The development of cardiac rehabilitation in elderly patients after revascularization
Keywords:
cardiac rehabilitation, acute myocardial ischemia, coronary angioplasty, elderlyAbstract
Cardiovascular disease is a leading cause of mortality among older adults. Although cardiac rehabilitation is essential after percutaneous coronary intervention (PCI), continuity of care following hospital discharge remains limited. This study aimed to: (1) explore the problems and situations related to cardiac rehabilitation among older patients after PCI, (2) develop a cardiac rehabilitation model, and (3) evaluate the effectiveness of the developed model. This research and development (R&D) study initially explored the existing situation through interviews with five healthcare professionals and five older patients who had undergone PCI. The findings were used to develop a cardiac rehabilitation model integrated with tele-nursing for a period of four weeks. The sample consisted of an experimental group and a control group, with 25 participants in each group. Data collection instruments included: (1) a demographic data form, (2) a self-care confidence assessment scale, and (3) a self-care behavior questionnaire. Data were analyzed using content analysis and descriptive statistics (frequency, percentage, mean, and standard deviation), as well as inferential statistics including the Chi-square test of independence and independent samples t-test.
The content analysis revealed three major themes: (1) insufficient self-care knowledge and confidence following hospital discharge, (2) gaps in continuity of care during home recovery, and (3) the need for supportive systems to promote self-care. Based on these findings, a cardiac rehabilitation model with telenursing was developed for older adults who underwent percutaneous coronary intervention (PCI). Results showed that participants in the intervention group demonstrated significantly higher self-care behavior and self-care confidence scores after the intervention compared with their baseline and the control group (t = 9.40, p < 0.05 and t = 4.49, p < 0.05, respectively).
This study recommends implementing telenursing-based cardiac rehabilitation to enhance self-care and quality of life among older adults post-PCI. Future studies should also incorporate physical functioning outcomes.
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