The UNMC 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.
Meet the Health Buddy
Researchers will test the effectiveness of the Health Hero Network’s Health Buddy to monitor and manage symptoms, as well as potential complications, in patients age 65 and older who have 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.
After patients leave the hospital it is imperative that they receive accurate and consistent information throughout the recovery process, Dr. Zimmerman said. 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 don’t 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 they’re 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 don’t 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 there’s 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 study
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 their hospital discharge, education material and a follow-up visit two weeks after being discharged. One group, however, also will 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. “It’s 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 don’t 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 group’s 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.
A boost of confidence
One of the goals of the study is to teach patients using the Health Buddy how to manage their needs after being discharged. 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 didn’t want the Health Buddy to leave because they felt like they were being watched and taken care of,” Dr. Zimmerman said.
For more information
For more information, call Dr. Zimmerman, (402) 472-3847, Sue Barneson, Ph.D., at (402) 472-7359 or Janet Nieveen, 472-7337.
For more information on the Heath Buddy and other Health Hero Network products, visit http://www.hhn.com.