Effects of outside bed elimination on physical and psychological reactions of the patients with coronary artery disease

Abstract

Introduction: This was a quasi-experimental study focused on evaluation of the effect of outside bed elimination on psychological and physical reaction of coronary patients in CCUs selected in hospitals of social security organization in 2002.

Methods: This was a two-group two-stage survey carried out on all coronary patients hospitalized in CCU of Dr. Shariati Hospital, well-qualified to enter the study selected through non-randomized convenient sampling method. The samples were randomly divided into two groups of study and control. The data were collected by interviews and observations through questionnaires, sphygmomanometer and telecardiac monitoring. The questionnaire included four sections and was made according to the scientific books and articles. The first section, filled out at the beginning of the research, included nine questions on individual and health related characteristics. The second part included five questions on urination and defecation status and the third section contained eight questions on urination and defecation signs. The fourth part was composed of an anxiety and depression hospital questionnaire including fourteen questions. Scientific validity of the questionnaire was made by content validity and the reliability was made through a pilot study with a Cronbach alpha of 0.9. All of the subjects were in complete bed rest for the first 12 hours and had in bed elimination. As soon as outside bed eliminations were licensed, blood pressure and heart rate were checked for study group before elimination and in case of arrhythmia, it was recorded. Elimination signs were asked from the subjects and recorded. Blood pressure, heart rate, arrhythmia and elimination signs were recorded after elimination. For controls, elimination was administrated handling a bedpan and in bed after interviewing and filling out the questionnaire without any further researchers' interventions. The data were processed and analyzed by SPSS and inferential descriptive statistics. Pair t-test, t-test, Wilcoxon and Mann-Whitney tests were used to reach the goals of the study.

Results: The findings showed a significant difference between mean blood pressure and heart rate before and after elimination in bed and out of bed (P=%001). Mean systolic blood pressure and heart rate showed a significant difference between, before and after elimination out of bed compared with controls (P>%05). The findings on frequency distribution of the signs before and after elimination out of bed also showed no significant difference with the controls (P>%05). Frequency distribution of arrhythmia after elimination out of bed showed a significant difference with controls (P=0.004). Mean number of eliminations after elimination out of bed showed a significant difference with controls (P=0.001). Regarding the frequency distribution of psychological reaction in study and control groups, there was a significant difference before and after eliminations in and out of bed (P=0.001). The findings also showed no significant difference in the frequency distribution of psychological reaction between the two groups before elimination out of bed while there was a significant difference between them after elimination out of bed (P=0.023).

Conclusion: This study suggests out of bed elimination in patients with CAD in CCU is safe and affects patient's physical and psychological reactions