Volume : 9, Issue : 5, MAY 2023

A PRE-EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED TEACHING PROGRAMME ON KNOWLEDGE AND PRACTICE REGARDING THE USE OF INCENTIVE SPIROMETRY AMONG POST OPERATIVE CARDIAC SURGERY PATIENTS IN SELECTED HOSPITAL AT DELHI/NCR.

KHUSHBOO TIWARI, LAVANYA NANDAN, DR BEULAH JASMINE RAO

Abstract

Background: Cardiovascular disease is the leading cause of death worldwide, responsible for 17.5 million deaths every year, of which 80% occur in low- and middle-income countries. Some 75% of the world does not have access to cardiac surgery when needed because of lack of infrastructure, human resources, and financial coverage.

Aim: The objective of the study is to assess the knowledge and practice regarding use of incentive spirometry among postoperative cardiac surgery patients in selected hospital at Delhi/NCR.

Materials and methods: This study was conducted on 30 postoperative cardiac surgery patients in Max hospital Shalimar bagh at Delhi NCR. Pre- experimental research design was adopted and purposive sampling technique was used to select the sample. A structured knowledge questionnaire of 21 questions and practice checklist of 10 items were prepared to assess the knowledge and practice of the postoperative cardiac surgery patients. On Day 1, self introduction was given and rapport was established ,introduction to the nature of the study was given and informed and signed consent was taken .On the day 1 of the surgery data collection was done and pretest was taken and teaching was given to the patients. On day 8th post -test was done with the same tool. Data was analyzed by using descriptive and inferential statistics in terms of frequency, percentages, Mean, S.D.

Result: In Pre-test, maximum number of postoperative cardiac surgery patients i.e., 19 (63.33%) were having very good knowledge, 11 (36.6%) were having good knowledge, regarding the use of incentive spirometry among postoperative cardiac surgery patients. In Post -test, most of the samples i.e., 30 (100%) were having excellent knowledge regarding the use of incentive spirometry among postoperative cardiac surgery patients which shows increase in the knowledge score. In Pre-test practice Scores, maximum number of postoperative cardiac surgery patients i.e., 21(70%) were having   good practice, 4 (13.3%) were having poor practice whereas 5(16.66%) were having very good practice regarding the use of incentive spirometry among postoperative cardiac surgery patients. Whereas in post-test practice scores, maximum number of postoperative cardiac surgery patients i.e.28 (93.33%) were having very good practice and 2 (6.66%) is having good practice regarding the use of incentive spirometry among postoperative cardiac surgery patients shows increase in practice score. The mean Post test knowledge score of postoperative cardiac surgery patients is (19.67) which is higher than mean Pretest knowledge score (11.2), with the mean difference of 8.47. The obtained mean difference was found to be statistically significant. The calculated “t” value is 21.6 which is greater than the table value at 0.05 level of significance at df (29). Hence, it is concluded that the planned teaching program was effective in increasing the knowledge regarding the use of incentive spirometry among postoperative cardiac surgery patients .The mean Posttest practice score of postoperative cardiac surgery patients is (26.43)  higher than the mean Pretest practice (15.67), with the mean difference of 10.76. The calculated “t” value is 13.30 which are greater than the table value at 0.05 level of significance at df (29).

Conclusion: it is concluded that the planned teaching program was effective in increasing the practice regarding the use of incentive spirometry among postoperative cardiac surgery patients. Hence the study revealed that planned teaching programme was effective and improving the knowledge and practice among postoperative cardiac surgery patients.

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References

1. Publilius Syrus Quotes [Internet]. Brainyquote.com. [cited 2021 Sep 17]. Available from: https://www.brainyquote.com/quotes/publili us_syrus_391791

2. Huffman MD, Prabhakaran D, Osmond C, Fall CHD, Tandon N, Lakshmy R, et al. Incidence of cardiovascular risk factors in an Indian urban cohort results from the New Delhi birth cohort. J Am Coll Cardiol. 2011;57(17):1765–74.

3. Vervoort D, Meuris B, Meyns B, Verbrugghe P. Global cardiac surgery: Access to cardiac surgical care around the world. J Thorac Cardiovasc Surg. 2020 Mar;159(3):987-996.e6. doi: 10.1016/j.jtcvs.2019.04.039. Epub 2019 Apr 26. PMID: 31128897.

4. Gayathiri T, Anandhi D. Efficacy of incentive spirometry in expiratory muscle training following abdominal surgery. Biomed Pharmacol J. 2021;14(01):335–41.

5. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics-2021 update: A report from the American Heart Association: A report from the American Heart Association. Circulation. 2021;143(8):e254–743.

6. Bifari AE, Sulaimani RK, Khojah YS, Almaghrabi OS, AlShaikh HA, Al-Ebrahim KE. Cardiovascular risk factors in coronary artery bypass graft patients: Comparison between two periods. Cureus. 2020;12(9):e10561.

7. Hussein AM, Ali BA, Mohammed MS. Prevalence of coronary artery disease in patients undergoing non coronary cardiac surgery: A single center study. Med-leg update. 2020;20(1):218–22.

8. Habibi MR, Alipour A, Soleimani A, Kiabi FH, Habibi A, Emami Zeydi A. The effect of opium addiction on short-term postoperative outcomes after coronary artery bypass graft surgery: A prospective observational cohort study. BioMedicine (Taipei). 2020;10(4):23–8.

9. Researchgate.net. [cited 2021 Sep 18]. Available from: https://www.researchgate.net/publication/341829124_Incentive_spirometry_inspiratory_capacity_changes_and_predictors_after_open_heart_surgery_A_5-day_prospective_study. Vol 75

10. Batra Adeep. Effect of Incentive Spirometry on Recovery of Post-operative Patients: . E?ect of Incentive Spirometry on Recovery of Post-Operative Patients: Pre Experimental Study. 2020;Vol. 12, No. 3.

11. Dote H, Homma Y, Sakuraya M, Funakoshi H, Tanaka S, Atsumi T. Incentive spirometry to prevent pulmonary complications after chest trauma: a retrospective observational study. Acute Med Surg. 2020;7(1):e619.

12. Aweto HA, Obikeh EO, Tella BA. Effects of incentive spirometry on cardiopulmonary parameters, functional capacity and glycemic control in patients with Type 2 diabetes. Hong Kong Physiother J. 2020;40(02):121–32.

13. Dos Santos E da C, Nunes Pinto ACP, De Macedo JRFF, Lunardi AC. Effect of incentive spirometry after cardiac surgery: protocol for a systematic review. Fisioter Bras. 2020;21(1):124–32.

14. Vervoort D, Meuris B, Meyns B, Verbrugghe P. Global cardiac surgery: Access to cardiac surgical care around the world. J Thorac Cardiovasc Surg. 2020;159(3):987-996.e6.

15. Ziv-Baran T, Mohr R, Yazdchi F, Loberman D. The epidemiology of coronary artery bypass surgery in a community hospital: A comparison between 2 periods. Medicine (Baltimore). 2019;98(13):e15059.

16. Sum S-K, Peng Y-C, Yin S-Y, Huang P-F, Wang Y-C, Chen T-P, et al. Using an incentive spirometer reduces pulmonary complications in patients with traumatic rib fractures: a randomized controlled trial. Trials [Internet]. 2019;20(1). Available from: http://dx.doi.org/10.1186/s13063-019-3943-x

17. Liu C-J, Kung P-T, Chu C-C, Chou W-Y, Shih C-M, Tsai W-C. Effect of the integrated prospective payment program on family members’ knowledge and acceptance of hospice care of patients on prolonged mechanical ventilation. Respir Care. 2020;65(4):464–74.

18. Eltorai AEM, Baird GL, Eltorai AS, Healey TT, Agarwal S, Ventetuolo CE, et al. Effect of an incentive spirometer patient reminder after coronary artery bypass grafting: A randomized clinical trial. JAMA Surg. 2019;154(7):579

19. Head SJ, Milojevic M, Daemen J, Ahn J-M, Boersma E, Christiansen EH, et al. Stroke rates following surgical versus percutaneous coronary revascularization. J Am Coll Cardiol. 2018;72(4):386–98.

20. Jamaan Al-Harbi  Walaa. “The Effect of Using Incentive Spirometry on Postoperative Breathing Pattern Among Abdominal Surgical Patients.” IOSR Journal of Nursing and Health Science (IOSR-JNHS), vol. 07, no. 1, 2018, pp. 20-34.

21. Khan S, Diwate A, Das AK. Immediate effect of Incentive Spirometry on arterial blood gases analysis after coronary bypass graft surgery patients. Int j clin biomed res. 2018;4(4):23–5.

22. Walaa Nasreldin Othman , Reham abdelhamed abdelmawla Elsaid ,Assess the effectiveness of deep breathing exercise with incentive spirometry on respiratory status of patients who undergone cardiothoracic surgery. Int j nurs didact [Internet]. 2017;7(4). Available from: http://dx.doi.org/10.15520/ijnd.2017.vol7.iss4.209.85-91

23. Yazdannik A, Bollbanabad HM, Mirmohammadsadeghi M, Khalifezade A. The effect of incentive spirometry on arterial blood gases after coronary artery bypass surgery (CABG). Iran J Nurs Midwifery Res. 2016;21(1):89–92.

24. El-Sobkey S, AlOtaibi K. Effect of cardiac patients’ perceived benefits from and perceived self-efficacy and performance accuracy in the use of an incentive spirometer on spirometric values after coronary artery bypass graft surgery. Kasr Al Ainy Med J. 2016;22(2):63.

25. Narayanan ALT, Hamid SRGS, Supriyanto E. Evidence regarding patient compliance with incentive spirometry interventions after cardiac, thoracic and abdominal surgeries: A systematic literature review. Can J Respir Ther. 2016 Winter;52(1):17–26.

26. Kumar AS, Alaparthi GK, Augustine AJ, Pazhyaottayil ZC, Ramakrishna A, Krishnakumar SK. Comparison of flow and volume incentive spirometry on pulmonary function and exercise tolerance in open abdominal surgery: A randomized clinical trial. J Clin Diagn Res. 2016;10(1):KC01-6.

27. Othman E, Abaas S, Hassan H. Resisted breathing exercise versus incentive spirometer training on vital capacity in postoperative radical cystectomy cases: a pilot randomized controlled trial. Bull Fac Phys Ther. 2016;21(2):61.

28. Effectiveness of incentive spirometry in improving peak expiratory flow rate in post abdominal surgery?: An experimental study [Internet]. Journalmedicalthesis.com. 2015 [cited 2021 Sep 18]. Available from: http://journalmedicalthesis.com/2015/06/effectiveness-of-incentive-spirometry-in-improving-peak-expiratory-flow-rate-in-post-abdominal-surgery-an-experimental-study/

29. Choinière M, Watt-Watson J. Persistent postoperative nonanginal pain after cardiac surgery. CMAJ. 2014;186(11):855.3-855.

30. do Nascimento Junior P, Módolo NSP, Andrade S, Guimarães MMF, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014;(2):CD006058.

31. Licskai CJ, Sands TW, Paolatto L, Nicoletti I, Ferrone M. Spirometry in primary care: An analysis of spirometry test quality in a regional primary care asthma program. Can Respir J. 2012;19(4):249–54.

32. Pinheiro AC, Novais MCM, Neto MG, Rodrigues MVH, de Souza Rodrigues E Junior, Aras R Junior, et al. Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry. J Cardiothorac Surg [Internet]. 2011;6(1). Available from: http://dx.doi.org/10.1186/1749-8090-6-70