NURSE'S ROLE AND RESPONSIBILITIES IN CARDIAC REHABILITATION TEAM WORK

Yıl 2020, Cilt: 24 Sayı: 3, 217 - 226, 01.01.2021

Yasemin Sazak , Keriman Aytekin Kanadlı Nermin Olgun

Öz

Cardiac rehabilitation; it is a coordinated physical, social and psychological intervention that positively affects the underlying risk factors for stopping, slowing or reversing the progression of the disease, thereby facilitating the patient's ability to actively engage or maintain the community. It has an important place in preventing mortality and morbidity related to cardiovascular diseases. It has positive effects in terms of re-hospitalization, mortality rates, quality of life and increase in functional capacity of the patients. Despite the proven clinical and economic benefits of cardiac rehabilitation, it remains an underutilized resource on a global scale. A multidisciplinary team work is carried out to achieve the desired goals in the cardiac rehabilitation program. The importance of presenting cardiac rehabilitation programs by a multidisciplinary team is stated in international guidelines. In this team, the nurse plays a key role in cardiac risk factor modification, patient education and is an indispensable member of the team. In this review; the importance of cardiac rehabilitation programs and the roles and responsibilities of nurses are emphasized.

Anahtar Kelimeler

: Cardiac rehabilitation, cardiovascular diseases, nurse

KARDİYAK REHABİLİTASYON EKİP ÇALIŞMASINDA HEMŞİRENİN ROL VE SORUMLULUKLARI

Öz

Kardiyak rehabilitasyon; hastalığın ilerlemesini durdurmak, yavaşlatmak veya tersine çevirmek için altta yatan risk faktörlerini olumlu yönde etkileyen ve böylece hastanın topluma aktif olarak katılımını sağlama veya sürdürme yeteneğini kolaylaştıran koordineli fiziksel, sosyal ve psikolojik bir müdahaledir. Kardiyovasküler hastalıklara bağlı mortalite ve morbiditenin önlenmesinde kardiyak rehabilitasyon önemli bir yere sahiptir. Hastaların hastaneye tekrar yatışları, mortalite oranları, yaşam kaliteleri ve kişinin fonksiyonel kapasitesindeki artış açısından olumlu etkileri bulunmaktadır. Kanıtlanmış klinik ve ekonomik faydalarına rağmen, küresel boyutta yetersiz kullanılan bir kaynak olmaya devam etmektedir. .Kardiyak rehabilitasyon programlarında istenilen hedeflere ulaşmak için multidisipliner bir ekip çalışması gerekmektedir. Bu ekip içerisinde hemşire kardiyak risk faktör modifikasyonunda, hasta eğitiminde anahtar rol üstlenir ve ekibin vazgeçilmez bir üyesidir. Bu derlemede; kardiyak rehabilitasyon programlarının önemi ve hemşirelerin rol ve sorumlulukları üzerinde durulmuştur.

Anahtar Kelimeler

Kardiyak rehabilitasyon, kardiyovasküler hastalıklar, hemşire

Kaynakça

• The WHO CVD Risk Chart Working Group. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health. 2019;7(10):1332-45.
• World Health Organization. Cardiovascular diseases 2017. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (Erişim tarihi: 18.04.2020).
• T.C. Sağlık Bakanlığı. Sağlık İstatistikleri Yıllığı 2018. https://dosyasb.saglik.gov.tr/Eklenti/36134,siy2018trpdf.pdf?0 (Erişim tarihi: 18.04.2020).
• Onat A, Can G, Yüksel H, Ademoğlu E, Ünaltun NE, Kaya A, et al. TEKHARF 2017 Tıp Dünyasının Kronik Hastalıklara Yaklaşımına Öncülük. İstanbul: Logos Yayıncılık; 2017. http://file.tkd.org.tr/PDFs/TEKHARF-2017.pdf (Erişim tarihi: 18.04.2020).
• Akın S. Kronik Hastalıklarda Primer ve Sekonder Korunma. In: Durna Z, editor. Kronik Hastalıklar ve Bakım. İstanbul: Nobel Tıp Kitabevleri; 2012. p. 9-22.
• Türkmen E, Badır A, Ergün A. Koroner arter hastalıkları risk faktörleri: primer ve sekonder korunmada hemşirelerin rolü. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2012;3:223-31.
• Akbulut E, Tülüce D, Kahraman BB. Kardiyak rehabilitasyonda hemşirenin rolü. Journal of Cardiovascular Nursing. 2016;7(14):140-6.
• İnkaya BV, Sıdıka O. Kardiyak Rehabilitasyon. Yoğun Bakım Hemşireliği Dergisi. 2010;14(1):14-9.
• Uysal H. Kardiyak Rehabilitasyon ve Hemşirenin Sorumlulukları. Kardiyovasküler Hemşirelik Dergisi. 2012;3(3):49-59.
• W.H.O. Expert Committee on Rehabilitation after Cardiovascular Diseases with Special Emphasis on Developing Countries World Health, Organizatio. Rehabilitation after cardiovascular diseases, with special emphasis on developing countries : report of a WHO expert committee [meeting held in Geneva from 21 to 18 October 1991] 1993. https://apps.who.int/iris/handle/10665/38455 (Erişim tarihi: 20.04.2020).
• Öncü GT. Kardiyak Rehabilitasyonun Tanımı, Ekip Çalışmasının Önemi Ve Ekip Üyelerinin Rolleri. Journal of Cardiovascular Nursing. 2016;7(Sup 2):35-40.
• Boydak B. Yaşlı hastalarda kardiyak rehabilitasyon. Turk Kardiyol Dern Ars. 2017;45(5):117-9.
• Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European 2016;37(29):2315-81.
• British Association for Cardiovascular Prevention and Rehabilitation. The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017. http://www.bacpr.com/resources/6A7_BACR_Standards_and_Core_Components_2017.pdf (Erişim tarihi: 21.04.2020).
• Price KJ, Gordon BA, Bird SR, Benson AC. A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus? European Journal of Preventive Cardiology. 2016;23(16):1715-33.
• O’Toole K, Chamberlain D, Giles T. Exploration of a nurse practitioner-led phase two cardiac rehabilitation programme on attendance and compliance. Journal of Clinical Nursing. 2020;29(5-6):785-93.
• Doimo S, Fabris E, Piepoli M, Barbati G, Antonini-Canterin F, Bernardi G, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. European Heart Journal. 2018;40(8):678-85.
• Salzwedel A, Jensen K, Rauch B, Doherty P, Metzendorf M-I, Hackbusch M, et al. Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II). European Journal of Preventive Cardiology. 2020;2047487320905719.
• Grace SL, Warburton DR, Stone JA, Sanderson BK, Oldridge N, Jones J, et al. International Charter on Cardiovascular Prevention and Rehabilitation: a call for action. J Cardiopulm Rehabil Prev. 2013;33(2):128-31.
• Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JM, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2007;115(20):2675-82.
• American Association of Cardiovascular and Pulmonary Rehabilitation (AACPR). Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs 2013. http://www.pthomegroup.com/sites/default/files/my%20liberary/American%20Association%20of%20Cardiovascular%20Pulmonary%20Rehabilitation%20Guidelines%20for%20cardiac%20rehabilitation%20and%20secondary%20prevention%20programs%20Human%20Kinetics%202013.pdf (Erişim tarihi: 21.04.2020).
• Ambrosetti M, Abreu A, Corrà U, Davos CH, Hansen D, Frederix I, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. European Journal of Preventive Cardiology. 2020;0(0):2047487320913379.
• Woodruffe S, Neubeck L, Clark RA, Gray K, Ferry C, Finan J, et al. Australian Cardiovascular Health and Rehabilitation Association (ACRA) core components of cardiovascular disease secondary prevention and cardiac rehabilitation 2014. Heart, lung & circulation. 2015;24(5):430-41.
• Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD Obezite Tanı ve Tedavi Kılavuzu 2019. http://temd.org.tr/admin/uploads/tbl_kilavuz/20190506163904-2019tbl_kilavuz5ccdcb9e5d.pdf (Erişim tarihi: 10.05.2020).
• Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD Hipertansiyon Tanı ve Tedavi Kılavuzu 2019. http://temd.org.tr/admin/uploads/tbl_kilavuz/20190527160350-2019tbl_kilavuz64f1da66bf.pdf (Erişim tarihi: 10.05.2020).
• Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018;39(33):3021-104.
• Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2018;71(19):127-248.
• Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update:a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. Journal of the American college of cardiology. 2011;58(23):2432-46.
• Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD Dislipidemi Tanı ve Tedavi Kılavuzu 2019. http://temd.org.tr/admin/uploads/tbl_kilavuz/20190506163838-2019tbl_kilavuz61855bdd04.pdf (Erişim tarihi: 10.05.2020).
• Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2019;73(24):285-350.
• Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). European Heart Journal. 2019;41(1):111-88.
• Şencan I, Keskinkılıç B, Ekinci B, Öztemel A, Sarıoğlu G, Çobanoğlu N, et al. Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı Eylem Planı (2015-2020). T.C. Türkiye Halk Sağlığı Kurumu, T.C. Sağlık Bakanlığı Yayın. (988):1-63. https://www.tkd.org.tr/TKDData/Uploads/files/Turkiye-kalp-ve-damar-hastaliklari-onleme-ve-kontrol-programi.pdf (Erişim tarihi: 10.05.2020).
• Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. Q 2013 ESC kararlı koroner arter hastalığı yönetimi kılavuzu: Avrupa Kardiyoloji Derneği (ESC) kararlı koroner arter hastalığı yönetimi görev grubu. Türk Kardiol Dern Arş. 2014; 4:73-134. https://www.journalagent.com/tkd/pdfs/TKDA_42_80_73_134.pdf (Erişim tarihi: 12.05.2020).
• Mampuya WM. Cardiac rehabilitation past, present and future: an overview. Cardiovasc Diagn Ther. 2012;2(1):38-49.
• Schmid J-P. Scientific evidence for cardiac rehabilitation. Cardiovascular Medicine. 2018;21(02):48-52.
• Thomas RJ, Balady G, Banka G, Beckie TM, Chiu J, Gokak S, et al. 2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation. A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. 2018;71(16):1814-37.
• Kim C, Sung J, Lee JH, Kim W-S, Lee GJ, Jee S, et al. Clinical Practice Guideline for Cardiac Rehabilitation in Korea. Ann Rehabil Med. 2019;43(3):355-443.
• Uysal H. Kalp Hastalarının Rehabilitasyonunda Psikososyal Yaklaşım. Turkiye Klinikleri Journal of Nursing Sciences. 2016;8(3):257-70.
• Lin SHM, Neubeck L, Gallagher R. Educational Preparation, Roles, and Competencies to Guide Career Development for Cardiac Rehabilitation Nurses. Journal of Cardiovascular Nursing. 2017;32(3):244-59.
• Akdemir N. Rehabilitasyon ve hemşirelik. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2006;13(1):82-91.
• Harbman P. The development and testing of a nurse practitioner secondary prevention intervention for patients after acute myocardial infarction: A prospective cohort study. International Journal of Nursing Studies. 2014;51(12):1542-56.
• O’Toole K, Chamberlain D, Giles T. Exploration of a Nurse Practitioner‐led phase two cardiac rehabilitation program on attendance and compliance. Journal of Clinical Nursing. 2019;29.
• Ögmundsdottir Michelsen H, Nilsson M, Scherstén F, Sjölin I, Schiopu A, Leosdottir M. Tailored nurse-led cardiac rehabilitation after myocardial infarction results in better risk factor control at one year compared to traditional care: a retrospective observational study. BMC Cardiovasc Disord. 2018;18(1):167.