Investigation of the Effect of Nursing-Led Rehabilitation Interventions on Patient Care Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery

Overview

Cardiovascular diseases are one of the leading causes of death globally. In addition to medical treatment and lifestyle changes, open heart surgery treatment also has an important place in the treatment of cardiovascular diseases. CABG surgery is the most common treatment aimed at improving patients' survival and quality of life. The rehabilitative interventions applied include all of the practices that accelerate the management of the disease in individuals with coronary heart disease and the individual's return to the living conditions before the disease. In our country, the cardiac rehabilitation process is carried out in a few centers , and a separate cardiac surgery rehabilitation program is not carried out. The study to be carried out will be the first in this field in our country. With the unit to be established; Rehabilitative interventions applied after coronary artery bypass graft surgery enable individuals to evaluate risk factors, help with any changes in their lifestyle, gain more information about the disease, increase their capacity by increasing cardiac/respiratory function, reduce the physical and psychological effects of the disease and enable them to act independently in their daily activities, Thus, it is aimed to increase the quality of life of individuals. To increase individual and social recovery, to manage and monitor the process by ensuring that families are involved in the process; It is aimed to ensure that it is evaluated and managed by the team (kvc specialist, cardiologist, clinical exercise physiologist, physiotherapist, nurse, dietitian, psychologist, coach) in order to ensure a multidisciplinary approach.

Importance of the Topic and Definition of the Problem According to the World Health Organization (WHO) data for 2023, cardiovascular diseases (CVD) are the first among the top ten causes of death in the world. Similar results are reported by the American Heart Association ( American Heart Association , AHA) for women and men in the United States, by the European Association of Cardiology ( European It is also reported by the Society of Cardiology (ESC) (2017) for ESC member countries and it is stated that approximately 3,800,000 individuals lose their lives due to CVD every year in ESC member countries. Similar to the world, according to the data of the Turkish Statistical Institute (TUIK), circulatory system diseases are the first cause of death in our country . Non-communicable diseases constitute 31.5% of all deaths worldwide, and CVD constitutes 45% of non-communicable diseases. A positive aspect of cardiovascular diseases, which are increasing all over the world, is that they are largely "preventable". graft (CABG) surgery, which is one of the methods applied in the treatment of coronary heart disease , is the most common treatment that aims to increase the life expectancy and quality of life of patients. The rehabilitative interventions applied cover all the applications that accelerate the management of the disease in patients with coronary heart disease and the individual's return to the living conditions before the disease. Cardiovascular diseases are one of the leading causes of death globally. In addition to medical treatment and lifestyle changes, open heart surgery also plays an important role in the treatment of cardiovascular diseases. Coronary artery bypass graft (CABG) surgery is the most common treatment that aims to increase the life expectancy and quality of life of patients. Infection , pain, deterioration in respiratory and circulatory patterns, inability to adapt to the disease, anxiety , depression, inability to cope with stress, fatigue, insomnia, dependence on daily living activities, and role changes in family processes are observed in patients in the short and long term after open heart surgery . the National Institute for Health and Care Excellence (NICE), the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the Centers for Disease Control and Prevention (CDC) and the European Society of Cardiology (ESC) have developed cardiac rehabilitation to provide the best possible physical, mental and social conditions for patients to maintain or maintain optimal functioning through their own efforts, as well as to positively influence the underlying cause of cardiovascular disease. rehabilitative interventions applied cover all the applications that accelerate the management of the disease in patients with coronary heart disease and the individual's return to the living conditions before the disease. Applied after coronary artery bypass graft surgery Rehabilitative interventions aim to increase the individual's quality of life by providing assistance in risk factor assessment, any changes in lifestyle, more information about the disease, increasing the capacity of the patient by increasing the heart/respiratory function, reducing the physical and psychological effects of the disease and allowing them to act independently in their daily activities . Cardiac rehabilitation has many proven benefits, including improvements in functional capacity and quality of life and reduced rates of rehospitalization and death. The results of a 2013 study on this subject showed that participation in cardiac rehabilitation programs significantly reduced ten-year mortality after CABG surgery. In a study conducted in 2018, it was found that the patient group included in the cardiac surgery rehabilitation program had a faster recovery and a decrease in postoperative complications. ( Pulmonary function tests were examined). Another study found that a home-based cardiac rehabilitation program had an impact on the patient's quality of life. rehabilitative interventions applied after coronary artery bypass graft surgery is to help individuals with risk factor assessment, any changes in their lifestyle, provide more information about their disease, increase their capacity by increasing their heart/respiratory function, reduce the physical and psychological effects of the disease and allow them to act independently in their daily activities, thus increasing the quality of life of individuals . In our country, the cardiac rehabilitation process is carried out in a few centers, but a separate cardiac surgical rehabilitation program is not carried out, and this study will be the first in this field in our country. The unit to be established aims to provide assistance in risk factor assessment of individuals after coronary artery bypass graft surgery , any changes in lifestyle, more information about the disease, increase the capacity by increasing the heart/respiratory function, reduce the physical and psychological effects of the disease and allow individuals to act independently in their daily activities, thus increasing the quality of life of individuals. It is aimed to increase individual and social recovery, manage and monitor the process by ensuring that families are included in the process, and ensure that the multidisciplinary approach is ensured by the team ( cardiac specialist, cardiologist, clinical exercise physiologist, physiotherapist , nurse, dietician, psychologist, trainer).