Beck CA, Joseph L, Belisle P, Pilote L. QOLAMI investigators: Predictors of quality ..... Rakowski W, Anderson L. Self-manage- ment of chronic disease by older ...
Chula Med J Vol. 56 No.2 March - April ;
Effects of comprehensive
cardiac nursing proqram on
health-related quality of life in patients with coronary heart disease Padthayawad Pragodpol* Yupin Aungsuroch**
Sureeparn Thanasil
Pragodpol P; Aungsuroch Y, Thanasilp S. Effects of comprehensive cardiac nursing program on health-related quality of life in patients with coronary
heart disease.
Chula Med J 201:2Mar - Apr; 56(2):189- 209
Introductions
Initially diagnosed coronary heart disease (CHO) patients experience new form ot life-threatening
illness which includes
various health
problems that significantly contribute to low health-related quality of life (HRQOL). Low HRQOL impacts the recovery process, decrease compliance
with treatments, and causes a higher rate of hospital
readmission
for numerous
complications
and/or
death.
Self-
management intervention is most successful in promoting outcome of health including HRQOL. Comprehensive cardiac nursing program (CCNP) has been developed with its emphasis on patient's management of risky health behevior. in order to improve their HRQOL. Objectives
To evaluate the effectiveness of CCNP on HRQOL in firstly diagnosed CHO patients.
Settings
Two seconoery healthcare settings in Thailand.
Research design
Randomized control tiiet.
Samples
There were 74 eligible patients who received their first diagnosis as CHO.
*
PhD Candidale.
** Faculty
~gcullyof N~rSing, Chulalongkorn University
of Nursing, Chulalongkorn
University
190
Chula Med J
Methods
The subjects
were randomly
assigned
by block
randomization.
Thirty-seven participants in the experimental group received CCNP together with their usual care, whereas 37 participants in the control groupreceived 4 phases
only their usual care. The experimental group underwent
which were: 1) the risky health behavior
assessment;
2) preparation phase; 3) practice phase; and, 4) evaluation phase. HRQOL was evaluated by Quality of Life Index, Cardiac version IV on the second day of admission and at 8 weeks after discharge. Results
HRQOL scores and the percentage of change in the overall and al/ domains of health and functioning, social and economic, psycho and spiritual, and family of the participants
who received the CCNP in
the experimental group had significantly higher than the participants who received usual care in the control group (p "I'l tJ1"U11ilu 'U'U'>1'UtI r..I'lVililfllilt1!ifllil~r1
March - April 2012
The CCNP was provided to the participants with multi components
by mutual
accompanied
f1lilGifll'l
t"
et et,
significantly
social and spiritual. related to the domain
203
who found social support independently
related to higher HRQOL.
of this program include pnysioloqical,
psychological,
wm'W-2i::i GlrYih ., tI
(79)
activities between participants and nurses. The multicomponents
.
All these are of HROOL and
Developing an effective.cardiac program for improving
HRQOL as CCNP since the
initial diagnosis of CHD is necessary. to improving
rehabilitation
HROOL
117, 3·i,
eo-
Due
8lj
is the best way to prevent
reflect holistic nursing care that are related to the
further health deterioration,
study of Bodenheimer et et.;
subsequent myocardial infarction, decrease the need
and Yusuf
et al.
(53)
(51)
Fernandez et el.,
They mentioned
management interventions supported
\52/
that self-
for surgical procedures,
patients to live
morbidity and mortality.
up to the best possible HRQOL in spite of their chronic
also representing
health condition.
the best way to decrease
The CCNP well supported to have sufficient manage
knowledge
their risky health
This is related necessary
the participants
of CHD and able to behaviors
to self-management
in real life. concept
method for maintaining
as a
and improving
patients' health behaviors and health status.?"
was promoted
the participants
of
and reduce readmission, (17.34.80·
81)
In addition,
it i!3
the quality of nursing care, and the cost of care of these
patients": 82) The results of this study show that the effectiveness of the CCNP on HROOL in patients with first diagnosed CHD.
Then, this program should be
implemented as a guideline for nursing practices used as an administration
to provide direction
or for
policy making.
Moreover, the CCNF) based on self-management model
reduce the incidence
lo
The CCNP was developed In
the secondary
healthcare
for the patients
settings.
It might be
limitation for the patients at other settings.
Another
health behaviors, regarding diet, physical activity and
limitation
is time-
exercise, stress, and smoking cessation. The patients
consuming
who accept
interesting and challenging.
perceive
toward
the significance
of management
their goals as desirable
their achievement.
of risky
are motivated
The literature
review
is the CCNP
implementation
intervention.
examine the long-term
However,
it is very
Future research should
effects of the CCNP, and
supported that risky health behaviors were correlated
develop self-management intervention similar to CCNP
with low HROOL.
for patients who are initially diagnosed
accomplished health
(IS1
cooperated significant
it significantly
In addition,
improved
have been the most
factors for the improvement initially diclgnosed
is in congruencE
of HROOL
with CHD.
with others
chronic illness.
their
tr e family's members who
in this program
of the patients finding
When the participants
20. rt-ts»
their goals ir, the management of risky
behaviors,
HROOL.
It.
This
with the study of Shen
Conclusion The CCNP
provides
holistic
care,
and
promotes the participants' management of risky health behaviors which significantly improves the HRQOL in patients who are initially diagnosed with CHD.
..
Chula MedJ
204
Acknowledgement The the research
7. Beck CA, Joseph L, Belisle P, Pilote L. QOLAMI
authors,
hereby,
acknowledge
grant from the Graduate
Chulalongkorn
University
the scholarship
for studying
from Praboromarajchanok
and
School,
acknowledge
in Ph.D. program
Institute for Health Care
Workforce Development, Ministry of Public Health.
investigators:
months and 1 year after -acute myocardial infarction.
Am Heart J 2001 Aug; 142(2):
271-9 8. Brink E, Karlson
BW, Hallberg.
LM. Health
experiences of first-time myocardial infarction: Factors
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