Open Access Open Access  Restricted Access Subscription Access

DUKUNGAN KELUARGA DAN READMISI PASIEN PASCAOPERASI KATUP JANTUNG

Muhamad Adam, Artati Artati, Tuti Herawati, Prima Agustia Nova, Irza Mirharina

Abstract


ABSTRAK

Operasi katup jantung sering dilakukan, seiring dengan prevalensi penyakit jantung katup yang masih tinggi. Namun, setelah menjalani operasi, pasien mengalami readmisi dalam 1 bulan yang kemungkinan berkaitan dengan dukungan keluarga. Tujuan penelitian: Penelitian ini bertujuan mengidentifikasi hubungan dukungan keluarga dengan readmisi setelah pasien menjalani operasi katup jantung. Metode: Penelitian cross-sectional ini melibatkan 105 responden pascaoperasi katup jantung yang mengalami readmisi di Rumah Sakit Pusat Jantung Nasional Harapan Kita, Jakarta dengan menggunakan teknik consecutive sampling. Penelitian ini menggunakan kuesioner karakteristik responden, readmisi, dan dukungan keluarga. Analisis univariat dilakukan untuk mengetahui distribusi frekuensi dan analisis bivariat chi square untuk mengetahui kemaknaan hubungan dukungan keluarga dan readmisi. Hasil: Sebagian besar responden (46,7%) berada pada rentang usia pertengahan (45–59 tahun), jenis kelamin perempuan (52%) lebih banyak daripada laki-laki (47%), katup mitral (37,1%) dan aorta (31,4%) yang paling banyak dilakukan operasi. Sebagian besar responden (75%) mengalami dukungan keluarga yang nonsuportif dan sebagian besar responden (61%) setidaknya mengalami satu  kali readmisi dalam 1 bulan. Terdapat hubungan yang bermakna antara dukungan keluarga dengan readmisi pasien pascaoperasi katup jantung (p = 0,019; α < 0,05). Diskusi: Dukungan keluarga dapat meningkatkan perilaku sehat dan proses pemulihan sehingga dapat mencegah terjadinya readmisi. Kesimpulan: Perawat dianjurkan mengkaji dukungan keluarga terhadap pasien yang direncanakan menjalani operasi katup jantung dan memberikan intervensi keperawatan yang diperlukan untuk meningkatkan dukungan keluarga dan mencegah readmisi. Penelitian lebih lanjut diperlukan untuk mengidentifikasi penyebab sebagian besar pasien pascaoperasi katup jantung mengalami dukungan keluarga yang nonsuportif.

Kata Kunci: dukungan keluarga, katup jantung, pascaoperasi, readmisi pasien

 

Family Support and Readmission After Heart Valve Surgery 

 

ABSTRACT

Heart valve surgery is often performed, along with the high prevalence of valvular heart disease. However, after surgery, the patient is readmitted within 1 month, probably related to family support. Objective: This research aims to identify the correlation between family support and readmission after the patient undergoes heart valve surgery. Methods: This cross-sectional research involved 105 respondents after heart valve surgery who were readmitted at Harapan Kita National Heart Center Hospital, Jakarta. The respondents were taken using a consecutive sampling technique. This research employed a questionnaire on the characteristics of the respondents, readmission, and family support. Univariate analysis was used to identify the frequency distribution, and bivariate chi-square analysis was used to identify the significance of the correlation between family support and readmission. Results: Most of the respondents (46.7%) were in the middle age range (45-59 years), more female (52%) than male (47%), mitral valve (37.1%), and aorta (31.4%) was the most frequently operated on. Most respondents (75%) had non-supportive families, and most respondents (61%) experienced at least 1 readmission in 1 month. There was a significant correlation between family support and patient readmission after the heart valve surgery (p=0.019; <0.05). Discussion: Family support can improve healthy behaviour and the recovery process so that it can prevent readmissions. Conclusion: Nurses are recommended to assess family support in patients planning for heart valve surgery and provide necessary nursing interventions to increase family support and prevent readmission. Further research is needed to identify the cause of most post-heart valve surgery patients having non-supportive families.

Keywords: Family support, heart valve, post-surgery, patient readmission


References


Andell, P., Li, X., Martinsson, A., Andersson, C., Stagmo, M., Zöller, B., Sundquist, K., & Smith, J. G. (2017). Epidemiology of valvular heart disease in a swedish nationwide hospital-based register study. Heart, 103(21): 1696.

http://dx.doi.org/10.1136/heartjnl-2016-310894

Baumgartner, H., Falk, V., Bax, J. J., De Bonis, M., Hamm, C., Holm, P. J., …, Zamorano, J. L. (2017). 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, 38(36): 2739–2791. https://doi.org/10.1093/eurheartj/ehx391

Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., …, Lichtman, J. H. (2018). American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation, 137(12): e67–e492. https://doi.org/10.1161/CIR.0000000000000558

Berg, S. K., Zwisler, A., Pedersen, B. D., Haase, K., & Sibilitz, K. L. (2013). Patient experiences of recovery after heart valve replacement: Suffering weakness, struggling to resume normality. BMC Nursing, 12: 23. http://dx.doi.org/10.1186/1472-6955-12-23

Borregaard, B., Sørensen, J., Ekholm, O., Møller, J. E., Riber, L. P., Thrysoee, L., …, Berg, S. K. (2018). Sociodemographic, Clinical and Patient-Reported Outcomes and Readmission After Heart Valve Surgery. The Journal of Heart Valve Disease, 27(1): 78–86.

Borregaard, B., Møller, J. E., Dahl, J. S., Riber, L., Berg, S. K., Ekholm, O., …, Sørensen, J. (2019). Early follow-up after open heart valve surgery reduces healthcare costs: A propensity matched study. Open Heart, 6(2): e001122. https://doi.org/10.1136/openhrt-2019-001122

Chan, B., Goldman, L. E., Sarkar, U., Guzman, D., Critchfield, J., …, & Kushel, M. (2019). High perceived social support and hospital readmissions in an older multi-ethnic, limited English proficiency, safety-net population. BMC Health Services Research, 19(1): 334. https://doi.org/10.1186/s12913-019-4162-6

Coffey, S., Cairns, B. J., & Iung, B. (2016). The modern epidemiology of heart valve disease. Heart, 102(1): 75–85. https://doi.org/10.1136/heartjnl-2014-307020

Crousillat, D. R., & Wood, M. J. (2019). Valvular Heart Disease and Heart Failure in Women. Heart failure clinics, 15(1): 77–85. https://doi.org/10.1016/j.hfc.2018.08.008

Danielsen, S. O., Moons, P., Sandven, I., Leegaard, M., Solheim, S., Tønnessen, T., & Lie, I. (2018). Thirty-day readmissions in surgical and transcatheter aortic valve replacement: A systematic review and meta-analysis. International Journal of Cardiology, 268: 85–91. https://doi.org/10.1016/j.ijcard.2018.05.026

Dodson, J.A., Wang, Y., Murugiah, K., Dharmarajan, K., Cooper, Z., & Hashim, S. (2015). National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010. PLoS ONE 10(7): e0132470. https://doi.org/10.1371/journal.pone.0132470

Elkhateeb, O. & Salem, K. (2018). Patient and caregiver education levels and readmission and mortality rates of congestive heart failure patients. EMHJ, 24(4): 345-350.

Fani, R., Dahlia, D., Sukmarini, L., Arista, L., & Fauzi, A. (2019). Analisis faktor yang berhubungan dengan kejadian rawat inap ulang pada pasien pascalaparoskopi kolesistektomi [Master Thesis]. Universitas Indonesia, Jakarta, Indonesia.

Ferraris, V. A., Ferraris, S. P., Harmon, R. C., & Evans, B. D. (2001). Risk factors for early hospital readmission after cardiac operations. The Journal of Thoracic and Cardiovascular Surgery, 122(2): 278–286. https://doi.org/10.1067/mtc.2001.114776

Goel, N. J., Iyengar, A., Kelly, J. J., Brown, C. R., Kurshan, F., Atluri, P., …, Desai, N. D. (2019). Causes, Risk Factors, and Costs of 30-Day Readmissions After Mitral Valve Repair and Replacement. The Annals of Thoracic Surgery, 108(6): 1729–1737. https://doi.org/https://doi.org/10.1016/j.athoracsur.2019.07.033

Green, Y. S., Hajduk, A. M., Song, X., Krumholz, H. M., Sinha, S. K., & Chaudhry, S. I. (2020). Usefulness of social support in older adults after hospitalization for acute myocardial infarction (from the SILVER-AMI study). The American Journal of Cardiology, 125(3): 313-319. http://dx.doi.org/10.1016/j.amjcard.2019.10.038.

He, S., Deng, H., Jiang, J., Liu, F., Liao, H., Xue, Y., …, Wu, S. (2021). The Evolving Epidemiology of Elderly with Degenerative Valvular Heart Disease: The Guangzhou (China) Heart Study. BioMed Research International: 1-8. https://doi.org/10.1155/2021/9982569

Holmås, T. H., Monstad, K., & Steskal, D. (2019). Family Matters? The Importance of Relatives for Frail Elders’ Mortality and Hospital Readmission. Journal of Population Ageing, 12(2): 229–246. https://doi.org/10.1007/s12062-017-9202-6

House, J., Umberson, D., & Landis, K. (2003). Structures and Processes of Social Support. Annu Rev Sociol, 14: 293–318. https://doi.org/10.1146/annurev.so.14.080188.001453

Iung, B., & Vahanian, A. (2011). Epidemiology of valvular heart disease in the adult. Nature reviews. Cardiology, 8(3): 162–172. https://doi.org/10.1038/nrcardio.2010.202.

Iung, B., & Vahanian, A. (2014). Epidemiology of Acquired Valvular Heart Disease. Canadian Journal of Cardiology, 30(9): 962–970. https://doi.org/10.1016/j.cjca.2014.03.022.

Kansagara, D., Englander, H., Salanitro, A., Kagen, D., Theobald, C., Freeman, M., & Kripalani, S. (2011). Risk prediction models for hospital readmission: a systematic review. JAMA, 306(15): 1688–1698. https://doi.org/10.1001/jama.2011.1515

Kripalani, S., Theobald, C. N., Anctil, B., & Vasilevskis, E. E. (2014). Reducing hospital readmission rates: current strategies and future directions. Annual review of medicine, 65: 471–485. https://doi.org/10.1146/annurev-med-022613-090415

Krumholz, H. M. (2013). Post-hospital syndrome — an acquired, transient con- dition of generalized risk. N Engl J Med, 368: 100–102.

McNeely, C., Telila, T., Markwell, S., Hazelrigg, S., & Vassileva, C. M. (2016). Hospital Readmission after Aortic Valve Replacement: Impact of Preoperative Heart Failure. The Journal of heart valve disease, 25(4): 430–436.

Moraes, R. C., Katz, M., & Tarasoutchi, F. (2014). Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department. Einstein (Sao Paulo, Brazil), 12(2): 154–158. https://doi.org/10.1590/s1679-45082014ao3025

Nitsche, C., Koschutnik, M., Kammerlander, A., Hengstenberg, C., & Mascherbauer, J. (2020). Gender-specific differences in valvular heart disease. Wien Klin Wochenschr, 132(3): 61–68. https://doi.org/10.1007/s00508-019-01603-x

Onuoha, P., Ocho, P., Singh, O., Bissoon, S., Kernahan-Hill, & Augustine, S. (2017). Family and Social Support Systems on Patients’ Readmission: Perceptions of the Elderly Diabetic Patients at San-Fernando General Hospital. IOSR Journal of Nursing and Health Science, 6(1): 81–88. https://doi.org/10.9790/1959-0601018188

Patel, D. K., Green, K. D., Fudim, M., Harrell F. E., Wang,T. J., Robbin, & M. A. (2014) Racial differences in the prevalence of severe aortic stenosis. J Am Heart Assoc, 28, 3(3):e000879. pmid:24870936

Piepoli, M. F., Corra, U., Benzer, W., Bjarnason-Wehrens, B., Dendale, P., Gaita, D., …, Schmid, J. P. (2010). Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the cardiac rehabilitation section of the European association of cardiovascular prevention and rehabilitation. Eur J Cardiovasc Prev Rehabil, 17(1): 1–17.

Rumah Sakit Pusat Jantung Nasional Harapan Kita (2019). Data Rekam Medis Tahun 2018-2019. Data tidak dipublikasikan.

Schwarz, K., & Elman, C. (2003). Identification of Factors Predictive of Hospital Readmissions for Patients with Heart Failure. Heart and Lung The Journal of Acute and Critical Care, 32: 88–99. https://doi.org/10.1067/mhl.2003.15

Sibilitz, K. L., Berg, S. K., Thygesen, L. C., Hansen, T. B., Køber, L., Hassager, C., & Zwisler, A. D. (2015). High readmission rate after heart valve surgery: A nationwide cohort study. International Journal of Cardiology, 189: 96–104

Shu, C., Chen, S., Qin, T., Fu, Z., Sun, T., Xie, M., …, Yin, P. (2016). Prevalence and correlates of valvular heart diseases in the elderly population in Hubei, China. Scientific Report, 6: 27253. https://doi.org/10.1038/srep27253.

Soesanto, A. (2012). Penyakit Jantung Katup di Indonesia; masalah yang hampir terlupakan. Indonesian Journal of Cardiology, 33(4): 205-208. https://doi.org/10.30701/ijc.v33i4.20

Vassileva, C. M., Ghazanfari, N., Spertus, J., McNeely, C., Markwell, S., & Hazelrigg, S. (2014). Heart failure readmission after mitral valve repair and replacement: five-year follow-up in the Medicare population. The Annals of thoracic surgery, 98(5): 1544–1550. https://doi.org/10.1016/j.athoracsur.2014.07.040

Zhang, B., Miller, V. M., & Miller, J. D. (2019). Influences of Sex and Estrogen in Arterial and Valvular Calcification. Frontiers in endocrinology, 10: 622. https://doi.org/10.3389/fendo.2019.00622




DOI: http://dx.doi.org/10.32419/jppni.v7i1.348

Article Metrics

Abstract view : 620 times
PDF (Bahasa Indonesia) - 409 times

Refbacks

  • There are currently no refbacks.


 

Creative Commons License
Jurnal PPNI (P-ISSN: 2503-1376 ; E-ISSN: 2549-8576)