Undertaking Nursing Interventions Throughout Europe: Research Activities of the Working Group on Cardiovascular Nursing of the European Society of Cardiology

1 Introduction

In recent years the nursing profession has increasingly realized that, in order to make a significant impact upon the care and management of our patients, we need to better coordinate our research efforts on an international, rather than national scale. This is problematic, of course, when both the funds to undertake international studies and our experience in such matters are severely limited.

This paper describes the efforts of a new, truly international research group (the Undertaking of Nursing Interventions Throughout Europe—otherwise known as the UNITE research group), formed within The Working Group on Cardiovascular Nursing (WGCN) of the European Society of Cardiology. The goal is to organize nursing research on an international basis throughout Europe.

2 Who and what is UNITE?

UNITE is a collaborative research group that was established via the part of the WGCN. This Working group is one of the 27 Working Groups that contribute significantly to the activities of the European Society of Cardiology.

During the regular meetings of the WGCN it became increasingly obvious that many members of the group were interested in, and indeed undertaking projects related to inter-disciplinary management programs for individuals suffering from a chronic cardiac illness. With the increasing flow of information and some examples of collaboration, it became clear to the group that a joint research project was both feasible and desirable.

In the year 2000, the ESC provided the stimulus and support for the WGCN to bring researchers together to discuss policy to improve European collaboration in research. This proved the catalyst for the formation of the UNITE research group. As such, a group of cardiovascular nursing researchers from a number of different European countries officially met in Stockholm, Sweden in May 2000. Given the chance to meet and formally discuss ideas for collaboration, it was relatively easy for those who attended this meeting to create and commit to a research group that is designed to promulgate international research in the field of cardiac nursing.

3 Purpose and aims of the UNITE research group

By including representatives from a number of European countries, the group is principally designed to be a good example of how nursing research can be undertaken on a truly international scale. It is hoped that, if successful, it will act as a model for future groups. On a more basic level, however, the principle aim of the group is to successfully undertake collaborative research studies that have a significant impact on the care of cardiac patients. The major focus of the UNITE investigators is those patients who have poor quality of life and poor symptom control despite maximal, gold-standard, medical therapy. By undertaking studies on an international scale, it is hoped that the standard and principles underpinning the nursing care of cardiac patients can improve and become more consistent in all countries involved. At present there are representatives from Sweden, The Netherlands, Belgium, Finland, Switzerland and the UK. There is also an active representative from Australia.

In committing themselves to the UNITE group, representatives from the different countries are committed to three important things. Firstly, to work collaboratively and undertake the research studies as agreed upon by the group. Secondly, to obtain funding (at a domestic level) to undertake the research studies within their country. Finally, in undertaking the various research studies, to encourage interest and research expertise development among cardiac nurses by offering the opportunity to participate in the studies (e.g. offering a research scholarship and/or the opportunity to undertake a higher degree related to the study).

In return for this commitment, by pooling the research expertise and experiences within the group, UNITE offers a reciprocal commitment to support the efforts of the researchers in whatever way it can (e.g. assistance in obtaining research grants and local ethics approval).

4 The first research project

UNITE's first collaborative research project generated a short report on the prevalence of the major coronary heart disease risk factors in a cohort of cardiac nurses from a range of European countries attending the WGCN's Spring Scientific Meeting in 2001. Entitled ‘A survey of coronary risk factors in a cohort of cardiac nurses from Europe: Do nurses practice what they preach?’ the study collected data on coronary heart disease risk factors in a sample 130 cardiac nurses from 11 countries. [1] Demographic data, lipid profile, blood pressure and exercise, alcohol and smoking habits were all recorded at a health-screening interview. The mean (S.D.) age of the nurses was 40 (7.5) years and 91% were female. The means of the risk factors were: systolic blood pressure 132 (16) mmHg, diastolic blood pressure 83 (11) mmHg, body mass index (BMI) 24.6 (3.8) kg/m², total cholesterol 5.1 (0.9) mmol/l, and blood glucose 5.5 (1.2) mmol/l. A total of 10 (8%) nurses admitted to smoking and the mean weekly alcohol consumption was 10 units. Over half (53%) of the sample reported a family history of CHD and 49% reported exercising regularly. We concluded that in general, cardiac nurses have adopted a healthier lifestyle than the general population. Self-reported exercise was higher than the UK national norms and BMI was lower than UK national norms [2]

5 Current research projects

Having already published one study, the UNITE investigators are keen to demonstrate the true potential of international collaboration. Focussed on the evaluation of a nursing intervention for patients with chronic chest pain, the group is currently undertaking the CAMPAIN (Collaborative Angina Management Project to Advance International Nursing) Study. As the title suggests, CAMPAIN is an international, randomized controlled study examining whether a nurse-led intervention can optimize the management and therefore improve the quality of life of patients with chronic intractable angina. As there will be at least four countries involved with the application of a common research protocol, a pooled patient cohort and central analysis of study outcomes, much planning is required. Currently, the group is actively seeking insights into the prevalence and magnitude of problems associated with intractable angina at the participating sites. Funding to start the study was provided by the ESC. Certainly, the group does not intend to wait for the CAMPAIN Study to reach the stage of reporting for other studies to be generated. Plans to generate more truly international studies, with even greater participation levels are already underway. Other projects entitled as follows are in the planning process:

Advanced care for patients with Grown up Congenital Heart disease: State of the art in Europe.

6 Conclusion

The UNITE research group represents an exciting (and hopefully productive) initiative of the WGCN. It is hoped that this group will generate a significant and sustained program of research that will benefit both the cardiovascular nursing profession and, most importantly, patients with cardiac disease.