Effects of the First Phase of Cardiac Rehabilitation Training on Self-Efficacy among Patients Undergoing Coronary Artery Bypass Graft Surgery
Background: Heart surgery is vital for patients with coronary artery diseases that do not respond to drug treatments. We aimed to determine the effects of the implementation of the first phase of a cardiac rehabilitation program on self-efficacy in patients after coronary artery bypass graft surgery (CABG).
Methods: This clinical trial study was conducted on 60 post-CABG patients by convenience sampling method in 2016. Those selected were randomly assigned to intervention (n=30) and control group (n=30). Overall, 72 hours after CABG, the first phase of the cardiac rehabilitation program both in theory and in practice (face-to-face and group methods) was conducted. Data were collected using a self-efficacy questionnaire completed by the patients in 3 stages: before the intervention, at discharge, and at 1 month after discharge. Data was analyzed by using analysis of covariance and repeated measures.
Results: The mean of age in the intervention and control groups was 61.60±11.72 and 57.97±13. 4 years, respectively. There were 16 (53.3%) male patients in each group. The mean score of self-efficacy was not significantly different between the 2 groups before the intervention (P=0.076), whereas it had a meaningful statistical difference between the 2 groups at discharge and 1 month afterward (P<0.001).
Conclusion: The implementation of the first phase of the cardiac rehabilitation program not only augmented self-efficacy in regard to independent daily activities but also lessened the need for the second phase of the program among our post-CABG patients.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation 2013;127:e6-e245.
Shafiee Z, Babaee S, Nazari A, Atashi V. The effect of massage therapy on sleep quality of patients after coronary artery bypass graft operation. Cardiovasc Nurs J 2013;2:22-29. [Persian]
Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med 2016;4:256.
Ozcan H, Yildiz Findik U, Sut N. Information level of patients in discharge training given by nurses following open heart surgery. Int J Nurs Pract 2010;16:289-294.
Wang LW, Ou SH, Tsai CS, Chang YC, Kao CW. Multimedia exercise training program improves distance walked, heart rate recovery, and self-efficacy in cardiac surgery patients. J Cardiovasc Nurs 2016;31:343-349.
Shafipour V, Mohammadi E, Ahmadi F. Experiences of open heart surgery patients from admission to discharge: a qualitative study. Iran J Critic Care Nurs 2013;6:1-10.
Busch JC, Lillou D, Wittig G, Bartsch P, Willemsen D, Oldridge N, Bjarnason-Wehrens B. Resistance and balance training improves functional capacity in very old participants attending cardiac rehabilitation after coronary bypass surgery. J Am Geriatr Soc 2012;60:2270-2276.
Taylor RS, Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal H, Lough F, Rees K, Singh S. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev 2014;:CD003331.
Thomas RJ, Goel K, Jumean M, Mullany C, Lahr B, Gibbons R. Short- and long-term impact of an inpatient quality improvement initiative: results of the CABG-GAP Practice Improvement Project. J Cardiopulm Rehabil Pre 2013;33:212-219.
Hajifathali A, Ainy E, Jafari H, Moghadam NM, Kohyar E, Hajikaram S. In-patient satisfaction and its related factors in Taleghani University Hospital, Tehran, Iran. Pak J Med Sci 2008;24:274-277.
Mahdavi Seyyed M, Abbasi I, Mohammadi N. Effect of cardiac rehabilitation program on quality of life in patients undergoing coronary artery bypass graft surgery. Horizon Med Sci 2015;21:67-74.
Ades PA, Pashkow FJ, Fletcher G, Pina IL, Zohman LR, Nestor JR. A controlled trial of cardiac rehabilitation in the home setting using electrocardiographic and voice transtelephonic monitoring. Am Heart J 2000;139:543-548.
Mampuya WM. Cardiac rehabilitation past, present and future: an overview. Cardiovasc Diagn Ther 2012;2:38-49.
Salavati M, Fallahinia G, Vardanjani AE, Rafiei H, Mousavi S, Torkamani M. Comparison between effects of home based cardiac rehabilitation programs versus usual care on the patients' health related quality of life after coronary artery bypass graft. Glob J Health Sci 2015;8:196-202.
Arefi S ZM, Ghiasvandian S, Haghani H. The effect of first phase cardiac rehabilitation programs on anxiety and depression in acute coronary syndrome patients. Cardiovasc Nurs J 2012;1:32-38. [Persian]
Sibilitz KL, Berg SK, Hansen TB, Risom SS, Rasmussen TB, Hassager C, Køber L, Steinbrüchel D, Gluud C, Winkel P, Thygesen LC, Hansen JL, Schmid JP, Conraads V, Brocki BC, Zwisler AD. Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR): study protocol for a randomized clinical trial. Trials 2013;14:104.
Kang Y, Yang IS. Cardiac self-efficacy and its predictors in patients with coronary artery diseases. J Clin Nurs 2013;22:2465-2473.
Varaei S, Shamsizadeh M, Cheraghi MA, Talebi M, Dehghani A, Abbasi A. Effects of a peer education on cardiac self-efficacy and readmissions in patients undergoing coronary artery bypass graft surgery: a randomized-controlled trial. Nurs Crit Care 2017;22:19-28.
Brink E, Alsén P, Herlitz J, Kjellgren K, Cliffordson C. General self-efficacy and health-related quality of life after myocardial infarction. Psychol Health Med 2012;17:346-355.
Ku SL, Ku CH, Ma FC. Effects of phase I cardiac rehabilitation on anxiety of patients hospitalized for coronary artery bypass graft in Taiwan. Heart Lung 2002;31:133-140.
Vibulchai N, Thanasilp S, Preechawong S. Randomized controlled trial of a self-efficacy enhancement program for the cardiac rehabilitation of Thai patients with myocardial infarction. Nurs Health Sci 2016;18:188-195.
Intarakamhang P, Intarakamhang U. Effects of the comprehensive cardiac rehabilitation program on psychological factors and quality of life among coronary heart disease patients. Glob J Health Sci 2012;5:145-152.
Slovinec D'Angelo ME, Pelletier LG, Reid RD, Huta V. The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease. Health Psychol 2014;33:1344-1353.
Zhou Y, Liao J, Feng F, Ji M, Zhao C, Wang X. Effects of a nurse-led phone follow-up education program based on the self-efficacy among patients with cardiovascular disease. J Cardiovasc Nurs 2018;33:E15-E23.
Poortaghi S, Baghernia A, Golzari SE, Safayian A, Atri SB. The effect of home-based cardiac rehabilitation program on self-efficacy of patients referred to cardiac rehabilitation center. BMC Res Notes 2013;6:287.
Copyright (c) 2018 The Journal of Tehran University Heart Center
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.