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Effect of planned patient teaching and psychological support on the adaptation of the elderly patient to the surgical insertion of a permanent pacemaker Shannon, Valerie Jane

Abstract

An experimental study, using a pretest-posttest control group design, was conducted in a 570 bed acute care teaching hospital. Its purpose was to evaluate the effect of planned patient teaching and psychological support on the ability of the elderly patient to adapt to the surgical insertion of a permanent cardiac pacemaker. Nine subjects, who met the study criteria, were randomly assigned to either the experimental or control group. Each subject was asked if he would like to include a significant other in the project. The members of the experimental group (5 patients, 3 significant others) were seen individually by the nurse investigator on or close to the third, fourth and fifth postoperative day at which time their questions were answered, they were given the opportunity to express their concerns and, they were shown a 15 minute slide-tape programme about pacemakers. The members of the control group (4 patients, 4 significant others) were provided with the usual nursing care given by the ward nursing staff. All patients received a booklet from the company supplying their specific type of pacemaker. The hypotheses tested were: 1. Patient teaching and psychological support will increase the knowledge base of the patient and his significant other. 2. Patient teaching and psychological support will decrease the state and trait anxiety levels of the patient and his significant other. 3. Patient teaching and psychological support will enable the patient and his significant other to demonstrate pulse taking. 4. Patient teaching and psychological support will maintain or increase the activity level of the patient from his preoperative state. At approximately two and four weeks after discharge from the hospital, the nurse investigator visited all the patients in the study and their significant others. Knowledge base, anxiety (state and trait) level, activity level and pulse taking ability were measured on all patients; whereas, only knowledge base, pulse taking ability and anxiety (state and trait) level were measured on all significant others. No significant differences were found between the two groups on any of these variables. Some methodological problems and clinical implications of the findings are discussed.

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