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      The Effect of Utilizing Organizational Culture Improvement Model of Patient Education on Coronary Artery Bypass Graft Patients’ Anxiety and Satisfaction: Theory Testing

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          Abstract

          Introduction

          Due to the increasing prevalence of arteriosclerosis and the mortality caused by this disease, Coronary Artery Bypass Graft (CABG) has become one of the most common surgical procedures. Utilization of patient education is approved as an effective solution for increasing patient survival and outcomes of treatment. However, failure to consider different aspects of patient education has turned this goal into an unattainable one. The objective of this research was to determine the effect of utilizing the organizational culture improvement model of patient education on CABG patients’ anxiety and satisfaction.

          Methods

          The present study is a randomized controlled trial. This study was conducted on eighty CABG patients. The patients were selected from the CCU and Post-CCU wards of a hospital affiliated with Iran University of Medical Sciences in Tehran, Iran, during 2015. Eshpel Burger’s Anxiety Inventory and Patients’ Satisfaction Questionnaire were used to collect the required information. Levels of anxiety and satisfaction of patients before intervention and at the time of release were measured. The intervention took place after preparing a programmed package based on the organizational culture improvement model for the following dimensions: effective communication, participatory decision-making, goal setting, planning, implementation and recording, supervision and control, and improvement of motivation. After recording the data, it was analyzed in the chi-square test, t-independent and Mann-Whitney U tests. The significance level of tests was assumed to be 0.05. SPSS version 18 was also utilized for data analysis.

          Results

          Research results revealed that variations in the mean scores of situational and personality anxiety of the control and experiment group were descending following the intervention, but the decrease was higher in the experiment group (p≤0.0001). In addition, the variations of the mean scores of patients’ satisfaction with education were higher in the experiment group than the control group (p≤0.0001).

          Conclusion

          Utilization of the organizational culture improvement model of patient education reduces stress in CABG patients and increases their satisfaction with the provided education considering the factors involved in patient education, which were incorporated in the designed model.

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          Most cited references41

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          Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A).

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            Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications.

            The epidemic of cardiovascular disease (CVD) is a global phenomenon, and the magnitude of its increase in incidence and prevalence in low- and middle-income countries (LIMIC) has potentially major implications for those high-income countries that characterize much of the developed world. Cardiovascular disease remains the leading cause of death in the world and approximately 80% of all cardiovascular-related deaths occur in LIMIC and at a younger age in comparison to high-income countries. The economic impact in regard to loss of productive years of life and the need to divert scarce resources to tertiary care is substantial. The 'epidemiologic transition' provides a useful framework for understanding changes in the patterns of disease as a result of societal and socioeconomic developments in different countries and regions of the world. A burning but as yet unanswered question is whether gains made over the last four decades in reducing cardiovascular mortality in high-income countries will be offset by changes in risk factor profiles, and in particular obesity and diabetes. Much of the population attributable risk of myocardial infarction is accountable on the basis of nine modifiable traditional risk factors, irrespective of geography. Developing societies are faced with a hostile cardiovascular environment, characterized by changes in diet, exercise, the effects of tobacco, socioeconomic stressors, and economic constraints at both the national and personal level in addition to exposure to potential novel risk factors and perhaps a genetic or programmed foetal vulnerability to CVD in later life. There are major challenges for primary and secondary prevention including lack of data, limited national resources, and the lack of prediction models in certain populations. There are two major approaches to prevention: public health/community-based strategies and clinic-based with a targeted approach to high-risk patients and combinations of these. There are concerns that in comparison with communicable diseases, cardiovascular and chronic diseases have a relatively low priority in the global health agenda and that this requires additional emphasis. The human race has had long experience and a fine tradition in surviving adversity, but we now face a task for which we have little experience, the task of surviving prosperity Alan Gregg 1890-1957, Rockefeller Foundation.
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              Patient satisfaction with nursing care in the context of health care: a literature study.

              To evaluate and improve the quality of care provided, it is of vital importance to investigate the quality of care in the context of health care. Patient satisfaction is a significant indicator of the quality of care. Consequently, quality work includes investigations that map out patient satisfaction with nursing care. To improve the quality of nursing care, the nurse needs to know what factors influence patient satisfaction. The aim of this literature study was to describe the influences on patient satisfaction with regard to nursing care in the context of health care. In the description of nursing care, we have used Henderson's nursing care model. The results describe eight domains that have an influence on patient satisfaction with nursing care: the socio-demographic background of the patients, patients' expectations regarding nursing care, the physical environment, communication and information, participation and involvement, interpersonal relations between nurse and patient, nurses' medical-technical competence, and the influence of the health care organization on both patients and nurses. The bulk of the literature included in the study came from the UK, Sweden and the USA. This means that the results should be applicable to health care in the western world. An important implication for future research is to continue to elucidate the factors that influence satisfaction with nursing care, as seen from the patient's perspective.
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                Author and article information

                Journal
                Electron Physician
                Electron Physician
                Electronic physician
                Electronic Physician
                Electronic physician
                2008-5842
                November 2016
                25 November 2016
                : 8
                : 11
                : 3272-3278
                Affiliations
                [1 ]Associate Professor in Nursing, Iran University of Medical Sciences, Tehran, Iran
                [2 ]Assistant professor, Nursing Care Research Center, Babol University of Medical Sciences, Mazandaran, Iran
                [3 ]Faculty Member, MSN, BSc, Nursing Care Research Center, Babol University of Medical Sciences, Mazandaran, Iran
                [4 ]Ph.D. in Biostatistics, Assistant Professor, Iran University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding author: Assistant Professor Dr. Fatemeh. Ghaffari, Ramsar Nursing Care Research Center, Babol University of Medical Sciences, Mazandaran, Iran. Postal Code: 4691714141, Tel: +98(11)55225151, E-mail: ghafarifateme@ 123456yahoo.com
                Article
                epj-08-3272
                10.19082/3272
                5217820
                6fec193e-9081-4bbe-9774-bb3424529e0d
                © 2016 The Authors

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 10 May 2016
                : 22 September 2016
                Categories
                Original Article

                patient education,anxiety,satisfaction,coronary artery bypass graft

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