Postoperative problems experienced by patients undergoing coronary artery bypass graft surgery and their self-care ability after discharge

Abstract

Postoperative problems experienced by patients undergoing coronary artery bypass graft surgery and their self-care ability after dischargeKoroner arter baypas greft cerrahisi yapılan hastaların taburcu edildikten sonra yaşadıkları sorunlar ve öz bakım yetileri Background:In this research, we aimed to assess the postoperative problems experienced by patients who underwent coronary artery bypass graft (CABG) surgery and their self-care ability after discharge.Methods: A total of 53 patients who underwent CABG surgery in the Cardiology Department of a state hospital affiliated with the Turkish Republic of Northern Cyprus Ministry of Health between September 2010 and February 2011 were included in this descriptive and crosssectional study. The data was collected using the "Personal Information" form, the "Problems Experienced by Patients after Discharge" form, and the Turkish version of the Exercise of Self-Care Agency (ESCA) Scale. Statistical analysis was performed using the SPSS version 15.0 software program. The Kruskal-Wallis and Mann-Whitney U tests were used to compare the frequency and distribution statistics. Results: Male participants made up 71.7% (n=38) of the study group while 43.4% (n=23) of the subects were primary school graduates, 83% (n=44) were married, 75.5% (n=40) were overweight, 45.3% (n=24) had undergone triple bypass surgery, and 84.9% (n=45) were connected to a heart-lung machine. After discharge, the patients reported fatigue, dyspnea, pain at the wound site, weakness, sleeplessness, loss of appetite, fear, pessimism, edema in the legs, wound dehiscence, palpitation, and constipation. When patients were asked how they handled these problems, 81.1% (n=43) stated that they simply waited until they were over, 71.7% (n=38) slept sitting up, 66% (n=35) took medication, and 15.1% (n=8) did breathing exercises. The mean selfcare ability score of the patients was 108.5±17, indicating that the patients had a moderate level of self-care ability. It was also found that these problems decreased over time. No statistically significant difference was found between the self-care ability scores and the problems experienced by the patients (p>0.05). Conclusion: It was found that all patients experienced at least one problem after discharge. Discharge education programs with an interdisciplinary perspective, and consultancy services in conjunction with home care and follow-up should be implemented with an improvement in quality so as to reduce and eliminate the problems faced by the patients.

Predictors of Health-Promoting Behaviors in Coronary Artery Bypass Surgery Patients: An Application of Pender’s Health Promotion Model

“…More than 30% of the patients had self-care abilities, as indicated in previous reports (6). The sample size was calculated using the following formula (Equation 1):…”

“…Even though CABG has improved in terms of its success rate, patients still have to deal with a number of physical, psychological, and social problems in the period following discharge from hospital (5). The side effects reported by patients after CABG include a variety of problems such as postoperative pain, insomnia, changes in appetite or taste, chest pain, respiratory difficulties, arrhythmia, palpitations, numbness of the arms, abdominal distention, weight loss, anxiety related to the treatment and their ability to adhere to the recommended physical activity schedule, weakness, headache, vertigo, depression, nausea, and vomiting (6). Patients undergoing cardiac surgery must be well-informed of the potential problems, activity enhancements, nutrition, and medication beforehand since the success of the surgery is highly dependent on the patients’ understanding of the disease and the required activities, including the diet and medical regimen, required after surgery (7).…”

“…Research on self-care behaviors among patients with cardiovascular diseases indicates poor self care in these patients, which therefore necessitates and emphasizes the need for further training in this regard (6, 9, 12). Many patients do not really believe in the positive effects of self-care behaviors on symptomatic relief and lifestyle improvement.…”

Discharge training and counseling: Functional autonomy and post-discharge problems of elderly patients undergoing coronary artery bypass graft surgery

“…Various studies have found that chest and leg pain, edema in the leg incision, numbness in the arms, dyspnea, arrhythmia, constipation, nausea, vomiting, loss of appetite, weight loss, sleep disorders, fatigue, weakness, dizziness, anxiety, and depression are common complications that occur after CABG surgery, and these cause difficulty in activities of daily living (ADLs) in older adults by restricting their functional independence. [1,2,[7][8][9][10][11][12] Comprehensive nursing care, discharge training, and counseling after discharge are crucial components which can decrease the postoperative problems of older adults and increase their functional independence. Discharge training and counseling can also decrease the length of hospital stays, reduce the number of postoperative complications, lower healthcare expenses, limit the chances for rehospitalization/ admission after discharge, and increase functional independence levels and the patients' quality of life (QoL).…”

Assessing the Impact of Family-Centered Empowerment Model on Self-Care of Patients With Prosthetic Heart Valves

“…Despite great advances in treatment of cardiovascular diseases, patients are still experiencing several physical, mental and social problems after surgery (9). Overall, 7461 cases of heart valve replacement procedures were performed in Brazil in 2012 with 8% mortality rate; this is while mortality rate was 4.6% in most of the analysis of other studies (10).…”