| ObjectivesTo analyze whether the characteristic continuity of care including health education could improve the quality of life in old patients with off-CABG outside the hospital.The elderly patients with coronary artery bypass surgery were implemented contrast special continuity of care with conventional continue nursing.To discuss the effectiveness and feasibility of content and methods of health education with coronary artery bypass surgery outside the hospital,and the feasibility of clinical application of various ways in nursing.Methods1.To choose 160 eligible cases of elderly patients with off coronary artery bypass surgery from November 2013 to March 2015 in the First Affiliated Hospital of Zhengzhou University. All patients were divided into control group (80 cases) and intervention group (80 cases) according to the number of hospitalization by random number table. Selection after the object of study in its general data acquisition, establishing patient contacts, and create a database in detail, for statistical data for each patient records, and signed the informed consent. To carry out discharge guidance during their hospitalization according to cardiac surgery routine care for patients of control group,in addition to routine care for the intervention group,there were researchers completing health education that related off coronary artery bypass surgery in the day before discharge, to issue the" Health Education Handbook of off Coronary Artery Bypass Grafting"and its audiotape to patients after the education, the content of audiotape is same with the handbook, to educate and help the patients with the five aspects that were daily life, food, protection and wound treatment, medication, review by "Knowledge of Rehabilitation Handbook after off Coronary Artery Bypass Grafting". Specialist nurses visit as the main way, telephone follow-up, brochures and a walkman for auxiliary way. There were health education that were 40 minutes every times by using the patient outpatient care by the nurse specialist outpatient visit when discharged from hospital after 1 month,2 months,3 months, and respectively at 1,5, 9,13 weeks by telephone follow-up according to "Knowledge of Rehabilitation Handbook after off Coronary Artery Bypass Grafting". Patients according to their own situation, play the walkman regularly by the patients themselves or caregivers.2.160 cases were investigated by questionnaire survey, to collected questionnaire data when were at the time of admission, discharge, four months after discharge. The baseline related the time of admission. Evaluating rely on Short-term health survey questionnaire (the Short Form Health Survey, SF-36).the patients of intervention group and control group educated in hospital by the researchers on the postoperative routine health education.Through designed simple coronary heart disease health education evaluation form,to evaluate patients'cognitive level of health knowledge. To understand the change of quality of life of patients with early postoperative, discusseing the influence of the continuity of care for patients.3.First, collecting data and then using SPSS 17.0 software, there were Logistic regression analysis Chi-square test, descriptive statistics analysis, t test of two independent sample.Results1.The study included 160 cases of eligible patients, two people died in hospital and three people lost outside the hospital in intervention group. Three people died in hospital and lost six people outside the hospital in control group,there were no significant difference between two groups with the baseline clinical data(Short-term health survey questionnaire and coronary heart disease health education evaluation form)(P>0.05).2.After the continuity of care,the scores of each dimension of quality of life in the intervention group were higher than control group, but only statistically significant differences in physical function, physical function, general health and vitality.3.Knowledge scores of the intervention group (89.35±3.56) was higher than the control group score (70.47+6.99) by continuity of care for elderly patients after off coronary artery bypass surgery,The difference was statistically significant (P<0.05).4. After the continuity of care, complications of patients in the intervention group were 5 people, complication rates are about 6.7%, patients with complications in the control group were 9 people,complication rates are about 12.7%,there was statistically significant difference of the incidence of complications after surgery between the two groups, The former was significantly lower than the latter (P<0.05).5.Logistic regression analysis showed:Patients with high levels of education (junior high school, high school, college and above) and good medication compliance (whether regular medication) can have high health rating scale,OR values were 11.624 (95% CI:1.884-71.735, P= 0.008) and 8.700 (95% CI:1.642-46.105, P= 0.011).ConclusionsContinuity of care can improve knowledge score of coronary heart disease of the patients and improve cognitive abilities in patients, throuth "Knowledge-Attitude-Practice" improve the quality of life of patients with off-CABG,there are depressed on complication of patients. At the same time,the continuity of care of the visit of specialist nurses were workable in clinical application,this pattern should be to promote in the clinical nursing work. |
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