A Study to Assess the Effectiveness of Nurse Assisted Milieu Activities on Activity Tolerance among Patients with Congestive Cardiac Failure at Sri Ramachandra Medical Centre

Abstract

The present study was to assess the effectiveness of nurse assisted milieu activities on activity tolerance among the patients with congestive cardiac failure at Sri Ramachandra Medical Centre with the following objectives as under:
1. Assess the activity tolerance of patients with congestive cardiac failure.
2. Assess the effectiveness of nurse assisted milieu activities on activity tolerance among patients with congestive cardiac failure.
3. Associate the background variables of patients with congestive cardiac failure with activity tolerance.
An extended review of literature and research studies were done through primary and secondary sources which enabled the investigator to collect further ideas to support the selected problem, to design the methodology, formulates the conceptual frame work and to design the tool. The conceptual framework was developed based on Widenbach’s helping art of Clinical Nursing Theory (1976), which provided a framework to determine the effectiveness of nurse assisted milieu activities on activity tolerance among patients with congestive cardiac failure at Sri Ramachandra Medical Centre, Porur, Chennai. The research design used in the study was true experimental design. The main study was conducted for a period of four weeks. A sample size of 40 patients, who fulfilled the inclusion criteria were selected. They were randomly assigned and allotted to the control and study groups respectively. The investigator assessed the activity intolerance of patients by using Katz activities of daily living scale on the day of admission for both the group as a pre-test and implemented the nurse assisted milieu activities for the study group prepared by the investigator to improve the activity tolerance for three days. On the fourth day investigator assessed the patients activity tolerance by using Katz Activities of Daily Living (ADL) scale for both group as a post-test to find out the changes in activities of daily living after implementing the nurse assisted milieu activities.
Analysis of the findings revealed that the planned milieu activities can improve the activity tolerance of patients with congestive cardiac failure. Descriptive statistics and inferential statistics (mean, standard deviation, independent’s’ test and chi-square) were used to analyse the data and to test the study hypothesis. Findings showed a statistical significance at P<0.001. The major findings of the study were:
1. Majority of the patients were male in the age group >40 years, with school education and self-employed.
2. In the study group, during the post-test 90% of the patients were mildly dependent and in the control group 35% of the patients were mildly dependent and 10% of patients were moderately dependent in the study group and 65% patients were moderately dependent in the control group.
3. There is a significant increase in the activity tolerance among patients with congestive cardiac failure which was proved statically at the level of P<0.001.
4. There was no significant association between the nurses assisted milieu activities and the socio demographic variables.
Keywords: nurse assisted milieu activities, activity tolerance, congestive cardiac failure, systolic dysfunction, diastolic dysfunction