Educational Intervention for Patients Undergoing Cardiac Surgery

Anna Farrús Torrella263 enrolled

Overview

Cardiovascular surgery is associated with high levels of anxiety, uncertainty, and postoperative complications. Educational interventions led by nurses may improve patients' psychological adaptation, self-care abilities, and recovery outcomes. This randomized controlled trial aims to evaluate the effectiveness of a nurse-led educational program designed to prepare and support patients undergoing cardiovascular surgery. Participants are randomly assigned to either an intervention group receiving a structured perioperative educational program or a control group receiving usual care. The primary outcome is anxiety. Secondary outcomes include posoperative complications, patient satisfaction, pain intensity, length of ICU Stay, length of Hospital Stay, Body Mass Index, blood pressure, fasting blood glucose, Glycated Hemoglobin (HbA1c) and total Cholesterol. Participants are followed for six months after surgery.

Patients undergoing cardiovascular surgery frequently experience anxiety and uncertainty before surgery and during postoperative recovery. Adequate preparation and follow-up may improve psychological well-being, promote self-care, and facilitate recovery. This single-center randomized controlled trial evaluates a nurse-led educational intervention for patients undergoing elective cardiovascular surgery at Hospital Clínic de Barcelona. The intervention includes structured education and follow-up throughout the perioperative period, focusing on preparation for surgery, postoperative recovery, self-care, symptom management, and lifestyle recommendations. Participants are randomly allocated to either the intervention group or the usual care group. Outcomes are assessed at baseline, during hospitalization, and during follow-up up to six months after surgery. The primary outcome is anxiety measured using validated assessment instruments. Secondary outcomes include self-efficacy, self-care capacity, health-related quality of life, postoperative complications, hospital readmissions, healthcare utilization, and patient satisfaction. The study aims to determine whether a structured nurse-led educational program improves psychological, behavioral, and clinical outcomes in patients undergoing cardiovascular surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

Interventions

Nurse-Led Educational ProgramBEHAVIORAL

A structured nurse-led educational program delivered throughout the perioperative period for patients undergoing cardiovascular surgery. The intervention included preoperative education, preparation for surgery, postoperative recovery guidance, self-care education, symptom management, lifestyle recommendations, and follow-up support after hospital discharge. The program aimed to reduce anxiety and improve self-efficacy, self-care, and recovery outcomes.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged 18 years or older. * Patients undergoing first-time cardiac surgery. * Ability to understand and communicate in Spanish or Catalan. * Provision of written informed consent. Exclusion Criteria: * Refusal or inability to provide informed consent. * Previous cardiovascular surgery. * Transcatheter aortic valve implantation (TAVI) or other percutaneous procedures. * Cardiogenic shock before surgery requiring sedation and endotracheal intubation. * Psychiatric disorders requiring treatment, including anxiety disorders, depression, alcoholism, dementia, psychosis, schizophrenia, amnesia, or personality disorders. * Severe chronic diseases, including cirrhosis, hepatitis B or C, HIV/AIDS, Parkinson's disease, severe autoimmune disorders, blindness, or severe hearing impairment. * Intensive care unit stay longer than 15 days after surgery. * Death during hospitalization, including perioperative mortality.

Outcomes

Primary Outcomes

Anxiety

Anxiety assessed using the Hospital Anxiety and Depression Scale (HADS). Total HADS scores range from 0 to 42, with higher scores indicating greater emotional distress.

Time frame: Baseline through 6 months after surgery

Secondary Outcomes

Postoperative Complications

Number and type of postoperative complications during hospitalization and within 6 months after cardiovascular surgery, including atrial fibrillation, hypotension, hypertension, acute kidney injury, acute respiratory distress syndrome, surgical wound infection, delirium, and hospital readmission.

Time frame: From surgery until 6 months post-surgery

Pain Intensity

Pain assessed using the Numeric Rating Scale (NRS/EVN) during hospitalization and follow-up. Scores range from 0 (no pain) to 10 (worst imaginable pain), with higher scores indicating greater pain intensity.

Time frame: Hospitalization through 6 months post-surgery

Patient Satisfaction

Patient satisfaction with perioperative education, preparation, support, and follow-up measured using a study-specific questionnaire. Scores range from 0 to 40, with higher scores indicating greater satisfaction.

Time frame: 6 months post-surgery

Length of ICU Stay

Number of days spent in the intensive care unit after cardiovascular surgery. From ICU admission after surgery until ICU discharge, during the index hospitalization.

Time frame: From ICU admission after surgery until ICU discharge during the index hospitalization (up to 15 days after surgery).

Length of Hospital Stay

Total number of days hospitalized following cardiovascular surgery. From hospital admission (previous day of surgery) until hospital discharge.

Time frame: From hospital admission until hospital discharge (up to 30 days after surgery)

Body Mass Index

Change in body mass index measured before surgery and at follow-up.