This is a prospective, randomized controlled trial to evaluate the effectiveness of a Technology-Enhanced Continuous Nursing System (TECNS) compared to routine care for patients after coronary artery bypass grafting (CABG). The study aims to determine if the TECNS intervention, which includes digital health tools, personalized tele-rehabilitation, and continuous nursing support, can improve clinical outcomes such as postoperative hemoglobin recovery, reduce long-term major adverse cardiac events (MACE), and enhance patients' quality of life and psychological well-being.
Patients undergoing coronary artery bypass grafting (CABG) face significant challenges during the post-discharge recovery period. The transition from hospital to home often creates a "care gap," where insufficient support and follow-up can lead to suboptimal outcomes, including poor medication adherence, increased complication rates, and diminished quality of life. This study was designed to address this gap by implementing and evaluating a Technology-Enhanced Continuous Nursing System (TECNS). Participants were randomized to receive either the comprehensive TECNS intervention for 6 months post-discharge or standard routine care. The TECNS intervention integrated a dedicated smartphone application for education, a WeChat group for peer and professional support, personalized tele-rehabilitation plans delivered by nurses, and coordination with community health centers. The study hypothesized that this proactive, continuous care model would lead to superior physiological recovery, better long-term clinical outcomes, and improved patient-reported outcomes compared to the traditional, fragmented approach to post-discharge care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
358
A multi-faceted behavioral and educational intervention lasting 6 months post-discharge. It utilized a smartphone app, WeChat, tele-monitoring (phone/video calls), and community health partnerships to provide structured education, personalized rehabilitation plans, and continuous professional nursing support.
Standard institutional care including standard discharge instructions and routine outpatient follow-up appointments.
The First Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
Change in Hemoglobin (Hb) Level
Change in blood hemoglobin concentration from baseline to 7 days after surgery, measured by laboratory analysis. This assesses the rate of postoperative hematopoietic recovery.
Time frame: Baseline, Day 7
Major Adverse Cardiac Events (MACE)-Free Survival
The rate of survival free from MACE, defined as a composite of cardiovascular death, non-fatal myocardial infarction, stroke, or unplanned revascularization.
Time frame: Up to 24 months
Change in Red Blood Cell Indices
Change in Mean Corpuscular Volume (MCV), Red Blood Cell Distribution Width (RDW), and Hematocrit (HCT) from baseline.
Time frame: Baseline, Day 7
Change in Quality of Life (QoL)
Change in patient-reported quality of life assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. The scale ranges from 0 to 100. Higher scores indicate better QoL.
Time frame: Baseline, 1 month, 3 months, 6 months
Patient Satisfaction
Patient-reported satisfaction with nursing care, assessed using a study-specific questionnaire. Responses are categorized ('Very Satisfied', 'Satisfied', 'Average', 'Dissatisfied').
Time frame: 1 month
Change in Interleukin-2 (IL-2) Level
Change in serum level of Interleukin-2 (IL-2) from baseline, measured by laboratory analysis.
Time frame: Baseline, Day 7
Change in Interleukin-6 (IL-6) Level
Change in serum level of Interleukin-6 (IL-6) from baseline, measured by laboratory analysis.
Time frame: Baseline, Day 7
Change in high-sensitivity C-reactive protein (hs-CRP) Level
Change in serum level of high-sensitivity C-reactive protein (hs-CRP) from baseline, measured by laboratory analysis.
Time frame: Baseline, Day 7
Change in Anxiety Symptoms
Change in symptoms of anxiety assessed using the Self-Rating Anxiety Scale (SAS). The scale range is 25-100. Lower scores indicate better mental health (less anxiety).
Time frame: Baseline, 1 month, 3 months, 6 months
Change in Depression Symptoms
Change in symptoms of depression assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The scale range is 0-60. Lower scores indicate better mental health (less depression).
Time frame: Baseline, 1 month, 3 months, 6 months
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