a social support intervention to improve quality of life in cardiac

A SOCIAL SUPPORT INTERVENTION TO IMPROVE QUALITY OF LIFE
IN CARDIAC REHABILITATION PATIENTS
Lisa Warren-Heft, BSN, RN
College of Nursing and Health Innovation, Arizona State University
Methods Responses from 20 program participants (9 who received
the EBP intervention and 11 who had the standard of care) to
questionnaires already utilized in the program (The Dartmouth Quality
of Life index survey) were analyzed using SPSS22® .
Outcomes The analysis output based on a Mann-Whitney U-test
indicated that the intervention group did significantly differ in
their scores on the Dartmouth Quality of Life Index, and therefore
reported more favorable levels of functioning (life quality) at program
completion
Ethical Approval IRB approval was obtained from ASU. An additional IRB was obtained from the
healthcare system where the project was conducted.
Participants A convenience sample of 20 participants (M age = 67 years, SD = 12.09) was selected
from the program. Eleven of these participants completed the CR program only. The remaining nine
participants attended both CR and the support group. See fig. 1
Intervention The intervention was completed with cardiac support group, sponsored by the health
care organization and affiliated with the Mended Hearts Group. CR participants who attended a
support group for cardiac disease patients were compared with participants who completed only the
CR program by analyzing the responses to questionnaires already utilized in the program (The
Dartmouth Quality of Life index survey)
Data Analysis After implementing the The Dartmouth Quality of Life index survey, the data was
entered into Statistical Package for the Social Sciences (SPSS22®). Descriptive and inferential
statistics were used to analyze the data. The critical value was set at p<0.10 and a two-tailed test
were used to analyze the data.
Conclusions. Despite a relatively small sample size, participants who
attended a support group had improved quality of life scores over
participants who attended the CR program alone
Research has shown that poor social support and psychological
distress significantly predict outcomes such as disease progression,
mortality, quality of life, and well-being, that follow cardiac events. 1. A
structured research question was formulated using the PICO format.
In cardiac rehabilitation participants, does attending a cardiac
support group in addition to the CR program compared to those
completing only the CR program affect quality of life scores?
Mann-Whitney Test
40
20
0
PRE CR - no
intervention
POST CR - no
intervention
CR Participants – No Support Group
N=11
60
40
20
0
PRE +
intervention
Post +
intervention
Support Group Participants N = 9
Results
Female
Male
Population: Convenience sample of
20 participants
Impact of Project Impact on patient outcomes include greater improvement on nine
measures on functional health status including feelings, physical fitness, social support, daily
activities, social activities, pain, overall health, quality of life and change in health. Impact on
the practice setting is to provide additional evidence that the support group contributes to
better patients outcomes and therefore should be continued.
Evidence exists that social support provided by participation in a support group may improve quality of life. This evidence-based, clinically applied
project in a CR setting, found that participants who attended a support group in addition to the CR program had improved quality of life scores over
participants who attended the CR program alone. Despite a small sample size, it can be anticipated that these results would be similar with a larger
group of participants. Although administering the Dartmouth Quality of Life survey and the cardiac support group were currently part of the program,
no comparison between those who attended the support group and those who did not had been done. The project provided evidence of improved
patient outcomes demonstrating that the program should continue to offer the support group.
Thus, the results of the present project provide greater insight into psychosocial dysfunction among CR program participants and the relationship
between improved quality of life and higher social support
Acknowledgements
A comprehensive appraisal of the body of knowledge, and review and
synthesis of the evidence, demonstrates a robust and consistent
relationship between social support and cardiovascular disease (CVD)
outcomes for those with coronary heart disease. Social support may
be considered a key predictor of prognosis in this population.2 Support
groups may engender social support. 3
Cardiac Rehabilitation,
community hospital in the
Southwest
60
Intervention Pre and Post QOL
Scores
Conclusion
Introduction
Setting:
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dartmouth QOL
scores
Purpose This study examined whether cardiac rehabilitation (CR)
participants at a community hospital in the Southwest, who attended a
cardiac support group in addition to the CR program, differed in their
scores on a quality of life survey from participants who only completed
the CR program.
Methods
Dartmouth QOL
Scores
Abstract
Standard of Care: Pre and Post QOL
Scores
Evelyn L. Cesarotti Ph.D., FNP-BC, FAANP: Academic Mentor
Kelly Grogan RN, MNA, FNP: Site Mentor & clinical preceptor
Donna Paychek, cardiac rehabilitation manager & cardiac rehabilitation staff
Results
Statistical Significance Analysis Output based on the Mann-Whitney U-test demonstrated
that CR participants who attended the support group (Mdn = 8.0) and CR participants who
did not (Mdn = 12.55) did significantly differ in their scores on the Dartmouth Quality of Life
Index, U = 27.00, p<.10, Z = -1.713.
Clinical Significance CR participants who received the EBP intervention reported greater
improvement in quality of life measures. Since the sample size was small, it can be
anticipated that the results would be similar even with a large group. The results support the
continuation of the support group by the CR program and the encouragement of participants
to attend.
References
1.Williams, M. A., Ades, P. A., Hamm, L. F., Keteyian, S. J., LaFontaine, T. P., Roitman, J. L., & Squires, R. W. (2006). Clinical evidence for a health benefit from cardiac rehabilitation: An update. American
Heart Journal, 152(5), 835-841. doi:10.1016/j.ahj.2006.05.015
2. Burg, M. M., Skala, J., Taylor, C. B., Barefoot, J., Berkman, L., Catellier, D. J., . . . ENRICHD Investigators. (2005). Low perceived social support and post-myocardial infarction prognosis in the enhancing
recovery in coronary heart disease clinical trial: The effects of treatment. Psychosomatic Medicine, 67(6), 879-888. doi:10.1097/01.psy.0000188480.61949.8c
Lee, D. T. F., Choi, K. C., Chair, S. Y., Yu, D. S. F., & Lau, S. T. (2014). Psychological distress mediates the effects of socio-demographic and clinical characteristics on the physical health component of health-related
quality of life in patients with coronary heart disease. European Journal of Preventive Cardiology, 21(1), 107 116. doi:10.1177/2047487312451541
3. Mookadam, F., & Arthur, H. M. (2004). Social support and its relationship to morbidity and mortality after acute myocardial infarction: Systematic overview. Archives of Internal Medicine,164(14), 1514-1518.
doi:10.1001/archinte.164.14.1514
For more information
Lisa Warren-Heft. ASU DNP student. Email: lwarre@asu.edu. Phone: 602-366-5634