title: Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.
abstract: Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated.
  
  
  
  The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery.
  
  
  
  For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach.
  
  
  
  Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P < .001), heart rate recovery (P = .04), and self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P < .001) and self-efficacy (P < .001) were sustained at 1 month after hospital discharge.
  
  
  
  Our inpatient multimedia exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.
authors.affiliation: Li-Wei Wang, MSN, RN Registered Nurse, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan. Shu-Hua Ou, MSN, RN Head Nurse, Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan. Chien-Sung Tsai, MD Professor and Dean, National Defense Medical Center, School of Medicine, and Associate Superintendent, Tri-Service General Hospital, Taipei, Taiwan. Yue-Cune Chang, PhD Professor, Department of Mathematics, Tamkang University, New Taipei City, Taiwan. Chi-Wen Kao, PhD, RN Associate Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Wang
authors.forename: Shu-Hua
authors.initials: SH
authors.lastname: Ou
authors.forename: Chien-Sung
authors.initials: CS
authors.lastname: Tsai
authors.forename: Yue-Cune
authors.initials: YC
authors.lastname: Chang
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Kao
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D013504:Cardiovascular Surgical Procedures / Q000534:rehabilitation*; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006339:Heart Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D020377:Self Efficacy; D016138:Walking