Subject(s)
Nursing Staff, Hospital , Nursing, Team , Nursing , Strikes, Employee , Humans , United States , WorkforceABSTRACT
OBJECTIVE: To determine the efficacy of a psychoeducational nursing intervention in patients who receive coronary artery bypass graft and valve repair surgery. DESIGN: A cluster-randomized controlled trial design. SETTING: Two hospitals in the western United States--a large community hospital with an active cardiovascular surgery practice and a health-sciences research center. SUBJECTS: 156 patients between 25 and 75 years of age, 125 (81.1%) men, and 31 (19.9%) women, all with primary care givers. OUTCOME MEASURES: Self-efficacy expectations, activities (behavior performance), quality of life, mood state. INTERVENTION: Supplemental in-hospital education followed by telephone contact from discharge to eighth week after discharge. RESULTS: Patients in the experimental group reported significantly greater self-efficacy expectations for walking and behavior performance for walking, lifting, climbing stairs, general exertion and, where applicable, for working. CONCLUSION: This trial suggests that a low-intensity psychoeducational nursing intervention can promote self-efficacy expectations for walking in recovery and is associated with more self-reported walking and lifting behavior after cardiac surgery.
Subject(s)
Cardiac Surgical Procedures/nursing , Patient Discharge/standards , Patient Education as Topic/standards , Perioperative Nursing/standards , Activities of Daily Living , Adult , Affect , Aged , Cardiac Surgical Procedures/psychology , Cardiac Surgical Procedures/rehabilitation , Clinical Nursing Research , Female , Humans , Male , Middle Aged , Patient Education as Topic/methods , Perioperative Nursing/methods , Quality of Life , Regression Analysis , Self Care , Treatment OutcomeABSTRACT
The contemporary patient undergoing CABG surgery has changed dramatically from patients undergoing the procedure a decade ago. Current patients are older and have more diffuse disease and left ventricular dysfunction. Many of the complications reflect the current characteristics of the CABG surgery patient. Despite these changes, patients can be expected to have good surgical outcomes. New indications for surgical treatment have many implications for a change in the approach to nursing management and nursing research.
Subject(s)
Coronary Artery Bypass/nursing , Coronary Disease/nursing , Coronary Disease/surgery , Aged , Coronary Artery Bypass/methods , HumansABSTRACT
Clinical investigation of the Novacor ventricular assist system has been ongoing since 1984. Major successes have been achieved using the device as a bridge to heart transplant. This system uses an electrically driven, pulsatile pump implanted in the left upper abdominal quadrant. The system has demonstrated the ability to provide long-term patient support, a feature that allows patients to become mobile and active once recovered from their initial heart failure. By the time of transplant, nutrition is restored, activity tolerance is improved, and most patients require no inotropic support. The system allows patients to recover from cardiogenic shock by providing total systemic circulatory support.
Subject(s)
Heart-Assist Devices , Nursing Care , Patient Care Planning , Adult , Equipment Design , Humans , Male , Nursing Diagnosis , Nursing ResearchSubject(s)
Cardiac Surgical Procedures/psychology , Consumer Behavior , Quality of Life , Activities of Daily Living , Adult , Aged , Cardiac Surgical Procedures/nursing , Cardiac Surgical Procedures/rehabilitation , Counseling , Female , Health Status , Humans , Male , Middle Aged , Patient Education as TopicABSTRACT
To enhance individual and family health during recovery from heart surgery, this study employed nursing interventions based on self-efficacy and family stress theory during the hospitalization period and for 3 months thereafter. The effectiveness of the interventions were assessed through a randomized trial in which 67 prospective bypass and valve surgery patients, aged 30-77 years, and their spouses, were allocated either the experimental interventions or usual care and followed for 6 months. At 3 months post-surgery, the only statistically significant differences between the experimentals and controls were on perceived self-efficacy for lifting and tolerating emotional distress. At 6 months no significant differences were found on individual or family measures. Analyses revealed that age, gender and preoperative cardiac status significantly affected individual recovery. The study is continuing with a larger sample in order to explicate the recovery process and to better determine whether a low intensity nursing intervention can effect changes in individual and family recovery.
