title: Influence of a symptom management telehealth intervention on older adults' early recovery outcomes after coronary artery bypass surgery.
abstract: OBJECTIVE
  The study objective was to examine the effect of a symptom management (SM) telehealth intervention on physical activity and functioning and to describe the health care use of older adult patients (aged > 65 years) after coronary artery bypass surgery (CABS) by group (SM intervention group and usual care group).
  
  
  METHODS
  A randomized clinical trial design was used. The study was conducted in 4 Midwestern tertiary hospitals. The 6-week SM telehealth intervention was delivered by the Health Buddy (Health Hero Network, Palo Alto, CA). Measures included Modified 7-Day Activity Interview, RT3 accelerometer (Stayhealthy, Inc, Monrovia, CA), physical activity and exercise diary, Medical Outcomes Study Short-Form 36, and subjects' self-report and provider records of health care use. Follow-up times were 3 and 6 weeks and 3 and 6 months after CABS.
  
  
  RESULTS
  Subjects (N = 232) had a mean age of 71.2 (+4.7) years. There were no significant interactions using repeated-measures analyses of covariance. There was a significant group effect for average kilocalories/kilogram/day of estimated energy expenditure as measured by the RT3 accelerometer, with the usual care group having a higher estimated energy expenditure. Both groups had significant improvements over time for role-physical, vitality, and mental functioning. Both groups had similar health care use.
  
  
  CONCLUSIONS
  Subjects were able to return to preoperative levels of functioning between 3 and 6 months after CABS and to increase their physical activity over reported preoperative levels of activity. Further study of those patients undergoing CABS who could derive the most benefit from the SM intervention is warranted.
authors.affiliation: University of Nebraska Medical Center, Lincoln, 68588-0220, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Barnason
authors.forename: Lani
authors.initials: L
authors.lastname: Zimmerman
authors.forename: Janet
authors.initials: J
authors.lastname: Nieveen
authors.forename: Paula
authors.initials: P
authors.lastname: Schulz
authors.forename: Connie
authors.initials: C
authors.lastname: Miller
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.forename: Chunhao
authors.initials: C
authors.lastname: Tu
mesh_terms: D000054:Acceleration; D000368:Aged; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D004734:Energy Metabolism; D005081:Exercise Therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009043:Motor Activity; D011594:Psychometrics; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D017216:Telemedicine; D013997:Time Factors; D016896:Treatment Outcome