Factors Affecting Compliance of Patients with Permanent pacemaker Regarding Therapeutic Regimen

Abstract

Background: Patients undergoing permanent implantable pacemaker, challenge with multiple physical, psychological and social complications. The patients may perceive the pacemaker device as an electronic security or as a source of physical, psychosocial and emotional discomfort. So self-care management for those patients and measuring nursing sensitive patient's outcomes will lead to improve their life and overcome physical, social and psychological problems. Aim of the study: This study was aiming to evaluate the effect of self-care management on nursing sensitive patients' outcomes after permanent pacemaker implantation. Study design: A quasi experimental design was utilized to meet the aim of the study. Subject: A Purposive sample included 50 patients after permanent pacemaker implantation which divided into two equal matched groups' (study and control groups). Setting: The study was conducted at the cardiac Catheterization unit at Ain Shams University Hospital. Data collection tools: 1) Patient's socio-demographic characteristics sheet, 2) Patient's clinical data sheet, 3) Self-care management level assessment sheet, 4) Patients’ self-care practice observational checklists, and 5) Nursing Sensitive patient Outcomes Measuring Scales. Results: The present study revealed that satisfactory level of self-care knowledge, practice and the different levels of Nursing Sensitive patient Outcomes of patients in the study group were improved post implementation of self-care guidelines compared to control group and to pre implementation of self-care guidelines. Conclusion: Implementation of self-care management guidelines has positive effect on improving patient's self-care management level and enhancing all dimensions of nursing sensitive patients' outcomes (physiological health outcomes, functional health outcomes, psychosocial outcomes, health knowledge and behaviors and family health outcomes. Recommendations Generalize using nursing sensitive patient's outcomes based on (NOC) to provide more comprehensive standardized information on patient, family, and community outcomes that result from nursing interventions. Self-care management guidelines for patients after permanent pacemaker implantation should be applied in all cardiac catheterization units and should be updated periodically to enhance self-care management for those patients based on NOC.