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- Hedbäck, Bo, 1944-, et al.
(författare)
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Cardiac rehabilitation after coronary artery bypass surgery : 10-Year results on mortality, morbidity and readmissions to hospital
- 2001
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Ingår i: Journal of Cardiovascular Risk. - : Ovid Technologies (Wolters Kluwer Health). - 1350-6277 .- 1473-5652. ; 8:3, s. 153-158
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the long-term secondary preventive effect of a comprehensive rehabilitation programme after coronary artery bypass grafting (CABG). Methods: The study group included 49 consecutive patients who underwent bypass surgery and were then offered a rehabilitation programme consisting of education in risk-factor control, a physical training programme and regular follow-up at a post-CABG clinic. The control group (n = 98), consisting of two well-matched CABG patients for each study patient, was offered the usual care with no access to a cardiac rehabilitation programme. The two groups were followed for 10 years and the results regarding cardiovascular mortality, morbidity, total cardiac events and readmissions to hospital were compared. Results: The total mortality (study group 8.2%, control group 20.4%) and cardiovascular mortality (8.2 versus 15.3%) after 10 years did not differ significantly between the groups. In the study group, nine patients (18.4%) had 10 cardiac events (four cardiovascular deaths, five non-fatal myocardial infarctions and one CABG) compared to 34 patients (34.7%, P < 0.05) suffering 46 (P < 0.01) cardiac events (15 cardiovascular deaths, 18 non-fatal myocardial infarctions, eight CABG, five coronary angioplasties) in the control group. The number of readmissions to hospital (2.1 versus 3.5 per patient) and length of admissions (11 versus 26 days per patient) was significantly lower in the study group (P < 0.01). Conclusion: A comprehensive cardiac rehabilitation programme offered to patients after coronary artery bypass surgery will improve the long-term prognosis and reduce the need for hospital care.
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- Malm, Dan, 1954-
(författare)
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Health-related quality of life in patients with pacemakers. A descriptive and experimental study
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis was to describe and evaluate the health-relatedquality of life (HRQoL) of patients with pacemakers, as well as to determine theeffects of a nurse-led intervention regarding health-related quality of life in theform of a self-care program for these patients. Descriptive designs were used todescribe (I) quality of life (n=182) as well as (II) HRQoL (n=697) of pacemakerpatients based on a nursing perspective. In order to describe the life situation ofthese patients from a deeper perspective (III) and examine the experiences ofdaily living with a pacemaker, patients (n=13) were interviewed and data wereanalyzed according to the grounded theory method, using constant comparativeanalysis. Finally (IV), 212 patients from three hospitals were allocated, using anexperimental, multi-center, randomized design, to either a control (n=115) or anexperimental group (n=97) to evaluate the effects of a nurse-led intervention, a10-month self-care program, on the HRQoL of patients with pacemakers.The total QoL for patients with pacemakers was acceptable. Through applicationof Orem s self-care theory, information, support and education can be providedin such a way that nursing care affects the entire QoL of patients withpacemakers. Measures should be taken on behalf women, those living alone, theelderly, blue-collar workers and retired persons, all of whom have a lower QoL(I, II). Experiences of daily living with a pacemaker generally indicate thatpatients with pacemakers can attain emotional stability and social participationunder the condition that there is understanding, empathetic treatment and insightconcerning the patient s new situation (III). There were no significantdifferences in HRQoL when comparisons were made between the experimentaland the control group. Two main findings for patients in the self-care program(experimental group) were: a significantly better HRQoL in terms ofexperiencing the symptoms that were the reason for pacemaker implantation ashaving decreased or disappeared, and a higher level of perceived exertion in a 11/2-minute stair test compared with patients who had standard checkups (controlgroup) (IV).In order to increase the HRQoL of patients with pacemakers it is important thathealth care professionals support the patient in a kind and professional mannerby providing clear, relevant information, and by planning a self-care programbased on a nursing assessment of the patient s needs using a comprehensiveapproach.
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