The effect of activities of daily living on the self-care agency of patients in a cardiovascular surgery clinic

Drug-related problems at the heart of cardiac surgery

OBJECTIVES

Optimal perioperative success in cardiac surgery requires precise management of drug treatment. This study aimed to determine the prevalence, types and associated factors of drug-related problems (DRPs) during the entire hospital stay.

METHODS

A prospective observational study was conducted at the department of cardiovascular surgery in a university hospital between November 2019 and March 2020. Patients with planned elective cardiac surgery, aged ≥18 years, were included. A clinical pharmacist collaboratively reviewed medications on a daily basis and identified DRPs.

RESULTS

A total of 100 patients (60 male) were included; median (range) age was 62 (19-86) years, and median (IQR) length of stay in hospital was 15 (9) days. A total of 275 DRPs were identified (median (IQR) 3 (2-4)). The number of patients who had at least one DRP was 47 preoperatively, 55 in the postoperative intensive care unit, 100 in the postoperative ward, and 16 at discharge. In order to reduce bias because of the small sample size, Firth's logistic regression analysis was conducted. Statistically significant variables according to univariate analysis were included into a logistic regression model. Therefore the length of hospital stay (OR 1.14, 95% CI 1.03 to 1.26, p=0.008), living arrangements (living alone) (OR 4.24, 95% CI 1.41 to 12.73, p=0.009), number of medications at admission (OR 1.32, 95% CI 1.09 to 1.59, p=0.002), and having coronary artery bypass graft surgery (OR 2.87, 95% CI 1.07 to 7.70, p=0.03) were associated with an increased risk for DRPs in the final model.

CONCLUSION

Hospital stay carries an increased risk for DRPs, especially at the postoperative stage. Modifiable risk factors for DRPs can be managed by required interventions performed by a multidisciplinary healthcare team.

Investigating the effect of implementing a program based on transitional care model on the quality of life and the ability of doing activities of daily living among patients with stroke

BACKGROUND

Stroke is one of the major causes of disability among individuals. Transitional care of a stroke patient can contribute to sustaining and enhancing the quality of care. The aim of this study is to determine the effect of implementing a program based on the transitional care model on the quality of life and ability of doing daily activities among patients suffering from stroke.

MATERIALS AND METHODS

This research was an interventional study performed on 80 patients with stroke referring to the hospitals affiliated with Isfahan University of medical sciences. For data collection, demographic, quality of life measurement following stroke, and Bartell index of daily activity measurement questionnaires were used at the beginning of the study and 10 weeks following discharge. The transitional care model was undertaken for the intervention group from the second day of hospitalization until 10 weeks postdischarge. The data were analyzed using SPSS software and statistical methods.

RESULTS

The results indicated that the mean quality of life and ability of performing the activities changed significantly after the intervention between the two groups, with the mean changes of these scores becoming significant compared to the preintervention between the two groups (P < 0.05). In both groups, the mean value of these scores increased after the study compared to the baseline, though this increase was greater in the intervention group.

CONCLUSION

Implementing the transitional care model could contribute to improving the quality of life and performing the daily activities among stroke patients.

Philanthropic Foundations' Discourse and Nursing's Future

In this article, we examine external agents' effect on nursing's professional evolution and the consequences for the discipline's collective agency, social contract, and self-regulation. Situated within Foucault's theories of power, we review how the power of organizations reaches into the fabric of everyday life and explore how philanthropic foundations have influenced a diverse array of disciplines, including nursing. Through a genealogic lens, we examine nursing history and professionalization and conclude with concerns surrounding nursing's exercise of its collective agency during one of the most significant, discipline-shaping activities of modern times-Robert Wood Johnson Foundation's Future of Nursing initiatives.

The Effect of Computer-Based Training on Self-care and Daily Living Activities in Patients With Lumbar Discectomy Surgery: A Randomized Controlled Study

This research was conducted to determine the effect of computer-based discharge training on patients with lumbar disc surgery on self-care agency and independence in daily living activities. A randomized controlled study was conducted on 60 patients, 30 in the intervention group and 30 in the control group. Computer-based lumbar disc surgery discharge training and a CD containing the training content were given to the intervention group after the surgery, whereas the control group received routine discharge training in the ward. The data of the study were collected using a Patient Information Form, the modified Barthel Index, and the Exercise of Self-Care Agency Scale. The increase in the modified Barthel Index and Exercise of Self-Care Agency Scale scores after training in the intervention and control groups were statistically significant (P < .001). The increase in Exercise of Self-Care Agency Scale scores after the training was found to be higher in the intervention group than in the control group. There was no difference between the modified Barthel Index mean scores before and after the training between the groups (P > .05). Computer-based discharge training improved the participants' independence in their daily living activities and increased the self-care power of the patients compared with the control group.

Effects of Illness Perception on Self-Care Agency and Hopelessness Levels in Liver Transplant Patients: A Descriptive Cross-Sectional Study

Individuals with liver transplantation (LT), hopelessness, and lack of self-care may occur and change in the illness perceptions; however, no study has examined the effects of the illness perceptions on self-care agency and hopelessness levels in individuals with LT. This study was conducted to examine the effects of the illness perceptions of patients who had received LT surgery on their self-care agency and hopelessness levels. A descriptive cross-sectional study with a convenience sample (N = 120) was conducted at a center in eastern Turkey. The data were collected by using the "Brief Illness Perception Questionnaire" (B-IPQ), "Self-Care Agency Scale" (SCAS), "Beck Hopelessness Scale" (BHS). In the study, the mean total B-IPQ, SCAS, BHS scores was found as 57.50 ± 3.61, 83.83 ± 9.43, 10.19 ± 3.81, respectively. There was a positive and significant relationship between the B-IPQ and BHS total scores.

Relación entre la capacidad de agencia de autocuidado y la calidad de vida en personas con insuficiencia cardiaca

Introducción. La persona con insuficiencia cardiaca enfrenta cambios biopsicosociales que deterioran su calidad de vida. Es necesario conocer la relación existente entre el autocuidado y la calidad de vida, lo que puede orientar al profesional de enfermería en el diseño de intervenciones efectivas. Objetivo. Determinar la relación existente entre la capacidad de agencia de autocuidado y la calidad de vida relacionada con la salud en las personas con insuficiencia cardiaca, que son atendidas en el programa multidisciplinario de insuficiencia cardiaca en una institución de salud de cuarto nivel en Bogotá, Colombia. Método. Estudio descriptivo correlacional de corte transversal, realizado entre mayo y agosto de 2018; utilizando los instrumentos Appraisal of Self-care Agency Scale y el Cuestionario de Cardiomiopatía de Kansas City; la muestra correspondió a 107 pacientes, mayores de edad, con insuficiencia cardiaca estadio C y D. Resultados. La capacidad de agencia de autocuidado se encontró en categorías alta con 63.55% y muy alta con 34.57%; la calidad de vida relacionada con la salud se encontró preservada, con un puntaje general de 73.33; la relación existente entre las dos variables, según el coeficiente de correlación de Spearman, fue 0.316 con un valor p = 0.002, relación débil pero significativa. Conclusiones. Existe una relación entre las variables de interés, que se reafirma con las correlaciones significativas identificadas entre las dimensiones que las conforman. Estos hallazgos resaltan la pertinencia de abordar, en las intervenciones, temáticas que fortalezcan la capacidad de agencia de autocuidado, contribuyendo a mejorar la calidad de vida de estas personas.

The Relationship Between Self-Care Agency and Depression in Older Adults and Influencing Factors

Depression is a significant mental health problem in older adults. There is a decrease in self-care agency and an increase in the prevalence of depression with aging. The current study was conducted to determine the relationship between self-care agency and depression in Turkish older adults aged ≥65 years (N = 473) and the influencing factors. Data were collected using a demographics questionnaire, the Self-Care Agency Scale, and the Geriatric Depression Scale. Self-care agency was related to age, marital status, level of education, economic status, and persons lived with, and depression was related to gender, marital status, level of education, economic status, chronic disease, and persons lived with. A negative correlation was found between the scales. As the score of self-care agency increased, depression decreased. [Journal of Psychosocial Nursing and Mental Health Services, 58(10), 39-47.].