasks, and the need for support. This scientific statement provides a comprehensive overview of CROs in populations with cardiovascular diseases (CROsCVD). The existing CROs measure impact of caregiving; caregiver skills and preparedness; caregiver emotional and psychological impact; and caregiver support. The integration of CROs into clinical practice, alongside the development of more specific and culturally adaptive tools, will enhance the recognition of caregivers as key stakeholders in CVD management.

Background: Cardioprotective medications have been shown to be effective in reducing morbidity and mortality in patients with a history of myocardial infarction; however, the adherence rate is lower than expected. An adherence-based intervention was designed. Purpose: The purpose of the study is to describe the theory of "Action and Coping Plans for Medication Adherence Intervention (ADHERE)," a nursing intervention to promote adherence to cardioprotective medications. Methods: Theoretical and empirical approaches were combined with the clinical and research experience of a committee of experts to carry out the following stages: (a) in-depth understanding of the problem under study, (b) defining the objectives and identifying the theoretical framework of the intervention, and (c) operationalization of the intervention and identification of immediate, intermediate, and final outcomes. Results: The application of the stages resulted in the generation of the theory underpinning the ADHERE nursing intervention, which aims to promote adherence to cardioprotective medications in patients with a history of myocardial infarction and should be implemented by a nurse in a primary health care unit. The content of ADHERE is delivered through action and coping plans, developed by patients with the support of the nurse, verbally and in writing, in a meeting lasting 30 minutes and a reinforcement at a 30-day interval. Implications for Practice: The description of the theory of this intervention provides detailed information to researchers and health professionals about how the intervention contributes to changing behavior related to medication adherence and in what context; the theory can enhance the fidelity of its implementation in clinical practice.

CONNECT is a network of nursing and allied professional researchers that focuses on strengthening collaborative cardiac surgery research through shared initiatives. In the final instalment of this five-article series, the authors discuss the future innovations that CONNECT is planning for its members, centring on global research initiatives.

ABSTRACT Objective: To identify the prevalence and sociodemographic and clinical factors associated with anxiety and depressive symptoms in patients with heart failure at a cardiology outpatient clinic. Methods: A cross-sectional study was conducted at a cardiology outpatient clinic in João Pessoa, Paraíba, Brazil, involving 88 patients. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale. Association tests, Spearman’s correlation and Poisson regression were conducted. Results: The prevalence of anxiety symptoms was 67.1%, and the prevalence of depressive symptoms was 34.1%. Marital status, sex, and education level were significantly associated with anxiety symptoms. Conclusions: A high prevalence of anxiety and depression symptoms was identified. Health interventions are necessary to minimize the impact of psychological symptoms, as such measures are essential to improve adherence to therapy and the quality of life of patients with heart failure.

Frailty, affecting between 20–46% of people presenting for cardiac surgery, is associated with increased mortality, perioperative complications and poorer post-operative quality of life. Due to a previous lack of standardised definition and tool for assessment a stricter evaluation of the impact of frailty on cardiac surgery is considered a research priority. Recently the Clinical Frailty Scale (CFS) was identified as the first line assessment tool of choice in cardiac surgery pre-assessment (1) To evaluate the impact of frailty, assessed pre-operatively using CFS, on cardiac surgery outcomes using routinely available data from international centres represented within our international network. Centres for participation were sought through our international network. Appropriate governance approvals were obtained according to local procedures. Routine electronic data for pre-operative details, risk factor profile, operative details and outcome data, matched for definitions (or based on country-norms), were extracted for patients undergoing elective coronary artery bypass graft (CABG) surgery, valve surgery or combination between 8th January 2024 and 7th January 2025. Outcome measures include In-hospital mortality, post-operative complications (new neurological dysfunction, return to theatre, infection), intensive care and hospital length of stay and post-operative supported care. Data will be cleaned and analysed locally, and collated for reporting (adhering to RECORD statement) and comparison. Analysis, conducted in SPSS, will include descriptive statistics and outcomes by age, sex and frailty severity. Of 17 international healthcare organisations across eight countries represented within our international network in January 2024, 6 (35.3%) assessed frailty routinely in cardiac surgery patients. Of those, one (Ireland) did not use CFS and a further two centres did not collect data electronically (Canada, Sweden). Final analysis will include three centres (Australia, England and Scotland). Overall, >2000 patients will be included, with discharge cut-off for final patients 1-month post-surgery (6th February 2025), thus analysis is still to be undertaken. All data analysis will be completed for presentation at ACNAP2025. This contemporary prospective cross-sectional study highlights the lack of routine frailty assessment prior to cardiac surgery, and documentation in the electronic health record, internationally. Completed analysis exploring the impact of frailty (measured using the recently preferred tool, the CFS) on cardiac surgery outcomes, will provide important and novel evidence in the process of identifying and addressing frailty in patients undergoing cardiac surgery.

Many nurses and allied professionals (NAPs) lack the skills, knowledge and confidence to engage in conducting and implementing research. This statement describes the importance of NAPs' involvement in clinical research within the context of cardiovascular care. The existing gaps, barriers and enablers to NAPs involvement in research as a potential response to workforce issues in these professions as well as to contribute to excellence in patient care delivery and associated outcomes are identified. Specifically, career development pathways for NAPs are discussed. Finally, potential future directions for NAP research in clinical practice are provided.

To synthesise the best available empirical evidence about the effectiveness of multimodal analgesics on pain after adult cardiac surgery. A systematic review with meta-analysis. Indexed full-text papers or abstracts, in any language, of randomised controlled trials of adult patients undergoing cardiac surgery investigating multimodal postoperative analgesic regimen effect on mean level of patient-reported pain intensity at rest. Eight databases, via two platforms and three trial registries were searched from 1 January 1995 to 1 June 2024 returning 3823 citations. Of the 123 full-text papers assessed, 29 were eligible for inclusion. Data were independently extracted by a minimum of two reviewers in Covidence. There were 2195 participants, aged 60.4 ± 6.6 (range 40–79) years, who were primarily male ( n  = 1522, 76.1%), randomised in the included studies. Risk of bias was high and reporting quality was poor. Patient-reported pain was measured at rest in 28 (96.6%) trials. Data were suitable for pooled analysis from 10 (34.5%) of these trials with an average rest pain intensity of 3.3 (SD 1.5) in the control and 2.7 (SD 1.9) in the intervention groups, respectively. No trials compared combinations of nonopioid, opioid-agonist–antagonist, partial opioid agonists or full opioid agonists. Most trials ( n  = 11, 37.9%) compared two different full opioid options for less than 72 h ( n  = 24, 82.7%). Robust trials are needed to determine which multimodal analgesic combination will optimise patient recovery after adult cardiac surgery. There is an urgent need to test and refine high-quality end-point measures. Adequate assessment precedes ideal pain treatment. The findings from this review reveal neither are sufficient, and the impact of suboptimal pain management on postoperative recovery is grossly underinvestigated. The optimal combination of multimodal analgesics is unknown despite being recommended in best practice guidelines for enhanced recovery after cardiac surgery. Almost 30% of adults continue to experience ongoing pain up to a year after cardiac surgery, and findings from this review reveal a dearth of robust empirical evidence for optimal pain management, and heterogeneity in the way pain is assessed, measured and managed. This review provides a premise for robust trials focused on acute postoperative recovery in cardiac surgery and beyond. This review was conducted in accordance with the PRISMA-P statement. There was no patient or public contribution. PROSPERO: CRD42022355834

As part of the CONNECT series, Suzanne Fredericks and colleagues discuss the need for specialised cardiothoracic surgical training for nurses and allied health professionals, as well as the implications of this both across the UK and internationally.

Journal Article Corrected proof Why isn’t frailty being assessed on an ongoing basis within the cardiac setting? Get access Suzanne Fredericks Suzanne Fredericks Daphne Cockwell School of Nursing, Toronto Metropolitan University, 350 Victoria St., Toronto, ON M5B 2K3, Canada Corresponding author. Tel: +416 979 5000 ext. 557978, Email: sfrederi@torontomu.ca https://orcid.org/0000-0002-7462-636X Search for other works by this author on: Oxford Academic Google Scholar European Journal of Cardiovascular Nursing, zvad126, https://doi.org/10.1093/eurjcn/zvad126 Published: 06 January 2024 Article history Received: 27 November 2023 Accepted: 28 November 2023 Corrected and typeset: 06 January 2024 Published: 06 January 2024

Background: Approximately half of all women develop palpitations during pregnancy, with a quarter experiencing arrhythmias. While most presentations are benign, some cases can result in sudden cardiac death or serious symptom development. Considering such clinical presentation, healthcare providers must acquire knowledge in this area to provide comprehensive prenatal, perinatal, and postnatal care. However, no study could be located that focused on women’s life experiences of such complications during or in the post-pregnancy period. Objectives: The study aims to share the results of a study that explored the life experience of one woman who developed non-sustained ventricular tachycardia during her third pregnancy that lasted into the postpartum period. Methods: Using narrative inquiry self-study methodology, a woman’s experiences were explored to uncover the challenges she faced in coping with such complications during a period of transition for herself and her family. This methodology allowed for an in-depth understanding of how these complications could affect all aspects of her life. Results: Four narrative threads were produced: (1) diagnostic challenges and delayed recognition; (2) impact on maternal identity and family dynamics; (3) navigating healthcare systems and treatment decisions; and (4) long-term adaptation and resilience. Conclusions: The intention was to add to this topic area to ensure future researchers, current and future healthcare providers, and patients have literature they can refer to when studying, providing care for, or experiencing similar health complications. Acquiring this knowledge can aid healthcare professionals to ensure appropriate care is provided, risks are minimized, and their recovery is well supported.

The virtual research environment called the CardiOthoracic Nurses and Allied Professionals rEsearch Network (CONNECT) was created to support, mentor and train these professionals. This paper aims to describe the creation of a social media intervention using an intervention mapping theoretical approach. Intervention Mapping Theory (IMT) was used for the design of the CONNECT social media intervention. IMT is a systematic approach to intervention design and consists of six steps. In the first stage of the IMT, a limited number of evidence produced by nurses was identified. In the second step, the objectives of the CONNECT were determined: increasing brand awareness, increasing user familiarity, association and promoting various opportunities offered. In the third and fourth step, the intervention was developed based on theory and empirical evidence to create the content for the posts and to determine the type of platform and frequency of use. In the fifth step, a protocol was created to guide the adaptation, implementation and maintenance of the CONNECT. Finally, in the sixth step, the resulting intervention is evidence-based, delivered through technology, and personalized for the target population. The use of IM can facilitate the identification of barriers and facilitators of the implementation of the strategy in social media.

CONNECT is a network of nursing and allied professional researchers, focused on strengthening collaborative cardiac surgery research through shared initiatives. In the third instalment of this five-article series, the authors introduce a CONNECT masterclass programme, aiming to meet the clinical and research development needs of nurses and allied professionals working in cardiac surgery.

El global y creciente movimiento de internacionalización en las universidades ha motivado la idea de construir la Red de Conocimientos en Enfermería (RCE) como un trabajo colectivo e innovador. Este trabajo tiene por interés identificar las formas de conocimiento en Enfermería, teniendo en cuenta que cada vez más la colaboración internacional se ha convertido en un factor importante para la formación de una comunidad global y solidaria en el intercambio de conocimientos (Beaver, 2001; Gheno et al., 2020). La internacionalización de la ciencia y la tecnología se considera una condición necesaria para el desarrollo de la práctica científica, así como un medio para mejorar la calidad de la producción de conocimiento en la formación de recursos humanos, la circulación de la información y la proyección de los resultados de la investigación (Red Iberoamericana de Indicadores de Ciencia y Tecnología, 2007). Cabe señalar que el capital intelectual, que es el activo más preciado de las instituciones, exige esfuerzos institucionales y personales, así como tiempo para alcanzar la madurez. Este informe presenta una síntesis de los resultados de un análisis preliminar sobre el capital intelectual de las universidades, sus recursos técnicos, financieros y de infraestructura para la participación de ellas en el proceso de organización, estructuración y futura operatividad de la RCE. Cabe señalar que los recursos que figuran en este trabajo representan la perspectiva del respondiente del cuestionario. En este sentido, estas respuestas pueden que no representen una respuesta institucional oficial o de los recursos existentes, ni caracterizan el pensamiento colectivo de sus profesores e investigadores. Se enviaron 60 cartas de invitación, de las cuales 42 fueron aceptadas, lo que indica una tasa de participación del 70% en el sondeo realizado. Los cuestionarios, que se crearon en inglés, spañol, francés y portugués, fueron compartidos en línea. La información recopilada demuestra que existe un fuerte deseo y una necesidad continua de colaboración de investigación entre las comunidades científicas internacionales que puedan ayudar a superar las barreras lingüísticas y las limitaciones impuestas por las cuestiones financieras. Además, se consideraron necesarios las políticas, la promoción y el desarrollo, así como los avances en el diseño y la difusión de la investigación para fortalecer la investigación en Enfermería. A partir de esta información, podrán darse futuros intercambios de conocimiento, por medio de comunicación asincrónica, sin necesidad de la participación simultánea en el proceso de enseñanza-aprendizaje. Esto permitirá la colaboración entre miembros ubicados en países de bajos, medianos y altos ingresos. Esta información muestra la posibilidad de intercambiar conocimientos, aprender nuevas alternativas para técnicas colaborativas de resolución de problemas y producir muchas formas de conocimiento basadas en las realidades culturales y socioeconómicas locales.