The impact of a self-management program on exercise adherence among patients discharged after coronary artery bypass grafts: A quasi-experimental study in Thailand
PDF
XML

Keywords

coronary artery bypass graft
exercise adherence
self-management
patient discharge
Thailand
nurses

How to Cite

Tippinit, S., & Polsook, R. (2023). The impact of a self-management program on exercise adherence among patients discharged after coronary artery bypass grafts: A quasi-experimental study in Thailand. Belitung Nursing Journal, 9(4), 322–330. https://doi.org/10.33546/bnj.2685
Crossref
Scopus
Google Scholar

Link to Google Scholar

Accepted for publication: 2023-06-12
Peer reviewed: Yes

Related articles in


Search Relations - Article by Author(s)

Share this article on:

Abstract

Background: Exercise adherence is essential for maintaining the physical and mental health of patients after coronary artery bypass grafts (CABG). However, adherence is often poor, particularly in the early weeks after hospital discharge, leading to adverse health outcomes. Therefore, implementing self-management programs is crucial to promote and sustain long-term exercise adherence among these patients.

Objective: This study aimed to examine the impact of self-management programs on exercise adherence in post-CABG patients.

Methods: A quasi-experimental posttest-only control group study was conducted from April to November 2022 at Surat Thani Hospital in Thailand. Forty post-CABG patients were gender and age-matched and randomly assigned to either the control group (n = 20) or the experimental group (n = 20). The experimental group participated in a six-week self-management program for exercise adherence, utilizing telephone and LINE applications, while the control group received standard care. Data were collected using validated exercise adherence rating scales and a self-management questionnaire. Descriptive statistics and independent t-tests were employed for data analysis.

Results: The mean exercise adherence score in the control group was 9.30 (SD = 4.91), whereas it was 21.30 (SD = 3.20) in the experimental group. The experimental group, which received the self-management program, exhibited significantly higher exercise adherence scores compared to the control group (t = 9.16, df = 32.65, p <0.001).

Conclusions: This study demonstrates the effectiveness of a post-CABG self-management program in improving exercise adherence. Nurses play a crucial role in promoting and enhancing self-management during the pre-and post-discharge phases, and regular phone or LINE application contacts can have a positive impact on post-CABG patients. Policymakers should consider implementing self-management programs to encourage patients to maintain their exercise routines, leading to improved physical and mental well-being.

https://doi.org/10.33546/bnj.2685
PDF
XML

Copyright

Copyright (c) 2023 Sudarat Tippinit, Rapin Polsook

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 337 [Abstract: 151 | PDF: 174 | XML: 12 ]

Downloads

Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors declared no potential conflict of interest in this study.

Acknowledgment

The authors would like to express their heartfelt gratitude to all participants for contributing to this project.

Authors’ Contributions

All authors contributed to the study design, data collection, data analysis, interpretation, drafting of the article, and critical revision. All authors were accountable in each phase of the study and approved the final version of the article to be published.

Data Availability

Datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

None.


References

Akbari, M., & Celik, S. S. (2015). The effects of discharge training and counseling on post-discharge problems in patients undergoing coronary artery bypass graft surgery. Iranian Journal of Nursing and Midwifery Research, 20(4), 442-449. https://doi.org/10.4103%2F1735-9066.161007

Ali, M. A., Yasir, J., Sherwani, R. N., Fareed, M., Arshad, F., Abid, F., Arshad, R., Ismail, S., Khan, S. A., & Siddiqui, U. (2017). Frequency and predictors of non-adherence to lifestyle modifications and medications after coronary artery bypass grafting: A cross-sectional study. Indian Heart Journal, 69(4), 469-473. https://doi.org/10.1016/j.ihj.2017.05.017

American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). (2020). Guidelines for cardiac rehabilitation programs (6th ed.). Champaign, IL: Human Kinetics.

Anderson, L., Thompson, D. R., Oldridge, N., Zwisler, A. D., Rees, K., Martin, N., & Taylor, R. S. (2016). Exercise‐based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews(1), CD001800. https://doi.org/10.1002/14651858.CD001800.pub3

Balasi, L. R., Paryad, E., Booraki, S. H., Leili, E. K., Meibodi, A. M. S., & Sheikhani, N. N. (2015). Medication adherence after CABG and its related to medication belief. Biomedical and Pharmacology Journal, 8(2), 603-610. https://dx.doi.org/10.13005/bpj/804

Bazargani, R. H., Besharat, M. A., Ehsan, B., Nejatian, M., & Hosseini, K. (2011). The efficacy of chronic disease self management program and Tele-health on adherence by increasing self efficacy in patients with CABG. Procedia-Social and Behavioral Sciences, 30, 817-821. https://doi.org/10.1016/j.sbspro.2011.10.158

Bikmoradi, A., Masmouei, B., Ghomeisi, M., Roshanaei, G., & Masiello, I. (2017). Impact of telephone counseling on the quality of life of patients discharged after coronary artery bypass grafts. Patient Education and Counseling, 100(12), 2290-2296. https://doi.org/10.1016/j.pec.2017.06.010

Blanchard, C. M., Rodgers, W. M., Courneya, K. S., Daub, B., & Knapik, G. (2002). Does barrier efficacy mediate the gender-exercise adherence relationship during phase II cardiac rehabilitation? Rehabilitation Psychology, 47(1), 106-120. https://doi.org/10.1037/0090-5550.47.1.106

Chiang, S.-L., Shen, C.-L., Chen, L.-C., Lo, Y.-P., Lin, C.-H., & Lin, C.-H. (2020). Effectiveness of a home-based telehealth exercise training program for patients with cardiometabolic multimorbidity: A randomized controlled trial. Journal of Cardiovascular Nursing, 35(5), 491-501. https://doi.org/10.1097/JCN.0000000000000693

Griffo, R., Ambrosetti, M., Tramarin, R., Fattirolli, F., Temporelli, P. L., Vestri, A. R., De Feo, S., & Tavazzi, L. (2013). Effective secondary prevention through cardiac rehabilitation after coronary revascularization and predictors of poor adherence to lifestyle modification and medication. Results of the ICAROS Survey. International Journal of Cardiology, 167(4), 1390-1395. https://doi.org/10.1016/j.ijcard.2012.04.069

Hair, J. F. (2010). Multivariate data analysis: A global perspective (7th ed.). Upper Saddle River, N.J.: Pearson Education.

Head, S. J., Davierwala, P. M., Serruys, P. W., Redwood, S. R., Colombo, A., Mack, M. J., Morice, M.-C., Holmes Jr, D. R., Feldman, T. E., & Ståhle, E. (2014). Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: Final five-year follow-up of the SYNTAX trial. European Heart Journal, 35(40), 2821-2830. https://doi.org/10.1093/eurheartj/ehu213

Hillis, L. D., Smith, P. K., Anderson, J. L., Bittl, J. A., Bridges, C. R., Byrne, J. G., Cigarroa, J. E., DiSesa, V. J., Hiratzka, L. F., & Hutter, A. M. (2012). 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. The Journal of Thoracic and Cardiovascular Surgery, 143(1), 4-34. https://doi.org/10.1016/j.jtcvs.2011.10.015

Højskov, I. E., Thygesen, L. C., Moons, P., Egerod, I., Olsen, P. S., & Berg, S. K. (2020). The challenge of non-adherence to early rehabilitation after coronary artery bypass surgery: Secondary results from the SheppHeartCABG trial. European Journal of Cardiovascular Nursing, 19(3), 238-247. https://doi.org/10.1177/1474515119883454

Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., & Cuisset, T. (2020). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: the Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal, 41(3), 407-477. https://doi.org/10.1093/eurheartj/ehz425

Kulik, A., Ruel, M., Jneid, H., Ferguson, T. B., Hiratzka, L. F., Ikonomidis, J. S., Lopez-Jimenez, F., McNallan, S. M., Patel, M., & Roger, V. L. (2015). Secondary prevention after coronary artery bypass graft surgery: A scientific statement from the American Heart Association. Circulation, 131(10), 927-964. https://doi.org/10.1161/CIR.0000000000000182

Lorig, K. R., & Holman, H. R. (2003). Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7. https://doi.org/10.1207/S15324796ABM2601_01

Miri, J., Naderipour, A., Ashtarian, H., & Hashemian, A. (2016). The effect of chronic disease self-management program on health status of patients undergoing coronary artery bypass graft surgery. Journal of Critical Care Nursing, 9(1), e5103.

Nahapetyan, A. (2007). Relationship between patients’ knowledge about post operative risk factors after coronary artery bypass surgery (CABG) and adherence to medication and lifestyle changes in Armenia [Master Thesis, College of Health Sciences American University of Armenia]. Yerevan, Armenia. https://dspace.aua.am/xmlui/handle/123456789/859

National Health Security Office (NHSO). (2022). Annual report year 2021. https://eng.nhso.go.th/view/1/Annual_Reports/EN-US

Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., & Head, S. J. (2019). 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal, 40(2), 87-165. https://doi.org/10.1093/eurheartj/ehz507

Newman-Beinart, N. A., Norton, S., Dowling, D., Gavriloff, D., Vari, C., Weinman, J. A., & Godfrey, E. L. (2017). The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: The Exercise Adherence Rating Scale (EARS). Physiotherapy, 103(2), 180-185. https://doi.org/10.1016/j.physio.2016.11.001

Prabhu, N. V., Maiya, A. G., & Prabhu, N. S. (2020). Impact of cardiac rehabilitation on functional capacity and physical activity after coronary revascularization: A scientific review. Cardiology Research and Practice, 2020, 1236968. https://doi.org/10.1155/2020/1236968

Rushton, M., Howarth, M., Grant, M. J., & Astin, F. (2017). Person‐centred discharge education following coronary artery bypass graft: A critical review. Journal of Clinical Nursing, 26(23-24), 5206-5215. https://doi.org/10.1111/jocn.14071

Schumacker, R. E., & Lomax, R. G. (2010). A beginner's guide to structural equation modeling (3rd ed.). New York, NY, US: Routledge/Taylor & Francis Group.

Stepanczuk, B., & Charvat, J. M. (2010). Women's and men's exercise adherence after a cardiac event: Does age make a difference? Research in Gerontological Nursing, 3(1), 30-38. https://doi.org/10.3928%2F19404921-20090706-03

Strategy and Planning Division Ministry of Public Health Thailand. (2022). Public health statistics A.D. 2021. Thailand: Ministry of Public Health. https://spd.moph.go.th/wp-content/uploads/2022/11/Hstatistic64.pdf

Supervia, M., Turk-Adawi, K., Lopez-Jimenez, F., Pesah, E., Ding, R., Britto, R. R., Bjarnason-Wehrens, B., Derman, W., Abreu, A., & Babu, A. S. (2019). Nature of cardiac rehabilitation around the globe. EClinicalMedicine, 13, 46-56. https://doi.org/10.1016/j.eclinm.2019.06.006

Task Force Members, Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A., Bugiardini, R., Crea, F., & Cuisset, T. (2013). 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. European Heart Journal, 34(38), 2949-3003. https://doi.org/10.1093/eurheartj/eht296

The Heart Association of Thailand under the Royal Patronage. (2020). Cardiac rehabilitation guideline (in Thai). http://www.thaiheart.org/images/column_1291454908/RehabGuideline.pdf

The Society of Thoracic Surgeons of Thailand. (2022). Cardiac surgery statistic in Thailand. https://thaists.org/en/

Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Ferguson, J. F., Generoso, G., Ho, J. E., Kalani, R., Khan, S. S., Kissela, B. M., . . . Martin, S. S. (2022). Heart disease and stroke statistics—2022 update: A report from the American Heart Association. Circulation, 145(8), e153-e639. https://doi.org/10.1161/CIR.0000000000001052

Vachenauer, R., Grunenfelder, J., Plass, A., Slankamenak, K., Pantic, L., Kisner, D., & Genoni, M. (2008). Changing lifestyle habits as secondary prophylaxis after coronary artery bypass grafting. Heart Surgery Forum, 11(4), E243.

Wattanasin, S., & Chupan, S. (2017). Exercise for cardiac rehabilitation. Journal of Health Education, 40(1), 1-11.

Yanagawa, B., Puskas, J. D., Bhatt, D. L., & Verma, S. (2017). The coronary heart team. Current Opinion in Cardiology, 32(5), 627-632. https://doi.org/10.1097/HCO.0000000000000432

Yuroong, A., Asdornwised, U., Pinyopasakul, W., Wongkornrat, W., & Chansatitporn, N. (2021). The effectiveness of the transitional care program among people awaiting coronary artery bypass graft surgery: A randomized control trial. Journal of Nursing Scholarship, 53(5), 585-594. https://doi.org/10.1111/jnu.12673


Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system