冠狀動脈繞道術後病患身體症狀困擾、身體活動功能及其自我效能相關之探討

Most patients who undergo coronary artery bypass graft (CABG) surgery continue to experience physical symptom distress and lack confidence in their ability to be physically active. This situation limits the potential to improve physical functions. The purposes of this study were 1) to explore changes over time in physical symptom distress, physical function self-efficacy and physical functions in patients following CABG surgery and 2) to examine relationships among these three variables. Seventy-four patients who had undergone CABG surgery at one medical center were selected by purposive sampling. Instruments for this study included a demographic questionnaire, symptom distress scale, in physical function self-efficacy survey, and functional status questionnaire. Data were collected from each participant at four different times: the day before surgery and ten days, one month and three months following surgery. Results of this study revealed progressive post-surgery improvement in physical symptom distress, physical functions and physical function self-efficacy. However, 25.7% of patients continued suffering from functional disabilities 3 months after surgery. Higher average symptom distress was observed in females above New York Heart Association (NYHA) class Ⅲ at 10 days following surgery than observed in males below NYHA class Ⅲ at over one month following surgery. Physical function and physical function self-efficacy scores were lower in elderly patients and those in higher NYHA classifications than in younger patients and those in lower NYHA classifications. Self-efficacy in physical function scores were significantly lower for those who could not exercise or had lengthy hospital stays than for those who exercised regularly or had shorter hospital stays. Although correlation between symptom distress and physical function was not statistically significant (p= .36), a significantly positive relationship was found between physical function self-efficacy and physical function (p＜ .0001). In conclusion, nurses can help patients improve postoperative physical function and enhance patient self-efficacy in physical function by encouraging exercise.