Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement
Introduction: Oral anticoagulant therapies are intended for prevention of thrombotic adverse effects and to maintain the level of drug without bleeding. The probability of risk highly depends on the patient compliance after discharge from hospital. This study was designed to compare the effect of gr...
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| Format: | Article |
| Language: | fas |
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Isfahan University of Medical Sciences, Medical Education Development Center
2012-04-01
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| Series: | مجله ایرانی آموزش در علوم پزشکی |
| Subjects: | |
| Online Access: | http://ijme.mui.ac.ir/article-1-1721-en.pdf |
| _version_ | 1797638306323759104 |
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| author | Leili Borimnejad Sedighe Asemi Niloufar Samiei Hamid Haghani |
| author_facet | Leili Borimnejad Sedighe Asemi Niloufar Samiei Hamid Haghani |
| author_sort | Leili Borimnejad |
| collection | DOAJ |
| description | Introduction: Oral anticoagulant therapies are intended for prevention of thrombotic adverse effects and to maintain the level of drug without bleeding. The probability of risk highly depends on the patient compliance after discharge from hospital. This study was designed to compare the effect of group and individual education on patients’ compliance and incidence of adverse effects of warfarin after cardiac valve replacement surgery.
Methods: In this quasi experimental study, 76 inpatients older than 18 years, undergone valve replacement surgery in cardiovascular ward of Shaheed Rajaei Heart Center who met the inclusion criteria were selected randomly. After informed consent, they were randomly allocated to intervention or control groups. The patients in control group received individual education (the regular method) and intervention group was instructed in groups for three sessions each having one week interval. Up to six months, the results of the lab tests (PT, PTT, INR), the number of carried out lab tests, time interval between tests, and the incidence of complications were recorded, and finally compared statistically between the groups.
Results: Comparing the compliance to therapy for two groups after six months, a significant difference was noticed (p=0.03). As 88.2% of intervention group vs. 61.2% in control groups had carried out their lab tests completely (p=0.02). Result of lab tests reported abnormal PT and INR in only 2 cases (5.9%) among patients of intervention group while 59.1% of patients in control group had the experience of once or more abnormal results (P=0.00). Three cases of deaths, two cases of hospitalization, and two cases of blood transfusions were reported in control group while none of the above was observed in the intervention group.
Conclusion: Group education leads to the improvement of adherence to therapy which results in reduction of mortality among warfarin consumers after valve replacement surgery. Therefore it is highly recommended to nursing administrators to establish education units in hospital and conduct group education sessions for patients to reduce their problems. Simultaneously this leads to the reduction of hospital charges as well as financial and emotional loads on patients. |
| first_indexed | 2024-03-11T13:01:17Z |
| format | Article |
| id | doaj.art-89051fc946e0409e9d3c46e74a6a36f4 |
| institution | Directory Open Access Journal |
| issn | 1608-9359 1735-8892 |
| language | fas |
| last_indexed | 2024-03-11T13:01:17Z |
| publishDate | 2012-04-01 |
| publisher | Isfahan University of Medical Sciences, Medical Education Development Center |
| record_format | Article |
| series | مجله ایرانی آموزش در علوم پزشکی |
| spelling | doaj.art-89051fc946e0409e9d3c46e74a6a36f42023-11-03T16:37:40ZfasIsfahan University of Medical Sciences, Medical Education Development Centerمجله ایرانی آموزش در علوم پزشکی1608-93591735-88922012-04-011211018Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve ReplacementLeili Borimnejad0Sedighe Asemi1Niloufar Samiei2Hamid Haghani3 Introduction: Oral anticoagulant therapies are intended for prevention of thrombotic adverse effects and to maintain the level of drug without bleeding. The probability of risk highly depends on the patient compliance after discharge from hospital. This study was designed to compare the effect of group and individual education on patients’ compliance and incidence of adverse effects of warfarin after cardiac valve replacement surgery. Methods: In this quasi experimental study, 76 inpatients older than 18 years, undergone valve replacement surgery in cardiovascular ward of Shaheed Rajaei Heart Center who met the inclusion criteria were selected randomly. After informed consent, they were randomly allocated to intervention or control groups. The patients in control group received individual education (the regular method) and intervention group was instructed in groups for three sessions each having one week interval. Up to six months, the results of the lab tests (PT, PTT, INR), the number of carried out lab tests, time interval between tests, and the incidence of complications were recorded, and finally compared statistically between the groups. Results: Comparing the compliance to therapy for two groups after six months, a significant difference was noticed (p=0.03). As 88.2% of intervention group vs. 61.2% in control groups had carried out their lab tests completely (p=0.02). Result of lab tests reported abnormal PT and INR in only 2 cases (5.9%) among patients of intervention group while 59.1% of patients in control group had the experience of once or more abnormal results (P=0.00). Three cases of deaths, two cases of hospitalization, and two cases of blood transfusions were reported in control group while none of the above was observed in the intervention group. Conclusion: Group education leads to the improvement of adherence to therapy which results in reduction of mortality among warfarin consumers after valve replacement surgery. Therefore it is highly recommended to nursing administrators to establish education units in hospital and conduct group education sessions for patients to reduce their problems. Simultaneously this leads to the reduction of hospital charges as well as financial and emotional loads on patients.http://ijme.mui.ac.ir/article-1-1721-en.pdforal anticoagulantvalve replacement surgerygroup educationindividual educationtherapy adherence. |
| spellingShingle | Leili Borimnejad Sedighe Asemi Niloufar Samiei Hamid Haghani Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement مجله ایرانی آموزش در علوم پزشکی oral anticoagulant valve replacement surgery group education individual education therapy adherence. |
| title | Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement |
| title_full | Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement |
| title_fullStr | Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement |
| title_full_unstemmed | Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement |
| title_short | Comparison of Group and Individual Training on the Patients’ Compliance and Incidence of Warfarin Side Effects after Cardiac Valve Replacement |
| title_sort | comparison of group and individual training on the patients compliance and incidence of warfarin side effects after cardiac valve replacement |
| topic | oral anticoagulant valve replacement surgery group education individual education therapy adherence. |
| url | http://ijme.mui.ac.ir/article-1-1721-en.pdf |
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