PREOPERATIVE PREPARATION OF ADULT PATIENTS FOR CARDIAC SURGERY: THE RELATIONSHIP OF SINGULARITY AND INTERACTION ELEMENTS. (VOLUMES I AND II) (PATIENT EDUCATION).
Contributors: Temple University.
Published: 1992
Number of pages: 614
Subjects: Education, Health.; Health Sciences, Nursing.; Health Sciences, Medicine and Surgery.
Description: Although preoperative preparation has received considerable attention in the nursing literature, research findings have been contradictory and confusing. One reason has been inadequate attention to the match of intervention strategies with client and provider characteristics.

The purpose of this study was to provide a data base on the relationship between characteristics of clients and nurses (singularity elements) and intervention strategies (interaction elements) which are used in preoperative preparation of adult patients for cardiac surgery. These factors were explored in the context of a modification of the Interaction Model of Client Health Behavior.

A survey and case studies were conducted of nurses responsible for preoperative preparation of adult cardiac surgery patients in hospitals of the Delaware Valley region of Pennsylvania and New Jersey. Two hundred and twenty-two nurses (51%) responded to the survey questionnaire at 13 hospitals and 3 nurses volunteered for the case studies at 1 hospital. Data were collected on the nurses': backgrounds, assessment of client characteristics, intervention strategies, and expected outcomes in preoperative preparation of patients for cardiac surgery.

Following factor analysis of element variables from the survey data, canonical correlation analysis produced two statistically significant correlations between the set of three client singularity factors and the set of four interaction factors (R$\sb\□rm c □$= 0.634, p = 0.000; R$\sb\□rm c □$= 0.311, p = 0.001) and two significant correlations between the set of six nurse singularity factors and set of four interaction factors (R$\sb\□rm c □$= 0.535, p = 0.000; R$\sb\□rm c □$= 0.422, p = 0.000). Further, hierarchical multiple regression analysis, alternating entry of client singularity and professional singularity factors as the first predictor block, demonstrated statistically significant (p = $\le$0.05) R$\sp2$'s for three interaction factors (R$\sp2$ = 0.328; R$\sp2$ = 0.277; R$\sp2$ = 0.115) with similar R$\sp2$ changes for both entries. Content analysis of the case study data elaborated on the survey results.

These findings demonstrated that assessment of clients' psychosocial responses and presence of professional resources related to individual psychoeducational approaches in preoperative preparation of adult patients for cardiac surgery. Therefore, in order to plan effective preoperative programs, consideration is needed of client and nurse characteristics which are associated with nurses' choices of intervention strategies. Future research on these decision-making processes needs to determine their impact on health outcomes.
Notes: Source: Dissertation Abstracts International, Volume: 53-01, Section: A, page: 0075.

Thesis (PH.D.)--TEMPLE UNIVERSITY, 1992.

School code: 0225.