الفهرس 
ABSTRACT
significance of the studyOnly 14 pages are availabe for public view
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Abstract
Heart valve diseases are common with an estimated prevalence of 2.5 % in the Western world population. The number is rising due to an aging population, thus leading to a growing public health problem. Once symptomatic, heart valve diseases affect exercise tolerance. In the case of aortic stenosis, the disease may lead to sudden death. Symptomatic heart valve disease heavily influences the performance of daily living and quality of life. Surgical treatment, either valve replacement or repair, remains the treatment of choice. Following surgery, the transition to daily living may become a physical, mental, and social challenge.(152)
Patients undergoing heart valve surgery commonly present with impairment of physical activity and physical capacity up to several years before surgery. Combined with a period of bed rest after surgery, this patient group is therefore not in an optimum state of physical fitness at hospital discharge and physical rehabilitation is required. (153)
An experimental, pre –post test nursing model has been utilized in this study. This study was carried out cardio thoracic surgery department, outpatient clinics of the cardio thoracic surgery at Assiut University Hospital. To test research hypothesis; sample of sixty adult male and female patients undergoing heart valve surgery.
The studied patients received the contents of rehabilitation program in the form of small sessions and assessed three times by using tool I part(3) and tool II.
The following tools were utilized for data collection; tool I ” Patient’s health need assessment sheet ”, tool II ” German version of the Rand Short Form Health Survey (SF-36) ” and tool III ’’the nursing intervention cardiac rehabilitation model (NICRM)’’, data was collected & analysed using necessary statistical manipulation.
The main findings of the present study were:-
1. Three quarters (76.7%) of studied patients their age ranged from(20-<40 years ). Regarding to sex it was found that more than half (53.3%) of studied patients were female. It was found that the highest percentages of studied patients were married, illiterate, housewife. Regarding to hospital stay, it was found that the highest percentages of studied patients stayed in hospital more than one week.
2. The vast majority (93.3%) of studied patients had rheumatic fever and more than quarter (30%) had arthritis or osteoarthritis .As regarding to family history more than half percentage (53.3%) had diabetes and less than half percentage (43.3%) had hypertension.
3. As regarding to local complications less than fifth percentage(13.3%) had deep sternal wound infection. As regarding to respiratory complications four (6.7) patients had pneumonia. As regarding to circulatory complications two (3.3) patients had Pericardial effusion , Pleural effusion and atrial fibrillation. As regarding to gastrointestinal complications two third percentage (66.7%) of the studied patients had nausea and vomiting and less than quarter (23.3%) had constipation.
4. There was significant difference between pre and follow up phases(3 months and 6 months) among studied patients as regarding to hospital anxiety and depression scale (HADS) at p value(0.001).
5. There was highly significant difference between anxiety level and age of studied patients before applications of NICRM.
6. There was no significant difference between depression level and demographic characteristics of studied patients before applications of NICRM except age there was highly significant difference between depression level and age.
7. There was significant difference between pre and follow up phases(3 months and 6 months) among studied patients as regarding to SF-36 at p value(0.001).This mean improvement in quality of life among studied patients after application of NICRM.
8. There was negative correlation coefficient(r -0.926 & -0.857) between anxiety and depression level with follow up time. There was positive correlation coefficient (r 0.874) between SF-36 scale with follow up time. This mean the patient’s physical, social and psychological status improvement with time.
9. there was no significant correlation coefficient between total of SF 36 scale and age in pre and follow up phases(3 months and 6 months) of application of NICRM among studied patients.