Abstract 4066: Response to Symptom Management Intervention among Functionally Impaired Older Adults Following Coronary Artery Bypass Surgery (CABS)

Abstract

Older adults with poor functioning preoperatively are at risk for delayed recovery following CABS. The purpose of this study was to determine if a symptom management (SM) telehealth intervention was effective in improving early recovery outcomes (physical activity, physiological and psychological functioning) for older adults with impaired functioning prior to CABS. A descriptive, repeated measures design was used in this subanalysis of a larger RCT. Subjects in the parent study (N=232), who met the preoperative impaired functioning criteria [physical component score of Medical Outcomes Study Short-form 36 (MOS SF-36) <50 and a RISKO score of ≥ 6], were included in either the SM intervention group (n=23) or the usual care group (n=31). Methods : Physical activity was measured at baseline using the Modified 7-Day Activity Interview; and at follow-up times by the RT3® accelerometer and an Activity Diary. Physiological and psychosocial functioning was measured by the MOS SF-36. Data was gathered prior to hospital discharge, at 3- and 6-weeks and 3-months after hospital discharge. Findings : Subjects ranged in age from 65– 85 years, with a mean of 71.6 (± 5.1) years. Analysis of covariance with repeated measures was used on physical activity and functioning measures, with preoperative levels used as covariates. There were significant group by time effects, with the SM intervention group as compared to the usual care group having higher levels of physical activity over time for: average daily activity counts [F (3,37)=3.55, p<.05]; levels of estimated energy expenditure (average kcal/kg/day expended) as measured by both the RT3® [F (3,37)=2.89, p<.05] and Activity Diary [F (3,42)=3.01, p<.05]; and average minutes/day in moderate or higher levels of activity [F (3,42)=3.18, p<.05]. Both groups had significantly (p<.05) increased role-physical, mental and social functioning over time. Conclusions : Study findings demonstrated the responsiveness of a subgroup of CABS subjects with impaired preoperative functioning to a SM intervention for older adults. Subjects’ improvements in physical activity functioning can help to decrease their risk for morbidity and mortality that can be associated with poor functioning after cardiac events.