J Nurs Acad Soc.  1993 Dec;23(4):664-677.

Post Discharge Nursing Needs of Patients with Open Heart Surgery

• Kim MH

Abstract

The purpose of this study was to provide basic data for the development of educational material in Korean for patients being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out-patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows: 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used(91.0%). The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many patients didn't know the importance of a low salt diet (57.8%), and did not get any education on low salt diet(66.7%). Gimchi was included as one of the most commonly ingested foods (77. 8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1%). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%). Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns(57.7%) related to nursing needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical dis comfort including the following: memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51,l%), sleep disturbance(46. 7%) and other symptoms in that order of frequency. Nursing needs related to phyaical condition were a concern for all of them. The viability and function of the replaced valve (53.3%) and weight gain (60.0%) were major concerns, 6. Looking at their psychoemotional condition it was found that 36 patients (80.0%) were emotionally unstable. The causes were physical discomfort (17 patients), insufficient knowlege of open heart sur-gery(6 patients), fear of death(6 patients), familial over protection(2 patients) and lack of support(5 patients).

MeSH Terms

Adult
Diet
Education
Follow-Up Studies
Hair
Heart*
Humans
Memory
Mitral Valve
Motor Activity
Nursing*
Outpatients
Return to Work
Thoracic Surgery*
Thorax
Weight Gain