Coronary Artery Bypass Graft, Discharge Education
Conditions
Keywords
mobile applications, education, self efficacy, discharge readiness, coronary artery bypass, nursing
Brief summary
This study was conducted to examine the effects of different discharge training methods on readiness to discharge and self-efficacy in individuals undergoing coronary artery bypass graft surgery.
Detailed description
With the shortening of the length of hospital stay after coronary artery bypass graft (CABG) surgery, patients can be discharged by taking on complex responsibilities before the healing process is completed and before their perception of self-efficacy increases. Today, in the discharge training traditionally given with oral or written materials after surgery, the subjects that are generally considered important are selected, which may lead to not addressing the specific needs of individuals. In addition, inconsistencies may occur due to the trainer, too much written information that is beyond the knowledge level of the patients, frequent forgetting or incorrect remembering of the information given, and the incompatibility between the time planned by the nurse for the training and the time the patient feels ready. In one study, it was reported that 55.3% of the nurses did not provide patient education, education was in the seventh place in their daily work routines, and the reasons for not training the patients were their excessive workload and inability to use time effectively. For this reason, traditional patient education methods have begun to be replaced by technological methods. Mobile applications create opportunities for patients to participate in their own care during their hospital stay in the remaining time spent on examinations and treatments. It has been reported that video interventions are extremely effective, especially in populations with low literacy rates, and longer-term information transfer can be achieved by leaving tablets used for educational purposes in the patient room. CABG surgery is most needed during middle and advanced ages. However, it is generally known that elderly individuals are mostly not familiar with recent mobile technologies. In Turkey, no research has been found on whether this patient group is suitable for using mobile technologies, the effectiveness of tablets in providing information to inpatients, the extent to which patients are interested and engaged with the application, the effectiveness of the application to bring the patient to a readiness state for discharge, the effect of the application on the perception of self-efficacy, and how it affects the state of satisfaction. Some authors also state that well-designed and reported studies are needed to demonstrate the effectiveness of mobile phone or tablet-based applications in the management of CAD (Coronary Artery Disease).
Interventions
OTHEREducation Booklet
Training titles and contents were created by listing the most common complications and needs of patients after CABG surgery. In the General Information section of the booklet, the definition of CAD, how CABG surgery is performed, the length of hospital stay, and what can be experienced in the hospital after surgery and in the home environment after discharge were discussed. In the Postoperative Self-Care Practices section, information about the healing process of the breastbone, pain management, medication, respiratory exercises, early nutrition, personal hygiene, protection from coronavirus-19, pulse control, postoperative heart attack, conditions to be reported, compression stockings use for varicose veins, physical activity, travel, sleep and rest, sexual life, and coping with stress and depression was presented. In the Postoperative Life section, training topics on exercise, nutrition, smoking, and alcohol use were included.
OTHERMobile application
The logo and content of the Bypass e-Discharge application was visually designed, and the software was developed. In-app transactions were secured with end-to-end encryption by entering the username and password, and internet access was not required to use the application. The application was presented for expert opinion (3 patients, 1 academician, 2 nurses, 2 physicians) in order to investigate the user experience, and edits were made on its interface (such as adding the acceleration feature in videos, an additional button for stopping and starting videos, displaying video total time on the screen, and magnification of all buttons).
Sponsors
Aydin Adnan Menderes University Member Training Program
Aydın Adnan Menderes University Scientific Research Projects Unit
Aydin Adnan Menderes University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
The study was carried out quasi-experimentally.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Being literate * Understanding and speaking the Turkish language * Having undergone a planned open-heart surgery for the first time.
Exclusion criteria
* Patients who received psychiatric diagnosis * Who were unable to use the tablet and mobile application after explanations * Who had postoperative hospitalization for more than 10 days * Who had a development of disorientation in the postoperative service * Who had a valve surgery added to their CABG surgery during the operation were excluded from the research.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Barnason Efficacy Expectation Scale (BEES) - Cardiac Surgery Version | on the day of discharge after standard care, estimated average 7 days and one month after discharge | The increasing score indicates that the individual's expectation of self-efficacy regarding recovery and behavioral changes is also high. |
| Readiness for Hospital Discharge Scale | on the day of discharge after standard care, estimated average 7 days | The patient with a ready-to-discharge score of 7 and above is considered ready to be discharged, whereas a score below 7 indicates that the patient is not ready. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| System Usability Scale (SUS) | on the day of discharge after standard care, estimated average 7 days | The increasing score indicates that the usability of the developed system has increased |
| Net Promoter Score | on the day of discharge after standard care, estimated average 7 days | People who respond with a score of 9 or 10 are labeled as 'promoters,' those who receive a score of 7 or 8 are labeled as 'neutrals,' and those who score 6 or less are labeled as 'detractors.' |
Countries
Turkey (Türkiye)
Outcome results
None listed