Teach-Back-Based Incentive Spirometry Training

Aydin Adnan Menderes University60 enrolled

Overview

Patients undergoing cardiac surgery may experience difficulty performing breathing exercises after surgery, which can increase the risk of respiratory complications. Incentive spirometry is a breathing exercise technique commonly used to support lung function; however, patients may not always perform this exercise correctly or frequently enough. This study aims to evaluate the effect of a structured incentive spirometry education program based on the teach-back method on patients' ability to perform the exercise correctly and their frequency of use after cardiac surgery. This randomized controlled study will include 60 patients admitted for elective cardiac surgery at a university hospital in Türkiye. Participants will be randomly assigned to either a routine care group or an intervention group. Patients in the intervention group will receive structured incentive spirometry education using the teach-back method in addition to routine care, while the control group will receive routine care only. The ability to perform incentive spirometry correctly and the frequency of exercise use will be evaluated. The findings of this study may provide information about effective education strategies to improve postoperative breathing exercise practices in cardiac surgery patients.

Cardiac surgery is associated with a risk of postoperative pulmonary complications due to factors such as anesthesia, surgical procedures, pain, and reduced respiratory function. Incentive spirometry is a commonly used breathing exercise technique to promote lung expansion and improve respiratory function after surgery. However, the effectiveness of incentive spirometry depends on patients' ability to perform the technique correctly and maintain regular practice. The teach-back method is an educational approach in which patients are asked to explain or demonstrate the information they have received to confirm their understanding. This method may improve patients' knowledge, confidence, and self-management skills. This study is designed to evaluate whether a structured incentive spirometry training program based on the teach-back method improves the correct performance and frequency of incentive spirometry use among patients undergoing cardiac surgery. The findings may contribute to the development of effective patient education strategies for improving postoperative respiratory care.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Interventions

routine careOTHER

Participants will receive routine care without additional structured incentive spirometry education based on the teach-back method.

Structured Teach-Back-Based Incentive Spirometry TrainingBEHAVIORAL

A structured teach-back-based incentive spirometry training program will be provided to patients undergoing cardiac surgery. The education aims to improve patients' ability to perform incentive spirometry correctly and increase the frequency of incentive spirometry use after surgery.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged 18 years and older. * Scheduled to undergo first-time elective open-heart surgery. * Hospitalized for at least 24 hours before surgery. * Able to read and understand Turkish. * Standardized Mini-Mental State Examination (SMMSE) score ≥24. Exclusion Criteria: * Chronic respiratory disease. * Visual impairment that could interfere with incentive spirometry use. * Hearing impairment that could interfere with education or assessment. * Remaining in the intensive care unit on postoperative Days 4 and 5. * Postoperative disorientation during the ward stay. * No use of the incentive spirometer during the postoperative period. * Withdrawal of consent or unwillingness to continue participation after enrollment.

Outcomes

Primary Outcomes

Correct Incentive Spirometry Performance

Correct incentive spirometry performance will be evaluated using an 11-item Incentive Spirometry Performance Checklist. Each item is scored on a 3-point scale (1 = not performed, 2 = partially performed, 3 = correctly performed), with total scores ranging from 11 to 33. Higher scores indicate better performance.

Time frame: Before the training intervention, immediately after the training intervention, and on postoperative Day 4.

Frequency of Incentive Spirometry Use

Incentive spirometry use frequency will be assessed by recording the number of incentive spirometry exercises performed per hour during the postoperative period. The average number of incentive spirometry uses per recorded hour will be calculated.

Time frame: Postoperative Days 4-5

Secondary Outcomes

Daily Inspiratory Performance

Daily inspiratory performance will be assessed by the maximum number of balls elevated simultaneously during incentive spirometry use.

Time frame: Postoperative Days 4 and 5.

Reasons for Not Performing Incentive Spirometry Exercises

Reasons for not performing incentive spirometry exercises will be recorded using patient self-reports during the postoperative period. Reported reasons (e.g., pain, fatigue, sleep, forgetfulness, or other factors) will be documented and analyzed descriptively.

Time frame: Postoperative Days 4 and 5