Search

Background: Caregivers (CGs) play a major role in cardiac surgery patients’ adoption of secondary prevention strategies. Little research has examined spousal CGs activities to preserve their own health and support patients’ heart-healthy behaviors. Purpose: The aims of this descriptive pilot study are to: 1) compare cardiovascular (CV) risk factors and physical activity (PA) levels and 2) examine trajectories of change in PA patterns at 3 and 6 weeks and 3 and 6 months after cardiac surgery. Sample: 28 rural residing adult (> 60 years) cardiac surgery patients and their spousal CGs. Methods: PA data was obtained from ActiGraph® accelerometers mailed to dyads at 4 time points after cardiac surgery. Descriptive analyses and multivariate hierarchical modeling were used to describe and identify PA patterns. Findings: The dyads were older (CG M = 68.5 ± 6.6, Patient M = 70.7 ± 6 years) with primarily female CGs (92%) residing in small rural towns (n=26, 46.4%) or farm/ranch (n=16, 28.6%). CV risk factor concordance was evident particularly for hypertension (60.7%) and hypercholesterolemia (25%). CGs and patients spent the majority of time in sedentary activity. Most patients (89.3%) completed cardiac rehabilitation programs and increased their mean minutes/day spent in moderate to vigorous PA over the 4 time points (13.3 ± 15.6 to 22.6 ± 24.4). However, CGs mean minutes/day remained virtually unchanged over time (15.8 ± 20.8 to 12.7 ± 11.7). Considered as dyads, 38% (n=8) showed essentially no change for either member, but for 29% (n=6) the caregiver showed no change while the patient activity increased. Conclusions: CGs were similar in age and comorbidities to their spouses, however, CGs were less likely to increase their PA levels. Health disparities in CVD mortality in the rural population may have additional impact and underscores the need for future targeted interventions addressing CV risk in CGs. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this secondary analysis was to describe symptom management strategies used by elderly patients (n = 236) 3 and 6 weeks after coronary artery bypass surgery (CABS). Three weeks after surgery, the most frequently used strategies were rest to manage shortness of breath (53%) and fatigue (53%), medications for incision pain (24%), and repositioning for swelling (35%) and sleep disturbance (18%). Overall, fewer patients experiencing sleep disturbances (39%), incision pain (39%), swelling (46%), and appetite problems (17%) reported using a strategy to manage their symptom. Nurses must assist patients in symptom identification and problem solving to accomplish effective symptom management. [Copyright &y& Elsevier]

Abstract: Objective: The purpose of this secondary analysis was to describe medication use and examine the relationship between medications and postoperative symptoms/problems in the first 3 months after coronary artery bypass surgery (CABS). Methods: The sample consisted of older (≥65 years) men and women (n = 232) who had undergone CABS. Medication data were collected through self-report 3 and 6 weeks and 3 months after surgery. Results: Most patients reported taking aspirin (88.2%–85.7%), statins or cholesterol-lowering drugs (88.6%–87%), and beta-blockers (68%–55.6%). No significant differences were found between the proportion of patients taking and not taking beta-blockers, antiarrhythmics, cholesterol-lowering drugs, or angiotensin-converting enzyme inhibitor medications for common medication-specific symptoms/problems. Conclusion: Patients experience symptoms after surgery, but these symptoms did not seem to be side effects from medications. Nursing assessments and interventions targeting postoperative symptoms, symptom management, and medication side effects can enhance recovery and reinforce medication adherence. [Copyright &y& Elsevier]