PILOT ABSTRACT:
A Skilled Nursing Facility Self-management Cardiac Rehabilitation Intervention
Mary Dolansky
Older and sicker patients are surviving cardiac events and require transitional care such as skilled nursing facilities (SNF) to assist with recovery. Cardiac rehabilitation (CR) also is available to assist with recovery, but is not available until 6 weeks after discharge from the hospital. Older adults that use SNF care attend out-patient CR at lower rates than others and thus forego the documented benefits of attending a CR program. The purpose of this pilot study is to test the efficacy and feasibility of a novel SNF- based CR program titled “Transitional Rehabilitation Using Self-management Techniques: Cardiac Rehabilitation (TRUST-CR). The TRUST CR is a family-focused intervention that includes a progressive exercise component that begins with low intensity walking and education on self-management skills to facilitate self-management of cardiac recovery. In an experimental two-group design, the following research questions will be addressed in a sample of 28 older adults who receive the TRUST CR and 28 older adults in a comparison group: (1) Does participation in the TRUST CR program during SNF care improve exercise maintenance, self-efficacy, and increase attendance in an out-patient CR program? (2) Do the effects of the TRUST CR program remain when controlling for gender, type of cardiac diagnosis, physical performance, comorbidity, cardiac function, pain, depression, and body mass index? And what are the feasibility, acceptability, and resource requirements of the TRUST CR Program? The information gained from this pilot study will provide information for further refinement of the TRUST CR intervention and information of effect sizes to calculate the sample size for a larger multi-center study. This innovative interdisciplinary intervention is proposed to empower the patient-family dyad to bridge the transition of care from hospital to SNF to home to out-patient CR by the enhancement of cardiac rehabilitation self-management.
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