Effects of a Designed Discharge Plan on Anxiety and Length of Hospital Stay in Patients Undergoing Heart Valve Replacement

Background & Objective: Anxiety is the most common issue in the candidates of surgical heart valve replacement. The length of hospital stay in these patients is economically and organizationally important as a predictor of their recovery from acute physical conditions. The present study aimed to assess the effects of a designed discharge plan on anxiety and length of hospital stay in patients undergoing heart valve replacement. Materials and Methods: This clinical trial was conducted on 65 candidates of heart valve replacement in Chamran Hospital in Isfahan, Iran, who were randomly divided into the intervention and control groups. In the intervention group, the designed discharge plan was implemented and continued one month after discharge via phone follow-up. Length of hospital stay and anxiety were analyzed before the intervention and one and three months after discharge in both groups in SPSS. Results: ANOVA indicated that the mean anxiety in the study groups was significantly different at different times (P0.05). Conclusion: The designed discharge plan reduced anxiety in the patients, while its effect on the length of hospital stay requires further investigation. Therefore, it is recommended that the discharge program be used as an effective approach to maintaining care in patients undergoing heart valve replacement. Keywords: Discharge Plan, Anxiety, Hospitalization, Heart Valve Replacemen

Effects of a Designed Discharge Plan on Anxiety and Length of Hospital Stay in Patients Undergoing Heart Valve Replacement

Background & Objective: Anxiety is the most common issue in the candidates of surgical heart valve replacement. The length of hospital stay in these patients is economically and organizationally important as a predictor of their recovery from acute physical conditions. The present study aimed to assess the effects of a designed discharge plan on anxiety and length of hospital stay in patients undergoing heart valve replacement. Materials and Methods: This clinical trial was conducted on 65 candidates of heart valve replacement in Chamran Hospital in Isfahan, Iran, who were randomly divided into the intervention and control groups. In the intervention group, the designed discharge plan was implemented and continued one month after discharge via phone follow-up. Length of hospital stay and anxiety were analyzed before the intervention and one and three months after discharge in both groups in SPSS. Results: ANOVA indicated that the mean anxiety in the study groups was significantly different at different times (P0.05). Conclusion: The designed discharge plan reduced anxiety in the patients, while its effect on the length of hospital stay requires further investigation. Therefore, it is recommended that the discharge program be used as an effective approach to maintaining care in patients undergoing heart valve replacement

99 mTc-MIBI washout as a complementary factor in the evaluation of idiopathic dilated cardiomyopathy (IDCM) using myocardial perfusion imaging

Rapid technetium-99 m methoxyisobutylisonitrile (99 mTc-MIBI) washout has been shown to occur in impairedmyocardia. This study is based on the hypothesis that scintigraphy can be applied to calculate the myocardial 99 mTc-MIBI washout rate (WR) to diagnose and evaluate heart failure severity and other left ventricular functional parameters specifically in idiopathic dilated cardiomyopathy (IDCM) patients. Patients with IDCMP (n = 17; 52.65 ± 11.47 years) and normal subjects (n = 6; 49.67 ± 10.15 years)were intravenously administered 99 mTc-hexakis-2-methoxyisobutylisonitrile (99 mTc-MIBI). Next, early and delayed planar data were acquired (at 3.5-h intervals), and electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT) was performed. The 99 mTc-MIBI WR was calculated using early and delayed planar images. Left ventricular functional parameters were also analyzed using quantitative gated SPECT (QGS) data. In target group, myocardial WRs (29.13 ± 6.68%) were significantly higher than those of control subjects (14.17 ± 3.31%; P\0.001). The 99 mTc-MIBI WR increased with the increasing severity of the NYHA functional class (23.16 ± 1.72% for class I, 30.25 ± 0.95%for class II, 32.60 ± 6.73%for class III, and 37.50 ± 7.77% for class IV; P = 0.02). The WR was positively correlated with the end-diastolic volume (EDV) index (r2 = 0.216; b = 0.464; P = 0.02 [ml/m2], the end-systolic volume (ESV) index (r2 = 0.234; b = 0.484; P = 0.01 [ml/m2]), the summed motion score (SMS) (r2 = 0.544; b = 0.738; P = 0.00), and the summed thickening score (STS) (r2 = 0.656; b = 0.810; P = 0.00); it was negatively correlated with the left ventricular ejection fraction (LVEF) (r2 = 0.679; b = –0.824; P = 0.00). It can be concluded that 99 mTc-MIBI scintigraphy might be a valuable molecular imaging tool for the diagnosis and evaluation of myocardial damage or dysfunction severity