Paper
Wednesday, July 11, 2007
A Pilot Trial of a Home-Based Peer Support Program to Aid Recovery Post Coronary Artery Bypass Graft Surgery
Monica J. E. Parry, RN, PhD(c), ACNP, CCN(C)1, Judy Watt-Watson, RN, PhD1, Ellen D. Hodnett, RN, PhD1, Joan E. Tranmer, RN, PhD2, Cindy-Lee Dennis, RN, PhD1, and Dina Brooks, PhD, MSc, BScPT3. (1) Faculty of Nursing, University of Toronto, Toronto, ON, Canada, (2) School of Nursing, Queen's Univeristy, Kingston, ON, Canada, (3) Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| Learning Objective #1: describe the early recovery experience of men and women following coronary artery bypass graft surgery. |
| Learning Objective #2: use the evidence presented in this pilot trial to plan a larger multi-centre trial with international colleagues. |
Coronary artery bypass graft surgery (CABG) is performed more frequently on individuals who are older and sicker than in previous years. Increased patient acuity and reduced hospital length of stays leave individuals ill prepared for their recovery following discharge. Individuals experience pain, functional impairment and depressive symptoms; which predispose them to adverse events and impaired HRQOL. Moreover, regionalization of services presents challenges to postoperative follow-up care in large geographical regions, where distance and geography restrict access to the specialized services offered by cardiac centres. A home-based peer support program may improve recovery outcomes for individuals following CABG surgery. Peer support has been shown to be an effective intervention for a variety of populations with beneficial effects across a wide spectrum of health outcomes. Despite the positive health outcomes in other patient populations, valid studies examining the impact of telephone-based peer support to individuals after hospital discharge from CABG surgery were not found.
A pre-post test RCT design with stratification for sex enrolled 100 men and women undergoing first-time non-emergency CABG surgery at a single site in Ontario, Canada. Participants were randomized to either a usual care or an intervention group. Participants in the intervention group received individualized education and support via telephone, throughout the 8-week recovery period, by peers who possessed knowledge derived from the shared experience of having CABG surgery. All outcome data was collected 9-weeks following discharge. The primary endpoint for the trial was HRQOL [SF-36v2TM (acute form)]. Secondary outcomes included pain and related interference with activities, function and depressive symptoms. The evidence obtained from this pilot trial are pivotal to foster transdisciplinary opportunities for international collaboration in planning a larger multi-centre trial, with a focus on improving care and promoting health for the postoperative cardiac surgery population.