Assessment of Effectiveness of Permanent Pacemaker Care Guidelines on Patient Activity and Adherence.

Abstract

Objectives:The objectives of present study was to evaluate the effectiveness of Pacemaker Care Guidelines on pacemaker care practices adherence and performance in activities of daily living in patients with permanent pacemaker implantation. Material and methods: A quasi experimental design was considered for the present study. Total 100 samples were taken (50 in each control and experimental group) from cardiology units of Advance Cardiac Centre, PGIMER, Chandigarh by total enumeration sampling. Pacemaker Care Guidelines were developed and taught to experimental group with routine care and only routine care was given to control group. Tools used were sociodemographic profile, personal profile, clinical profile, Barthel Index for ADL and pacemaker care practices adherence checklist. Interview schedule and observation method was used for assessment of outcome variables at pre pacemaker implantation, 1 st ,5 th , 10 th post implantation day and after 1month and 2 month of pacemaker implantation. Results: The present study revealed that 94% patients in experimental group exhibited good adherence with pacemaker care practices as in control group average adherence was seen in 90% patients with statistically significant difference (p value <0.01). whereas ,in term of performance of activities of daily living, the Barthel score was 19.80±0.40 (range 18-20) in experimental group and in control group the Mean Barthel score was 16.43±1.92 (range 11-18) at 2 month of post Pacemaker implantation was seen with statistically significant improvement in ADL in experimental group (p value <0.05) Conclusion: In the present study, Pacemaker Care Guidelines were found effective in term of increasing adherence with pacemaker care practices and increasing independence in activities of daily living. Therefore such nursing guidelines should be taught to patients to improve pacemaker care and reduce the pacemaker related complications due to non-adherence.