CAUSAL RELATIONSHIP MODEL ON HEALTH STATUS AMONG PATIENTS AFTER CORONARY ARTERY BYPASS GRAFT SURGERY
Keywords:
coronary artery bypass graft surgery, health status, MIMIC Model AnalysisAbstract
The purpose of this research aimed to explore the causal relationship affecting health status among patients undergoing coronary artery bypass graft surgery (CABG). The participants were 310 patients who received CABG and visited physicians in the cardiac surgery clinics, both general and premium, at Ramathibodi Hospital. The instruments for data collection were questionnaires including comorbidity, knowledge of the disease and operation, self-care behaviors, and health conditions. The content validity was rated by experts and the internal consistency reliabilities for each questionnaire equaled .93, .87, .79, and .85, respectively. Descriptive statistics and the causal relationship model were analyzed by using the Mplus program.
The results showed that patients undergoing CABG had a good level of health status. Applying transition theory, the causal relationship model of health status outcomes among patients undergoing CABG was consistent with empirical data (2 (df= 58, N = 310) = 97.588, p = .0009,
2/df = 1.68, CFI = .985, TLI = .981, RMSEA = .047, SRMR = .042). The factors in the model could together explain the variances of health status among patients undergoing CABG up to 81.60 percent. Age, comorbidity, and the level of cardiac function before surgery demonstrated a negatively direct effect on health status. In addition, left ventricular ejection fraction, knowledge of the disease and operation, and self-care behavior showed a positively direct effect on health status.
The findings of this study provided essential fundamental information for nurses to enhance knowledge and change self-care behavior among patients undergoing CABG. Furthermore, developing nursing interventions or protocols should prioritize patient-centered care before, during, and after surgery to optimize postoperative care and health outcomes.
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