The effect of Orem self-care program on sleep quality, daily activities, and lower extremity edema in patients undergoing coronary artery bypass graft surgery

Aliakbari, Fatemeh; Moosaviean, Zahra; Masoudi, Reza; Kheiri, Soleiman

The effect of Orem self-care program on sleep quality, daily activities, and lower extremity edema in patients undergoing coronary artery bypass graft surgery

Document Type : Original Article

Authors

¹ Community-Oriented Nursing Midwifery Research Center, Department of Adult and Geriatric Nursing, Nursing and Midwifery School, Shahr-e-Kord University of Medical Sciences, Shahr-e-Kord, Iran

² Department of Epidemiology and Biostatistics, School of Health, Shahr-e-Kord University of Medical Sciences, Shahr-e-Kord, Iran

Abstract

Background: Postoperative complications of open heart surgery require extensive care, especially by the patient. One of the important strategies in this regard is self-care education and one of the well-known patterns is Orem self-care model. This study aimed to investigating the effect of Orem-based self-care program on sleep quality, daily activities, and lower extremity edema in patients undergoing coronary artery bypass graft surgery. Materials and Methods: This clinical trial study was performed on 74 patients with coronary artery bypass graft surgery in Kashani Hospital in Shahrekord. The patients were randomly assigned to intervention and control groups. Data were collected using need assessment form according to the Orem model, quality of life and activity daily living questionnaire and measurement of edema by the meters. Data were analyzed using descriptive and analytical statistics with SPSS software. Results: The sleep quality score in the intervention group immediately after the intervention and 2 months after, was significantly lower in the intervention group than in the control group (P = 0.001). In the intervention group immediately after the intervention and 2 months after, the daily activity score was significantly higher than the control group (P < 0.05) 2 months after intervention, edema score in intervention group was significantly lower than the control group (P = 0.006). Conclusions: Results of the recent study showed that the implementation of the Orem-based self-care program can reduce the postoperative complications and the use of nursing patterns, such as Orem, to enhance self-care ability in patients who require long-term care can be very effective.

Keywords

References

1.	Fayyazi S, Sayadi N, Gheybizadeh M. Comparison of quality of life before and after open heart surgery. Zahdan J Res Med Sci 2012;14:98-100.
2.	Abedi H, Salimi S, Feizi A. A survey on the relationship between self-efficacy and self-care in patients with COPD. J Urmia Nurs Midwifery Fac 2012;1:1-10.
3.	Tahereh D. Design and evaluation of theorybased educational program for reducing patients anxiety after CABG. Tarbiat Modares Univ School Med Sci 2007;5:10-8.
4.	Belczak CE, Tyszka AL, Godoy JM, Ramos RN, Belczak SQ, Caffaro RA. Clinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique. Rev Bras Cir Cardiovasc 2009;24:68-72.
5.	LaPier TK, Wintz G, Holmes W, Cartmell E, Hartl S, Kostoff N, Rice D. Analysis of activities of daily living performance in patients recovering from coronary artery bypass surgery. Physical and Occupational Therapy In Geriatrics. 2008;27:16-35.
6.	Koch CG, Khandwala F, Cywinski JB, Ishwaran H, Estafanous FG, Loop FD, et al. Health-related quality of life after coronary artery bypass grafting: A gender analysis using the Duke Activity Status Index. J Thorac Cardiovasc Surg 2004;128:284-95.
7.	Sheikhizadeh S. Self-care activities among women referred to health care centers in Kerman. Journal of Health Based Research. 2016;2:55-67.
8.	Mohammadpour A, Rahmati Sharghi N, Khosravan S, Alami A, Akhond M. The effect of a supportive educational intervention developed based on the Orem's selfcare theory on the self care ability of patients with myocardial infarction: A randomised controlled trial. J Clin Nurs 2015;24:1686-92.
9.	Buysse DJ, Reynolds CF 3^rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
10.	Farrahi J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A). Sleep Breath 2009;13:259-62.
11.	Esmaeeli M, Kazem Nejad A. The effect of supportive educational intervention on sleep before coronary artery bypass graft surgery. Iranian Journal of Cardiovascular Nursing. 2016 Mar 10;4:40-7.
12.	Blättler W, Zimmet SE. Compression therapy in venous disease. Phlebology 2008;23:203-5.
13.	Parker PP, Dunbar SB. Sleep in cardiac surgery. In: Woods SL, Froelicher ES, editors. Vol. 5. Philadelphia: Lippincott; 2005. p. 197-212.
14.	Oveisgharan S, Shirani S, Ghorbani A, Soltanzade A, Baghaei A, Hosseini S, et al. Barthel Index in a Middle-East country: Translation, validity and reliability. Cerebrovasc Dis 2006;22:350-4.
15.	Pooladi SH, Dehghan-Azad F, Yazdankhahfard MR, Tahmasbi R, Ahmadi A. Design and psychometric measurement of the questionnaire on attitude, knowledge and utilization of self-care for patients undergoing coronary artery bypass graft surgery based on Waltz model. Cardiovas Nurs J 2017;6:14-23.
16.	Dahmardeh H, Vagharseyyedin SA, Amiri Fard H, Sharif-Zadeh GH, Rakhshani-Zabol F. Effect of self-care educational program based on Orem's theory on hope in patients with multiple sclerosis. Med Surg Nurs J 2015;4:57-63.
17.	Sampaio F, Aquino P, Araújo T, Galvão M. Nursing care to an ostomy patient: Application of the Orem's theory. Acta Paul Enferm 2008;21:94-100.
18.	Hamedanizadeh F, Ebadi A, Zandi A, Kachuyee H. Effectiveness of implementation of Orem self-care program on headache indices in Migraineur. Trauma Mon 2010;3:155-61.
19.	Aghakhani N, Alizadeh S, Hemmati Maslakpak M, Alinejad V, Khademvatan K. Study of the effect of self -care program model based on Orem's pattern on the quality of life in patients with heart failure. J Urmia Nurs Midwifery Fac 2018;16:65-72.
20.	Shahbaz A, Hemmati Maslakpak M, Nejadrahim R, Khalkhali H. The effect of implementing Orem's self-care program on self-care behaviors in patients with diabetic foot ulcer. J Urmia Nurs Midwifery Fac 2016;14:108-17.
21.	Ranjbaran S, Dehdari T, Sadeghniiat-Haghighi K, Mahmoodi Majdabadi M, Geravand A. The survey of knowledge and attitude status in patients with poor sleep quality about sleep problems after coronary artery bypass Surgery. Mil Caring Sci J 2015;1:99-108.
22.	Sadeghi H, Azizzadeh Forouzi M, Haghdust AA, Mohammad Alizadeh S. Effect of implementing continuous care model on sleep quality of hemodialysis patients. J Nurs Care 2011;1:13-8.
23.	Johansson A, Adamson A, Ejdebäck J, Edéll-Gustafsson U. Evaluation of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease – A randomised intervention study. J Clin Nurs 2014;23:2822-34.
24.	Karimi S, Vanaki Z, Bashiri H, Hassani SA. The effect of self-care plan based on Orem's self-care model on self-care improvement in patients with gastrointestinal cancer. Sci J Hamadan Nurs Midwifery Fac 2016;24:105-12.
25.	Behrouzifar S, Nezafati M, Esmaily H. The relationship between sleep patterns and the quantity of life in coronary artery bypass graft patients. J Sabzevar Univ Med Sci 2007;14:53-61.
26.	Nerbass FB, Feltrim MI, Souza SA, Ykeda DS, Lorenzi-Filho G. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery. Clinics (Sao Paulo) 2010;65:1105-10.
27.	Siavashi S, Roshandel M, Zareiean A, Ettefagh L. The effect of the cardiac rehabilitation program on the quality of life of patients undergoing coronary artery bypass surgery. J Alborz Univ Med Sci 2013;4:217-26.
28.	Fathani M, Afzal AM, Tadayonfar M. Effectiveness of education based on self-care needs on quality of life of patients with heart failure. J Sabzevar Univ Med Sci 2015;22:893-902.
29.	Omatreza S, Moshtagh Eshgh Z, Eshagh M, Hekmatafshar M, Naieni M. Effect of educational program based on “Orem Self Care Model” on quality of life in patients with migraine. JHPM 2014;3:7-13.
30.	Samah Elsayed GH, Marwa Mosaad A, Soha Kamel M. Effectiveness of planned discharge instructions on patients' recovery following coronary artery bypass graft surgery. IOSR J Nurs Health Sci 2018;7:1-12.
31.	Masoudi R, Kheiri F, Ahmadi F, Mohammadi I. The effect of self-care program base on the Orem frame work on fatigue and activity of daily living in multiple sclerosis patients. J Rehab 2009;10:12-20.
32.	Shi XP, Wu FY, Li YY. The effect of dialectical nursing according to the Orem self-nursing theory applied to patients with sequelae of stroke. Pract J Card Cerebral Pneum Vasc Dis 2012;4:96.
33.	Babakhani B. The Effect of Orem's Self-Care Pattern on Daily Activities of Life in Chronic Obstructive Pulmonary Patients Admitted to Treatment Centers of Urmia University of Medical Sciences in 1395, Master's Thesis, Urmia University of Medical Sciences; 2014.
34.	Zeinali V, Riahinia N, Javadi PV, Asadi S. Effect of health information prescription (HIP) on caregiver's self-care ability. Hum Inf Interact 2017;4:1-12.
35.	Chesser AK, Woods NC, Davis AA, Bowers CJ. Prescribing information therapy: Opportunity for improved physician-patient communication and patient health literacy. J Prim Care Community Health 2012;3:6-10.

Advanced Biomedical Research