Discharge Training and Telephone Counseling

Overview

The education and counseling role is one of the independent roles of the nurse. In this context, discharge training and telephone counseling given to patients who underwent coronary artery bypass graft surgery increase the ability of patients to cope with and adapt to their self-care. This study was conducted to determine the effect of discharge training and telephone counseling on self-care agency, coping and adaptation process in patients undergoing coronary artery bypass graft surgery. The study has a randomized controlled, experimental design. Both experimental and control groups consisted of 35 individuals (N=70). Patients in the experimental group were given discharge training and telephone counseling service was given for two months. At the end of the process, data collection forms were administered to both groups for the last time. Necessary ethical approvals were taken and consent was taken from the patients. After the discharge training and telephone counseling given to the experimental group, the mean exercise of self-care agency scale score of the patients increased by 13.94; the mean coping and adaptation processing scale increased by 13.6. The mean exercise of self-care agency scale score of the control group increased by 7.86; the mean coping and adaptation processing score increased by 9.14. The effect size occurred for both groups was statistically significant (p\<0.05). Positive results were achieved in the experimental group which received given discharge training and telephone counseling. It is recommended to provide planned discharge training and telephone counseling to patients undergoing coronary artery bypass graft surgery.

Coronary artery bypass graft (CABG) is the process of creating a bridge (grafting) to narrowed or clogged coronary arteries using artery and/or vein grafts. Discharge training has many effects such as pain management, reduction of home care visits, reduction of re-admissions to the hospital, acceleration of the recovery process, improvement of self-care agency, reduction of cost, reduction of anxiety level, enhancement of coping and adaptation, and patient satisfaction. Self-care, coping and adaptation remain important in promoting health. Self-care is defined as the decisions and practices made by individuals, who face health concerns, to cope with these concerns, improve their health, and enhance their adaptation. With these improved decisions and practice skills, patients can protect their health more actively. Besides self-care, coping and adaptation are other important issues in patient follow-up. The concept of coping and adaptation is defined as the cognitive and behavioral efforts of the individual to eliminate the necessities and obligations that occur in the inner and outer world, take them under control, and reduce the tension. These efforts may differ according to variables such as family support and spirituality. Patients who are insufficiently informed and not followed up in the postoperative period experience deficits in self-care and difficulties in coping and adaptation. Today, with the increase in the technology use, patient counseling by telephone can be provided for patient follow-up at home, monitoring drug side effects, counseling, sudden situations, appointment reminder, evaluation of the effectiveness of discharge training, determining training needs, performance evaluation, providing communication between hospital and home, increasing participation in training, improving self-care, increasing quality of life, ensuring coping and adaptation. Postoperative care outcomes and the patient's medical condition can be improved by ensuring continuity in telephone counseling. Postoperative mobile health applications are important in terms of evaluating changes, that may occur in the home environment, on time. Today, the rapid development of medicine and technology and the development of products that facilitate monitoring patients can help individuals who have undergone CABG surgery through telephone counseling and patient training. Training and telephone counseling services may reduce the number of hospital admissions, increase self-care agency, improve the quality of life, and enhance coping and adaptation.