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The Implementation of Post-Discharge care services on smoking in elderly Patients Undergoing Coronary Artery Angioplasty
Shahnaz Karimi *, Elahe Rahpeima, Mostafa Bizhani
fasa university of medical science
Abstract:   (121 Views)
Background and Aim: Cardiovascular disease is one of the most common causes of hospitalization and mortality of the elderly worldwide and has become a serious health challenge in the 21st century. According to statistics, this group of diseases causes 50% of deaths in developed countries and 25% of deaths in developing countries. In Iran, according to statistics from the Ministry of Health and Medical Education, more than 40% of deaths are due to cardiovascular disease. Numerous studies have shown that cardiovascular patients undergoing angioplasty experience concerns about lifestyle, activity and diet, medications, and side effects at the time of discharge, which necessitates awareness.  On the other hand, the success of heart disease treatment depends to a large extent on adherence to health behaviors, so much so that if patients do not follow the treatment recommendations, including smoking cessation, the best treatment regimens will be worthless. According to the results of some studies, following the care and treatment recommendations in the elderly with cardiovascular problems is not very satisfactory. In Iran, the discharge program of all hospitalized patients is performed in the traditional way at the time of discharge. The aim of this study was to investigate the effect of post-discharge care services on smoking in elderly patients with cardiovascular problems undergoing coronary angioplasty.
Materials and Methods: This clinical trial study had two intervention groups and a control group with pre-test and post-test in order to investigate the effect of discharge program on medical adherence of elderly patients with cardiovascular disease who underwent angioplasty, that referred to Hazrat Vali-e-Asr Medical Center. Fasa University of Medical Sciences in 1398-1399. The sample size in this study was determined based on previous studies of 80 people. The sampling method in this study was convenience. In this way, elderly patients referred to the cardiac ward who underwent angioplasty, after completing the written informed consent form, were placed in two groups of intervention and control. The Morisky Therapy Adherence Questionnaire was used to collect data in this study. Information on smoking behavior was collected through interviews and included in a questionnaire. The questionnaire was completed at the time of hospitalization, one month, and three months after discharge for both groups. In this study, after-discharge services were provided for the intervention group in person and by telephone up to three months after discharge. But the control group received only the time of discharge from hospital services. The data analysis process was performed using SPSS-22 statistical software at a significant level (α = 0.05). Data analysis consists of two parts: descriptive and inferential statistics.
Results: Out of 80 patients participating in this study, due to the decline in groups, 35 people were placed in each group. Most of the subjects are men (75.7%), married (92.9%) with undergraduate education (44.3%), and self-employed (38.6%). 53 patients (75.7%) were male and 17 patients (24.3%) were female. Kolmogorov-Smirnov test showed that there was no statistically significant difference between the two groups in terms of demographic variables (age, sex, marriage, and level of education, and underlying disease). The mean and standard deviation of patientschr('39') age was 62.08 10 10 in the control group and 59.08 12 12.05 in the intervention group. Kolmogorov-Smirnov test showed that there was no statistically significant difference between the two groups in terms of demographic variables (age, sex, marriage, and level of education, and underlying disease). The mean of smoking was 34.3 in the intervention group and 31.4 in the control group. Based on the results, there was no significant difference between smoking and medical adherence scores in the two groups before the intervention with independent t-test (P = 0.79 and P = 0.84, respectively). Based on the t-test, the mean score of adherence to medical care after the training program in the intervention group compared to the control group showed a statistically significant difference (p <0.001). Also, regarding the smoking behavior, a comparison between the control and intervention groups in this study shows that the rate of smoking cessation three months after the intervention in the intervention group was 20% (7 people) and in the control group no smoking cessation was observed. Independent t-test showed a significant difference between the two groups (p = 0.006) هn smoking cessation behavior. In other words, post-discharge care had an effect on smoking cessation in the intervention group.
Conclusion: According to the results of providing post-discharge care services in the elderly with cardiovascular problems, it is effective on their adherence to treatment and adopting health behaviors such as smoking cessation. Therefore, the program after discharge can reduce the side effects of patients with heart problems.
Keywords: Elderly, discharge plan, medical adherence, coronary angioplasty
Type of Study: Research | Subject: General
Received: 2021/06/4 | Accepted: 2021/07/24 | Published: 2021/08/1
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Research code: 97252
Ethics code: IR.FUMS.REC.1397.181
Clinical trials code: IRCT20190316043065N1

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karimi S, rahpeima E, bizhani M. The Implementation of Post-Discharge care services on smoking in elderly Patients Undergoing Coronary Artery Angioplasty. 3. 2021; 1
URL: http://elderhealth.jmu.ac.ir/article-1-55-en.html

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