Tele-Nursing Counseling in Coronary Artery Bypass Graft Surgery

Fenerbahce University72 enrolled

Overview

It was planned as randomized controlled experimental study to examine the effect of post discharge telenursing counseling on symptom control and self-care in patients who undergoing coronary artery bypass graft surgery. The research was carried out between July 2022 and July 2023, Istanbul Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Cardiovascular Surgery (CVS) Clinic. The sample of the study consisted of patients, 36 intervention and 36 control. In the study, ethics committee approval, institutional permissions and written consent were obtained from the patients. Data were collected with the Personel Information Form, Cardiac Surgery Symptom Inventory and Self-Care Strength scale.Cardiac Surgery Symptom Inventory and Self-Care Scale were administered to the control group in the first 24 hours of discharge and in the 3rd week after discharge. The Cardiac Surgery Symptom Inventory and Self-Care Scale were evaluated in the intervention group by applying a telephone call protocol in the first 24 hours, first week, second week and third week of discharge.Data were evaluated with Kolmogorov-Smirnov test, ANAOVA (variance) test, Tukey test, Chi-Square tests, Pearson correlation test and Cronbach alpha reliability coefficients using SPPS software version 26 (IBM Corp, Armonk, NY,USA). All analyzes were performed with a 95% confidence interval.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Coronary Artery Bypass Surgery

Interventions

THE EFFECT OF TELENURSING COUNSELING ON SYMPTOM CONTROL AND SELF-CARE ABILITY IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT SURGERY.BEHAVIORAL

Complications following coronary artery bypass graft surgery typically occur within the first six weeks. Patients who do not develop complications postoperative period are discharged within an average of 7 days and spend a large part of their recovery at home. Early diagnosis and prevention of complications that may arise after hospital discharge are possible with good monitoring and care.Telephone Counseling Form: The protocol was developed considering the times when patients undergoing open heart surgery experience the most problems and need support after discharge.Telephone Interview Protocol: This system was developed to support interpersonal interaction, problem-solving, and socio-emotional communication, and conceptually divides communication into two main categories.Self-Care Ability Scale:This scale,designed to determine individuals' ability and capacity to care for themselves.Cardiac Surgery Symptom Inventory (CSSI): The original inventory consists of 5 sub-dimensions.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Being the first patient to undergo open heart surgery, * Not having undergone any other surgical procedures during heart surgery, * Being able to read and write Turkish, * Being able to communicate by telephone, * Volunteering to participate in the research. Exclusion Criteria: * Having hearing, comprehension, vision, and speech problems; * Having neurological diseases such as dementia or Alzheimer's; * Developing complications after discharge and deciding on a second surgical intervention; * Not having a phone and not being able to communicate regularly.

Outcomes

Primary Outcomes

Patients in the experimental group who received post-discharge telenursing counseling after coronary artery bypass graft surgery reported fewer symptoms compared to the control group.

The symptoms experienced by the experimental group were recorded according to the Cardiac Surgery Symptom Inventory through telephone interviews conducted over a period of 4 weeks. Cardiac Surgery Symptom Inventory (CSSI): The original inventory contains 76 items and consists of 5 sub-dimensions: general, cardiac, trunk, lower and upper extremity symptoms. The scale is unidimensional and consists of 35 items. The inventory is Likert-type, and symptoms are rated on a scale of 0-4 as "None", "Very Little", "Moderate", "Much", "Quite a lot". Following the counseling sessions, inventory scores were calculated based on patient statements and compared with a control group.

Time frame: Three weeks

Patients in the experimental group who received telenursing counseling after discharge from coronary artery bypass graft surgery had higher self-care abilities compared to the control group.

After receiving telephone-based counseling training, patients in the study group were assessed weekly for their self-care abilities for four weeks. Self-Care Ability Scale was used to assign scores based on patients' statements. Self-Care Ability Scale: This scale, designed to determine individuals' ability and capacity to care for themselves, consists of 35 items. The scale focuses on individuals' self-assessment of their engagement in self-care activities. Each item is scored from 0 to 4. Individuals' orientation towards self-care is determined by participants' responses on a 5-point Likert-type scale. The response "Does not describe me at all" receives 0 points, while the others receive 1 point each: "Does not describe me much," 2 points each: "No opinion," 3 points each: "Describes me somewhat," and 4 points each: "Describes me very much."