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Abstract

Post-coronary artery bypass graft (CABG) patients often experience decreased cardiac output, which slows recovery and increases the risk of cardiovascular complications. This research and development study evaluated the preliminary effectiveness of the REHCARDICARE application in increasing cardiac output, a key indicator of successful cardiac rehabilitation. The research also assessed user satisfaction to determine the feasibility of broader implementation. The findings can inform further development of the application. The application development used the (Analysis, Design, Development, Implementation, Evaluation) ADDIE model. The study subjects consisted of 30 post-CABG patients purposively selected at the North Sumatra Integrated Heart Center. An application-based resistance and flexibility training intervention was implemented for eight weeks. Data collection and analysis took place two weeks after the intervention was completed. Using a single-group pretest–posttest design, transthoracic Doppler echocardiography was used to measure cardiac output before and after the intervention. Data analysis involved a paired t-test with a significance level of p < 0.05. Cardiac output significantly increased from 4.12 ± 0.55 L/min to 5.28 ± 0.62 L/min (p = 0.001). The feasibility evaluation showed high user satisfaction (87.5 ± 6.8), indicating that REHCARDICARE was perceived as useful and easy to use, with good patient adherence and no significant safety events. Overall, REHCARDICARE demonstrated improved cardiac output after eight weeks and good user acceptance as a digital cardiac rehabilitation tool for post-CABG patients. It is recommended that this application be structurally integrated into the hospital’s cardiac rehabilitation program, that remote monitoring features be developed for clinical use, and that further tests be conducted using an experimental design with a control group and a larger sample to strengthen the evidence of clinical effectiveness.

Bahasa Abstract

REHCARDICARE: Platform Telerehabilitasi Digital untuk Pemulihan Jantung Setelah Operasi Bypass Arteri Koroner. Pasien pasca operasi bypass arteri koroner (CABG) sering mengalami penurunan curah jantung, yang memperlambat pemulihan dan meningkatkan risiko komplikasi kardiovaskular. Studi penelitian dan pengembangan ini mengevaluasi efektivitas awal aplikasi REHCARDICARE dalam meningkatkan curah jantung sebagai indikator kunci keberhasilan rehabilitasi jantung. Studi ini juga menilai kepuasan pengguna untuk menentukan kelayakan implementasi yang lebih luas. Temuan ini dapat menjadi dasar pengembangan aplikasi lebih lanjut. Pengembangan aplikasi menggunakan model ADDIE (Analisis, Desain, Pengembangan, Implementasi, Evaluasi). Subjek penelitian adalah 30 pasien pasca CABG yang dipilih secara purposif di Pusat Jantung Terpadu Sumatera Utara. Intervensi pelatihan resistensi dan fleksibilitas berbasis aplikasi diimplementasikan selama delapan minggu. Pengumpulan dan analisis data dilakukan dua minggu setelah intervensi selesai. Penelitian menggunakan desain pretest-posttest kelompok tunggal, ekokardiografi Doppler transtoraks digunakan untuk mengukur curah jantung sebelum dan sesudah intervensi. Analisis data melibatkan uji t berpasangan dengan tingkat signifikansi p < 0,05. Curah jantung meningkat secara signifikan dari 4,12 ± 0,55 L/menit menjadi 5,28 ± 0,62 L/menit (p = 0,001). Evaluasi kelayakan menunjukkan kepuasan pengguna yang tinggi (87,5 ± 6,8), menunjukkan bahwa REHCARDICARE dianggap bermanfaat dan mudah digunakan, dengan kepatuhan pasien yang baik dan tidak ada kejadian keamanan yang signifikan. Secara keseluruhan, REHCARDICARE menunjukkan peningkatan curah jantung setelah delapan minggu dan penerimaan pengguna yang baik sebagai alat rehabilitasi jantung digital untuk pasien pasca CABG. Hasil penelitian merekomendasikan agar aplikasi ini diintegrasikan secara struktural ke dalam program rehabilitasi jantung rumah sakit, fitur pemantauan jarak jauh dikembangkan untuk penggunaan klinis, dan pengujian lebih lanjut dilakukan menggunakan desain eksperimental dengan kelompok kontrol dan ukuran sampel yang lebih besar untuk memperkuat bukti efikasi klinis.

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