Department of Intensive Care Medicine, Launceston General Hospital, 274-280 Charles Street, Launceston, Tasmania, Australia.
School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
Aust Crit Care. 2018 Mar;31(2):93-100. doi: 10.1016/j.aucc.2017.03.002. Epub 2017 May 6.
Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia.
To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program.
This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program.
Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery.
Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with patients during their recovery, assisted nurses in developing the mentor role.
心脏康复对患者有许多益处，但参与度并不理想，尤其是在澳大利亚的偏远地区。需要创新的心脏康复模式来提高参与度。为支持患者从医院过渡到家庭，提供护士导师代表了澳大利亚一种新的服务提供模式。
探讨基于家庭的心脏康复计划在帮助患者从急性冠状动脉综合征中康复以及满足提供该计划的护士导师的期望方面的影响。
本案例研究基于结构、过程和结果模型，于 2008 年至 2011 年在澳大利亚的三家医院进行。通过电话对 13 名从急性冠状动脉综合征中康复的患者进行了访谈，并在完成该计划后对 7 名护士导师进行了调查。
导师对基于家庭的心脏康复计划结构的看法包括患者的及时招募、导师培训以实施该计划、对导师角色发展的承诺，以及获得认知行为疗法和以患者为中心的护理方面的知识和技能。过程包括导师与患者之间的治疗关系、计划的适用性以及促进更健康的生活方式行为。结果表明，患者对该计划的视听资源以及他们的护士导师提供的支持和指导水平感到满意。导师认为该计划在交付方面易于使用。
患者认为该计划有助于他们的康复，对从导师那里获得的信息、指导和支持感到满意。有积极的迹象表明，该计划影响了患者改变不健康生活方式行为的决定。结果突出了通过电话在家中指导患者所面临的奖励和障碍。在患者康复期间与他们建立治疗关系的经验有助于护士发展导师角色。
