EFFECTS OF PRE OPERATIVE EDUCATION AND VENTILATORY EXERCISE TRAINING IN REDUCING ANXIETY AND IMPROVEMENT IN RECOVERY AMONG CARDIAC PATIENTS

DR.CHIRAG PURBIA, Assistant Professor, Geetanjali college of Physiotherapy, Udaipur, Rajasthan  


Abstract:
Background: Patients awaiting cardiac surgery typically experience physical and psychological stress. Although there is evidence that preoperative education can improve postoperative outcomes among general surgical patients, less is known about preoperative education for patients undergoing cardiac surgery. Physiotherapists play an important role in the preparation and rehabilitation of patients who had undergone surgical procedures. In the present study, the effects of pre operative education and ventilatory exercise training were observed to know the effectiveness in reducing anxiety and improvement in recovery among patients undergoing cardiac surgery.

METHODOLOGY:
This study includes 100 subjects both male and female undergoing elective cardiac surgery of age 18-60 years who were eligible as per the inclusion criteria. Pre- participation questionnaire along with the consent form was given to the subjects to fulfill criteria for selection. Subjects were allocated physiotherapy instructions and ventilatory exercise training pre operatively. The primary outcome was change in anxiety which was measured by BAI (Beck Anxiety Inventory) pre operatively before and after education and training and 4 days post operatively. Secondary outcomes were pain and SPO2 which were measured by VAS (Visual Analogue Scale) and pulse oxymetry respectively.

RESULTS:
Results showed that anxiety score after pre operative instructions and ventilatory exercise training exercise was significantly higher (p<0.01) in males as compared to females. There was a significant decrease in score of anxiety pre and post operatively after physiotherapy instructions and ventilatory exercise training (p<0.01) and there was also a significant reduction in VAS score (p<0.01) whereas SPO2 was increased significantly (p<0.01). Thus it showed that pre operative education and ventilatory exercise training is effective in reducing anxiety and improves recovery among patients undergoing cardiac surgery.

CONCLUSION:
This study provides empirical support for the hypothesis that a pre operative education intervention involving counseling, verbal explanation and ventilatory training are effective in reducing anxiety and pain among patients undergoing cardiac surgery. This study not only have important implications for effective strategies to control patient’s elevated anxiety in anticipation of cardiac surgery, but also help make recommendations for quality improvement of pre operative education in practice.

KEY WORDS: Pre operative education, cardiac surgery, anxiety, ventilatory training.