Xiu Meng, Yang Fei, Yang Fangfang, Wang Chenwei, Zhang Meijie, Zhang Weiying
School of Medicine, Tongji University, Shanghai, People's Republic of China.
Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
Patient Prefer Adherence. 2025 Aug 30;19:2697-2709. doi: 10.2147/PPA.S537861. eCollection 2025.
Coronary artery bypass grafting (CABG) is an essential intervention for treating coronary artery disease. However, the effectiveness of postoperative rehabilitation often depends on the implementation of early mobilization by patients. In practice, adherence to early mobilization post-CABG is frequently suboptimal. This study focuses on patients who have successfully implemented early activity post-CABG, exploring the situational factors that facilitate early mobilization.
Semi-structured interviews were conducted with 15 post-CABG patients from three hospitals in Shanghai who had successfully implemented early mobilization. Data collection was conducted from October 1, 2024 to December 31, 2024. Utilizing a constructivist grounded theory approach, the interview guide was modified based on emerging themes throughout the study.
Patients who successfully implement early mobilization typically undergo three main stages: intention, initiation, and maintenance. The study identified three main domains influencing these phases: Core Context (including the perception of the importance of exercise rehabilitation, understanding and beliefs about early mobilization, positive personal experiences with physical activity, and observing positive outcomes from others' activities); Essential Conditions (including physical condition, psychological preparedness, knowledge literacy, and initial outcomes); External Factors (including the atmosphere and promotion of early mobilization, the development of an exercise rehabilitation system from pre-surgery to ICU to ward, and social support).
This study provides a new perspective by examining the situational factors associated with the successful implementation of early mobilization after CABG. By focusing on successful cases, healthcare professionals can better understand the implementation process and experiences, enabling them to develop targeted interventions to improve adherence.
冠状动脉旁路移植术（CABG）是治疗冠状动脉疾病的重要干预措施。然而，术后康复的效果往往取决于患者早期活动的实施情况。在实际操作中，冠状动脉旁路移植术后早期活动的依从性常常不尽人意。本研究聚焦于冠状动脉旁路移植术后成功实施早期活动的患者，探索促进早期活动的情境因素。
对来自上海三家医院的15例成功实施早期活动的冠状动脉旁路移植术后患者进行了半结构式访谈。数据收集于2024年10月1日至2024年12月31日进行。采用建构主义扎根理论方法，根据研究过程中出现的主题对访谈指南进行了修改。
成功实施早期活动的患者通常经历三个主要阶段：意向、启动和维持。该研究确定了影响这些阶段的三个主要领域：核心情境（包括对运动康复重要性的认知、对早期活动的理解和信念、体育活动的积极个人经历以及观察他人活动的积极结果）；基本条件（包括身体状况、心理准备、知识素养和初步结果）；外部因素（包括早期活动的氛围和推广、从术前到重症监护病房再到病房的运动康复系统的发展以及社会支持）。
本研究通过考察冠状动脉旁路移植术后早期活动成功实施的情境因素提供了一个新的视角。通过关注成功案例，医护人员可以更好地理解实施过程和经验，从而制定有针对性的干预措施以提高依从性。
