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首页> 外文期刊>South African Journal of Physiotherapy >Self-responsibility predicts the successful outcome of coronary artery bypass surgery
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Self-responsibility predicts the successful outcome of coronary artery bypass surgery

机译：自我责任感预示冠状动脉搭桥手术的成功结果

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Purpose: This study was designed to determine whetherthe acceptance of self-responsibility is an important determinant of the successful outcome of coronary artery bypass graft (CABG) surgery. The success of this costly intervention may be limited unless patients understand and adhere to the prescribed medical regimen, including diet and exercise after surgery. Patients suffering from chronic diseases must take charge of their own health and not abrogate that responsibility to the care providers.Method: Questionnaires were designed to determine aspects of improved quality of life and self-responsibility. For the study, 73 patients who had undergone CABG surgery were selected from surgical patients in the private as well as the public sector. In order to assess the acceptance of self-responsibility, the spouses/care-givers of the patients were included in the study. Patients were interviewed during the first few days after the operation when they had returned to the wards and again six months and 12 months later. Successful outcome was measured in terms of improved quality of life using the criteria suggested by the Coronary Artery Surgery Study (Coronary Artery Surgical Study PrincipalInvestigators, 1983). The acceptance of self-responsibility was then investigated as a possible factor influencing the improvement of the quality of life of these patients.Results: The acceptance of self-responsibility was a significant factor predicting the successful outcome of CABG surgery in the group of patients who achieved an improved quality of life following surgery (p0.01). From the results of this study, a profile of South African patients with improved quality of life was identified. They are: Men, married, annual income R50 000 (US $8 000), who had a normal sex-life prior to the operation.? They differ significantly from the group without an improved quality of life in the following aspects: they spend more hours participating in sport at school (p=0.04), stop their sporting activities for a shorter period of time? prior to the operation (p0.01) and are taller (p0.01). Twelve months after the operation their sexual performance has improved (p0.01) and they are not depressed (p0.01). Patients who accept self-responsibility for their recovery after CABGsurgery have the following characteristics:? married (p0.01), have a level of education grade 12 (p=0.01), have? anannual income R50 000 (p=0.05). They differ from the group who did not accept personal responsibility in that theyand their spouses/care-givers had a greater knowledge about the disease and the risk factor modification (p=0.01; p0.01), and twelve months after the operation the patients are satisfied with the outcome of the operation (p0.01).Conclusions: A stepwise logistic regression established that the acceptance of self-responsibility was the strongest? factor predicting an improved quality of life after CABG surgery. Patients who did not accept responsibility did not have an improved quality of life irrespective of the impact of all other parameters. Patients' satisfaction with the outcome of the operative procedure is an important predictor of the acceptance of self-responsibility. Realistic expectations of the outcome of CABG surgery will improve patients' satisfaction with the outcome. The knowledge of the spouse is a significant factor in the patients' acceptance of self-responsibility. Knowledge of the chronic nature of their disease as well as risk factor modification and realistic expectations of the outcome of CABG surgery influences patientsacceptance of self-responsibility.
机译：目的：本研究旨在确定接受自我责任感是否是冠状动脉搭桥术（CABG）手术成功结果的重要决定因素。除非患者理解并遵守规定的医疗方案，包括手术后的饮食和运动，否则这种昂贵的干预措施的成功可能受到限制。患有慢性疾病的患者必须负责自己的健康，而不是放弃对护理人员的责任。方法：问卷旨在确定改善生活质量和自我责任感的方面。在这项研究中，从私人和公共部门的手术患者中选出了73位接受CABG手术的患者。为了评估对自己负责的接受程度，将患者的配偶/照顾者纳入研究。在手术后的最初几天（当他们回到病房时）接受了采访，并在六个月和十二个月后再次接受了采访。根据冠状动脉手术研究（Coronary Artery Surgery Study PrincipalInvestigators，1983年）提出的标准，根据改善的生活质量衡量成功的预后。然后，对自我责任感的接受程度作为可能影响这些患者生活质量改善的因素进行了研究。结果：自我责任感的接受是预测CABG手术在以下患者组中成功的重要因素：手术后生活质量得到改善（p <0.01）。根据这项研究的结果，确定了南非患者的生活质量得到改善的概况。他们是：已婚男性，年收入> 50000兰特（8000美元），在手术前过着正常的性生活。他们在以下方面与没有明显改善生活质量的群体有很大不同：他们花更多时间参加学校的体育活动（p = 0.04），在较短的时间内停止体育活动吗？术前（p <0.01）较高（p <0.01）。手术十二个月后，他们的性能力得到改善（p <0.01），并且没有沮丧（p <0.01）。接受CABG手术后自我恢复的患者具有以下特征：已婚（p <0.01），受教育程度> 12年级（p = 0.01），有吗？年收入> R50 000（p = 0.05）。他们与不承担个人责任的小组不同，因为他们和他们的配偶/护理人员对疾病和危险因素的改变有更深入的了解（p = 0.01; p <0.01），并且在术后十二个月对手术的结果感到满意（p <0.01）。结论：逐步logistic回归确定自我责任感最强？预测CABG手术后生活质量改善的因素。不承担责任的患者的生活质量没有改善，而不受所有其他参数的影响。患者对手术结果的满意程度是接受自我责任感的重要指标。对CABG手术结果的现实期望将提高患者对结果的满意度。配偶的知识是患者接受自我责任感的重要因素。了解其疾病的慢性性质以及对危险因素的修改以及对CABG手术结局的现实期望会影响患者对自我责任感的接受程度。

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