The Effect of Early Ambulation Program for Cardiac Rehabilitation on Fatigue and Anxiety in Patients Undergoing Open Heart Surgery
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Abstract
This quasi-experimental study utilized a comparative group design with pretest and posttest measurements to investigate the effects of an early ambulation cardiac rehabilitation program on fatigue and anxiety levels in patients undergoing open-heart surgery. The sample consisted of 48 patients admitted to the surgical ward at Somdej Pranangchaosirikit Hospital, selected through purposive sampling based on predefined inclusion criteria. Participants were equally divided into an experimental group and a control group, each comprising 24 individuals. The experimental group received an early ambulation cardiac rehabilitation program guided by Bandura’s self-regulation theory, while the control group received standard nursing care. Research instruments included a personal information questionnaire, a fatigue assessment scale, an anxiety scale tailored to open-heart surgery, and the rehabilitation program itself. The content validity index (CVI) of the program was 1. The fatigue and anxiety scales demonstrated high reliability, with Cronbach's alpha coefficients of 0.91 and 0.94, respectively. Data were analyzed using descriptive statistics, the Wilcoxon Signed Ranks Test, and independent t-tests.
The results showed that the mean fatigue score in the experimental group was significantly lower than that of the control group (t46 = 20.14, p < .001). Likewise, the mean anxiety score in the experimental group was significantly lower than in the control group (t30 = 5.87, p < .001). These findings support the effectiveness of early ambulation cardiac rehabilitation in reducing fatigue and anxiety among patients after open-heart surgery.
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References
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019;40(2):87-165.
The Society of Thoracic Surgeons of Thailand. Statistics of heart surgery in Thailand 2001 - present. [Internet]. [cited 2020 Jul 10]. Available from: https://thaists.org/en/stat-2564/. (in Thai).
Somdej Pranangchaosirikit Hospital. Patient statistics of heart surgery 2016-2022. Chonburi: Somdej Pranangchaosirikit Hospital; 2016. (in Thai).
Gowdak L, Fernandes F, Vianna C, Dallan L, Cesar LAM. Complications after coronary artery bypass surgery: Is there a role for noninvasive testing before surgery. JACC 2015;65(10s):A1619.
Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. J Am Coll Cardiol 2016;67(1):1-12.
Vititsiri B, Swanpitak P, Sanjaroensuttikul N, Uaaree P, Kobkitsumongkol K, Sangmanee S. Effects of group therapy in cardiac rehabilitation program on quality of life in open heart surgery patients. J Thai Rehabil Med 2018;28(2):44-8. (in Thai).
Tanprasert P, Kunchorn Na Ayudhya R, Kantaratanakul V, Intrakamhaeng P, Phongprapai S, Rakpanich P, et al. Cardiac rehabilitation guideline. [Internet]. [cited 2022 Jul 22]. Available from: http://www.thaiheart.org/guideline.html. (in Thai).
Intarat B. Program enhancing self-efficacy in cardiac rehabilitation on physical fitness and satisfaction of patients with coronary artery bypass grafting. [Master’s Thesis, Faculty of Nursing]. Prince of Songkla University; 2013. (in Thai).
Waiwaree D, Sindhu S, Utriyaprasit K, Slisatkorn W. Factors predicting functional status in patients post coronary artery bypass graft. Thai Journal of Cardio-Thoracic Nursing 2017;28(2),126-39. (in Thai).
Rao A, Zecchin R, Newton PJ, Phillips JL, DiGiacomo M, Denniss AR, et al. The prevalence and impact of depression and anxiety in cardiac rehabilitation: A longitudinal cohort study. Eur J Prev Cardiol 2020;27(5):478-89.
Piathip D, Liangchawengwong S, Satdhabudha O. The effects of enhancing self-efficacy in early cardiac rehabilitation program on physical outcomes and anxiety among patients post coronary artery bypass graft surgery. Songklanagarind Journal of Nursing 2018;38(3),12-24. (in Thai).
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs (NJ): Prentice-Hall; 1986.
Bandura A. Social Cognitive theory of self-regulation. Organizational Behevior and Human Decision Processes 1991;50:248-87.
Janssen V, Gucht V, van Exel H, Maes S. A self-regulation lifestyle program for post-cardiac rehabilitation patients has long-term effects on exercise adherence. J Behav Med 2014;37(2):308-21.
Burns N, Grove SK. Practice of nursing research: conduct, critique, & utilization. 5th ed. St. Louis, MO: Elsevier Saunders; 2005.
Udonsat S. Factors related to burden among male caregivers of elderly with stroke. [Master’s Thesis, Faculty of Nursing]. Burapha University; 2018. (in Thai).
Charoenthai P, Kespichayawattana J. Selected factors related to fatigue in elderly with heart failure. Journal of Nursing Science Chulalongkorn University 2013;25(3):39-50. (in Thai)
Physical Medicine and Rehabilitation Team. Behavioral manual for patients with coronary heart disease. [Brochure]. Chonburi: Somdej Pranangchaosirikit Hospital; 2021.
Srimuang J, Sathiyamas J, Homvises B. The effects of an enhancing self-efficacy program and mobile application in rehabilitation on physical fitness and anxiety among coronary artery bypass graft surgery patients. Kuakarun Journal of Nursing 2024;31(2):296-309. (in Thai).
Jampathet W, Masingboon K, Ponpinij P, Chantamit-O-Pas C. Factors influencing adherence to cardiac rehabilitation in patients undergoing coronary artery bypass graft surgery. RTN Med J 2022;49(2):275-90. (in Thai).
Suriya R, Jomkan W, Konsawan S, Promwichai P. Rating of perceived exertion and physical activity in patients with open heart surgery in Chiangrai Prachanukroh hospital. Chiangrai Medical Journal 2017;9(1):85-97. (in Thai).
Khemthong A, Saengchan H, Naka K. Relationship between cardiac rehabilitation behaviors and quality of life among patients post coronary artery bypass graft. Songklanagarind Journal of Nursing 2018;38(3):1-11. (in Thai).
