The Effects of a Cardiac Rehabilitation Program on Ischemic Heart Disease Patients after Stent Placement at Hua Hin Hospital, Prachuap Khirikrun Province

Abstract

Background: Myocardial infarction is a leading cause of death globally, including in Thailand, where it ranks as the second leading cause of mortality. The trend of deaths due to myocardial infarction continues to rise each year, making it a major public health issue. Currently, the treatment of coronary artery disease with coronary stent implantation is considered an effective and widely accepted method. It is known for high efficiency, minimal complications, and favorable outcomes. After treatment, it takes time to help the heart muscle recover, allowing the heart to function efficiently again. Most patients who experience complications do so due to a lack of knowledge about proper self-care, cardiac rehabilitation after receiving a stent, and education on appropriate exercise and daily activities. These factors can help reduce complications and improve the body's functional abilities.

Objective: To compare knowledge before and after receiving the cardiac rehabilitation program, assess physical fitness using the 6-Minute Walk Test (6 MWT), and evaluate satisfaction with the cardiac rehabilitation program.

Method: The preliminary experimental research design (pre-experimental research) using a one-group pretest-posttest design was conducted. The sample consisted of patients with acute myocardial infarction who had undergone percutaneous coronary intervention with stent placement. The participants included both male and female patients aged between 18 to 65 years, who were hospitalized at Hua Hin Hospital. A purposive sampling method was used to select 30 participants. The research instruments included two parts: 1) various assessment forms and 2) a cardiac rehabilitation program. The program was designed in accordance with the ethical standards for human research. The content validity was determined to be 0.97, the Index of Inter-Object Congruence (IOC) was 0.97, and the reliability was 0.75. The data were analyzed using descriptive statistics and inferential statistics (Paired sample t-test).

Results: 1. Personal information: The majority of patients with coronary artery disease who underwent stent insertion were male, with 22 individuals (73.3%), compared to 8 females (26.7%). The average age was 55.8 years (S.D. 8.53), with 80% of the patients being between 50-65 years old. Most were married (80%). In terms of education, 43.3% had completed only primary school. The majority had a monthly income between 5,001-10,000 Baht (33.3%) and were employed as laborers (43.3%). Additionally, 56.7% had underlying health conditions, and 39.9% had a BMI between 18.6-22.9. 2. The patients showed a statistically significant increase in knowledge before and after receiving the cardiac rehabilitation program (P<0.05). 3. The physical fitness, as assessed by the 6-minute walk test (6MWT), significantly improved (p<0.05), with an average distance of 214.23 ± 31.44 meters before and after.4. The satisfaction with the heart rehabilitation program at a high level (= 2.88)

Conclusion: Patients with ischemic heart disease who received stent placement at Hua Hin Hospital in Prachuap Khiri Khan Province showed significant improvement in knowledge and physical fitness following the cardiac rehabilitation program, with statistical significance at the 0.05 level. Additionally, they reported a high level of satisfaction with the cardiac rehabilitation program (=3.00)