الفهرس 
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Abstract
Coronary artery bypass graft surgery (CABG) is an invasive revascularization procedure used to treat coronary artery disease. After the CABG, Home health care is a structured program of exercise, education and risk factor modifications that aims to accelerate recovery following CABG and to reduce the risk of recurrent cardiac events, Home health care is designed to help patients with cardiac diseases return to optimal fitness, functional ability and independence following the CABG (Yuroong et al., 2021).
Aim of the study:
This study aims to assess Home Health Care among patients Post Coronary Artery Bypass Grafting Surgery through:
1. Assessing patient’s health condition by daily activity after discharge at home.
2. Assessing patients reported practices toward home health care such as wound care, exercises and taking medications according to guidelines after Coronary Artery Bypass Grafting Surgery.
3. Assessing home environment.
Research questions:
1. Is their relationship between socio demographic characteristics of the patients and their practices toward care post Coronary Artery Bypass Grafting Surgery?
2. What is the effect of patient practices toward the home care after Coronary Artery Bypass Grafting Surgery on their physical health condition?
Research design:
A descriptive analytical design was used to assess home health care among patients post coronary artery bypass graft surgery.
Research setting:
The study was conducted at outpatient clinic of open heart surgery affiliated to the National Heart Institute of General organization for hospitals and institutes.
Subjects:
A purposive samplewhich composed of all coronary artery Bypass Surgery adult patients undergoing to Coronary artery bypass graft surgery (CABG) during three months after operation.Total population 648 Cases and sample size 240 patient according to formula sample.
Sample size 264 patient (240 study sample + 24 pilot study). According to formula sample:
Data collection tools:
Data were collected through the use of the following tool:
First tool: An Interview questionnaire it was consisted of 5 parts:
• Part I: Patient Socio-demographic data:
Socio-demographic data of studied post coronary artery bypass graft surgery patient; as age, gender, level of education, marital status, occupation, type of work, Monthly income.
• Part II: Patient medical history:
This part as operation date, length of stay during hospitalization, history of health problem, smoking pre and post-operative.
• Part III: PT reported health practices post CABG:
This part was covering patient reported practices toward wound care, personal hygiene, clothing, bathing, respiratory exercise by using spirometer device, body exercise and daily activity, sleeping, nutritional practices and compliance to medications regimen.
• Part IV:modified Barthel Index Scale:
Composed of measuring Activities of Daily Living (MBI) to measures a person’s daily functioning specifically the activities of daily living and mobility.
• Part V: Home environmental assessment scale: it was uses to assess patient home environment in sanitation, ventilation, crowding index, water supply, sewage, disposable system, safety measures to prevent falling and patient home modification after discharge.
Second tool: Physical examination by medical record review:
Patient medical record review to collect data about Physical examination such as wound condition, hemodynamic symptoms as pulse, blood pressure, temperature, presence of chest pain.
Results:
The results of this study have shownthe following:
• 56.7% of the studied patients were between age of (50 – 60) years old. It is showed that 72.1% of them were males and married. About 50.4% and 69.6% of them had middle level of education and lived in rural areas respectively. Regarding working status, 62.1% were working and 55% of them their work need mental effort. In relation to the studied patients’ income, 52.1% of them hadn’t enough income. Concerning method of paying the treatment cost 41.7% of them payed their treatment at the state expense.
• 52.5% of the studied patient performed daily breathing exercises using a spirometer and 47.5% of them didn’t have performed daily breathing exercises using a spirometer.
• 25% of the studied patients had a satisfactory level of healthy practices after hospital discharge, about 50.4% of them had average practices level, and 24.6% of them had a poor practices level.
• 2.1% of the studied patients were severe dependency while 72.5% were moderate dependency, and 25.4% of them were slight dependency regarding their Total Barthel Index Scale for measuring Activities of Daily Living.
• 16.3% of the studied patients had good and safe environment while 83.8% had poor home environment.
• As regard total Physical Health assessment, 17.9% of the studied patients had good physical health and 82.1% of them had poor physical health.
• There was highly statistically significance relation between total reported practices and patients’ age p-value <0.01. There were statistically significance relation between total reported practices and patients’ educational level, marital status, and income p-value <0.05. While there was no statistically significance relation between total reported practices and patients’ gender, occupation, treatment cost, and residence.
• There was a highly positive statistically significant correlation between reported practice and ADL p-value <0.01, while there was no correlation between reported practice and physical health assessment p-value >0.05.
• There was a highly positive statistically significant correlation between home environment and reported practice (p-value <0.01), while there were no correlation between home environment and ADL, and physical health assessment and home environment (p-value >0.05).
Conclusion
In the light of the current study findings, it can be concluded that,
There were highly statistically significance differences between patients’ socio demographic characteristics and their practicing for home health care post coronary artery bypass surgery and there was a highly positive statistically significant correlation between reported practice and ADL p-value <0.01, while there was no correlation between reported practice and physical health assessment p-value >0.05.
Recommendations
The result of this study projected the following recommendation:
1) Educational program about home health care should be designed for patients with post CABG to improve their knowledge about potential complications.
2) Asimplified and comprehensive booklet should be designed including guidelines about home health care post CABG.
3) Frequent follow up for patient post CABG to follow their health and emphasize practicing of the home health care post CABG.
4) Further researches should be conducted on larger probability sample to allow generalizability.