Term Paper on "Nurse Training in Cardiac Procedures the Effects"

Term Paper 30 pages (9322 words) Sources: 3 Style: APA

[EXCERPT] . . . .

Nurse Training in Cardiac Procedures

The effects of pre-operative nursing teaching on the stress/anxiety level of patients who will undergo heart surgeries and percutaneous interventions

Patients undergoing any heart-related procedure could expect to experience a certain amount of stress. Stresses go beyond the physical stresses associated with the procedure. Emotional responses before, during, and after the procedure have an impact on the ability of the patient to cope. Additional stress has an effect on the ability of the patient to recover and their willingness to make life changes to accommodate their condition. Stress has a negative impact on the lives of patients and families of patients who have undergone invasive heart-related interventions. This research will examine the effectiveness of nurse training on reducing the stress level of the patient post operative.

Research Problem

Background of the Problem

Stress has a negative impact on the body's ability to heal itself and on the recovery period from traumatic events such as surgery. Until recently, attention from the medical community has focused on the physical stress of the surgical procedure itself. However, the medical community is not beginning to attend to the emotional state of the patient, before and after the procedure. The impact of stress can haven an impact on how the events effect them for the rest of their lives. This research will examine ways to reduce anxiety in patients that must undergo invasive heart-related procedures.

Significance of the Problem

This study is important, as it will provide insight into an important aspect of the healing process and quality of life for the patient. Patients that are more knowledgeable about their disease and the effects of the surgery are more likely to take actions that result in long-term changes in lifestyle. Patients that are knowledgeable about their disease and about health related issues in general will be able to play a more active role in the recovery process.

This study will help to determine the role that patient education plays in the anxiety level of the patient prior to discharge. Reducing stress prior to discharge is expected to have a positive impact on the life of the patient and their caregivers once they arrive home. They will have a greater feeling of control over their circumstances and will be able to better assist in the recovery process than those that are not thoroughly trained in the management of their particular condition. This study will play a significant role in helping patients and families to adjust to the changes that will take place once they are discharged from the hospital. The goal of this research is to lower anxiety regarding their disease and the procedure that they have undergone in a permanent manner.

Theoretical Basis of the Study

The study is based on past evidence that indicates stress has a negative impact on the outcome of several medical procedures. Stress not only effects the emotional state of patients, stress produces chemical reactions in the body that are detrimental to health. Reducing stress before, during, and after a traumatic procedure has positive medical benefits and can dramatically improve a patient's quality of life. Heart surgery is a stressful prospect for most patients that must undergo procedures. This study will focus on finding a way to reduce stress in patients that must undergo a heart procedure.

This study will examine patients that are scheduled for one of several heart-related procedures. Any of these procedures could reasonably be expected to produce a certain level of stress for patients. Patients in this study will be scheduled to undergo CABG, valve surgeries, hear transplant, or have percutaneous interventions such as PTCA, stent placement, or AICD/pacemaker placement.

Education is one of the keys to reducing stress in situations that are unfamiliar. The premise of this study is that pre-operative teachings by the nursing staff will play a significant role in reducing stress in patients undergoing the above procedures. These teachings will be designed to give the patient knowledge regarding the disease process, the risks and benefits or specific surgeries, what to expect before the procedure, what to expect during the procedure, and what to expect after the surgery. It will address cardiac rehabilitation, discharge planning and what will happen in follow up visits.

Experimental Overview

The study will examine a group of patients that are scheduled to undergo any of the procedures previously mentioned. The patients will be divided into two groups. One group will be given a training course during their pre-operative hospital stay by one of the nursing staff. The training program will be designed to address the specific needs of the procedure that the patient will undergo.

The test group will receive the training, while the control group will receive no pre-operative training. After the patients undergo their procedure and spend the required time in the hospital, they will be administered the State-Trait Anxiety Inventory for Adults as part of their pre-discharge routine. This survey instrument is a standard instrument that is useful in addressing stress related to traumatic events such as medical procedures. There is a considerable amount of information available about this survey instrument and its reliability traits. It is expected that there will be significant differences between the control and test groups. The test group is expected to demonstrate reduced anxiety, as opposed to the control group.

Hypotheses/Research Questions

The purpose of this study is to examine the impact of nurse training on the anxiety level of patients following an invasive heart related procedure. The procedures will be considered in aggregate, rather than addressing a separate hypothesis regarding every different type of procedure. The anxiety produced by each procedure is difficult to differentiate and there are a number of external factors that could influence the perceived stress level of the patient. It is expected that the impending procedure will have an equal chance of producing stress in each of the patients and that the type of procedure will not be a variable in the study. All of the procedures will be assumed to have a similar chance of producing perceived stress in the patient.

The research will examine the following hypotheses.

H1: Patients that receive specific training regarding their particular condition and procedure prior to the procedure will have significantly lower anxiety scores prior to discharge from the hospital than those that did not receive the training prior to having the procedure performed.

H0: Patients that receive specific training regarding their particular condition and procedure prior to the procedure will not have significantly lower anxiety scores prior to discharge from the hospital than those that did not receive the training prior to having the procedure performed.

This research will address a single research hypothesis, but it will involve many facets of the research topic. Therefore, in addition to the hypothesis, the research will address the following research questions.

How does nurse training prior to the procedure affect a patient's anxiety level prior to the procedure?

What impact, if any, does nurse training prior to the procedure have on the patient's anxiety level during the procedure?

What impact, if any, does nurse training prior to the procedure have on the patient's anxiety level after the procedure?

How does nurse training prior to the procedure affect the patient's perceived quality of life?

What impact does nurse training prior to the procedure have on the patient's ability to cope with necessary changes in their life as a result of the procedure?

What impact does nurse training prior to the procedure have on the patient's willingness to adhere to necessary changes in their life as a result of the procedure?

What impact does nurse training prior to the procedure have on the patient's overall feelings of satisfaction with the outcome of the procedure?

Conclusion

This research will examine a side of surgical heart procedures that has only recently begun to be addressed by academic literature. The mind-body connection has only recently begun to achieve an importance that resembles that which is attributed to physiological responses to traumatic procedures. There are many aspects to heart surgery that have an impact on the outcome of the procedure from a physiological standpoint. However, the life of the patient and their loved ones does not end when the physiological illness has passed. The disease itself and the procedure to remedy it have a lasting emotional impact on the patient and those that are close to them.

After the procedure, the patient must adjust to many new ideas and changes. They may have an electronic device or other implant. This not only has an impact on their physical well-being, but has a significant emotional impact as well. They may not feel as if they are "whole" anymore. If the procedure means limiting certain activities to which they were accustomed, this may mean further adjustments and a sense of "grieving" for things that are no longer a part of their life.

Quality of life goes beyond the physical act of living and being able to care for one's physical needs. A patient's… READ MORE

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