Carroll D L
Department of Nursing, Massachusetts General Hospital, USA.
Heart Lung. 1995 Jan-Feb;24(1):50-9. doi: 10.1016/s0147-9563(05)80095-0.
To describe and test a model of recovery in the elderly after coronary artery bypass surgery derived from Self-Care and Self-Efficacy Theory.
Prospective, longitudinal, repeated measures.
Two large urban teaching hospitals on the East Coast.
One hundred thirty-three adults over the age of 65 years who had coronary artery bypass surgery on hospital admission. There were 32 women and 101 men with an age range of 65 to 87 years (M = 71.8 years +/- 4.8 years) in whom 77.5% were in a New York Heart Association class of 3 or 4, indicating significant functional limitations.
Self-care agency, self-efficacy expectations, and the performance of self-care/recovery behaviors at discharge, 6, and 12 weeks after coronary artery bypass surgery.
The exercise of self-care agency was measured with the Exercise of Self-Care Agency Scale, self-efficacy expectation, and the performance of self-care/recovery behavior by the Jenkins Self-Efficacy Expectation Scales and Activity Checklists. Data were collected at discharge, 6 weeks, and 12 weeks after surgery for the specific behaviors of walking, climbing stairs, resuming general activities, and the performance of roles.
Repeated measures analysis of variance revealed significant changes in self-care agency, the self-efficacy expectations for all behaviors, and the performance of the behaviors for walking, resuming general activities, and performance of roles over the recovery period (p < 0.01).
In support of the model, self-efficacy expectations mediated between self-care agency and all self-care/recovery behaviors at selected times. Comparison of the performance of self-care/recovery behaviors with other samples from the literature found recovery in the elderly to be protracted. Nurses can be pivotal in providing the elderly with accurate projections of recovery and an environment to support the initial mastery of self-care/recovery behaviors to promote optimal health in this vulnerable population.
描述并检验一种基于自我护理和自我效能理论得出的老年冠状动脉搭桥术后恢复模型。
前瞻性、纵向、重复测量。
东海岸的两家大型城市教学医院。
133名65岁以上因入院接受冠状动脉搭桥手术的成年人。其中有32名女性和101名男性，年龄范围为65至87岁（平均年龄 = 71.8岁 ± 4.8岁），77.5%的患者纽约心脏协会心功能分级为3级或4级，表明存在明显的功能受限。
自我护理能力、自我效能期望，以及冠状动脉搭桥术后出院时、6周和12周时的自我护理/恢复行为表现。
自我护理能力通过自我护理能力量表进行测量，自我效能期望通过詹金斯自我效能期望量表进行测量，自我护理/恢复行为表现通过活动清单进行测量。在术后出院时、6周和12周收集关于行走、爬楼梯、恢复日常活动以及角色履行等特定行为的数据。
重复测量方差分析显示，在恢复期间，自我护理能力、所有行为的自我效能期望以及行走、恢复日常活动和角色履行行为的表现均有显著变化（p < 0.01）。
为支持该模型，自我效能期望在特定时间中介于自我护理能力和所有自我护理/恢复行为之间。将自我护理/恢复行为表现与文献中的其他样本进行比较发现，老年人的恢复过程较为漫长。护士在为老年人提供准确的恢复预测以及营造支持其初步掌握自我护理/恢复行为以促进这一脆弱人群最佳健康状态的环境方面起着关键作用。
