Transisyonel Bakım Modeli: Açık Kalp Cerrahisi Geçiren Yaşlı Hastalarda Fonksiyonel Bağımsızlık Düzeyi ve Yaşam Kalitesi Üzerine Etkileri

Abstract

Çoşkun, S. Transitional Care Model: The Effects on Level of Functional Autonomy and Quality of Life in Elderly Patients with Open Heart Surgery. Hacettepe University, Graduate School Health Sciences Fundamentals and Management Nursing Integrated Doctorate Program Doctor of Philosophy Thesis, Ankara, 2019. This randomized, controlled interventional study aimed to assess the effects of nursing care provided in line with the Transitional Care Model on functional autonomy levels, quality of life and recurrent admission and hospitalization rates in elderly patients with open heart surgery. The study was carried out between November 2017- December 2018 on the patients in the age group of 60 years and over who were admitted to the Cardiovascular Surgery Clinic of İzzet Baysal Education and Research Hospital Faculty Unit of Ministry of Health-Abant İzzet Baysal University, for open heart surgery. The study sample consisted of a total of 64 patients, including 32 patients in intervention group and 32 patients in control group, who were selected by computer assisted randomization. The patients in the intervention group were offered care based on the Transitional Care Model up to nine weeks after discharge from the hospital. Within the scope of the model, the services provided by the patients in the intervention group included care with multidisciplinary collaboration, four home visits after discharge and telephone counseling services in line with the needs of the patient / relatives. Patients in the control group received standard care services. In the collection of data, identifying information forms, Functional Measurement System, SF-36 Quality of Life Form and Follow-up Form for Recurrent Admission of Patients after Discharge were used. The research data were collected on the first day of admission to the clinic and in the 9th week and 6th month after the discharge of patients from the hospital. Descriptive statistics, Independent Sample t-Test, One-Way Analysis of Variance and Chi-Square were used to evaluate the data. It was found that Functional Measurement System average scores and SF-36 Quality of Life sub-dimension average scores of the patients in the intervention group in their follow-up of 9th week after discharge were statistically significantly higher than those of the patients in the control group (p<0,05). Also, recurrent admission and hospitalization rates of the patients in the control group in the follow-up process after the discharge (6 months) were found to be statistically significantly higher than those of the patients in the intervention group (p<0,05). In the study, it was concluded that the care service practices offered under the Transitional Care Model improve the functional autonomy levels and quality of life of the patients and are effective in decreasing the post-discharge recurrent admission and hospitalization rates of the patients. In line with the findings of the study, the Transitional Care Model is recommended to be used in nursing care practices for elderly patients who will undergo surgery.