The associated factors for inhibiting early ambulation among patients in acute phase cardiac rehabilitation after cardiovascular surgery

2019 Fiscal Year Final Research Report

• Project/Area Number: 15K20696
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Clinical nursing
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Satoh Yuki 浜松医科大学, 医学部, 教務補佐員 (40634952)
• Project Period (FY): 2015-04-01 – 2020-03-31
• Keywords: 離床 / 急性期 / 心大血管リハビリテーション / 心大血管術後

Outline of Final Research Achievements

This study aimed to clarify the factors for inhibiting early ambulation in acute-phase cardiac rehabilitation for patients who underwent cardiovascular surgery. A survey was conducted with 231 patients who underwent cardiovascular surgery. Additionally data were extracted from medical records and their leaving condition and the related factors were clarified.
The mean time taken to achieve first sitting, standing, and walking was 1.9, 2.2, and 3.9 postoperative days, respectively. Appearance of wobbling and cognitive dysfunction after surgery were identified as risk factors for delayed bed leaving with assistance. It is important for nurses to encourage patients to exit from the ICU by promoting posture change immediately after surgery, getting up from the bed, performing floor exercises, and achieving end sitting hours from the day after the surgery.

Free Research Field

臨床看護学

Academic Significance and Societal Importance of the Research Achievements

心大血管手術を受けた患者に、離床を遅らせる要因が具体的に存在する場合、看護師が病棟において情報共有を行うことができ、術前術後における理学療法士の介入を促すことができる。また、術直後からも離床を遅らせる要因の発見、把握、および観察を行いながら積極的にアプローチすることで、より安全に早期離床を行うことでき早期の自宅退院および社会復帰につながるのではないかと考える。
したがって、急性期において心大血管リハビリテーションに関わる際に、看護師が統一した介入ができるような指標が必要であり、指標を作るために必要となる具体的な離床を遅らせる要因の検討を行った。現在、関連学会への投稿に向けて準備中である。