Date of Award

2006-04-01

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN Jane M. Georges, PhD, RN; Linda D. Urden, DNSc, RN, CNA-BC

Keywords

Cardiac disease, functional status, home healthcare, nursing, patients

Abstract

The purpose of this research is to examine the functional status (ADLs and IADLs) in patients with a primary/secondary diagnosis of cardiac disease in the home health setting. The independent variables of dyspnea and service were examined for the effect on discharge functional status while controlling for the effects of age, gender, race, admission functional status, primary and secondary diagnosis. A descriptive correlational, non-experimental study of cardiac patients in an urban home health agency from January 2003 to December 2004 was conducted using data collected through a retrospective chart review. Seventeen areas of OASIS (ADL and IADL) were assessed for changes in function in this study. The null hypothesis that Home Health Care does not effect a change in functional status for cardiac patients was not supported. A paired t-test was conducted for the total admission functional score and the total discharge functional score. The mean difference in the scores was found to be significant with a t score of -11.094 (p = 0.000), thus patient's functional status improved from admission to discharge. In the standard multiple regression, (F (DF=160) = 24.271, p < 0.001, R2= .645) the independent variables significantly predicts the dependent variable. A stepwise multiple regression was conducted next to determine which specific independent variables made meaningful contributions to the overall predictions. The biggest contributions to discharge functional scores was admission functional score, R2 = .64, R2adj = .619, F = 24.271, p < .05. With the addition of dyspnea at admit the R2 increased to .620, R2 change = .019, F = 6.451, p < .05. It is interesting to note that age, gender, ethnicity, diagnosis, or service were not significant for discharge functional status scores.

Document Type

Dissertation: Open Access

Department

Nursing

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