Coronary Heart Disease (CHD)
Conditions
Keywords
Continuous comprehensive nursing system, Coronary artery bypass surgery, Hemoglobin levels, Quality of life, Nursing Efficacy
Brief summary
This study evaluates the effectiveness of a continuous comprehensive nursing (CCN) system compared to routine care for patients after coronary artery bypass graft (CABG) surgery. The primary goal is to determine if the CCN system improves postoperative hemoglobin levels. The study also investigates the effects on quality of life, mental health (anxiety and depression), red blood cell indices, immune markers, and patient satisfaction.
Detailed description
Coronary artery bypass surgery (CABG) is a major procedure, and the postoperative recovery process is complex, often impacting patients' hemoglobin levels and quality of life. Standard nursing care is often limited to the inpatient period. A continuous comprehensive nursing (CCN) system is a holistic, patient-centered model that extends care beyond hospital discharge. This model includes preoperative education, continuous monitoring, personalized care plans, psychological support, rehabilitation guidance, and structured follow-up. While the benefits of comprehensive nursing are recognized, its specific impact on hemoglobin recovery and quality of life after CABG has not been extensively studied. This randomized controlled trial was designed to compare the outcomes of patients receiving a CCN plan with those receiving routine postoperative care to provide evidence for optimizing post-CABG nursing strategies.
Interventions
BEHAVIORALContinuous Comprehensive Nursing System
A multi-faceted nursing plan delivered by trained cardiac nurses, extending from the preoperative phase to 3 months post-discharge. In addition to routine inpatient care, the intervention included: preoperative education and psychological support; postoperative individualized rehabilitation guidance; and a continuous post-discharge program. The post-discharge phase involved structured follow-up (monthly phone calls, one 6-week outpatient visit), ongoing psychological support, reinforcement of education on medication adherence, diet, and activity progression, and guidance on a structured home-based exercise program.
Standard institutional postoperative care for patients after Coronary Artery Bypass Graft (CABG) surgery. This care was primarily focused on the inpatient period and included monitoring of vital signs, wound and drainage tube management, respiratory and circulatory support, and progressive diet guidance. The care concluded with standard discharge instructions and did not include the structured, continuous, or extended follow-up provided to the intervention group.
Sponsors
The First Hospital of Hebei Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 70 years. * Confirmed diagnosis of coronary heart disease and evidence of coronary artery illness requiring CABG. * Ability to understand the purpose and procedures of the study. * Willingness to sign the informed consent form.
Exclusion criteria
* Presence of serious complications such as unstable myocardial ischemia or significant arrhythmia. * Severe lung diseases (e.g., chronic obstructive pulmonary disease GOLD stage III/IV). * Severe kidney diseases (e.g., chronic kidney disease Stage 4/5). * Significantly impaired left ventricular ejection fraction (EF \< 30%). * Concurrent participation in other clinical trials or receiving other interventions. * Presence of severe mental illnesses or cognitive impairments.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hemoglobin (Hb) Levels from Baseline to Day 7 Post-Surgery | Baseline (preoperatively) and Day 7 post-surgery. | The change in hemoglobin concentration (g/L) was measured from the preoperative baseline value to the value at 7 days after the surgery. Venous blood samples were analyzed using an automatic biochemical analyzer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Red Blood Cell Indices | Day 7 post-surgery. | Measurement of Mean Corpuscular Volume (MCV, in fL), Red Blood Cell Distribution Width (RDW, in %), and Hematocrit (HCT, in %). |
| Levels of Immune-Related Inflammatory Markers | Day 7 post-surgery. | Levels of Interleukin-2 (IL-2, in pg/mL) and Interleukin-6 (IL-6, in pg/mL) in peripheral blood, quantified using an ELISA kit. |
| Quality of Life (QoL) | Day 14 post-surgery. | Assessed using the World Health Organization Quality of Life BREF (WHOQOL-BREF) scale. This scale evaluates four domains: physical health, psychological health, social relationships, and environment. Higher scores indicate better quality of life. |
| Change in Hemoglobin (Hb) Levels at Other Time Points | Baseline, 12 hours, 72 hours, and 14 days post-surgery. | Hemoglobin concentration (g/L) measured at multiple time points to assess the recovery trajectory. |
| Anxiety Symptoms | Day 14 post-surgery. | Assessed using the Self-Rating Anxiety Scale (SAS). The scale ranges from 20 to 80, with higher scores reflecting more severe anxiety symptoms. |
| Patient Satisfaction | Up to 14 days post-surgery (at time of hospital discharge). | Assessed using a study-specific satisfaction questionnaire. Responses were categorized as very satisfied, satisfied, average, or dissatisfied based on a scoring system from 1-100. |
| Depressive Symptoms | Day 14 post-surgery. | Assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The scale ranges from 0 to 60, with higher scores indicating more severe depressive symptoms. |
Countries
China
Outcome results
None listed