GERRY O’DONNELL Chairman - PowerPoint Presentation

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GERRY O’DONNELL

ChairmanEvesham Vale Cardiac Rehab

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Coronary Heart Disease

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22 December 1988

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EVCR – Beginnings

29 January 1991 Easterbrook Hall, Dumfries

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Basingstoke & Alton CR

The Basingstoke & Alton Rehabilitation Unit opened in 1976 with just a few cardiac patients, utilising facilities in Alton Sports Centre.

A team led by local GP Dr Hugh

Bethell

and

physio

Sally Turner supervised and

monitored the performance

of patients on a course of

graduated exercise.

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Alton Cardiac Rehab – New Centre

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WHAT IS CARDIAC REHABILITATION ?

“ Cardiac rehabilitation is the process by which a person who is suffering from

ischaemic

heart disease or who has had a myocardial infarction (MI), is encouraged to achieve their full potential in terms of physical and psychological health.

“

For optimal effect, cardiac rehabilitation programmes are structured and tailored to the individual patient following an initial assessment.

All patients who have had an MI should

be offered a cardiac rehabilitation programme

which includes an exercise component.

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Cardiac Rehab benefits

Reduced morbidity Maintenance or increase in regular moderate physical exerciseImproved health and wellbeing Improved quality of lifeReduction in anxiety and depressionImproved functional capacity and physical activity statusReduced number of acute readmissions due to secondary cardiac events and unplanned proceduresIncreased service uptake and access at all stages of the service

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The main thrust of the latest guidance is that cardiac rehabilitation should be made more accessible

.

Despite its proven benefits, the uptake of cardiac rehabilitation services in the UK is currently poor.

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What do the Cardiac Rehabilitation programmes involve ?

Exercise

Health Education,

Advice on risk reduction,

Stress management and Psychological support

This process is divided into Phase 3 and Phase 4 Classes, progressing from the latter to the former.

All are carried out in a supportive environment with people who are in similar circumstances.

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Exercise

Phase 3 programme offers an Individual exercise programme, which is agreed between the patient and cardiac nurse. The intensity of the exercise is gradually increased according to how the patient feels during the exercise, but is not set at a level which is a deterrent. As Cardio vascular fitness increases, the patient is moved on to Phase 4 programme where the process is similar, but more challenging.

All exercise is supervised by a qualified fitness instructor.

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EDUCATION

WHAT WILL YOU LEARN AT EVCR ?What causes a heart attackRisk factors to avoidTreatment options for CHD to avoid reoccurrenceHow to identify warning signs and seek helpHow to maintain a healthy heart & Healthy eatingThe importance of medications and their purposeExercises to strengthen your cardiovascular systemPathways to wellbeing

How to deal with Anxiety, Stress, and Panic attacks

How to

fulfill

your potential – Lifestyle changes

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EVCR ESTABLISHED

AS A CHARITY IN JANUARY 2009

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THE NEW EXTENSION

The success of EVCR meant it had outgrown its present facility in Evesham Leisure Centre. It Needed:Larger and more flexible accommodationImproved patient education and management facilities

To respond to a growing demand for prevention strategies

To raise awareness of the benefits of a community based facility

A base dedicated to cardiac rehabilitation and prevention activities

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NEW EXTENSION

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Cost of CVD

CVD’s cost to the UK economy (including premature death and disability) is estimated to be over £18 billion each year. Healthcare costs relating to CVD are estimated at up to £12 billion each year.

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“Regular

physical activity can reduce the risk of developing a new chronic condition, reduce the risk of progression of a condition already present, and improve quality of life and physical function”

Public Health England - Physical Activity

Prevention

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7

Prevention

Prevention

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PREVENTION

- Local PictureIn Wychavon District (where The Vale of Evsham lies) 17.6% of the population have a long term health issue or disability, and

30.1%

of adults are inactive.

Obesity levels are at

65.5%,

and rising.

60 Deaths a year could be prevented if 75% of population (aged 40-79) engaged in recommended levels of physical activity.

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HEALTH DETERMINANTS

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LIFESTYLE RISK FACTORS

Over a quarter (27 per cent) of adults in the UK are obese and in addition more than a third are overweight (by BMI). It’s estimated that nearly 30 per cent of children in the UK are overweight or obese. Nearly two out of five adults in the UK do not achieve recommended levels of physical activity.

Only a quarter of UK adults and one in five children consume the recommended minimum five portions of fruit and vegetables per day.

Over a quarter (27 per cent) of adults in the UK are obese and in addition more than a third are overweight (by BMI).

• It’s estimated that nearly 30 per cent of children in the UK are overweight or obese.

• Nearly two out of five adults in the UK do not achieve recommended levels of physical activity.

•

Only a quarter of UK adults and one in five children consume the recommended minimum five portions of fruit and vegetables per day.

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HEALTHY HEARTS PROGRAMME

GP Referral ProgrammePatients who

ARE AT RISK

of heart attack, Diabetes, Overweight, etc.

Referred by GP or health professional

12 week exercise programme

Tailored to identified need

Progress monitored at regular intervals

Patient can see progress……motivates

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Anxiety & Depression After a Heart Attack

Cardiac rehabilitation

(CR)

is widely seen as a vehicle for

psychological

i

ntervention

for

cardiac

patients

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PSYCHOLOGICAL EFFECTS

Survivors of cardiac arrest show high rates of

mental

conditions,

with:

40% +

suffering from

anxiety

,

30%

from

depression,

and

25%

from post-traumatic stress disorder

(PTSD)

30% - 50%

of survivors of

cardiac arrest

suffer from

cognitive deficits

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Post Cardiac Trauma - Signs and Symptoms

1. Shock, Denial or Disbelief

2. Aggression

3. Issues Sleeping

4. Anxiety

5. Dissociation

6. Physical Concerns

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People who get depressive symptoms are actually more likely to have recurrent cardiac problems

“Some people don’t really want to think about the problem, they think it’s better to shut it out of their minds

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Existing studies suggest people with cardiac conditions are three times more likely to suffer from depression and/or anxiety than the general population

.

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Support is There

Just being with other people helps enormously

Being together, supporting each

other, is crucial

You need to be there for that person when and if they want to talk, ..but some people do find it hard if their relatives are ‘over-solicitous’

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AFTER CARDIAC REHAB

Depression reduced from 28.3% to 10.8%

Anxiety

decreased from 31.7% to 9.1%

Panic

symptoms reduced from 16.7% to 5.8% and

Difficulty in Adapting

decreased from 30.0% to 10.9%

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EVCR - 10 YEARS

Why ‘Community Based’ Cardiac Rehab ?Removes from hospital environmentInvolves the CommunityClose links with Health providersSocial opportunities – positive psychological benefitsIN PAST TEN YEARS EVCR HAVE HAD 30K – 35K PARTICIPATIONS

IN ALL THEIR CLASSES

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CARDIAC REHAB

AND WELLBEING

“

Maintaining positive thoughts and feelings through intervention programs can help patients achieve better overall outcomes when it comes to their cardiovascular health.”

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A

life course approach"Those who think they have

no

time

for

bodily

exercise

will

sooner

or

later have

to

find

time

for

illness."

Edward

Stanley

(1826-1893)

7

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THANK YOU ?

ANY QUESTIONS ?