Literature Review

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Abstract
Individuals undergoing cardiac surgery can be of any age and functional ability. This literature review examines the correlation between the patient’s ability to engage in self-care behaviors and the efficacy of their rehabilitation. Using Orem’s Self-Care Nursing Deficit Theory and Bandura’s Self-Efficacy Theory peer-reviewed research studies were selected from accredited journals using CINHAL, Ovid, PubMed and Google Scholar ranging from 1988 to 2009. The literature reviewed indicated that the patients’ perceived ability to engage in self-care behaviors impacted their recovery after they were discharge from the hospital. The literature also suggests that nursing interventions can promote and enable self-care while the patients is in the hospital and throughout their recovery at home.

Recovery After Cardiac Surgery: A Literature Review
During the last thirty years, invasive procedures have been able to improve the survival and quality of life despite a deteriorating risk profile of the patients undergoing them. (Zarani, Besharat, Sarami, & Sadeghian, 2011) The presence of pre-existing conditions and increased age can be difficult for patients that are undergoing cardiac surgery and challenging for the nurses involved in the recovery and rehabilitative plans for these patients. Many theories have been utilized in research to develop interventions and improve outcomes for these patients. Two of most commonly used theories are Orem’s Self-Care Deficit Nursing Theory and Bandura’s Self-Efficacy Theory. The principle philosophy of the Self-Care Deficit Theory is that all patients want to care for themselves and by encouraging the independence they are able to heal quickly and holistically. The overall purpose is to view the patient as a whole person and to utilize nursing knowledge to restore and maintain the patient’s ideal health. (Orem, 1995) Definitions

Self-care is defined as the activities that individuals do to themselves to maintain health and well-being. Self-care agency is defined the ability to engage in self-care influenced by conditions such as age, developmental state, experience, sociocultural and available resources. Therapeutic self-care demand is defined as the care actions to be done for a patient to meet self-care needs. Self-care requisites are defined as actions done by or for an individual that affect that persons’ function or development. Self-care deficit defines when nursing care is needed by the relationship deficit between self-care agency and the therapeutic self-care demand. Theory of self-care deficit is defined as the theory that individuals can benefit from nursing care because they are subject to health-related or self-derived limitations that make them unable to be effective in self-care. Theory of self care is defined as the theory that self-care is a learned behavior and practice of activities that individuals perform to maintain their life, health and well being. Theory of nursing systems is defined as the theory describing how the the patient’s self care needs will be met by the nurse, patient or both. Significance of the Problem

Coronary artery bypass graft surgery (CABG) and valve replacement surgeries are commonly performed cardiothorasic procedures used to treat patients with coronary artery disease. Physical impairments and activity restrictions are common in the immediate postoperative period leaving patients with a decreased ability to perform their daily activities and provide self-care. The time required for a patient to recovery from this surgery is often filled with uncertainty and emotional confusion; they have to adjust to changes in their lifestyle that requires specific knowledge. (Jaarsma, Kastermans, Dassen, & Philipsen, 1995) Patients have the need to be taught about their illness, risk factors, medications, diet and exercise so they can learn to assume responsibility for their well-being. By understanding what the patient’s self-care...
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