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出院计划对冠状动脉旁路移植术患者再入院、护理满意度和自我护理能力的影响。

The impact of discharge plan upon re-admission, satisfaction with nursing care and the ability to self-care for coronary artery bypass graft surgery patients.

机构信息

Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran.

出版信息

Eur J Cardiovasc Nurs. 2012 Dec;11(4):460-5. doi: 10.1016/j.ejcnurse.2011.05.001. Epub 2012 Apr 4.

Abstract

BACKGROUND AND AIM

Grafting coronary arteries and post operative recovery has many challenges, which can be ameliorated through continues care and an appropriate discharge plan. Therefore, the current study was undertaken aiming to evaluate the impact of discharge plan on satisfaction with nursing care, ability to self-care, and incidence of re-admission.

METHOD

This is a quasi experimental study involving patients who were due to undergo coronary artery bypass graft in Chamran Hospital in 2010. In the intervention group, the discharge plan was initiated at the time of admission and continued for 2 weeks after discharge by home visit and telephone follow ups. Satisfaction with nursing care was assessed 2 days after discharge, whilst patients' ability for self-care was measured 6 weeks and 3 months post discharge and the incidence of re-admission was determined at the 3 months point.

FINDINGS

Satisfaction levels with nursing care and the ability to take self-care were higher in intervention group comparing with control group (p < 0.001). There was a significant difference for self-care ability between pre test and post test in both groups but the improvement was more pronounced for the intervention group (p = 0.04). There was no significant difference between the two groups in terms of re-admission incidence after 3 months (p = 0.15).

DISCUSSION AND CONCLUSION

The results indicate that the discharge plan, as a method of continual care plan, can lead to higher satisfaction levels and enhanced self-care abilities of patients. Such discharge plan can therefore be utilised as an effective method of continuous care for patients who are going to undergo coronary artery bypass graft.

摘要

背景与目的

冠状动脉移植和术后恢复存在诸多挑战,可以通过持续护理和适当的出院计划来改善。因此,本研究旨在评估出院计划对护理满意度、自我护理能力和再入院率的影响。

方法

这是一项准实验研究,涉及 2010 年在 Chamran 医院接受冠状动脉旁路移植术的患者。在干预组中,入院时即开始制定出院计划,并通过家访和电话随访在出院后继续进行 2 周。出院后 2 天评估护理满意度,出院后 6 周和 3 个月评估自我护理能力,3 个月时确定再入院率。

结果

与对照组相比,干预组对护理的满意度和自我护理能力更高(p<0.001)。两组的自我护理能力在预测试和后测试之间均有显著差异,但干预组的改善更为明显(p=0.04)。两组在 3 个月后的再入院率方面无显著差异(p=0.15)。

讨论与结论

结果表明,出院计划作为持续护理计划的一种方法,可以提高患者的满意度和自我护理能力。因此,这种出院计划可以作为冠状动脉旁路移植术后患者的有效连续护理方法。

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