Açık Kalp Ameliyatı Sonrası Rehabilitasyonda Bütüncül Yaklaşımlar: Fiziksel, Psikolojik ve Sosyal İyileşmenin Önemi
Özet
Açık kalp ameliyatı sonrası rehabilitasyon süreci, hastanın fiziksel, psikolojik ve sosyal iyileşmesini hedefleyen bütüncül bir yaklaşımla ele alınmalıdır. Fiziksel iyileşme sürecinde, düzenli egzersiz programları, solunum terapisi ve medikal tedavi ile kalp fonksiyonları desteklenir. Fiziksel aktivite, dolaşım sistemini güçlendirirken, kas gücünü artırır ve hastanın günlük yaşamına daha hızlı dönmesine katkı sağlar. Psikolojik iyileşme, ameliyat sonrası depresyon, kaygı ve stresle başa çıkmada kritik öneme sahiptir. Ameliyat sonrasında yaşanabilen duygusal dalgalanmalar ve kaygı, psikolojik destek ve gerektiğinde terapi yardımıyla yönetilmelidir. Sosyal iyileşme ise hastanın toplumsal yaşamda kendini güvende ve desteklenmiş hissetmesi için önemlidir. Aile desteği, sosyal çevrenin hastaya olan anlayışı ve destekleyici bir sosyal ağ, iyileşme sürecini olumlu yönde etkiler. Ayrıca, sosyal katılım ve etkinlikler, hastaların kendilerini toplumun bir parçası olarak hissetmelerine katkı sağlar. Bütüncül rehabilitasyon, fiziksel, psikolojik ve sosyal iyileşmeyi kapsayarak hastaların hayata daha sağlıklı, mutlu ve güçlü bir şekilde dönmelerine yardımcı olur.
Referanslar
Ball L, Costantino F, Pelosi P. Postoperative complications of patients undergoing cardiac surgery. Curr Opin Crit Care. 2016;22(4):386–92.
Kankaya EA, Bilik Ö. Current Nursing Approaches After Heart Valve Surgery: Why care is important? BALIKESIR Heal Sci J [Internet]. 2018;7(2):101–11. Available from: https://www.journalagent.com/z4/download_fulltext.asp?pdir=bsbd&plng=eng&un=BSBD-93585
Yanık TÇ, Yılmaz SG. Kardiyovasküler Cerrahi Sonrası Yoğun Bakımda Yaşanan Sorunlar ve Hemşirelik Bakımı 1 Problems after Cardiovascular Surgery in Intensive Care Unit and Nursing Care. 2019;1(2):122–7.
Senol-Durak E, Ayvasik HB. Factors Associated with Posttraumatic Growth Among Myocardial Infarction Patients: Perceived Social Support, Perception of the Event and Coping. J Clin Psychol Med Settings [Internet]. 2010 Jun 20;17(2):150–8. Available from: http://link.springer.com/10.1007/s10880-010-9192-5
Karataş T, Bostanoğlu H. Perceived social support and psychosocial adjustment in patients with coronary heart disease. Int J Nurs Pract [Internet]. 2017 Aug 16;23(4). Available from: https://onlinelibrary.wiley.com/doi/10.1111/ijn.12558
Bozdağ F. Anxiety, Depression, Perceived Social Support, and Life Satisfaction in Mothers with Children in the Pediatric Cardiac Care Unit After Heart Surgery. J Cardiovasc Nurs [Internet]. 2023;1–7. Available from: https://jag.journalagent.com/kvhd/pdfs/KVHD_14_33_1_7.pdf
Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, et al. Guidelines for Perioperative Care in Cardiac Surgery. JAMA Surg [Internet]. 2019 Aug 1;154(8):755. Available from: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511
Susana Hernández García L, José L, Oquendo ÁM, Rivas Estany CE. Fase hospitalaria de la rehabilitación cardíaca. Protocolo para el síndrome coronario agudo-. Ernesto Che Guevara [Internet]. 2014;6(1):97–104. Available from: https://www.medigraphic.com/pdfs/corsalud/cor-2014/cor141m.pdf
Yildirim GÖ. Kalp Ameliyatı Sonrası Hasta Pozisyonunun Hemodinamik Ölçümlere Etkisi. 2016;(January 2010).
Uzun M. Yoğun Bakım Biriminde Pulmoner Rehabilitasyon. In: Kardiyak ve Pulmoner Rehabilitasyon. 2017. p. 1. Baskı: 2017:353-362.
Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Arch Med Sci – Atheroscler Dis. 2019;4(1):280–5.
Borges MGB, Borges DL, Ribeiro MO, Lima LSS, Macedo KCM, Nina VJ da S. Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review. Brazilian J Cardiovasc Surg [Internet]. 2022;37(2). Available from: https://cdn.publisher.gn1.link/bjcvs.org/pdf/0102-7638-rbccv-37-02-0227.pdf
Cameron S, Ball I, Cepinskas G, Choong K, Doherty TJ, Ellis CG, et al. Early mobilization in the critical care unit: A review of adult and pediatric literature. J Crit Care [Internet]. 2015 Aug;30(4):664–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0883944115001410
Chen B, Xie G, Lin Y, Chen L, Lin Z, You X, et al. A systematic review and meta-analysis of the effects of early mobilization therapy in patients after cardiac surgery. Med (United States). 2021;100(15):E25314.
Macedo RM de. Phase I of cardiac rehabilitation: A new challenge for evidence based physiotherapy. World J Cardiol [Internet]. 2011;3(7):248. Available from: http://www.wjgnet.com/1949-8462/full/v3/i7/248.htm
Rodrigues SN, Henriques HR, Henriques MA. Effectiveness of preoperative breathing exercise interventions in patients undergoing cardiac surgery: A systematic review. Rev Port Cardiol (English Ed [Internet]. 2021 Mar;40(3):229–44. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2174204921000763
Shahood H, Pakai A, Rudolf K, Bory E, Szilagyi N, Sandor A, et al. The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study. Ann Saudi Med [Internet]. 2022 Jan;42(1):8–16. Available from: http://www.annsaudimed.net/doi/10.5144/0256-4947.2022.8
Nardi P, Pisano C, Altieri C, Buioni D, Pedicelli C, Saulle S, et al. The benefit of a preoperative respiratory protocol and musculoskeletal exercise in patients undergoing cardiac surgery. Kardiochirurgia i Torakochirurgia Pol. 2020;17(2):94–100.
Talib Abdullah R, Hamza RA, Mahbuba WA. Effectiveness of preoperative breathing exercises on postoperative lung function outcomes for patients with cardiac surgery. Curr Probl Cardiol [Internet]. 2024 Nov;49(11):102784. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0146280624004201
Vitomskyi V, Al-Hawamdeh K, Vitomska M, Lazarіeva O, Haidai O. The effect of incentive spirometry on pulmonary function recovery and satisfaction with physical therapy of cardiac surgery patients. Adv Rehabil [Internet]. 2021;35(1):9–16. Available from: https://www.termedia.pl/doi/10.5114/areh.2020.102020
Hill A, Nesterova E, Lomivorotov V, Efremov S, Goetzenich A, Benstoem C, et al. Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know? Nutrients [Internet]. 2018 May 11;10(5):597. Available from: https://www.mdpi.com/2072-6643/10/5/597
Stoppe C, Goetzenich A, Whitman G, Ohkuma R, Brown T, Hatzakorzian R, et al. Role of nutrition support in adult cardiac surgery: A consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Crit Care. 2017;21(1):1–16.
Drover JW, Cahill NE, Kutsogiannis J, Pagliarello G, Wischmeyer P, Wang M, et al. Nutrition Therapy for the Critically Ill Surgical Patient. J Parenter Enter Nutr [Internet]. 2010 Nov 19;34(6):644–52. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/0148607110372391
Martindale RG, McClave SA, Taylor B, Lawson CM. Perioperative Nutrition. Martindale RG, McClave SA, Kozar RA, Heyland DK, editors. J Parenter Enter Nutr [Internet]. 2013 Sep 5;37(5S). Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/0148607113496821
Nygren J, Thacker J, Carli F, Fearon KCH, Norderval S, Lobo DN, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr [Internet]. 2012 Dec;31(6):801–16. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561412001793
Zubrzycki M, Liebold A, Skrabal C, Reinelt H, Ziegler M, Perdas E, et al. Assessment and pathophysiology of pain in cardiac surgery. J Pain Res. 2018;11:1599–611.
Eti Aslan F, Badir A, Karadag Arli S, Cakmakci H. Patients’ experience of pain after cardiac surgery. Contemp Nurse [Internet]. 2010 Jan 17;34(1):48–54. Available from: http://www.tandfonline.com/doi/abs/10.5172/conu.2009.34.1.048
Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin [Internet]. 2014 Jan 15;30(1):149–60. Available from: http://www.tandfonline.com/doi/full/10.1185/03007995.2013.860019
Sethares KA, Chin E, Costa I. Pain intensity, interference and patient pain management strategies the first 12weeks after coronary artery bypass graft surgery. Appl Nurs Res [Internet]. 2013 Nov;26(4):174–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0897189713000736
Göktuna G, Dağcan N, Arslan GG. The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary Artery Bypass Graft Surgery. J Cardiovasc Nurs [Internet]. 2023 Aug 7; Available from: https://journals.lww.com/10.1097/JCN.0000000000001033
Dai WS, Huang ST, Xu N, Chen Q, Cao H. The effect of music therapy on pain, anxiety and depression in patients after coronary artery bypass grafting. J Cardiothorac Surg. 2020;15(1):1–5.
Referanslar
Ball L, Costantino F, Pelosi P. Postoperative complications of patients undergoing cardiac surgery. Curr Opin Crit Care. 2016;22(4):386–92.
Kankaya EA, Bilik Ö. Current Nursing Approaches After Heart Valve Surgery: Why care is important? BALIKESIR Heal Sci J [Internet]. 2018;7(2):101–11. Available from: https://www.journalagent.com/z4/download_fulltext.asp?pdir=bsbd&plng=eng&un=BSBD-93585
Yanık TÇ, Yılmaz SG. Kardiyovasküler Cerrahi Sonrası Yoğun Bakımda Yaşanan Sorunlar ve Hemşirelik Bakımı 1 Problems after Cardiovascular Surgery in Intensive Care Unit and Nursing Care. 2019;1(2):122–7.
Senol-Durak E, Ayvasik HB. Factors Associated with Posttraumatic Growth Among Myocardial Infarction Patients: Perceived Social Support, Perception of the Event and Coping. J Clin Psychol Med Settings [Internet]. 2010 Jun 20;17(2):150–8. Available from: http://link.springer.com/10.1007/s10880-010-9192-5
Karataş T, Bostanoğlu H. Perceived social support and psychosocial adjustment in patients with coronary heart disease. Int J Nurs Pract [Internet]. 2017 Aug 16;23(4). Available from: https://onlinelibrary.wiley.com/doi/10.1111/ijn.12558
Bozdağ F. Anxiety, Depression, Perceived Social Support, and Life Satisfaction in Mothers with Children in the Pediatric Cardiac Care Unit After Heart Surgery. J Cardiovasc Nurs [Internet]. 2023;1–7. Available from: https://jag.journalagent.com/kvhd/pdfs/KVHD_14_33_1_7.pdf
Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, et al. Guidelines for Perioperative Care in Cardiac Surgery. JAMA Surg [Internet]. 2019 Aug 1;154(8):755. Available from: https://jamanetwork.com/journals/jamasurgery/fullarticle/2732511
Susana Hernández García L, José L, Oquendo ÁM, Rivas Estany CE. Fase hospitalaria de la rehabilitación cardíaca. Protocolo para el síndrome coronario agudo-. Ernesto Che Guevara [Internet]. 2014;6(1):97–104. Available from: https://www.medigraphic.com/pdfs/corsalud/cor-2014/cor141m.pdf
Yildirim GÖ. Kalp Ameliyatı Sonrası Hasta Pozisyonunun Hemodinamik Ölçümlere Etkisi. 2016;(January 2010).
Uzun M. Yoğun Bakım Biriminde Pulmoner Rehabilitasyon. In: Kardiyak ve Pulmoner Rehabilitasyon. 2017. p. 1. Baskı: 2017:353-362.
Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Arch Med Sci – Atheroscler Dis. 2019;4(1):280–5.
Borges MGB, Borges DL, Ribeiro MO, Lima LSS, Macedo KCM, Nina VJ da S. Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review. Brazilian J Cardiovasc Surg [Internet]. 2022;37(2). Available from: https://cdn.publisher.gn1.link/bjcvs.org/pdf/0102-7638-rbccv-37-02-0227.pdf
Cameron S, Ball I, Cepinskas G, Choong K, Doherty TJ, Ellis CG, et al. Early mobilization in the critical care unit: A review of adult and pediatric literature. J Crit Care [Internet]. 2015 Aug;30(4):664–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0883944115001410
Chen B, Xie G, Lin Y, Chen L, Lin Z, You X, et al. A systematic review and meta-analysis of the effects of early mobilization therapy in patients after cardiac surgery. Med (United States). 2021;100(15):E25314.
Macedo RM de. Phase I of cardiac rehabilitation: A new challenge for evidence based physiotherapy. World J Cardiol [Internet]. 2011;3(7):248. Available from: http://www.wjgnet.com/1949-8462/full/v3/i7/248.htm
Rodrigues SN, Henriques HR, Henriques MA. Effectiveness of preoperative breathing exercise interventions in patients undergoing cardiac surgery: A systematic review. Rev Port Cardiol (English Ed [Internet]. 2021 Mar;40(3):229–44. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2174204921000763
Shahood H, Pakai A, Rudolf K, Bory E, Szilagyi N, Sandor A, et al. The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study. Ann Saudi Med [Internet]. 2022 Jan;42(1):8–16. Available from: http://www.annsaudimed.net/doi/10.5144/0256-4947.2022.8
Nardi P, Pisano C, Altieri C, Buioni D, Pedicelli C, Saulle S, et al. The benefit of a preoperative respiratory protocol and musculoskeletal exercise in patients undergoing cardiac surgery. Kardiochirurgia i Torakochirurgia Pol. 2020;17(2):94–100.
Talib Abdullah R, Hamza RA, Mahbuba WA. Effectiveness of preoperative breathing exercises on postoperative lung function outcomes for patients with cardiac surgery. Curr Probl Cardiol [Internet]. 2024 Nov;49(11):102784. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0146280624004201
Vitomskyi V, Al-Hawamdeh K, Vitomska M, Lazarіeva O, Haidai O. The effect of incentive spirometry on pulmonary function recovery and satisfaction with physical therapy of cardiac surgery patients. Adv Rehabil [Internet]. 2021;35(1):9–16. Available from: https://www.termedia.pl/doi/10.5114/areh.2020.102020
Hill A, Nesterova E, Lomivorotov V, Efremov S, Goetzenich A, Benstoem C, et al. Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know? Nutrients [Internet]. 2018 May 11;10(5):597. Available from: https://www.mdpi.com/2072-6643/10/5/597
Stoppe C, Goetzenich A, Whitman G, Ohkuma R, Brown T, Hatzakorzian R, et al. Role of nutrition support in adult cardiac surgery: A consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Crit Care. 2017;21(1):1–16.
Drover JW, Cahill NE, Kutsogiannis J, Pagliarello G, Wischmeyer P, Wang M, et al. Nutrition Therapy for the Critically Ill Surgical Patient. J Parenter Enter Nutr [Internet]. 2010 Nov 19;34(6):644–52. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/0148607110372391
Martindale RG, McClave SA, Taylor B, Lawson CM. Perioperative Nutrition. Martindale RG, McClave SA, Kozar RA, Heyland DK, editors. J Parenter Enter Nutr [Internet]. 2013 Sep 5;37(5S). Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/0148607113496821
Nygren J, Thacker J, Carli F, Fearon KCH, Norderval S, Lobo DN, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr [Internet]. 2012 Dec;31(6):801–16. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561412001793
Zubrzycki M, Liebold A, Skrabal C, Reinelt H, Ziegler M, Perdas E, et al. Assessment and pathophysiology of pain in cardiac surgery. J Pain Res. 2018;11:1599–611.
Eti Aslan F, Badir A, Karadag Arli S, Cakmakci H. Patients’ experience of pain after cardiac surgery. Contemp Nurse [Internet]. 2010 Jan 17;34(1):48–54. Available from: http://www.tandfonline.com/doi/abs/10.5172/conu.2009.34.1.048
Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin [Internet]. 2014 Jan 15;30(1):149–60. Available from: http://www.tandfonline.com/doi/full/10.1185/03007995.2013.860019
Sethares KA, Chin E, Costa I. Pain intensity, interference and patient pain management strategies the first 12weeks after coronary artery bypass graft surgery. Appl Nurs Res [Internet]. 2013 Nov;26(4):174–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0897189713000736
Göktuna G, Dağcan N, Arslan GG. The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary Artery Bypass Graft Surgery. J Cardiovasc Nurs [Internet]. 2023 Aug 7; Available from: https://journals.lww.com/10.1097/JCN.0000000000001033
Dai WS, Huang ST, Xu N, Chen Q, Cao H. The effect of music therapy on pain, anxiety and depression in patients after coronary artery bypass grafting. J Cardiothorac Surg. 2020;15(1):1–5.
