Programa de educación para la salud en el trasplantado de corazón. Ensayo controlado con asignación aleatoria

[Effects of a pre-transplant educational program on the improvement of knowledge at hospital discharge after a liver transplant]

OBJECTIVE

To determine the effect of an educational program implemented before liver transplant on improving understanding at hospital discharge after the transplant and examine the contribution of different demographic and clinical variables on the level of knowledge.

METHODS

A quasi-experimental study with a non-equivalent control group undertaken at the Hepato-Biliary-Pancreatic and Transplant Unit of Carlos Haya Regional University Hospital, Malaga, Spain. Sampling was consecutive (non-probabilistic), with a sample size of 31 patients for each group. An educational program was designed, encompassing the following Nurse Intervention Classification (NIC): Teaching: disease process; Teaching: prescribed diet; Education: prescription drugs; Protection against infection; Management of Hyperglycaemia; Management of Hypoglycaemia. For the outcome variable, a knowledge questionnaire was designed, with a total score range between 5-30 points, structured according to 6 indicators for Nurse Outcomes Classification (NOC): Description of the disease process, Description of the medication prescribed, Description of the prescribed diet, Description of self-care responsibilities, Description of practices that reduce transmission, Identification of actions to take in relation to blood glucose.

RESULTS

The study included 61 patients, 33 for the control group and 28 for the intervention group. The mean score on the questionnaire of the intervention group was 20.25 ± 2.8 and that of the control group 13.06 ± 3.51 points. The difference between the two groups was 7.19 (95% CI: 5.73-8.64; P<.01). The analysis of the indicators showed that there were significant differences between the study groups, except for the indicator identification of actions to take in relation to blood glucose. No demographic or clinical variable (sex, education level, primary caregiver, waiting list time, time in hospital unit, hospital stay and days since the last talk before the transplant (only in intervention group)) was significantly associated with level of knowledge.

CONCLUSION

This educational program conducted at Carlos Haya hospital in patients on the liver transplant waiting list improved their knowledge after their transplant.

[Nutritional analysis of 25 heart transplanted patients]

BACKGROUND AND OBJECTIVE

Malnutrition could be very important in patients under surgery. Moreover, the immunosuppressive therapy can cause metabolic and nutritional disorders to the transplanted patients. The aim of this study was to obtain information about the nutritional situation of the cardiac transplanted patients with biochemical and anthropometric parameters.

PATIENTS AND METHOD

A retrospective descriptive transversal study. We reviewed clinic records of cardiac transplanted patients between 2004 and 2005. Biochemical and anthropometric parameters recorded before surgery, in the intensive care unit and at the hospital discharge.

RESULTS

At discharge, there is a decrease of the following parameters: albumin, 68%; creatinine, 68%; proteins, 92%, and body mass index, 64%; whereas one year after discharge an increase of the body mass index was observed (60%). It was observed that 36% of the patients presented high results of triglycerides, after both a month and a year after discharge. The percentage is of 32% of glucose and between 52% and 24% for cholesterol, respectively.

CONCLUSIONS

In patients submitted to cardiac transplantation, there is a tendency for a damaged nutritional situation, both at discharge and after a year. It is important to point out the need for a nutritional education to decrease possible complications.