REHABILITATION OF CARDIOLOGICAL AND CARDIOSURGICAL PATIENTS IN MODERN CONDITIONS: POSSIBILITIES AND MILITARY HEALTH CARE PROBLEMS
DOI:
https://doi.org/10.32782/2077-6594.1.1.2021.227163Keywords:
Armed Forces of Ukraine, rehabilitation, patients of cardiological and cardiosurgical profileAbstract
The purpose of the study: to analyze the system of physical and medical rehabilitation of patients at the Military Medical Clinical Treatment and Rehabilitation Center (MMCTRC) to determine its compliance with the main recommendations of the World Health Organization (WHO) and the development of further capabilities.
Materials and methods. Data from 316 cards of inpatients of cardiological and cardiosurgical profile of MMCTRC were analyzed. The WHO recommendations, legislative and normative documents of the Ministry of Health (MOH) of Ukraine, literature sources are used. Methods applied: analytical-statistical, information-search, theoretical, comparative analysis.
Results. The system of providing physical and medical rehabilitation to patients of cardiological and cardiosurgical profile in the Military Medical Clinical Medical Rehabilitation Center and its compliance with modern requirements are analyzed.
Data on the number of rehabilitators are given. In particular, for the period from 2015 to 2020, 316 patients underwent cardiorehabilitation in the cardiology department. Of these, 239 patients underwent cardiac surgery at various times. The basic principles of construction of the rehabilitation process, means, methods and techniques of rehabilitation are highlighted. Problematic issues are presented and ways to solve them are suggested.
Conclusions. Based on the analysis of the structure of patients in the cardiology department of the Military Medical Clinical Medical Rehabilitation Center, it was found that in the period 2015-2020 316 patients underwent cardiac rehabilitation, among them 75% had cardiac surgery at different times (mostly aorto-coronary artery bypass grafting and stenting), which determines the importance of developing and implementing appropriate rehabilitation programs. The introduction of the proposed system in the rehabilitation of patients with cardiac and cardiosurgical will reduce the degree of limitation of their lives, restore independence in everyday life, accelerate the return to professional activity and (or) to active life. It is necessary to carry out further organizational and methodological measures to improve the system of physical and rehabilitation medicine in the rehabilitation of patients with cardiac and cardiosurgical in the Armed Forces of Ukraine.
First of all, it needs to adequately address the issue of providing continuous postgraduate training of specialists in medical rehabilitation, staffing of medical institutions with modern rehabilitation equipment.
References
Balady, G.J., Williams, M.A., Ades, P.A., Bittner V., Comoss, P., Foody, J.M., Franklin, B., Sanderson, B., Southard, D. (2007). American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology. American Heart Association Council on Cardiovascular Nursing. American Heart Association Council on Epidemiology and Prevention. American Heart Association Council on Nutrition, Physical Activity, and Metabolism. American Association of Cardiovascular and Pulmonary Rehabilitation Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 115(20): 2675–2682. doi: 10.1161/CIRCULATIONAHA.106.180945.
Heran, B.S., Chen, J.M., Ebrahim, S., Moxham, T., Oldridge, N., Rees, K., Thompson, D.R., Taylor, R.S. (2011). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst; (7): CD001800. doi: 10.1002/14651858.CD001800.pub2.
Wong, W.P., Feng, J., Pwee, K.H., Lim, J. (2012). A systematic review of economic evaluations of cardiac rehabilitation. BMC Health Serv Res. ;12: 243. doi: 10.1186/1472-6963-12-243.
Taylor, R.S., Sagar, V.A., Davies, E.J., Briscoe, S., Coats, A.J., Dalal, H., Lough, F., Rees, K., Singh, S. (2014). Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev ; (4): CD003331. doi: 10.1002/ 14651858.CD003331.pub4.
Beatty, A.L., Li, S., Thomas, L., Amsterdam, E.A., Alexander, K.P., Whooley, M.A. (2014). Trends in referral to cardiac rehabilitation after myocardial infarction: data from the National Cardiovascular Data Registry 2007 to 2012. J Am Coll Cardiol.;63(23): 2582–2583. doi: 10.1016/j.jacc.2014.03.030.
Suaya, J.A., Shepard, D.S., Normand, S.T., Ades, P.A., Prottas, J., Stason, W.B. (2007). Use of cardiac rehabilitation by medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation;116(15):1653–1662. doi: 10.1161/CIRCULATIONAHA.107.701466.
Schopfer, D.W., Takemoto, S., Allsup, K., Helfrich, C.D., Ho, P.M., Forman, D.E., Whooley, M.A. (2014). Cardiac rehabilitation use among Veterans with ischemic heart disease. JAMA Intern Med.;174(10): 1687–1689. doi: 10.1001/jamainternmed.2014.3441.
Daly, J., Sindone, A.P., Thompson, D.R., Hancock, K., Chang, E., Davidson, P. (2002). Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs.;17(1): 8–17.
Jackson, L., Leclerc, J., Erskine, Y., Linden, W. (2005). Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors. Heart; 91(1): 10–14. doi: 10.1136/hrt.2004.045559.
Burns, K.J., Camaione, D.N., Froman, R.D., Clark, B.A. (1998). Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy. Clin Nurs Res. ;7 (2): 147–63. doi: 10.1177/105477389800700205.
Smith, S.C. J.R., Benjamin, E.J., Bonow, R.O., Braun, L.T., Creager, M.A., Franklin, B.A., Gibbons, R.J., Grundy, S.M., Hiratzka, L.F., Jones, D.W., Lloyd-Jones, D.M., Minissian, M., Mosca, L., Peterson, E.D., Sacco, R.L., Spertus, J., Stein, J.H., Taubert, K.A. (2011). World Heart Federation and the Preventive Cardiovascular Nurses Association 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. Circulation. 124(22): 2458–73. doi: 10.1161/CIR.0b013e318235eb4d.
Taylor, R.S,, Dalal, H., Jolly, K., Moxham, T., Zawada, A. (2010). Jan Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst 20; (1): CD007130. doi: 10.1002/14651858.CD007130.
Steblyuk, V.V., Khomenko, I.P., Lurin, I.A., Savitsky, V.L., Kazmirchuk, A.P., Kuznetsova, S.M., Нalushka, A.M., Shvets, A.V., Kikh, A.Yu., Kornatsky, V.M., Gaida, I.M., Danilkov, R.I., Volyansky, O.M., Horishna, O.V., Ivantsova, G.V. (2020). Development of the system of physical and rehabilitation medicine in the conditions of armed conflict (monograph) / for general. ed. Academician V.I. Tsymbalyuk. Kyiv: Lyudmila Publishing House. 436.
Therapeutic physical culture in diseases of the cardiovascular system. (2014). Guidelines. Uzhhorod National University. Uzhhorod, 62.
Urvantseva, I.A., Mamedova, S.I., Nokhrin, A.V. (2016). Carrying out medical rehabilitation to patients with diseases of the circulatory system after surgical treatment. Surgut, 64 p.
Sudzhaeva, S.G., Sudzhaeva, O.A., Gubich, T.S. (2010). Rehabilitation of patients with cardiological and cardiosurgical profile (cardiac rehabilitation) / National recommendations of the Ministry of Health of the Republic of Belarus. Minsk, 238.
Austin, J., Williams, R., Ross, L., Moseley, L., Hutchison, S. Randomised controlled trial of cardiac rehabilitation in elderly patients with heart-failure. Eur J Heart Fail 2005; 7:411–417.
Military Cardiac Rehabilitation (1992). BMJ Military Health; 138: 63-65.
