RECOVERY IN THE ELDERLY AFTER CORONARY ARTERY BYPASS SURGERY.
Contributors: Boston College.
Published: 1993
Number of pages: 172
Subjects: Health Sciences, Nursing.; Gerontology.; Health Sciences, Medicine and Surgery.
Description: Recovery after coronary artery bypass surgery (CABG) is a complex process for the elderly who are faced with not only managing recovery, but also attempting to regain functional loss from coronary disease. The purpose of this study was to describe recovery after CABG from a model derived from Self-Care Theory (Orem, 1991) and Self Efficacy Theory (Bandura, 1977). It was hypothesized that the relationship between self-care agency (ESCA) and self-care/recovery behavior is mediated by self-efficacy expectation (SE).

A sample of 133 subjects, 65 years and older, were interviewed preoperatively, at discharge, and 6 and 12 weeks after CABG. There were 101 men and 32 women with a mean age of 71.8 years and a New York Heart Association classification of 3.1, indicating an elderly population with significant functional limitations. ESCA, perception of fatigue, SE and behavior of walking, climbing stairs, general activities, and roles were measured.

Repeated measures analysis of variance, revealed significant changes in ESCA, SE for all behaviors, and in the behaviors for walking, general activities and role over recovery, although compared to other samples these subjects appeared less efficacious and performed fewer behaviors. In support of the model, changes were mediated by SE for walking, climbing stairs, general activities, and roles at selected times. Fatigue was significantly correlated with walking, general activities, and role at 6 and 12 weeks, but the moderator effect between ESCA and behavior was not significant. Fatigue may influence this model as a negative physiological arousal affecting the judgments of SE.

Regression analysis demonstrated 27% of variance in behavior 6 weeks postoperatively was accounted for by summarized SE at discharge, younger age, and less functional limitations before surgery. At 22 weeks after surgery, summarized SE at 6 weeks explained 37% of variance in behavior.

Recovery in elderly is protracted, and mediated by SE. Nursing can play a pivotal role with strategies that offer performance support, efficacy enhancement, and knowledge to heighten SE and improve self-care.
Notes: Source: Dissertation Abstracts International, Volume: 54-06, Section: B, page: 2992.

Thesis (PH.D.)--BOSTON COLLEGE, 1993.

School code: 0016.