الفهرس 
Overview of the HeartOnly 14 pages are availabe for public view
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Abstract
Sudden death is one of the most common reasons of death worldwide which can be prevented by inserting a pacemaker. Studies have proved that 60 percent of all sudden cardiac deaths occur due to arrhythmia.” Each year 1-2 million person’s worldwide die because of lack of access to pacemakers Normally the heart produce its own electrical streams allowing it to beat at diverse rates according to the daily needs (Olshansky and Hayes, 2015). Pacing may be temporary, with an external pulse generator, or permanent, with an implanted pulse generator.More recently, the indications for cardiac pacing have extended beyond symptomatic such as bradycardia (Snegalatha and Anand, 2019).
Aim of the study:
The aim of this study is to evaluate the effect of educational program on improving the quality of life for adult clients with a permanent pacemaker at home through:
1. Assessing of adult clients with a permanent pacemaker at home about their knowledge and their practices regarding a permanent pacemaker.
2. Assessing of adult clients with a permanent pacemaker at home about their practice regarded to: (TV, computer, phones, refrigerators, washing machine, dryers, microwaves, electric ovens, and their percussion, toward permanent pacemaker.
3. Assessing of the quality of life through physical, social, psychological, spiritual and sexual health status of adult clients with a permanent pacemaker at home to detect their needs.
4. Developing and implementing programs for adult clients with a permanent pacemaker at home according to their needs.
5. Evaluating the effectiveness of educational programs on improvement of adult clients with a permanent pacemaker at home about their knowledge and practices to improve their quality of life.
Research hypotheses:
The educational program will improve quality of life for adult clients with a permanent pacemaker at home pre / post program.
Subject and methodology:
I) Technical Design:
The technical design for the study will include research design, the setting of the study subject, sample and tools for data collection.
A-Research design:
Quasi-experimental research design was utilized to fulfill the aim of this study.
B- Setting:
The study was conducted in outpatient clinics at Ain Shams University (El-Demerdash Hospitals) Cairo Governorate, the place consist of one large halls, contains of three rooms, one for the consultant well equipped with the latest diagnostic device examiner room, the second room for pacemaker insertion the third room for post insertion follow-up and the fourth room is for waiting to follow up after post insertion and well ventilation and illuminated perception with comfortable chairs it suitable for session and two clean and illuminated bathroom.
C- Sampling:
A purposive sample was used in this study. The total number of clients with a permanent pacemaker admitted 2016 at the Ain Shams El-Demardash Hospital were 25% (84) adult clients with a permanent pacemaker 336 (7 adult clients /week). 25% was chosen according previous criteria and pilot study it was chosen and carried out on 10 adult clients with permanent pacemaker whom & excluded later the study sample. The sample was became 74 adult clients with a permanent pacemaker for both genders (male &female), adult clients with permanent pacemaker above 40 years old –recent insertion after 2 years and accepting to participate in the study program.
D-Tools of data collection:
Data was collected by using the following tool:
First tool (I): Self-administered questionnaire was developed by researcher based on the recent related literature review and supervisors guidance to assess clients s’ knowledge, it comprised two parts:
Part One: adult clients’s Socio- Demographic characteristics Data: it included age, gender, marital status, level of education & job.
Part two: included age, gender, marital status, level of education & job.
Part two:
a- Assess the adult clients with permanent pacemaker at home about their knowledge about the cardiovascular system (heart) including, position, component, function, natural pacemaker &clients knowledge about artificial pacemaker, including; meaning, types, indication, parts, site of insertion in the body, signs of a permanent pacemaker malfunction, time of the follow-up visit, signs & warning signs of a permanent pacemaker s that might occur.
Second Tool (II):
a- Assess the adult clients with a permanent pacemaker at home about their daily living activities as house works, shopping, walking, driving dietary, smoking habits, hygine and adherence to the follow-up care
b- Assess the adult clients with a permanent pacemaker at home about their practice about dealing with their home safety environment regards to: (TV, computer, phones, refrigerators, washing machine, dryers, microwaves, and electric ovens) and the percussion regarding to the permanent pacemaker.
The questionnaire sheet was completed by the researcher from each adult clients with a permanent pacemaker pre and post program implementation.
Third tool (III): To assess the quality of life of a adult clients with a permanent pacemaker at home: using the quality of life scale by (Ferans & Powers, 1985). Which composed of the following aspects Physical, social, psychological, spiritual and sexual.
- The Physical dimension it was included: Physical health, personal hygiene, nutrition, exercise, grooming, clothing, and physical appearance.
- The Social dimension it was included Links with social environments and includes the sense of acceptance by intimate others, family, friends, co-workers, neighborhoods and the community.
- The Psychological dimension it was included adult clients with a permanent pacemaker at home about their level of anxiety, depression, and fear.
- The Spiritual dimension it was included inner peace, hopefulness, religious activities and supports.
- The Sexual dimension it was included: adult clients with a permanent pacemaker at home about their sexual activities.
Fourth Tool (VI): Observation checklist for radial pulse measurement: This tool was developed by Westat, (1989), to measure the ability of adult clients with permanent pacemaker at home to count their own radial pulse
II) Operational design
The study in order to be completed has passed through different phases as follows: the preparatory phase, pilot study phase and the field work phase.
Results:
The finding of present study could be summarized as follows:
Program
- Show that 59.5 adult clients with permanent pacemaker regarded to gender were male, while 40.5 were female.-There was a highly statistical significant regarding to their knowledge about cardiovascular system pre and post educational program implantation (p<0.0001).- There was a highly statistical significant regarding to their knowledge about permanent pacemaker pre and post educational program implementation (p<0.0001).-
- Clarify that 44.6% of the adult clients with a permanent pacemaker were satisfactory regarded to total practice and 55.4% were unsatisfactory and changed in post educational program implementation to 79.7 satisfactory, 20.3% unsatisfactory- There was a highly statistical significant differences between pre and post educational program regarding to their practice at p -value=-0.0001*. There was a highly statistical significant differences between pre and post educational program implementation regarding their quality of life at p -value =-0.0001*. There was a highly statistical significant differences between pre and post educational program implementation regarding to their performance of radial pulse measurement.
That there was no statistically significant relation between studied sample regarded to total practice and their age, marital status, living condition, level of education, post the educational program implementation (p<0.0001). But there were highly statistically significant relation between total quality of life and total practice after the educational program implementation at p -value =-0.0001*.