| Summary: | 碩士 === 台北醫學院 === 護理學研究所 === 89 === Cardiac rehabilitation program is commonly performed in America and Europe, whereas in Taiwan, it still is in a beginning level. Therefore, the purpose of this study was to design an aggressive and countable inpatient cardiac rehabilitation （treadmill exercise） program for patients with coronary artery bypass graft, and to examine the influences of the program on the physical endurance, performance of ADL, self-efficacy of ADL, and fatigue.
This study was conducted from Oct. 2000 to Aug. 2001. Twenty-fifth subjects who met the selection criteria were selected by purposive sampling from a teaching hospital in Taipei. The independent variable was the exercise program and the dependent variables included a maximal distance by using a 6-minute walk test, fatigue, self-efficacy, and the ADL. The data were collected at the 1st week and 4th week after discharge from hospital by the 6-minute walk test, the Fatigue/Stamina scale, the Activity Self-Efficacy scale and the Duke Activity Index. Data was analyzed by percentage, mean, standard deviation, t test, one-way ANOVA, correlation, and repeated measurement.
The major finding of this study were as follows ：
1. The average time in hospital was 8 days after CABG. It took 7.8 days after operation to complte the stage Ⅵ （4.5 METs） of the program.
2. The average days for completing each stage was 2.72 days （stageⅠ, 1.5 METs）, 3.88 days （stageⅡ, 2.0 METs）, 5.24 days （stageⅢ, 2.5 METs, as first treadmill’s using）, 6.25 days （stageⅣ, 3.0 METs）, 6.87 days （stageⅤ, 3.7 METs）, and 7.8 days（stageⅥ, 4.5 METs）.
3. Patients in every stage of training achieved 100 ﹪completion, the average day of completion was stageⅠ at 5th day after operation, stageⅡ at 6th day after operation, stageⅢ at 9th day after operation, stageⅣ at 10th day after operation, stageⅤ at 9th day after operation, stageⅥ at 9th day after operation.
4. The major reasons for prolonging the progression of exercise training were plural effusion, tachycardia, atrial fibrillation, subcutaneous emphysema, fever, chest wall’s wound pain, dizziness, and weakness.
5. The thired stage of the program was started early in patients who are male, non-diabetes and the endotracheal tube removed in 24 hours after operation.
6. After discharge, the maximal walking distance, self-efficacy, fatigue and stamina were significantly improved at the 1st week and 4th week after discharge from the hospital.
7. From discharge to after discharge 1st week and from after discharge 1st week to 4th week, these two section increased percentages of the self-efficacy scores with the first treadmill’s use shows a significant positive correlation.
8. One week after discharge from hospital, 78.38 ﹪of patients may perform 5.5 METs ADL. Four weeks after discharge from hospital, 100 ﹪of patients may perform the same level of ADL without complaint.
9. The maximal performed at discharge was significantly correlated with the self-efficacy scores at the 1st week after discharge.
It was concluded that the patients who undergone the inpatient cardiac rehabilitation（treadmill exercise）program can perform higher intensity in daily activities than the patients who received the general inpatient cardiac rehabilitation programs.
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