Revista Portuguesa de Enfermagem de Reabilitação (Oct 2020)
CARDIAC REHABILITATION PROGRAM FOR THE PERSON HEART TRANSPLANTED AT HOME: CASE REPORT
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.
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