The University of Nebraska Medical Center College of Nursing Lincoln
Division has received a $1.3 million grant to study the effectiveness of
a home health device in improving the management of symptoms in older patients
following heart surgery. The researchers, whose grant is funded by the
National Institutes of Health National Institute of Nursing Research, will
recruit 284 Nebraskans for the study.
Management of symptoms following coronary artery bypass graft surgery
(CABG) is important in the recovery process and in preventing health complications
and unplanned visits to health providers or rehospitalization. CABG surgery
reroutes blood around clogged arteries to improve the supply of blood and
oxygen to the heart.
Studies show 13 to 44 percent of patients are rehospitalized for cardiac-related
problems after surgery. According to the American Heart Association, 553,000
people had bypass surgery in 1998. Of all the CABG surgeries performed
in 1998, 51 percent were performed on people age 65 or older.
Preliminary data has shown patients are going home with limited symptom
management skills in as few as two or three days after surgery, said Lani
Zimmerman, Ph.D., professor, UNMC College of Nursing Lincoln Division and
principal investigator of the study. Complications arising from problems
once patients get home might be prevented with early detection and management.
After hospital discharge, patients typically experience pain, weakness
and fatigue, and may experience infection, pulmonary and heart rhythm problems.
Researchers will test the effectiveness of the Health Hero Health Buddy,
to monitor and manage symptoms, as well as potential complications, in
patients age 65 and older whove had CABG surgery. The device will deliver
personalized nursing information and questions to patients. Patients will
send their answers back so nurse researchers can track patients and intervene
before potential problems escalate into life-threatening emergencies.
Dr. Zimmerman said it is imperative after patients go home from the
hospital that they receive accurate and consistent information throughout
the recovery process. She said the Health Buddy device can help patients
ease back into their routine and provide a health support system if they
have problems or questions when they go home.
Patients dont always remember the things they need to know about managing
their symptoms after they get home from the hospital after heart surgery,
Dr. Zimmerman said. Patients need information reinforced after they leave
the hospital, so theyre better able to manage their symptoms and so they
can get back functioning and enjoy life.
She said this is especially important for patients from rural areas
who return home with limited access to health care.
They can end up back in the hospital because they dont recognize and
address their symptoms early. People come from rural areas 70 percent
of the patients treated in Lincoln live outside of Lincoln or even out
of state. They go back home and theres not always specialized cardiac
care available if they have questions or problems. This device provides
information and support to help keep them on track.
The research team will divide the 284 study participants into two groups.
Both groups will receive routine postoperative care, which includes an
education session in the hospital, and as part of discharge, education
material and a follow-up visit two weeks after hospital discharge. However,
one group will also use the Health Buddy, a communication device about
the size of a paperback book, that plugs into a phone line, like a telephone
answering machine.
Patients will use the device for six weeks.
Patients go into the system everyday and record information, Dr. Zimmerman
said. Its like a health care provider is watching over them.
This technology can be used to deliver care for people with chronic
disease. It helps motivate the patient and they dont have to come in to
see a health provider as often. The Health Buddy provides daily contact
with patients at a time convenient to them, and eliminates phone tag.
Researchers will compare each groups physical and social functioning,
as well as problems encountered after surgery. Researchers also will measure
number of visits to seek health care, including rehospitalization, as well
as patient satisfaction.
One of the goals of the study is to teach patients using the Health
Buddy how to manage their needs after hospital discharge. Dr. Zimmerman
said education promotes patient confidence and knowledge in the ability
to manage symptoms and, in turn, decreases problems.
The researchers, who conducted a pilot study with the Health Buddy
two years ago, believe tools like the Health Buddy will become more important
as heart disease continues to affect more people than any other in the
United States.
Dr. Zimmerman said patients in the pilot study liked the device because
it gives them educational tips and was non-judgmental. Many of those participating
in the study didnt want the Health Buddy to leave because they felt like
they were being watched and taken care of, Dr. Zimmerman said.
For more information, call Dr. Zimmerman, (402) 472-3847, Sue Barneson,
Ph.D., at (402) 472-7359 or Janet Nieveen, 472-7337.