The Effect of Utilizing Organizational Culture Improvement Model of Patient Education on Coronary Artery Bypass Graft Patients’ Anxiety and Satisfaction
Theory Testing
Keywords:
Patient education, Anxiety, Satisfaction, Coronary Artery Bypass GraftAbstract
Introduction: Due to the increasing prevalence of arteriosclerosis and the mortality caused by this disease, Coronary Artery Bypass Graft (CABG) has become one of the most common surgical procedures. Utilization of patient education is approved as an effective solution for increasing patient survival and outcomes of treatment. However, failure to consider different aspects of patient education has turned this goal into an unattainable one. The objective of this research was to determine the effect of utilizing the organizational culture improvement model of patient education on CABG patients’ anxiety and satisfaction.
Methods: The present study is a randomized controlled trial. This study was conducted on eighty CABG patients. The patients were selected from the CCU and Post-CCU wards of a hospital affiliated with Iran University of Medical Sciences in Tehran, Iran, during 2015. Eshpel Burger’s Anxiety Inventory and Patients’ Satisfaction Questionnaire were used to collect the required information. Levels of anxiety and satisfaction of patients before intervention and at the time of release were measured. The intervention took place after preparing a programmed package based on the organizational culture improvement model for the following dimensions: effective communication, participatory decision-making, goal setting, planning, implementation and recording, supervision and control, and improvement of motivation. After recording the data, it was analyzed in the chi-square test, t-independent and Mann-Whitney U tests. The significance level of tests was assumed to be 0.05. SPSS version 18 was also utilized for data analysis.
Results: Research results revealed that variations in the mean scores of situational and personality anxiety of the control and experiment group were descending following the intervention, but the decrease was higher in the experiment group (p≤0.0001). In addition, the variations of the mean scores of patients’ satisfaction with education were higher in the experiment group than the control group (p≤0.0001).
Conclusion: Utilization of the organizational culture improvement model of patient education reduces stress in CABG patients and increases their satisfaction with the provided education considering the factors involved in patient education, which were incorporated in the designed model.
References
Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. World
Health Organization. 2011; 164.
Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular
disease in the developing world: global implications. Eur Heart J. 2010; 31(6): 642-8. doi:
1093/eurheartj/ehq030. PMID: 20176800.
Jalili M, Chavoshzadeh A, Fereshtehnejad SM, Aghili S, Shafiee Sabet A, Shahzadi M, et al. Stroke
following coronary artery bypass grafting (CABG): Evaluation of the prevalence and possible risk factors
in Iranian patients. Iranian Journal of Neurology. 2010; 9: 678-85.
Sendelbach SE, Halm MA, Doran KA, Miller EH, Gaillard P. Effects of music therapy on physiological
and psychological outcomes for patients undergoing cardiac surgery. J Cardiovasc Nurs. 2006; 21(3): 194- 200. doi: 10.1097/00005082-200605000-00007. PMID: 16699359.
Siavoshi S, Roshandel M, Zareiyan A, Ettefagh L. The effect of cardiac rehabilitation care plan on the
quality of life in patients undergoing Coronary Artery Bypass Graft surgery. Cardiovascu Nursing J. 2012;
(2): 38-46.
Rigi F, Feizi A, Naseri M, Salehi SH. Effect of foot reflexology massage on pain in patients undergoing
coronary bypass surgery. Anesthesiology and Pain. 2015; 5(4): 42-9.
Sharif F, Shoul A, Janati M, Zareh N, Kojouri J. Effect of Cardiac Rehabilitation on Anxiety and
Depression in CABG Patients. Journal of Rehabilitation. 2011; 12(2(47)): 8-13.
Alters S, Schiff W. Essential concepts for healthy living. Jones & Bartlett Publishers. 2009.
McCaffrey R, Taylor N. Effective anxiety treatment prior to diagnostic cardiac catheterization. Holist Nurs
Pract. 2005; 19(2): 70-3. doi: 10.1097/00004650-200503000-00007. PMID: 15871589.
Herrera-Espiñeira C, Rodríguez del Aguila Mdel M, Rodríguez del Castillo M, Valdivia AF, Sánchez IR.
Relationship between anxiety level of patients and their satisfaction with different aspects of healthcare.
Health policy. 2009; 89(1): 37-45. doi: 10.1016/j.healthpol.2008.04.012. PMID: 18550203.
Mann DL, Zipes DP, Libby P, Bonow RO. Braunwald's heart disease: a textbook of cardiovascular
medicine: Elsevier Health Sciences. 2014.
Kyngäs H. Patient education: perspective of adolescents with a chronic disease. J Clin Nurs. 2003; 12(5):
-51. PMID: 12919221.
Utriyaprasit K, Moore SM, Chaiseri P. Recovery after coronary artery bypass surgery: effect of an
audiotape information programme. J Adv Nurs. 2010; 66(8): 1747-59. doi: 10.1111/j.1365- 2648.2010.05334.x. PMID: 20557390. 14) Bastable SB. Essentials of patient education. Jones & Bartlett Learning. 2006.
Aziznezhad P, Zabihi A, Hosseini S, Bizhani A. Nurses and Nurse Managers Opinions about the Patient’s
Training Barriers. Journal of babol university of medical sciences (jbums). 2010; 12(1): 60-4.
Keuter K, Byrne E, Voell J, Larson E. Nurses' job satisfaction and organizational climate in a dynamic
work environment. Appl Nurs Res. 2000; 13(1): 46-9. PMID: 10701283.
Morton PG, Fontaine DK, Hudak CM, Gallo B. Critical care nursing: a holistic approach. Lippincott
Williams & Wilkins Philadelphia. 2005; 25(6): 56.
Ashgali farahani M. Developing and evaluating of patient education nursing model in patient’scoronary
artery disease. PhD Dissertation. 2008; Tarbiat Modares University.
Oh K, Lee I, Lee J, Yim E, Jo S. Strategies for theory construction in nursing. 2008.
Julian LJ. Measures of anxiety: State‐Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI),
and Hospital Anxiety and Depression Scale‐Anxiety (HADS‐A). Arthritis care & research. 2011;
(11): 467-72. doi: 10.1002/acr.20561.
Spielberger CD, Sydeman SJ. State-Trait Anxiety Inventory and State-Trait Anger Expression Inventory.
Heshmati Nabavi F, Memarian R, Vanaki Z. The effect of implementing Clinical Supervision Model on the
patient education outcomes. Journal of Health Promotion Management. 2012; 1(3): 28-36.
Yeganeh khah MR, Abedini A, Akbari H, Ziyayi Nezhad MT. Comparison of different methods of
education on reducing the anxiety of patients with myocardial infarction. Iran Journal of Nursing. 2012;
(74): 36-44.
Lalani NS, Gulzar AZ. Nurses role in patients discharge planning at the Aga Khan University hospital,
Pakistan. J Nurs Staff Dev. 2001; 17(6): 314-9. doi: 10.1097/00124645-200111000-00009. PMID:
Chan DS, Cheung HW. The effects of education on anxiety among Chinese patients with heart disease
undergoing cardiac catheterization in Hong Kong. Contemporary nurse. 2003; 15(3): 310-20. PMID:
Asilioglu K, Celik SS. The effect of preoperative education on anxiety of open cardiac surgery patients.
Patient education and counseling. 2004; 53(1): 65-70. doi: 10.1016/S0738-3991(03)00117-4.
Basampour SS. The effect of education on anxiety before and after open heart surgery. Payesh. 2004; 3(2):
-44.
Sørlie T, Busund R, Sexton J, Sexton H, Sørlie D. Video information combined with individualized
information sessions: effects upon emotional well-being following coronary artery bypass surgery-a
randomized trial. Patient education and counseling. 2007; 65(2): 180-8. doi: 10.1016/j.pec.2006.07.006.
Pourang P, Besharat MA. An Investigation of the Relationship Between Coping Styles and Psychological
Adaptation with Recovery Process in a Sample of Coronary Heart Disease Patients. Procedia-Social and
Behavioral Sciences. 2011; 30: 171-5. doi: 10.1016/j.sbspro.2011.10.034.
Momeni T, Musarezaie A, Moeini M, Naji Esfahani H. The effect of spiritual care program on ischemic
heart disease patients, anxiety, hospitalized in CCU: a clinical trial. Journal of Research in Behavioural
Sciences. 2013; 6: 554-64. PMCID: PMC3696210.
Moser DK. “The rust of life”: impact of anxiety on cardiac patients. Am J Crit Care. 2007; 16(4): 361-9.
PMID: 17595368, PMCID: PMC2668571.
Tzeng HM, Ketefian S, Redman RW. Relationship of nurses’ assessment of organizational culture, job
satisfaction, and patient satisfaction with nursing care. Int J Nurs Stud. 2002; 39(1): 79-84. PMID:
Mehdi Pur R, Jamshidi N, Soltani N, Sabzevari S. Effects of Nurse Education on both patients ′
satisfaction of teaching patients, and Nurses′ Knowledge, Attitude and Performance in Intensive Care
Unit of Teaching Hospitals. Iranian J Health and Care. 2011; 13(1): 30-7.
Lamiani G, Furey A. Teaching nurses how to teach: An evaluation of a workshop on patient education.
Patient Education and Counseling Journal. 2009; 75(2): 270-3. doi: 10.1016/j.pec.2008.09.022.
Johansson P, Oleni M, Fridlund B. Patient satisfaction with nursing care in the context of health care: a
literature study. Scand J Caring Sci. 2002; 16(4): 337-44. doi: 10.1046/j.1471-6712.2002.00094.x. PMID:
Tolooee M, Dehghan Nayery N, Faghihzadeh S, Sadooqi Asl A. Motivational factors for nurses with
patient education. Hayat. 2006; 2(12): 43-5.
Heshmati Nabavi F, Memarian R, Vanaki Z. Clinical Supervision System: A Method for Improving
Educational Performance of Nursing Personnel. Iranian Journal of Medical Education. 2008; 7(2): 257-66.
Paunonen M. Promoting nursing quality through supervision. J Nurs Staff Dev. 1991; 7(5): 229-33. PMID:
Ashghali Farahani M, Mohammadi E, Ahmadi F, Maleki M, Hajizadeh E. Obstacles of Patient Education
in CCU and Post CCU: A Grounded Theory Study. Iran Journal of Nursing (IJN). 2009; 22(58): 55-73.
Sandra Cruz, António Luís Carvalho, Paulino Sousa. Clinical Supervision and Emotional Intelligence
Capabilities: E Excellence in Clinical Practice. Procedia - Social and Behavioral Sciences. 2015; 171(16):
-7. doi: 10.1016/j.sbspro.2015.01.101.
Martinali J, Bolman C, Brug J, van den Borne B, Bar F. A checklist to improve patient education in a
cardiology outpatient setting. Patient Educ Couns. 2001; 42(3): 231-8. doi: 10.1016/S0738-3991(00)00126- 9. PMID: 11164322.
Joolaee S, Hajibabaee F, Jalal EJ, Bahrani N. Assessment of Patient Satisfaction from Nursing Care in
Hospitals of Iran University of Medical Sciences. Hayat. 2011; 17(1): 35-44.
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