الفهرس 
Indications and Contraindications of Permanent pacemakersOnly 14 pages are availabe for public view
 |  | from | 223 |  |  |
| | | from | 223 | | |
Abstract
C
ardiovascular disease is the leading cause of morbidity and mortality worldwide, with economic effects at the levels of both the individual and society. Cardiac pacing is an established treatment for the prevention of asystole, while recently it has been used as an adjunctive therapy in non-bradycardiac diseases. Although for almost 45 years, cardiac pacing has offered an improvement in the quality of life and/or prolonged survival in patients with complete heart block, sick sinus syndrome, although, congestive heart failure and ventricular conduction disturbances. Cardiac pacing is associated with a range of unintended negative physical, psychological and social health changes.
Patients waiting cardiac pacing can experience physical and psychological stress, including anxiety and depression due to fears, worries about depending on a mechanical device for support and uncertainties about surgery. These symptoms can adversely affect physiological parameters before, after and during procedure, and can result in prolonged recovery from surgery.
Emotional and physical rehabilitation as a nursing intervention can reduce anxiety, depression and improve procedure outcomes in various cardiac pacing patients.
This study supposed that the rehabilitation protocol will have a positive effect on patients undergoing permanent cardiac pacemaker implantation.
The aim of the study was to investigate the effect of emotional and physical rehabilitation protocol for patients undergoing permanent cardiac pacemaker implantation. A quasi-experimental research design was used in this study. All available random patients along 6 months period undergoing permanent cardiac pacemaker implantation at the inpatient and outpatient cardiac clinic, in Nasr City Health Insurance Hospital consisted the target of this study. The number of patients along 6 months period were 70 patients, classified into two groups, study group (35 patients) and control group (35 patients). All patients were subjected to three data collection tools including; 1) Beck Depression Inventory Scale to measure the degree of depression 2) Taylor Manifest Anxiety Scale to measure the degree of anxiety 3) Questionnaire to assess patients’ physical needs. The Statistical Package for Social Sciences (SPSS ver. 11.5) was used for data analysis. The numbers, percentage, mean + SD, T. test, ANOVA &Chi Square tests were used to test the research hypotheses.
The main findings of the present study were as follows:
As regards to socio-demographic and medical data results:
• There are no statistically significant differences between control and study groups during regarding anxiety. Inconsistent, the present study findings revealed that there are highly statistically significant differences between pre and post tests in both groups regarding post test.
There are no statistically significant differences between the control and study groups during pretest and in the control group between pre and post tests of the patients undergoing permanent cardiac pacemaker implantation regarding depression. Importantly, the depression changed of the patients as the present study findings revealed that there are highly statistically significant differences between pre and post tests in the study group and between both groups regarding post test.
• There are no statistically significant differences between the control and study groups during pretest and in the control group between pre and post tests of the patients undergoing permanent cardiac pacemaker implantation regarding assessing the physical needs. However, the present study findings revealed that there are highly statistically significant differences between pre and post tests in the study group and between both groups regarding post test.
Rehabilitation protocol intervention comprising an information leaflet and verbal advice was relatively simple to design and administer and offered substantial gains for patients undergoing permanent cardiac pacemaker implantation. Despite patients’ increasing demands for emotional rehabilitation, nurses focused on medical tasks and collecting factual information and often failed to address the patients’ fears and emotional issues, especially when those nurses were facing heavy workloads with a limited time. Thus, it is recommended that this area of care should receive attention.
The training of nurses in the importance of delivering emotional and physical rehabilitation is a key recommendation to be incorporated into routine practice. Liaison psychiatric nurses should have a role in, or responsibility for, giving general information and supporting patients and their families in relation to the reduction of pre and post operative anxiety and depression.
Improving emotional and physical needs in the future can be achieved through changing in nurses’ attitudes, values, knowledge and skills. Improving also requires time and commitment, as well as support from individual, professional and organizational levels.