Tack B B, Gilliss C L
Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco.
Heart Lung. 1990 Sep;19(5 Pt 1):491-9.
Health problems and related patient management during early recovery after cardiac surgery are not well documented. As part of a larger study of recovery from cardiac surgery 75 patient-care giver pairs received telephone calls from nurses at 1, 2, 3, 4, 6, and 8 weeks after discharge for the purpose of intervening to facilitate early recovery at home. After each call, nurses recorded detailed notes on the patients' progress and concerns. Content analysis of detailed nurses' recordings revealed the following predominant nursing actions: assessment, provision of support, reinforcement of predischarge teaching, referrals, and teaching. The five nursing diagnoses that occurred most frequently across the 8-week recovery period were altered comfort: pain; ineffective coping, individual; activity intolerance; sleep pattern disturbance; and altered nutrition. In response to these problems, patients managed and prevented health-related problems and engaged in health promotional and normalizing activities. By anticipating common problems in recovery, patients and care givers can be better prepared for going home. Similarly nurses can be better prepared to anticipate and respond to common recovery problems.
心脏手术后早期恢复期间的健康问题及相关患者管理情况记录并不完善。作为一项关于心脏手术恢复情况的大型研究的一部分，75对患者-护理人员组合在出院后1周、2周、3周、4周、6周和8周接到了护士打来的电话，目的是进行干预以促进患者在家中的早期恢复。每次电话后，护士都会记录患者进展及相关问题的详细笔记。对护士详细记录的内容分析显示了以下主要护理行为：评估、提供支持、强化出院前的指导、转诊和教学。在8周的恢复期内最常出现的五个护理诊断为：舒适度改变：疼痛；应对无效，个体；活动不耐受；睡眠模式紊乱；营养改变。针对这些问题，患者应对并预防了与健康相关的问题，还参与了健康促进和恢复正常生活的活动。通过预见恢复过程中的常见问题，患者和护理人员可以更好地为回家做好准备。同样，护士也能更好地准备好预见并应对常见的恢复问题。
