Thai Journal of Cardio-Thoracic Nursing

Chronic post thoracotomy pain experience, and pain management among patients after discharge: a cross-sectional study

Siraluk Tonghui, Luppana Kitrungrote, Voravit Chittitavorn — Mon, 22 Jan 2024 00:00:00 +0700

This cross-sectional descriptive study aimed to investigate chronic post-thoracotomy pain (CPTP) and pain management among patients having had thoracotomy after discharge. The 60 samples were purposively selected from patients with open thoracotomy who had CPTP for at least 3 months after being discharged from the Songklanagarind Hospital from June 2020 to May 2021. Data were collected using interviews with a set of questionnaires including 1) the Demographic and Health-related Data Questionnaire, 2) the CPTP Experience Questionnaire, and 3) the Chronic Pain Management Methods Questionnaire. Data were analyzed using descriptive statistics and content analysis.

The results were as follows: the location of chronic pain was at an incision wound site. Pain characteristics were commonly described as sharp (71.7%), burning or electrical shock (25.0%), and tingling (23.3%). The pain intensity was at a mild level (Mdn = 3.0, IQR = 2.0). Most patients had no interference with daily life. Most of the patients managed their CPTP by using non-pharmacological methods (97.0%). The commonly used pain management methods included 1) caring for surgical wounds by reducing or not using muscle force at the surgical wound site, 2) using distraction, receiving information and encouragement, and 3) adjusting thought and performing religious activities. They gave the reasons that they relax the body and mind and relieve pain. Moreover, most patients evaluated the effectiveness of these pain management methods at high to moderate levels.

The results of this study suggest that nurses should provide knowledge about CPTP, pharmacological and non-pharmacological pain management for pain relief to patients prior to hospital discharge.

Predictive factors of sleep quality among patients undergoing cardiac surgery in intensive care unit

Waruntorn Leelasettakul, Luppana Kitrungrote, Voravit Chittitavorn — Mon, 22 Jan 2024 00:00:00 +0700

This correlational predictive study aimed to investigate the level of sleep quality and predictive factors on sleep quality among patients undergoing cardiac surgery in the intensive care unit. Ninety-four participants were patients with cardiac surgery in the intensive care unit at Songklanagarind Hospital who were consecutively enrolled according to the eligibility criteria. Data were collected from November 2021 to July 2022. The instruments included the Demographic and Health-related Data Questionnaire, the History of Sleep Quality Questionnaire, the Sleep Quality During Admission in the Intensive Care Unit Questionnaire, Pain Intensity Scale, the Anxiety Questionnaire, and the Environment Questionnaire. The data were analyzed using descriptive statistics and hierarchical multiple regression.

The results showed that the patient had sleep quality at a moderate level. After controlling confounding factors including the history of using sleep medications and having nausea and vomiting, the history of sleep quality; surgical wound pain; anxiety and environment could explain 24.2% of the variance in sleep quality of patients undergoing cardiac surgery (Adjusted R² change= .242, F= 10.55, p< .001). The history of sleep quality; surgical wound pain and anxiety were predictive sleep quality of patients undergoing cardiac surgery in the intensive care unit, but the environment did not show predictive power on sleep quality (β=.29, p< .001; β= -.29, p< .01; β= -.26, p< .01; β= -.04, p> .05), respectively.

The findings of this study suggest that nurses should assess history of sleep quality, manage surgical wound pain and reduce anxiety to promote sleep quality of patients undergoing cardiac surgery in the intensive care unit.

Relationship between age, education, income, duration of illness from chronic non-communicable diseases (NCDs), knowledge of cerebrovascular disease and Stroke perception in health insurance patients with NCDs

Prapaiwan Danpradit, Saree Dangthongdee — Mon, 22 Jan 2024 00:00:00 +0700

This descriptive research studied the relationships between age, education, income, duration of non-communicable disease (NCDs), knowledge of cerebrovascular disease and stroke perception in health insurance patients with NCDs. The 326 samples were health insurance patients with NCDs who received treatment at the outpatient department of a private hospital in Samut Sakhon Province. Data were collected by using questionnaires which consisted of perception of stroke risk factors, perception of the warning signs of cerebral ischemia, perception of the danger signs of cerebral ischemia, and knowledge of cerebrovascular disease. The data obtained were analyzed by using descriptive statistics, and Pearson’s Moment Product Correlation Coefficient.

The results showed that most of the sample were patients with high blood pressure and moderate levels of stroke perception (Mean =13.23, SD =2.10). Level of education had low negative correlations on stroke perception with statistical significance at 0.01. (r = -0.25, p < 0.01). Knowledge of cerebrovascular disease had low positive correlations on stroke perception with statistical significance at 0.01. (r = 0.19, p < 0.01).

This study suggests that healthcare teams need to promote stroke perception among health insurance patients with updated programs and innovations to improve their stroke knowledge and awareness.

The effect of self-efficacy program for cardiac rehabilitation combined with applied qigong on dyspnea in persons with congestive heart failure

Suttilak Sricharernchaiyasit, Borwarnluck Thongthawee, Adisai Buakhamsri — Mon, 22 Jan 2024 00:00:00 +0700

This study was quasi-experimental research, using a two-group, pre-test/post-test design. The objective was to study the effect of a self-efficacy program for cardiac rehabilitation in combination with applied Qigong effects on dyspnea in patients with congestive heart failure. The sample group is patients diagnosed with left ventricular heart failure admitted to the internal medicine and/or cardiac intensive care unit at a supra-tertiary hospital, 64 patients selected a purposive, 32 people in the control group received normal nursing care, and the experimental group, who received a self-efficacy program to rehabilitate the heart with applied qigong, designed for 10 weeks in a group of 32 people. The research tools consisted of a self-efficacy program to rehabilitate the heart with applied qigong, designed for 10 weeks, the personal information questionnaire, the dyspnea symptom scale, and the self-efficacy scale in heart failure patients. Data were analyzed using descriptive statistics and t-test.

The study found that after participating in the self-efficacy program for cardiac rehabilitation combined with applied qigong, the mean scores of dyspnea in the experimental group (Mean=1.84, SD=1.08) were lower than the control group (Mean=23.28, SD=2.65) (P<0.001).

The study suggests for healthcare providers who take care of patients with heart failure, this program may be considered for use in caring for heart failure patients to reduce dyspnea.

The effectiveness of the synergy model utilization with application line during the pandemic covid-19 on the stress and satisfaction of caregivers of patients with brain surgery

Pattanan Buaphueng, Sakul Changmai, Tipa Toskulkao — Mon, 22 Jan 2024 00:00:00 +0700

This quasi–experimental research (One-group pretest-posttest design) aimed to examine the effectiveness of the synergy model utilization with Application LINE during the COVID-19 pandemic on the stress and satisfaction of caregivers of patients with brain surgery. The sample comprised 15 caregivers of patients with brain surgery in the Surgery Intensive Care Unit from a tertiary care hospital in Samutsongkhram of was selected by convenience sampling. The research instruments consisted of the AACN synergy model with LINE Application. The other tools used for data collection included personal data of brain surgery patients, personal data of primary caregivers, caregiver’s stress scale, and satisfaction questionnaires. The data were analyzed by using descriptive statistics, frequency, percentage, mean and standard deviation, and inferential statistics using paired t-test and one sample t-test.

The results of the study revealed that after using the synergy model utilization with Application LINE, the mean score for the stress of caregivers of patients with brain surgery was lower than before at a statistical significance (p < .05), and the mean score for the satisfaction of caregivers was higher than 85% of hospital quality certification standard.

Based on the results of this research, can reduce stress and improve satisfaction. Therefore, there should be an encouragement to apply the synergy model utilization with Application LINE for all groups of neurological and brain disease patients during the period of an emerging infectious disease outbreak if it continues in the future.

The development of practice guidelines for referring acute ischemic stroke patients for mechanical thrombectomy in Samut Sakhon Hospital

Orawan Somboonjan, Sakul Changmai — Mon, 22 Jan 2024 00:00:00 +0700

This action research aimed to develop guidelines for referring acute ischemic stroke patients for mechanical thrombectomy in Samut Sakhon Hospital and study the feasibility and satisfaction with using guidelines for referring acute ischemic stroke patients for mechanical thrombectomy in Samut Sakhon Hospital. The sample was 12 stroke nurses. Data collection tools were a questionnaire on the feasibility of implementing the guidelines, a Satisfaction questionnaire, and an Appraisal of Guidelines for Research & Evaluation II (AGREE II).

Guidelines for referring acute ischemic stroke patients for mechanical thrombectomy Samut Sakhon Hospital were developed from 15 empirical evidence. The guideline consisted of 5 steps such as: 1) evaluate large cerebral artery occlusions, 2) evaluate indications for mechanical thrombectomy, 3) prepare for referral, 4) nursing care provision during patient transfer, and 5) handing over patients. The feasibility score of using guidelines is at a very good level and nurses have a very good level of satisfaction. The guidelines were pilot-studied by five patients resulting in nurses could perform practically every step.

Recommendations: The developed guidelines should be used to refer ischemic stroke patients for mechanical thrombectomy in Samut Sakhon Hospital and follow up for evaluation to improve it to be more efficient.

Factors predicting health behaviors for cardiovascular disease prevention among Rangsit University personnel

Mon, 22 Jan 2024 00:00:00 +0700

This predictive study aimed to investigate the factors predicting cardiovascular disease preventive health behaviors among 365 Rangsit University personnel who had an annual health check-up in 2021. Samples were selected via stratified random sampling. Data was collected by using questionnaires including the Personal Data Record Form, Health Literacy Scales, Questionnaires of Perceived benefit, Perceived barrier, Perceived Self-efficacy, Activity-related affect, Social support, and Situation influences in performing health behaviors for cardiovascular disease prevention, and Health behaviors for cardiovascular disease prevention questionnaire. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.

Results revealed that the sample had the mean scores of health behaviors in cardiovascular disease prevention, health literacy, perceived self-efficacy, social support, and situation influences in performing health behaviors for cardiovascular disease prevention at moderate levels. They perceived benefits and activity-related effects at a high level, whereas perceived barriers at a low level. Predictors of health behaviors for cardiovascular disease prevention including perceived self-efficacy, health literacy, activity-related affect, and perceived benefit were significant predictors (β = 0.427, p < 0.001; β = 0.194, p < 0.001; β = 0.207, p < 0.001; and β = 0.091, p < 0.05, respectively). These four variables could explain 52.2% of the variance in health behaviors for cardiovascular disease prevention (p < 0.001).

Suggestions from this study include the institute creating health promotion activities for promoting self-efficacy, health literacy, activity-related effect, and perceived benefit for university personnel in performing health behaviors for cardiovascular disease prevention.

Nursing care of patients with post-operative open-heart surgery undergoing cardiopulmonary bypass in critical stage: a case study

Chantira Chiaranai, Triphop Pidtanang, Sudarat Phuangngoen, Nudchaporn Doommai — Mon, 22 Jan 2024 00:00:00 +0700

Patients with post-operative open-heart surgery undergoing cardiopulmonary bypass require closed monitoring and care due to the high risk of severe complications after surgery. Essential nursing care includes monitoring of changes of signs and symptoms and preventing serious complications associated with CPB. Those complications are myocardial injury, altered neurological system, acute kidney injury, bleeding, limb ischemia, inflammation, and coagulation disorder resulting in prolonged hospital stay. Therefore, nurses play an important role in caring patients after heart surgery during critical period. That roles include monitoring and preventing complications from open-heart surgery, as well as complications associated with CPB machine. This article will benefit the critical care nurses who care for patients with post-operative open-heart surgery undergoing CPB. The authors present knowledge from reviewing the empirical evidence including 1) CPB components, 2) principle operation of CPB, 3) the key to achieving extracorporeal blood flow, 4) nursing care for patients undergoing heart surgery in critical period, and 5) a case study