The effect of gradual Activity program on life quality and physical activities in patients with coronary artery bypass surgery

• Main Authors: Shu-Ching Chen, 陳淑卿
• Other Authors: Yann-fen Chao
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/58583402140333515261

碩士 === 國立臺灣大學 === 護理學研究所 === 92 === This study is to investigate whether abdominal breathing and Tai-Gi Chi-Guang progressive rehabilitation exercise can affect body activity and life quality of patients undergoing coronary artery bypass grafting (CABG). This study is a quasi-experimental study that measures pre- and post-intervention parameters in two groups of patients. We recruited the study patients by intention from a medical center in the northern Taiwan. Sixty-nine CABG patients, meeting inclusion and exclusion criteria, were collected in this study. Experiment group patients started abdominal breathing exercise after they had been extubated in the intensive care units, and started Tai-Gi Chi-Guang exercise after they were transferred back to general wards. Control group patients did not receive any training of these exercise. We recorded symptoms and life quality by questionnaires, and measured 6-minute walk distance two days before, one weeks, three weeks, and seven weeks after the operations. We compared symptoms, body activity, and life quality between the two groups at the corresponding time points by t-test. We compared symptoms, body activity and life quality at different time points in the same groups by paired-t test and repeated measures ANOVA. We also investigated what factors can affect body activity and life quality by independent-T test and one-way ANOVA test. The results of this study are as follows: 1. Annoying symptoms The annoying symptoms are the most severe in the first week after the operation in CABG patients. More than 50% of patients had symptoms of cough, weakness, pain and tight sensation of leg wounds, dyspnea during exercise, susceptibility to fatigue, pain and tight sensation of chest wounds, and shoulder muscle soreness. The patients, who had fewer and less severe symptoms, had better life quality and 6-minute walk distance. Limited body activity and postoperative wound pain are the major complaints of CABG patients. Rehabilitation exercise could not improve annoying symptoms. 2. Life quality Rehabilitation exercise can partly improve physiological and psychological life quality in CABG patients; however the effect is not obvious maybe due to short-tem study period. 3. Body activity Six-minute walk distance significantly decreased one week after the operation, but could improve to pre-operative level 7 weeks after the operation. Rehabilitation exercise can make the patients have better 6-minute walk distance than per-operative level since 3 weeks after the operation. 4. Effect of demography and health status on life quality and body activity Age, gender, marital status, chronic morbidities, and New York heart Association (NYHA)status are the major determing factors of life quality and body activity, and other demographic factors are not so significant. This study demonstrated that abdominal breathing exercise and Tai-Gi Chi-Guang exercise indeed could significantly improve body activity and partly improve life quality. The study results could provide a reference for clinical practice, nursing education, and research in CABG patients. Key words: progressive rehabilitation exercise, coronary artery bypass grafting, body activity, life quality.