Cardiac Surgical Procedures (Postoperative Population), Clinical Outcomes, Frail Patient, Patient-centered Care
Conditions
Brief summary
This study is a randomized controlled trial aiming to compare targeted individualized nursing care with standard care in frail elderly patients undergoing cardiac surgery. The hypotheses of the study are: H1: Targeted individualized nursing care has an effect on the frailty level of frail elderly patients undergoing cardiac surgery. H2: Targeted individualized nursing care affects the factors influencing frailty in frail elderly patients undergoing cardiac surgery.
Interventions
OTHERExperimental
Targeted Individualized Nursing Care
Sponsors
SELDA MERT
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Investigator)
Intervention model description
Targeted Individualized Nursing Care Group (Intervention Group) Standard Care Group (Control Group)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged 65 years and older * Scheduled for elective surgery * Edmonton Frail Scale score ≥ 7 * Able to speak Turkish and communicate effectively * Can be transferred from the postoperative intensive care unit to the ward * Patients who agree to participate in the study
Exclusion criteria
* Patients with neurological or psychological disorders * Patients who cannot be transferred from the postoperative intensive care unit to the ward * Emergency and unplanned cases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive Function - Standardized Mini-Mental State Examination (MMSE) | Postoperative day 1 and the day of discharge | Cognitive status will be assessed using the Standardized Mini-Mental State Examination (MMSE). The MMSE evaluates orientation, memory, attention, recall, language, and visuospatial skills. The total score ranges from 0 to 30, with higher scores indicating better cognitive function. Scores of 23 or below are generally considered indicative of cognitive impairment. |
| Cognitive Function - Delirium Risk - Nursing Delirium Screening Scale (Nu-DESC) | Postoperative day 1 and the day of discharge | Delirium risk will be evaluated using the Nursing Delirium Screening Scale (Nu-DESC). The scale assesses five domains: disorientation, inappropriate behavior, inappropriate communication, hallucinations, and psychomotor retardation. Each symptom is scored per shift as follows: 0 points: Symptom absent, 1 point: Symptom present/mild, 2 points: Symptom present and pronounced/severe A total score of 2 points or higher is considered indicative of delirium. |
| Physical Status Assessment - Pain Level - Numeric Rating Scale (NRS) | Postoperative day 1 and the day of discharge | Pain Level - Numeric Rating Scale (NRS): Pain intensity will be assessed using the Numeric Rating Scale (NRS). Patients rate their pain from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. |
| Physical Status Assessment - Katz Activities of Daily Living (ADL) Scale | Postoperative day 1 and the day of discharge | Katz Activities of Daily Living (ADL) Scale: Functional status will be evaluated using the Katz Activities of Daily Living (ADL) Scale, which assesses independence in six activities: bathing, dressing, toileting, transferring, continence, and feeding. Higher scores indicate greater independence in daily activities. Evaluation of the scale is based on the total score obtained from these items: 0-6 points: Dependent, 7-12 points: Partially dependent, 13-18 points: Independent. |
| Physical Status Assessment - Itaki Fall Risk Scale | Postoperative day 1 and the day of discharge | Itaki Fall Risk Scale: The Itaki Fall Risk Scale will be used to evaluate patients' risk of falling. The scale assesses various risk factors related to falls in hospitalized patients. The scale consists of 19 risk factors that may contribute to patient falls. The risk factors are categorized as major and minor, with 1 point assigned for each minor risk factor and 5 points for each major risk factor. Based on the total score obtained from evaluating all risk factors, two risk levels are defined: 0-4 points: Low risk, 5 points and above: High risk. |
| Nutritional Status - Mini Nutritional Assessment Short Form (MNA-SF) | Postoperative day 1 and the day of discharge | Mini Nutritional Assessment Short Form (MNA-SF): Nutritional status will be assessed using the Mini Nutritional Assessment-Short Form (MNA-SF). The total score ranges from 0 to 14, with higher scores indicating better nutritional status. |
| Psychological Status Assessment - Geriatric Depression Scale (GDS) | Postoperative day 1 and the day of discharge | Geriatric Depression Scale-15 (Short Form): It is a scale used to screen for depression in older adults. The total score ranges from 0 to 15. Scores of 0-4 indicate no depression, 5-8 indicate mild depression, 9-11 indicate moderate depression, and 12-15 indicate severe depression. |
Countries
Turkey (Türkiye)
Outcome results
None listed