Issues in cardiovascular nursingImpact of an early recovery management intervention on functioning in postoperative coronary artery bypass patients with diabetes
Section snippets
Physical functioning
Recovery from CABG surgery in the early postoperative period can be accurately gauged by improvements in physical functioning. Although there is little literature describing the recovery patterns of CABG patients with diabetes, physical functioning in the general CABG population is known to improve significantly between hospital discharge and 6 months after surgery5, 14, 15, 16; most improvement occurs in the first 3 months after CABG procedures.5 Patients with lower preoperative physical or
Methods
A 2-group, repeated measures experimental design was used in this pilot study. Patients who were eligible to participate were randomly assigned to either the intervention group (received early recovery management intervention and routine care) or the routine care group (received routine care only) using a previously generated randomization schedule. Routine care for all post-CABG patients at the study institutions consisted of in-hospital teaching related to discharge orders, such as activity,
Discussion
Given that this was a pilot study, and significant differences were not expected, consideration must be given to possible reasons for these preliminary results. Several of the outcome variables had large SDs, indicating a great deal of within-group variability. However, both groups improved with time, with significant improvement on variables such as physical, role physical, and social functioning (as measured by the MOS SF-36 subscales) and levels of anxiety and depression (as measured by the
Implications and Recommendations
As more CABG procedures are performed on higher risk patients, such as those with diabetes, it is imperative that interventions enhancing the improvement of physical and psychosocial outcomes in this population in the early recovery period are tested. However, much more work must be done to develop interventions that are more specific to this patient population. Intervention mapping should be used before redesign of the intervention to ensure that the intervention promotes action rather than
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This research study was supported by funds from the Clinical Research Fund at the University of Nebraska Medical Center.