J Korean Acad Nurs.  2008 Apr;38(2):217-228. 10.4040/jkan.2008.38.2.217.

The Development and Effects of an Integrated Symptom Management Program for Prevention of Recurrent Cardiac Events after Percutaneous Coronary Intervention

• Son YJ

• KMID: 820075
• DOI: http://doi.org/10.4040/jkan.2008.38.2.217

Abstract

PURPOSE: This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. METHODS: Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care. RESULTS: The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences. CONCLUSION: These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.

Keyword

Percutaneous coronary intervention; Recurrence; Symptom management

MeSH Terms

Adult
Aged
*Angioplasty, Balloon
Biological Markers/blood
Coronary Disease/*prevention & control/psychology/surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
*Patient Education as Topic
Postoperative Care
Program Development
Program Evaluation
Quality of Life
Recurrence
*Self Care

Figure

• 

  Figure 1 Conceptual framework of this study

• 

  Figure 2 Research design

Reference

1. Appels A, Bär F, Lasker J, Flamm U, Kop W. The Effect of a psychological intervention program on the risk of a new coronary event after angioplasty: a feasibility study. Journal of Psychosomatic Research. 1997. 43:209–217.

2. Barnason S, Zimmerman L, Nieveen J, Schmaderer M, Carranza B, Reilly S. Impact of a home communication intervention for coronary artery bypass graft patients with ischemic heart failure on self efficacy, coronary disease risk factor modification, and functioning. . Heart&Lung. 2003. 32:147–158.

3. Barnason S, Zimmerman L, Brey B, Catlin S, Nieveen J. Patterns of recovery following percutaneous coronary intervention: a pilot study. Applied Nursing Research. 2006. 19:31–37.

4. Black JM, Matassarin-Jacobs E. Medical-Surgical Nursing. 1997. 5th ed. Philadelphia: Saunders Co..

5. Bogaty P, Poirier P, Simard S, Boyer L, Solymoss S., Dagenais G. Biological profiles in subjects with recurrent acute coronary events compared subjects with long standing stable angina. Circulation. 2001. 103:3062–3068.

6. Brown SJ, Lieberman DA, Germeny BA, Fan YC, Wilson DA, Pasta DJ. Educational video games for juvenile diabetes: results of a controlled trial. Medical Informatics. 1997. 22:77–89.

7. Cohen J. Statistical power analysis for the behavioral science. 1988. 2nd ed. New Jersey: Lawrence Erlbaum Association Pub..

8. Dodd M, Janson S, Facion N, Faucett J, Froelicher ES. Advancing the science of symptom management. Journal of Advanced Nursing. 2001. 33:668–676.

9. Fernandez RS, Griffiths R, Juergens C, Davidson P, Salamonson Y. Persistence of coronary risk factor status in participants 12 to 18 months after percutaneous coronary intervention. The Journal of Cardiovascular Nursing. 2006. 21:379–387.

10. Gulanick M, Blileu A, Perino B, Keough V. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with CAD. Circulation. 1998. 89:975–990.

11. Hanssen TA, Nordrehaug JE, Eide GE, Hanestad BR. Improving outcomes after myocardial infarction: a randomized controlled trial evaluating effects of a telephone follow up intervention. European Journal of Cardiovascular Prevention and Rehavilitaion. 2007. 14:429–437.

12. Kim GY. Development of a critical pathway for patients with coronary artery bypass graft. Journal of Korean Academy of Nursing. 1998. 28:117–131.

13. Kim HS, Park MJ. Correlation between knowledge and educational needs related to recurrence in coronary artery bypass graft patients. Journal of Korean Academy of Nursing. 2000. 30:549–559.

14. Koh SB, Chang SJ, Kang MG, Cha BS, Park JK. Reliability and validity on measurement instrument on health status assessment in occupational workers. Korean Journal of Preventive Medicine. 1997. 30:251–266.

15. Kop WJ. Acute and chronic psychological risk factors for coronary syndromes: moderating effects of coronary artery disease severity. Journal of Psychosomatic Research. 1997. 43:167–181.

16. 2005 Etiology of mortality in Korea. 2006. Retrieved 2006 Nov 10. Korea National Statistical Office;from http://www.nso.go.kr.

17. Lee YW, Kim HS, Cho EY. The influencing factors on health behavior of patients with coronary artery disease. Journal of Korean Academy of Nursing. 2002. 32:40–49.

18. Lerakis S, El-chami MF, Patel AD, Veledar E, Alexopoulos E, Zacharoulis A, et al. Effects of lipid levels and lipid lowering therapy on restenosis after coronary artery stenting. The American Journal of Medical Sciences. 2006. 331:270–273.

19. Lichtman JH, Amatruda J, Yarri S, Cheng S, Smith GL, Mattera JA, et al. Clinical trial of an educational intervention to achieve recommended cholesterol levels in patients with coronary artery disease. American Heart Journal. 2004. 147:522–528.

20. Odell A, Grip L, Hallberg LR. Restenosis after percutaneous coronary intervention: experiences from the patient's perspective. European Journal of Cardiovascular Nursing. 2006. 5:150–157.

21. Park JA. The comparative study on stress and the compliance of sick role behavior according to the restenosis of coronary artery intervention patient. 2003. Seoul: Kyunghee University;Unpublished master's thesis.

22. Sinclair AJ, Conroy SP, Davies M, Bayer AJ. Post discharge home based support for older cardiac patients: a randomized controlled trial. Age and Ageing. 2005. 34:338–343.

23. Slavin L, Chhabra A, Tobis JM. Drug-eluting stents: preventing restenosis. Cardiology in Review. 2007. 15:1–12.

24. Taylor CB, Miller NH. Wenger NK, Hellerstein HK, editors. Rehabilitation of coronary patient. Education of the coronary patient and family: the behavioral approach. 1991. 3rd ed.New York: Churchill Livingstone.

25. Ware JE, Sherboune CD. The Mos 36-item short form health survey (SF-36). Medical Care. 1992. 30:473–483.

26. Wong MS, Chair SY. Changes in health related quality of life following percutaneous coronary intervention: a longitudinal study. Internaltional Journal of Nursing Studies. 2007. 44:1334–1342.

27. Zimmerman L, Barnason S, Schulz P, Nieveen J, Miller C, Hertzog M, et al. The effects of a symptom management intervention on symptom evaluation, physical functioning, and physical activity for woman after coronary artery bypass surgery. Journal of Cardiovascular Nursing. 2007. 22:493–500.