Master of Science. Cardiovascular Rehabilitation

Transcription

1 Department f Clinical Sciences Master f Science in Cardivascular Rehabilitatin Full-Time and Part-Time Taught Mdular Masters Prgramme Mdule Descriptr Outlines

2 MSc Cardivascular Rehabilitatin -Shrt mdule descriptrs XN7401. Cardivascular Diseases, Risk Factrs, Investigatins and Treatments (cmpulsry) The aim f this mdule is t equip the student with a clinically-based understanding f relevant cardivascular disrders, the risk factrs and an analysis f these disrders, and the investigative techniques and therapeutic strategies used t manage such risk. The prcess f rehabilitatin in keeping with BACPR Cre Cmpnents (bimedical bi-psychscial/patient centred appraches, sci-cultural influences n success) The pathway f rehabilitatin (ratinale, cntent, benefits & drawbacks) Epidemilgical influences and risk factrs f cardivascular disease Pathphysilgical influences and prcesses f cardivascular disease Links between risk factrs and develpment and prgressin f athersclersis (crnary, peripheral and their similarities and differences) Prcedures fr diagnsing disease Diagnsis decisin making (pearls and pitfalls) Treatment selectin chices Medicatins taking fr CVD Metablic syndrmes and endcrinlgy related t diabetes, besity, hypertensin and ethnicity The strength and weaknesses f the evidence in Cardivascular Rehabilitatin Bimedical versus rehabilitative/behaviural, quality f life issues beynd the statistics f mrbidity and mrtality XN7402. Cardivascular Anatmy & Exercise Physilgy (cmpulsry) The aims f this mdule are t equip the student with advanced knwledge f the anatmy and physilgy that is central t the spectrum f cardivascular and related diseases; and t understand hw the bdy respnds physilgically under-exertin cmpared t rest Review f general mechanisms and structures f the cardivascular system that cntrl circulatin The integratin f the CV system s histlgical, electrphysilgical, neur-humral cntrlling factrs Mechanical, electr-physilgical-neur-humral factrs specifically cntrlling the cardiac cycle Cardiac metablism and similarities and differences with skeletal muscle Functin related t mycardial and valvular disease and arrhythmia Changes in heart rate, strke-vlume, ejectin fractin bld pressure, MVO2 (ratepressure prduct) during exercise; Effects f psture n cardivascular functin during exertin; Cnsideratin f electr-physilgical, circulatry factrs, similarities and differences between the nset f acute exertin and cessatin after prlnged (> 10 mins) exertin; Circulatry, arterial-histlgical, cardiac (electrical-mechanical) adaptatins with chrnic exercise training; Fick Principle - central v peripheral adaptatins in individuals with cardiac disease; Evidence-base and ratinale fr the reductin in mrbidity and mrtality risk assciated with regular exercise and increased aerbic fitness

3 XN7403. Clinical Exercise Testing & Prescriptin The aims f this mdule are t analyse critically the physilgical evidence base fr exercise prescriptin; t develp a cmprehensive understanding f clinical exercise testing prcedures and critical evaluatin f results; and t translate test results int effective and evidence-based exercise prescriptin in a variety f settings. The cntent includes: - The rle f exercise in health and the preventin f cardivascular disease; - Pre-exercise health screening and risk stratificatin - Overview f types f exercise testing prcedures including, lab based assessments (cardi-pulmnary exercise testing) and field-based functinal capacity submaximal testing - Integrated analysis f exercise ECG and respiratry respnses; alluding t risk stratificatin and exercise prescriptin - Designing exercise prgrammes and guiding physical activity frm test results fr safety and effectiveness - Effective use f heart rate and RPE in clinical settings - Similarities and differences f prgrammes fr individuals with MI, CABG, PCI, CHF XN7404. Nutritin and Cardivascular Health The mdule has the fllwing aims: T cnslidate the knwledge and understanding that implicate the rle f diet and nutritin in the aetilgy f cardivascular disease T cnsider the evidence, and relative risk f diet expsure and lifestyle in the develpment f cardivascular disease T examine the ppulatin nutrient intake gals and plicy in chrnic disease: preventin, primary and secndary interventin T explre the relative strengths f interventin mdes (eg. pharmaclgical) against reducing dietary expsure (eg. fat). The mdule is delivered using an evidence-based, cncept-driven apprach Diet, nutritin and chrnic disease in cntext Dietary agents implicated in develpment f cardivascular disease Metablism f dietary agents implicated in increased cardivascular risk The histrical, anecdtal, evidence and nature f the assciatin between dietary behaviur, lifestyle and cardivascular disease develpment; Ppulatin fd and nutrient intake gals designed t reduce cardivascular risk and imprve cardivascular health; Natural histry f, and ptential influences n, cardivascular disease thrughut the life curse; Scientific basis upn which dietary guidelines rest; Dietary adherence, risk, mtivatin and cmpliance. XN7405. Cardivascular Psychlgy: Psychlgical Cnsideratins in Primary Preventin and Rehabilitatin The mdule seeks t prvide the student with an understanding f the psychlgical factrs that cntribute t successful rehabilitatin f the cardivascular patient. It includes elements f bth mental health and health educatin and behaviur.

4 Mdifiable risk factrs fr cardivascular disease: Cmparisns between psychscial risk factrs and traditinal risk variables. Is there a crnary prne persnality? An examinatin f the stress diasthesis apprach. A descriptin and critical analysis f the Type A Crnary Prne Behaviur Prfile. Putting persnality back int cardivascular disease - The Type D prfile. Negative affective states and their rle in primary and secndary cardivascular episdes. An examinatin f the imprtance f hstility, anxiety and depressin in cardivascular patients. Scales t measure affective states. Patients' perceptins f illness. Patients' attributins cncerning cardivascular disease and hw these impact n rehabilitatin. Descriptins f the Transtheretical Mdel dealing with 'readiness t change' and Leventhal s mdel f patient perceptin f illness f disease, including time curse and cure. Scial supprt in cardivascular disease. The rle f the spuse. Different mechanisms thrugh which scial supprt perates. Psychlgical issues in cardivascular surgery. Anxiety and depressin as predictrs f utcme fllwing stent r bypass surgery. Psychlgical preparatin f the patient prir t surgery. Neurpsychlgical assciated with cardipulmnary bypass. The extent f neurlgical and neurpsychlgical deficit (NPD) fllwing CABG surgery The cre battery f neurpsychlgical tests fr assessment f NPD fllwing CABG surgery. Assessment f Health Related Quality f Life (HRQL). Generic and disease specific questinnaire measures f HRQL, including psychscial and emtinal utcmes. The relatinship between HRQL utcmes and NPD fllwing CABG surgery Causal pathways fr psychlgical variables. Is the impact f md status in cardivascular disease mediated thrugh pathgenic behaviurs r thrugh direct physilgical prcesses? Explratin f changes in autnmic reactivity t stress and endthelial variables assciated with affective states. Psychlgical interventins in the clinic: An examinatin f the rle and effectiveness f psychlgical interventin in cardivascular rehabilitatin. Health behaviur change in supprting patients t manage and adhere t the cre cmpnents f a cardivascular disease preventin and rehabilitatin prgramme The rle f educatin in supprting health behaviur change and imprving health related quality f life and managing r imprving cardivascular health.

5 XN7408. Public Health Plicy, Prgramme Planning and Management The mdule aims t prvide the student with: Knwledge and a systematic understanding f public health plicy with respect t cardivascular disease and the ptins fr implementatin at all levels; The ability t make sund judgements in the planning and management f cardivascular rehabilitatin resurces. Curse cntent includes: Current cardivascular plicy initiatives in the UK, third cuntries and internatinally Develpment f values, standards, guidelines and agreed practices Practical cnsideratins fr plicy implementatin in a range f settings (natinal thrugh t lcal) Planning fr and management f cardivascular rehabilitatin resurces in keeping with natinal standards, guidelines related the interactin between health care cmmissiners, managers and clinical practitiners The student will develp an understanding f: The philsphies and cncepts f caring fr the cardivascular patient in a rehabilitatin setting - review definitins, idelgies and mdels; evaluate critically ptins fr plicy develpment, prgramme planning and management, (nt nly fr cardivascular patients in general but als fr particular grups with special rehabilitatin requirements); Natinal and lcal debates leading t public health plicy fr the primary and secndary preventin f cardivascular disease; The implementatin f relevant plicies within the cntext f specific cardivascular rehabilitatin settings and prfessinal practice XN7409. Research Methds and Data Analysis The mdule aims t expse students t the essential elements in the prcess f cnducting sund scientific research; and t develp students skills in the key aspects f data handling and statistical analysis in preparatin fr the planning and cmpletin f the Research Prject. The building blcks f scientific research: types f research (analytical, descriptive, experimental, and qualitative), scientific parlance (hypthesis, cncepts, peratinal definitins, and dependent/independent variables), sampling prcedures, and measurement issues (reliability and validity); Research and data cllectin methds: experimental research (develping hyptheses, independent/dependent variables, cntrls, sample selectin, study designs, and experimental validity); Descriptive research (questinnaires and interviews, case studies); qualitative research (characteristics, prcedures, methds f data cllectin, data analysis, and internal/external validity); Typical research f relevance t the discipline; The nature f research; scientific methds f enquiry, pure versus applied ways f prblem slving. Develping the research prblem; identifying a tpic area, devising specific questins, discvering what is already knwn (reviewing the literature), determining feasible ways t answer the questins; Ethics in research. Intrductin t data analysis sftware (SPSS fr Windws); Establishing an SPSS database; Defining and transfrming variables; data strage and retrieval;

6 Data analysis fr descriptive and experimental research; descriptive statistics; Describing data; measures f variability, crrelatin and multiple crrelatin, scatter plts and predictin analysis (regressin); Inferential statistics; Selecting an apprpriate statistical test (parametric r nn-parametric), and types f statistical tests (chi-square; t-tests; ne-way ANOVA & pst-hc tests; Wilcxn, Mann-Whitney U). Wrked examples in SPSS; Additinal statistics; Repeated Measures ANOVA & Intraclass crrelatin; Factrial ANOVA. Limits f agreement analysis fr methd cmparisn and test retest reliability; Wrked examples in SPSS. XN7414. Physical Activity & Exercise Prgramming in the Management f Cardivascular Disease A fur-day mdule delivered in partnership with the British Assciatin fr Cardivascular Preventin and Rehabilitatin (BACPR). Students will receive all the curse materials and learning pprtunities ffered by the BACPR n their Part 1 and Part 2 curse in Exercise and Physical Activity in Cardivascular Disease. The mdule reflects bth the traditinal appraches t the exercise cmpnent f cardiac rehabilitatin and the ever emerging needs f mre specialist client grups. It aims t cmpliment Mdule XN7403, by taking theretical cncepts and further applying them in real and practical scenaris. The Cre Cntent will include: - The evidence and cmpnents f Cardiac Rehabilitatin and the rle f Physical Activity within this cntext. - Applied principles f cardivascular anatmy and physilgy as they relate t the respnses and adaptatins t exertin, physical activity and exercise training. - Muscle structure and functin and mvement analysis related t typical cardiac rehabilitatin exercises. - Thery and practice f safe and effective warm-up (and cl dwn). - Thery and practice f the cnditining cmpnent t exercise prgramming. - Risk stratificatin and challenges t special cases f risk stratificatin. - Thery and practice f mnitring exercise intensity thrugh heart rate and RPE. - Special cnsideratins t managing and adapting activity t typical different levels f risk stratificatin and c-mrbidities. - Evaluating the rle f exercise testing in relatin t diagnsis, prgnsis, exercise prescriptin/adaptatin and utcme measures - Outcme measures related t physical activity, exercise and fitness - Envirnmental effects n activity. - Exercise in Heart Failure, Arrhythmia, Heart Transplants and ventricular assist devices - Clinical case study wrkshps and clinical decisin making fr difficult cases XN7415 Research Prject Pre- requisites: Successful cmpletin f all taught/cmpulsry mdules; preparatin f an apprved research prpsal, ethical apprval Ratinale & Cntent Fllwing cmpletin f six taught mdules, MSc students are required t undertake a prgramme f persnal research n a tpic f relevance t exercise and nutritin science. Prjects may be labratry-based in the university r wrkplace-based and may utilise a range f methdlgical appraches and traditins; whilst sme prjects will be experimental thers

7 will adpt mre qualitative methds. It is envisaged that many f thse students wh are in emplyment will undertake prjects in cllabratin with their emplyer. Thrughut the research stage f their studies all students are under the guidance and directin f the Research C-rdinatr and an individually allcated supervisr. It is a respnsibility f the Research C-rdinatr t maintain an verview f all students at the research stage t ensure that research prjects are cnsistent with the aims and bjectives f the prgramme. The mdule will cnsist f the submissin f a prject reprt and literature review. XN7412. Advanced Exercise Practice in Cardivascular Rehabilitatin This mdule is nly available t thse with dcumented evidence f at least 100 hurs f experience and present emplyment in a health and rehabilitatin service that invlves wrking with patients, frm which a case-study can be chsen. Nrmal requirements fr entry nt Clinical Sciences MSc Prgrammes plus, ne f the fllwing: (a) BACR Phase IV Exercise Instructr Qualificatin, (b) Cmplete attendance f bth the BACR Intrductin t Exercise fr Health Care Prfessinals Curse and the ACPICR Curse Exercise Prescriptin: New Insights and the Management f the Cmplex Patient, r (c) Evidence f ther qualificatins and experience that are deemed equivalent t ne f the abve. Other prfessinal develpment curses may be cnsidered and added t the abve list in the future. This mdule aims t analyse critically the psych-scial and physilgical evidence base fr exercise testing, prescriptin and patient prgramme design using a single case-study apprach; and demnstrate that exercise testing and prescriptin knwledge, skills and cmpetencies are at an advanced practice level which is supprted by an equivalent level f pst-graduate learning Students will chse an apprpriate case-study: a patient fr whm the student has been respnsible in the psitin f exercise rehabilitatin r secndary preventin and prduce a 5000 wrd evidenced-based and critically appraised reprt. The student will als need t prvide a summarised lg, signed by an apprpriate clinician, that cnfirms the student has bserved the clinical investigatins and treatments related t the chsen patient's/client's inpatient and early utpatient phases f cardiac rehabilitatin (e.g. visits t crnary care, angigraphy, percutaneus interventins, cardi-thracic r vascular surgery, clinical exercise testing and chest-pain clinics). Wrkshps t supprt Writing an evidence based critically appraised case-study reprt Review f evidence searching and infrmatin technlgy Review f lab-based exercise techniques that under-pin the scientific ratinale f practice based functinal assessments Specific case-study infrmatin Patient histry that is directly related t the acute r chrnic cardivascular event frm which an exercise-based rehabilitatin prgramme will be develped Assessments, invesitgatins and treatments Risk stratificatin Applied health psychlgy and exercise physilgy priniciples that under-pin a safe and effective exercise rehabilitatin plan that lead t the patient pursuing a physically active lifestyle and/r participatin in lng-term structured exercise prgrammes