Health Patterns of Cardiac Surgery Clients Using Home Health Care Nursing Services (original) (raw)
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Egyptian Journal of Health Care
Background: Serious problems can occur after cardiac surgery, so mothers need more comprehensive home care educational programs to help them recognize complications and care for their children following hospital discharge. The Aim of the study was to evaluate the effect of a guiding program for mothers on enhancing home care and the health outcomes of their children after cardiac surgery. A quasi-experimental design was used to conduct the present study at the
European Journal of Cardiovascular Nursing, 2011
Background: Knowledge is lacking on what predicts psychological distress in cardiac surgery patients. Aim: To describe the post-operative symptoms of anxiety and depression in cardiac surgery patients; to detect associations between those symptoms and patient's experiences of illness and hospitalisation and also their family and social situations; and identify experiences and situations that predict symptoms of anxiety and depression at home when measured at least four weeks after hospital discharge. Method: In this prospective explorative panel study all eligible cardiac surgery patients over a six month period in 2007 were invited to participate. Data was collected at the hospital and at home. Two questionnaires were developed and included the Hospital Anxiety and Depression Scale (HADS), questions on family and social issues, patient's experience of illness, hospitalisation and family and social situations. Results: Of the 66 participants few had symptoms of anxiety and depression at hospital or at home. Significant associations were found between symptoms of anxiety and depression measured at home and the same symptoms at hospital; pain and general post-operative symptoms; satisfaction with discharge education; self-assessed post-operative recovery and quality of sleep at home. Post-operative anxiety was predicted by depression at the hospital, not feeling rested upon awakening and presence of pain at home. Post-operative depression was predicted by depression at the hospital and not feeling rested upon awakening. Conclusion: Signs of patients' anxiety and depression should be assessed before surgery and appropriate intervention planned accordingly in order to support patients at risk of post-operative psychological distress.
Randomized trial of a home recovery intervention following coronary artery bypass surgery
Research in Nursing & Health, 2001
For this study a randomized clinical trial was designed to test the effects of an early home recovery information intervention on physical functioning, psychological distress, and symptom frequency 1 month following coronary artery bypass graft surgery (CABG). Recovery outcomes were compared between two groups: those receiving an audiotape of information on expected physical sensations and their management (Cardiac Home Information Program [CHIP]) in addition to the usual care, and those receiving the usual cardiac discharge information protocol. A nonprobability sample of 180 patients (84 women and 96 men; mean age = 62 years) was equally distributed between the two study groups. When controlling for age, comorbidity, and cardiac functional status, the results showed positive effects on physical functioning in women and psychological distress, vigor and fatigue in men. Consistent with other studies, women had worse physical functioning and more symptom frequency than men. These findings indicate that the CHIP intervention is an effective method to prepare CABG patients for home recovery. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 93–104, 2001
Journal of Education and Health Promotion, 2021
BACKGROUND: More than one-half of people with diabetes need at least one surgery in their lifespan. Few studies have addressed how to manage the needs of these patients after discharge from the hospital. The present study is designed to determine the effect of home care on readmission of Type 2 diabetic patients who underwent surgical procedures. MATERIALS AND METHODS: The present study was a randomized clinical trial. Sixty-nine patients with Type 2 diabetes undergoing surgery were assigned to the intervention and control groups via blocking order in the selected educational hospitals of Isfahan 2019. Home care was performed for 3 months with interprofessional team approach. Data collection tools were re-admission checklist. Data were entered in SPSS software version 23 and were analyzed by nonparametric tests. RESULTS: The background characteristics in the intervention and control groups were not different. The frequency of readmission in the control and intervention groups from t...
Heart, 2004
T he UK has one of the longest waiting lists for coronary artery bypass grafting (CABG). In 1999 CABG procedures were performed 1 at a typical cost of £4956, 2 leading to total direct costs in excess of £122 million. Early discharge programmes have been introduced as a strategy to reduce hospital costs, increase the throughput of patients and decrease waiting list times. Early studies have reported reductions in hospital length of stay (LOS) and hospital costs, without an increase in complication rates. There are concerns that early discharge programmes may increase morbidity after discharge and increase the demand on community health care resources, simply moving costs downstream without any true overall savings. The Royal Brompton Hospital has introduced a new early discharge programme that contained enhanced preoperative preparation, planned early discharge, and specialist homecare. We report the results of a randomised trial to compare costs, clinical outcomes, and quality of life in an early discharge homecare programme compared to conventional hospital care.
Journal of Global Health Reports, 2019
Back Background ground Patient and family caregiver education is essential for adequate home care after a cardiothoracic surgical intervention. In resource-poor settings where access to medical care is limited and health literacy is low, pre-discharge caregiver education is frequently overlooked. This study evaluates the effect of the Care Companion Program (CCP), an in-hospital patient family engagement and education program that targets family caregivers to support post-surgical patient recovery. Methods Methods This study was based on a quasi-experimental design at a tertiary care facility in Kolkata, India, in which 188 patient-caregiver dyads providing support to patients undergoing surgical intervention for cardiovascular disease were selected to participate. One hundred dyads received standard of care (SoC), and 88 dyads received the CCP. Patient-caregiver dyads were evaluated on patient post-discharge complications and physical functional status; Caregiver Activation Measure and health knowledge. Assessments were conducted at baseline, discharge, and post-discharge at 30 days. R Results esults Post-discharge 30-day complication rates were significantly lower for the CCP group compared to SoC (34.4% vs. 14.5%, respectively, P0.003). The CCP group showed a significantly greater increase in their Caregiver Activation Measure scores between baseline and discharge (4.2 ± 9.1 vs. 1.3 ± 7.4, respectively, P<0.001) that were sustained at 30 days post-discharge (7.2 ± 17.4 vs. 1.4 ± 10.4, respectively, P<0.001). Knowledge scores for the CCP group showed significant improvement (P<0.001) between baseline and discharge and were sustained at 30 days post-discharge (P0.003). Compared to the SoC group, patients in the CCP group reported a significantly greater increase in their physical functional status (World Health Organization Quality of Life short form assessment (WHOQOL-BREF) physical health domain) between baseline and 30 days post-discharge (P=0.018). C Conclusions onclusions The results of the study suggest significant associations between participation in the CCP and reduced 30-day complications, increased caregiver activation, and increases in health knowledge. Programs such as the CCP may play an important role in engaging family caregivers to improve health outcomes in settings with limited healthcare resources. Family caregivers play an essential role in the successful recovery of hospitalized patients by serving as the primary care providers following hospital stays. Integrating patient families as part of the care team can result in cost savings, enhanced patient and family experience of care, improved acute disease management, enhanced continuity of care,
Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes , specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.
Can home care for homebound patients with chronic heart failure reduce hospitalizations and costs?
PLOS ONE, 2017
Background Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. Purpose To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. Methods A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012-1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs. A comparison was conducted between the 6-month period prior to entry into home care and the time in home care. Results Over the study period 196 patients were treated by home care for CHF with a mean age of 79.4±9.5 years. 113 (57.7%) were women. Compared to the six months prior to home care, there were statistically significant decreases in hospitalizations (46.3%), in the number of total in-hospital days (28.7%), in the number of in-hospital days for CHF (66.7%), in emergency room visits (47%), and in overall costs (23.9%). Conclusion Home care for homebound adults with CHF can reduce healthcare utilization and healthcare costs.