The Effect of Different Training Methods On Discharge

Coronary Artery Bypass Graft Clinical Trial

Official title:

Effect of Different Discharge Training Methods On Readiness and Self-Efficacy for Discharge After Coronary Artery Bypass Surgery: A Randomized Uncontrolled Clinical Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05737901
• Other study ID #: AdnanU
• Status: Completed
• Phase: N/A
• Start date: August 15, 2019
• Est. completion date: March 1, 2022

Study information

• Verified date: July 2023
• Source: Aydin Adnan Menderes University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study was conducted to examine the effects of different discharge training methods on readiness to discharge and self-efficacy in individuals undergoing coronary artery bypass graft surgery.

Description:

With the shortening of the length of hospital stay after coronary artery bypass graft (CABG) surgery, patients can be discharged by taking on complex responsibilities before the healing process is completed and before their perception of self-efficacy increases. Today, in the discharge training traditionally given with oral or written materials after surgery, the subjects that are generally considered important are selected, which may lead to not addressing the specific needs of individuals. In addition, inconsistencies may occur due to the trainer, too much written information that is beyond the knowledge level of the patients, frequent forgetting or incorrect remembering of the information given, and the incompatibility between the time planned by the nurse for the training and the time the patient feels ready. In one study, it was reported that 55.3% of the nurses did not provide patient education, education was in the seventh place in their daily work routines, and the reasons for not training the patients were their excessive workload and inability to use time effectively. For this reason, traditional patient education methods have begun to be replaced by technological methods. Mobile applications create opportunities for patients to participate in their own care during their hospital stay in the remaining time spent on examinations and treatments. It has been reported that video interventions are extremely effective, especially in populations with low literacy rates, and longer-term information transfer can be achieved by leaving tablets used for educational purposes in the patient room.

CABG surgery is most needed during middle and advanced ages. However, it is generally known that elderly individuals are mostly not familiar with recent mobile technologies. In Turkey, no research has been found on whether this patient group is suitable for using mobile technologies, the effectiveness of tablets in providing information to inpatients, the extent to which patients are interested and engaged with the application, the effectiveness of the application to bring the patient to a readiness state for discharge, the effect of the application on the perception of self-efficacy, and how it affects the state of satisfaction. Some authors also state that well-designed and reported studies are needed to demonstrate the effectiveness of mobile phone or tablet-based applications in the management of CAD (Coronary Artery Disease).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 72
• Est. completion date: March 1, 2022
• Est. primary completion date: October 3, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Being literate

• Understanding and speaking the Turkish language

• Having undergone a planned open-heart surgery for the first time.

Exclusion Criteria:

• Patients who received psychiatric diagnosis

• Who were unable to use the tablet and mobile application after explanations

• Who had postoperative hospitalization for more than 10 days

• Who had a development of disorientation in the postoperative service

• Who had a valve surgery added to their CABG surgery during the operation were excluded from the research.

Related Conditions & MeSH terms

• Coronary Artery Bypass Graft

Intervention

Other:
• Education Booklet
Training titles and contents were created by listing the most common complications and needs of patients after CABG surgery. In the "General Information" section of the booklet, the definition of CAD, how CABG surgery is performed, the length of hospital stay, and what can be experienced in the hospital after surgery and in the home environment after discharge were discussed. In the "Postoperative Self-Care Practices" section, information about the healing process of the breastbone, pain management, medication, respiratory exercises, early nutrition, personal hygiene, protection from coronavirus-19, pulse control, postoperative heart attack, conditions to be reported, compression stockings use for varicose veins, physical activity, travel, sleep and rest, sexual life, and coping with stress and depression was presented. In the "Postoperative Life" section, training topics on exercise, nutrition, smoking, and alcohol use were included.
• Mobile application
The logo and content of the "Bypass e-Discharge" application was visually designed, and the software was developed. In-app transactions were secured with end-to-end encryption by entering the username and password, and internet access was not required to use the application. The application was presented for expert opinion (3 patients, 1 academician, 2 nurses, 2 physicians) in order to investigate the user experience, and edits were made on its interface (such as adding the "acceleration" feature in videos, an additional button for stopping and starting videos, displaying video total time on the screen, and magnification of all buttons).

Locations

Country	Name	City	State
Turkey	Aydin Adnan Menderes University	Aydin	Merkez

Sponsors (3)

Lead Sponsor	Collaborator
Aydin Adnan Menderes University	Aydin Adnan Menderes University Member Training Program, Aydin Adnan Menderes University Scientific Research Projects Unit

Country where clinical trial is conducted

Turkey, 

References & Publications (4)

Cook DJ, Moradkhani A, Douglas KS, Prinsen SK, Fischer EN, Schroeder DR. Patient education self-management during surgical recovery: combining mobile (iPad) and a content management system. Telemed J E Health. 2014 Apr;20(4):312-7. doi: 10.1089/tmj.2013.0 — View Citation

Greysen SR, Khanna RR, Jacolbia R, Lee HM, Auerbach AD. Tablet computers for hospitalized patients: a pilot study to improve inpatient engagement. J Hosp Med. 2014 Jun;9(6):396-9. doi: 10.1002/jhm.2169. Epub 2014 Feb 13. — View Citation

Noor Hanita Z, Khatijah LA, Kamaruzzaman S, Karuthan C, Raja Mokhtar RA. A pilot study on development and feasibility of the 'MyEducation: CABG application' for patients undergoing coronary artery bypass graft (CABG) surgery. BMC Nurs. 2022 Feb 4;21(1):40 — View Citation

van Steenbergen GJ, van Veghel D, Ter Woorst J, van Lieshout D, Dekker L. IMPROV-ED trial: eHealth programme for faster recovery and reduced healthcare utilisation after CABG. Neth Heart J. 2021 Feb;29(2):80-87. doi: 10.1007/s12471-020-01508-9. Epub 2020 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Barnason Efficacy Expectation Scale (BEES) - Cardiac Surgery Version	The increasing score indicates that the individual's expectation of self-efficacy regarding recovery and behavioral changes is also high.	on the day of discharge after standard care, estimated average 7 days and one month after discharge
Primary	Readiness for Hospital Discharge Scale	The patient with a ready-to-discharge score of 7 and above is considered ready to be discharged, whereas a score below 7 indicates that the patient is not ready.	on the day of discharge after standard care, estimated average 7 days
Secondary	System Usability Scale (SUS)	The increasing score indicates that the usability of the developed system has increased	on the day of discharge after standard care, estimated average 7 days
Secondary	Net Promoter Score	People who respond with a score of 9 or 10 are labeled as 'promoters,' those who receive a score of 7 or 8 are labeled as 'neutrals,' and those who score 6 or less are labeled as 'detractors.'	on the day of discharge after standard care, estimated average 7 days