Keywords
Cardiac rehabilitation
Rehabilitation Nursing
How to Cite
Citações
Dimensions
Abstract
Introduction: The cardiac rehabilitation programs (CRP), in its different phases, allow the rehabilitation nurse to have a privileged intervention in the monitoring and care of the person submitted to a heart transplant, from the preoperative phase, in the mediate recovery period and late postoperative. It contributes to the autonomy and self-care of the person and his family, adapting to new health condition and increasing their quality of life, intervening in the various psychological and physiological changes resulting from transplant, with cardiac rehabilitation being an advantageous therapeutic option in this case.
Objective: To analyze the health outcomes of Rehabilitation Nursing in a Cardiac Rehabilitation Program home-based.
Strategies / methodology: Case report of mixed approach integrated 7 cases. There were included person submitted to a heart transplant who have never been part of a cardiac rehabilitation program (CRP), manifesting changes in functional capacity.The following patient characteristics were defined as variables: time of transplant, age, gender and anthropometric measurements. Physiological parameters such as heart rate (HR), blood pressure (BP), subjective perception of effort (PSE) were evaluated using the modified Borg scale and 6-minute walk test, in 2 moments of follow-up consultation, with a 3-months interval. At first, after evaluation, a PRC was prescribed in a Home-based model. Telephone and email contacts were made to understand the difficulties experienced, as well as the level of compliance with the program. The measurement of results was made in a second moment of contact.
Results: The integration in the CRP provided an improvement in functional capacity, with 85.71% of the cases of this study with clinically significant increase in the distance of the the 6-minutes walk test, with an improvement in the subjective notion of effort in 57.14% of subjects. There were improvements in the status of the common nursing diagnoses identified, such as Intolerance to activity; Self-care: physical activity not compromised. There was also an improvement in the control of cardiovascular risk factors, such as diet, stress, among others, all patients changed part of their diet plan, resulting in Adherence to the non-compromised diet.100% of patients present speeches in favor of improving the quality of life related to the program and monitoring. There were no adverse events during the program.
Conclusions: In this study it is observed that the participation in phase III of CRP is safe and translates improvement of the functional capacity, greater capacity of adherence to the dietary regime and control of cardiovascular risk factors, being associated with positive discourses of quality of life.
References
Lund LH, Khush KK, Cherikh WS, Goldfarb S, Kucheryavaya AY, Levvey BJ, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report—2017; Focus Theme: Allograft ischemic time. J Hear Lung Transplant. 2017 Oct;36(10):1037–46. Available from: https://doi.org/10.1016/j.healun.2017.07.019
Nygaard S, Christensen AH, Rolid K, Nytrøen K, Gullestad L, Fiane A, et al. Autonomic cardiovascular control changes in recent heart transplant recipients lead to physiological limitations in response to orthostatic challenge and isometric exercise. Eur J Appl Physiol. 2019 Aug 12; Available from: https://doi.org/10.1007/s00421-019-04207-5
Anderson L, Nguyen TT, Dall CH, Burgess L, Bridges C, Taylor RS. Exercise-based cardiac rehabilitation in heart transplant recipients. Cochrane Database Syst Rev. 2017 Apr 4; Available from: https://doi.org/10.1002/14651858.CD012264.pub2
Rosenbaum AN, Kremers WK, Schirger JA, Thomas RJ, Squires RW, Allison TG, et al. Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients. Mayo Clin Proc. 2016 Feb;91(2):149–56. Available from: https://doi.org/10.1016/j.mayocp.2015.12.002
International Society of Heart and Lung Transplantation. International Thoracic Organ Transplant (TTX) Registry Data Slides [Internet]. 2018.
Söderlund C, Rådegran G. Immunosuppressive therapies after heart transplantation--The balance between under- and over-immunosuppression. Transplant Rev (Orlando). 2015;29(3):181–189. doi:10.1016/j.trre.2015.02.005
Loureiro MFS. Reabilitação e transplante cardíaco: revisão sistemática da literatura. 2015 [cited 2019 Oct 18]
Awad M, Czer LS, Hou M, et al. Early Denervation and Later Reinnervation of the Heart Following Cardiac Transplantation: A Review. J Am Heart Assoc. 2016;5(11):e004070. Published 2016 Nov 1. doi:10.1161/JAHA.116.004070
Perrier-Melo RJ, dos Santos Figueira FAM, Guimarães GV, da Cunha Costa M. Treinamento Intervalado de Alta Intensidade em Transplantados de Coração: Uma Revisão Sistemática com Meta-Análise. Arq Bras Cardiol. 2018;110(2):188–94.
ACSM. ACSM´s guideline for exercise testing and prescription. Tenth. American College of Sports Medicine; 2018. 501 p.
Bachmann JM, Shah AS, Duncan MS, Greevy RA, Graves AJ, Ni S, et al. Cardiac rehabilitation and readmissions after heart transplantation. J Hear Lung Transplant. 2018 Apr;37(4):467–76. Available from: https://doi.org/10.1016/j.healun.2017.05.017
Fogaça D, Goés GG de, Fuhro MI, Mariante P, Frasson R, Monteiro MB, et al. O papel da reabilitação física após o transplante cardíaco: uma revisão da literatura. EFDeportes. 2012;(171)
Rocha JAGM da. Efectividade de um programa de reabilitação cardíaca [Internet]. Dissertação de candidatura ao grau de Mestre em Epidemiologia. Faculdade de Medicina. Universidade do Porto; 2010.
Karapolat H, Eyigor S, Zoghi M, Yagdi T, Nalbantgil S, Durmaz B, et al. Effects of cardiac rehabilitation program on exercise capacity and chronotropic variables in patients with orthotopic heart transplant. Clin Res Cardiol. 2008 Jul 3;97(7):449–56. Available from: https://doi.org/10.1007/s00392-008-0648-7
Regulamento n.º 392/2019 Regulamento das competências específicas do enfermeiro especialista em Enfermagem de Reabilitação- . Diário da República 2ª Série, NºN.º 85 –( 3-05-2019) 13565-13568
Regulamento nº350/2015 de 22 de Junho (2015). Regulamento dos padrões de qualidade dos cuidados especializados em enfermagem de reabilitação. Diário da República 2ª Série, Nº 116 (22-06-2015) 16655-16660.
Riley, D. S., Barber, M. S., Kienle, G. S., Aronson, J. K., von Schoen-Angerer, T., Tugwell, P., Gagnier, J. J. (2017). CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol, 89, 218-235. doi:10.1016/j.jclinepi.2017.04.026
Borracci, R. A., Ingino, C. A., & Miranda, J. M. (2018). Association of body mass index with short-term outcomes after cardiac surgery: Retrospective study and meta-analysis. Med, 78(3), 171–179.
Organização Mundial da Saúde (OMS). (2001) Waist circunference and waist-hip ratio: report of a WHO expert consultation. Geneve: Organização Mundial da Saúde;. 8
Direção-Geral da Saúde (DGS). Orientação da Direção-Geral da Saúde: Avaliação Antropométrica no Adulto. Lisboa: Direção-Geral da Saúde; 2013. 1-9.
Uithoven, K. E., Smith, J. R., Medina-Inojosa, J. R., Squires, R. W., & Olson, T. P. (2020). The Role of Cardiac Rehabilitation in Reducing Major Adverse Cardiac Events in Heart Transplant Patients. J Card Fail. https://doi.org/10.1016/j.cardfail.2020.01.011
Kawauchi, e. a. (2013). Randomized and comparative study between two intra-hospital exercise programs for heart transplant patient. Rev Bras Cir Cardiovasc, 28(3), pp. 338- 346.
Forestieri, P., Guizilini, S., Peres, M., Bublitz, C., Bolzan, D. W., Rocco, I. S., Santos, V. B., Moreira, R. S., Breda, J. R., de Almeida, D. R., Carvalho, A. C., Arena, R., & Gomes, W. J. (2016). A Cycle Ergometer Exercise Program Improves Exercise Capacity and Inspiratory Muscle Function in Hospitalized Patients Awaiting Heart Transplantation: a Pilot Study. Braz J Cardiovasc Surg, 31(5), 389–395. https://doi.org/10.5935/1678-9741.20160078
Ciolac, e. a. (2014). Prescribing and Regulating Exercise with RPE after Heart Transplant: A Pilot Study . Medicine & Science in Sports & Exercise
Oliveira, A.; Costa, D., Teodoro, E. ; Pereira, W.; Miranda, V., (2016) Reabilitação cardíaca fase III em pacientes submetidos ao transplante cardíaco in Ver Bras Fisiol Exerc - ano 2016 - volume 15 - número 2. DOI: http://dx.doi.org/10.33233/rbfe.v15i2.147
Chen, e. a. (2010). Mediating effect of symptom severity on the relationship between self-efficacy for exercise and depressio. J Clin Nurs, 20, pp. 294-296
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2020 Revista Portuguesa de Enfermagem de Reabilitação
Downloads
| Abstract Views | 763 |
|---|
| PDF (Português (Portugal)) | 304 |
|---|