Application of an Early Graded Rehabilitation Nursing Model in Postoperative Children with Congenital Heart Disease.

Abstract

Background: The current focus of cardiac rehabilitation is on adults, with no standard nursing plan available for children with congenital heart disease. Therefore, it is very necessary to develop a standardized early rehabilitation nursing model for children with congenital heart disease to promote the recovery of bodily functions and improve quality of life in this population.

Purpose: This study was designed to explore the feasibility of an early graded rehabilitation nursing model for postoperative children with congenital heart disease and evaluate its clinical effect to promote the standardization of postoperative rehabilitation nursing care.

Methods: One hundred and sixteen postoperative children with congenital heart disease treated at a medical university hospital between August 2022 and January 2023 enrolled as participants in this study, with 58 assigned to the control (routine rehabilitation nursing) group and 58 assigned to the intervention (graded rehabilitation nursing) group. The outcome indicators of the two groups were assessed at the time the participants transferred out of the pediatric intensive care unit (PICU) and at discharge, and then analyzed and compared. The Strengthening the Reporting of Observational Studies in Epidemiology Checklist (case-control studies) was used in this study.

Results: No statistical differences were found between the two groups at baseline. After implementation of the model, more intervention group participants succeeded in achieving difficult target functions when they were transferred out of the PICU and at discharge. At discharge, intervention group participants aged 3 months to 3 years showed higher gross motor quotient (95.36 ± 7.46 vs. 86.77 ± 12.34), fine motor quotient (94.79 ± 4.59 vs. 88.73 ± 14.04), and total motor quotient (95.57 ± 5.49 vs. 86.27 ± 13.08) than their peers in the control group. Also, the average 6-minute walk test (6MWT) duration for intervention group participants older than 3 years was longer than that for their control group peers. Furthermore, average total hospital stay (16.60 ± 5.14 vs. 20.69 ± 12.95 days) and PICU residence time (122.48 ± 46.00 vs. 133.66 ± 66.70 hours) were shorter in the intervention group than the control group. No adverse events occurred during the study period.

Conclusions/implications for practice: The early graded rehabilitation nursing model is safe and feasible. This model can help children achieve more difficult target functions, significantly improve their motor development ability, and shorten their hospital stay. Also, the model can help guide medical staff implement rehabilitation nursing in clinical settings.