What constitutes the 'Minimal Care' interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology.

Silvia Brazzo, Massimo Piepoli, Raffaele Griffo, Sabrina Barro, Marinella Sommaruga, Roberto Pedretti, Antonio Mazza, Maria Luisa Masini, Barbara Maffezzoni, Manuela Iannucci, Pompilio Faggiano, Francesco Fattirolli, Silvana Borghi, Barbara Biffi, Marco Ambrosetti, Susanna Agostini, Daniele Temporelli, Antonia Pierobon, Marina Ferrari, Letizia da Vico, Elisabetta Angelino, Ornella Bettinardi

Journal: European journal of preventive cardiology 2019;25(17):1799-1810

PMID: 30066589

Abstract

BACKGROUND

In cardiovascular prevention and rehabilitation, care activities are carried out by different professionals in coordination, each with their own specific competence. This GICR-IACPR position paper has analysed the interventions performed by the nurse, physiotherapist, dietician and psychologist in order to identify what constitutes minimal care, and it lists the activities that are fundamental and indispensable for each team member to perform in clinical practice.

RESULTS

In analysing each type of intervention, the following dimensions were considered: the level of clinical care complexity, determined both by the disease and by environmental factors; the 'area' complexity, i.e. the specific level of competence required of the professional in each professional section; organisational factors, i.e. whether the care is performed in an inpatient or outpatient setting; duration of the rehabilitation intervention. The specific contents of minimal care have been identified for each professional area together with the specific goals, the assessment tools and the main essential interventions. For the assessments, only a few validated tools have been indicated, leaving the choice of which instrument to use to the individual professional based on experience and usual practice.

CONCLUSION

For the interventions, attention has been focused on conditions of major complexity requiring special care, taking into account the different care settings, the clinical conditions secondary to the disease event, and the distinct tasks of each area according to the operator's specific role. The final report performed by each professional has also been included.

Address: 1 Department of Experimental and Clinical Medicine, University of Florence, Italy.; 2 Psychiatric Emergency and Urgency Service, Department of Mental Health, Italy.; 3 Psychology Service, Istituti Clinici Scientifici Maugeri, Italy.; 4 Department of Health Professions, Azienda Ospedaliero Universitaria Careggi, Italy.; 5 Cardiovascular Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Italy.; 6 Cardiovascular Rehabilitation, Istituti Clinici Scientifici Maugeri, Italy.; 7 Dietology Service, Bassa Friulana-Isontina Hospital, Italy.; 8 Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Italy.; 9 Dietology and Clinical Nutrition Service, Don Carlo Gnocchi Foundation, Italy.; 10 Cardiovascular Department, MultiMedica Group, Italy.; 11 Dietology and Clinical Nutrition, Istituti Clinici Scientifici Maugeri, Italy.; 12 Cardiology Department, Spedali Civili, Italy.; 13 Cardiac Rehabilitation Unit, S Filippo Neri Hospital Salus Infirmorum, Italy.; 14 Cardiac Rehabilitation Unit, 'La Colletta' Hospital, Italy.; 15 Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Italy.; 16 Clinical Psychology and Social Support, Istituti Clinici Scientifici Maugeri, Italy.; 17 Cardiology Unit, Center for Heart Failure, Italy.; 18 Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR), Research and Educational Centre, Italy.; 19 Heart Failure Unit, Guglielmo da Saliceto Hospital, Italy.
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