冠狀動脈繞道手術病人出院後身體恢復及心理社會調適情形與相關影響因素之探討

Physical Recovery and Psychosocial Adjustment of Patients Having Coronary Artery Bypass Grafting after Discharge from the Hospital

蔡佩珊(Pei-Shan Tsai) ； 胡琪容(C. J. Hu)

《長庚護理》 8卷4期 (1997/12) Pp. 1-12

摘要

冠狀動脈繞道移植(CABG)手術爲冠狀動脈疾病(CAD)常見的一種外科療法，然而有關手術後病人的活動進展以及心理社會預後方面的資料卻非常有限。本研究旨在探討CABG病人，出院後二個月內的身體恢復、心理社會調適情形及相關影響因素。
本研究採方便取樣，樣本取自北部某醫學中心之CABG病人，共計27人。本研究採用基本資料調查表、恢復情況調查表及心理社會調適量表，分別以面對面訪談。電話訪談及問卷調在法來收集資料。敘述性統計以百分比及平均值來呈現：以t-test測試恢復情形及症狀之改善；使用Likelihood Ratio Chi-Square與ANOVA檢定身體恢復與心理社會調適之影響因素；及以Pearson積差相關測試身體恢復與心理社會調適之間的關係。
病人自覺的身體恢復情形及症狀的嚴重度，隨著出院週數的增加而改善，然出院後活動之進展卻相當緩慢。傷口疼痛爲症狀中發生率圾高者。手術前心臓功能較佳者，在出院滿一個月時症狀嚴重度較低，且於出院滿兩個月時之活動程度較高。百分之七的病人出現心理社會調適功能失常。腦血管意外病史及糖尿病史影響病人整體的心理社會調適表現。冠狀動脈繞道移植病人之身體功能恢復並不一定能預測正向的心理社會預後。

關鍵字

冠狀動脈繞道移植手術 ； 身體恢復 ； 心理社會調適

並列摘要

Coronary artery bypass grafting, (CABG) is the most common modality in treating the patients with coronary artery disease (CAD). While surgical management is well documented, there has been a paucity of information regarding activity and psychosocial out comes after surgery. The purpose of this study was to investigate physical recovery, psychosocial adjustment and related factors over a 2-month period after discharge from the hospital.
The convenient sample consisted of 27 patients having CABG. The instrument for data collection included Personal and illness survey, Patients' Recovery From CABG Survey, and Psychosocial Adjustment to illness Seale. Face-to-face structured interviews, telephone interviews, and self-report questionnaire were data collection methods. Descriptive statistics, t-test. Likelihood Ratio Chi-Square, ANOVA, and Pearson correlation were used to analyze data.
The patients' perceptions of physical recovery and severity of symptoms gradually improved over time, however, however, activity level advanced slowly. The incidence of complaints of incisional discomforts was the highest among symptoms. Those patients with better cardiac function prior to surgery reported less severe symptoms. Those patients with better cardiac function prior to surgery reported less severe symptoms at the first month after discharge and higher level of activity at the second month after discharge.
Seven percent of the patients indicated psychosocial maladjustment at the second month after discharge from the hospital. The over all psychosocial adjustment were affected by history of cerebral vascular accident (CVA) and diabetes mellitus (DM). There is no relationship between physical recovery and psychosocial adjustment.

並列關鍵字

Coronary Artery Bypass Surgery CABG ； Physical Recovery ； Psychosocial Adjustment