2.50
Hdl Handle:
http://hdl.handle.net/10755/157442
Type:
Presentation
Title:
QUALITY OF RECOVERY IN OLDER ADULTS FOLLOWING CARDIAC SURGERY
Abstract:
QUALITY OF RECOVERY IN OLDER ADULTS FOLLOWING CARDIAC SURGERY
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Aldrich, Katherine, RN, PhD, NP
P.I. Institution Name:Dominican University
Title:Adjunct faculty
Contact Address:1445 Baird Rd, SANTA Rosa, CA, 95409, USA
Co-Authors:Nancy Stotts; Virginia Carrieri-Kohlman; Mark Rollins
PURPOSE: Little is known about quality of recovery (QoR) in older adults during the first 30 days after cardiac surgery. Older adults are less likely to regain prior functional status by hospital discharge and temporary postoperative functional loss may become permanent, adversely affecting QoR. A descriptive repeated measures design was used to: examine relationships between pain, wound healing, surgical risk, functional status, mood, quality of life (QoL) and QoR at discharge and 30 days; estimate effects of change over time in functional status, mood and QoL on the change in QoR from discharge to 30 days; and describe factors hindering or promoting recovery and the amount of recovery achieved by older adults 30 days after cardiac surgery.
METHODS: Functional status, (ability to perform basic/intermediate activities of daily living [BADL, IADL]), mood, and QoL were assessed preoperatively, at discharge, and at 30 days using the Functional Status Questionnaire, Profile of Mood States Short Form and the Quality of Life Index. Wound healing and pain were assessed for the first five postoperative days and at 30 days using ASEPSIS and an 11ûpoint NRS. QoR was measured with the QoR-40 at discharge and 30 days. Promoters, inhibitors, and percentage of achieved recovery were assessed at 30 days.
RESULTS: Subjects (n = 62) were > 65 years with a mean age of 75.9 (+7.0) and mostly male (74.2%). Half had OPCAB surgery. Mean surgical risk was 5.6% (+9.8). QoR at discharge and 30 days was positively correlated with preoperative BADL and IADL (rho = .35, .37; .46, .27). QoR at 30 days was positively correlated with preoperative mood and QoL (rho = -.43, .53). Negative binomial regression models predicted a 19-point increase in QoR over time as ability to perform IADLs improved. At 30 days, family support was the greatest promoter of recovery and mobility limits the greatest barrier to recovery, while 84% of participants felt at least 50% recovered.
CONCLUSIONS: Preoperative function, progressive improvement after surgery and family support significantly enhances 30-day QoR in older cardiac surgery patients. Limited mobility is a barrier to recovery. Optimizing functional ability and mobility in the first postoperative month may lead to improved QoR in older cardiac surgery patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleQUALITY OF RECOVERY IN OLDER ADULTS FOLLOWING CARDIAC SURGERYen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157442-
dc.description.abstract<table><tr><td colspan="2" class="item-title">QUALITY OF RECOVERY IN OLDER ADULTS FOLLOWING CARDIAC SURGERY</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Aldrich, Katherine, RN, PhD, NP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Dominican University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Adjunct faculty</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1445 Baird Rd, SANTA Rosa, CA, 95409, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kaldrich@sonic.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Nancy Stotts; Virginia Carrieri-Kohlman; Mark Rollins</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: Little is known about quality of recovery (QoR) in older adults during the first 30 days after cardiac surgery. Older adults are less likely to regain prior functional status by hospital discharge and temporary postoperative functional loss may become permanent, adversely affecting QoR. A descriptive repeated measures design was used to: examine relationships between pain, wound healing, surgical risk, functional status, mood, quality of life (QoL) and QoR at discharge and 30 days; estimate effects of change over time in functional status, mood and QoL on the change in QoR from discharge to 30 days; and describe factors hindering or promoting recovery and the amount of recovery achieved by older adults 30 days after cardiac surgery. <br/>METHODS: Functional status, (ability to perform basic/intermediate activities of daily living [BADL, IADL]), mood, and QoL were assessed preoperatively, at discharge, and at 30 days using the Functional Status Questionnaire, Profile of Mood States Short Form and the Quality of Life Index. Wound healing and pain were assessed for the first five postoperative days and at 30 days using ASEPSIS and an 11&ucirc;point NRS. QoR was measured with the QoR-40 at discharge and 30 days. Promoters, inhibitors, and percentage of achieved recovery were assessed at 30 days. <br/>RESULTS: Subjects (n = 62) were &gt; 65 years with a mean age of 75.9 (+7.0) and mostly male (74.2%). Half had OPCAB surgery. Mean surgical risk was 5.6% (+9.8). QoR at discharge and 30 days was positively correlated with preoperative BADL and IADL (rho = .35, .37; .46, .27). QoR at 30 days was positively correlated with preoperative mood and QoL (rho = -.43, .53). Negative binomial regression models predicted a 19-point increase in QoR over time as ability to perform IADLs improved. At 30 days, family support was the greatest promoter of recovery and mobility limits the greatest barrier to recovery, while 84% of participants felt at least 50% recovered.<br/>CONCLUSIONS: Preoperative function, progressive improvement after surgery and family support significantly enhances 30-day QoR in older cardiac surgery patients. Limited mobility is a barrier to recovery. Optimizing functional ability and mobility in the first postoperative month may lead to improved QoR in older cardiac surgery patients.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:52:37Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:52:37Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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