The Effect of Different Training Methods On Discharge

July 19, 2023 updated by: Dilara ŞAHAN, Aydin Adnan Menderes University

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

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed 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).

Study Type

Interventional

Enrollment (Actual)

72

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Merkez
      • Aydın, Merkez, Turkey
        • Aydın Adnan Menderes University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Standard care group
The standard discharge training of the clinic was carried out in the patient's room on the day of discharge in an average of 5 minutes, in the form of verbally explaining the information deemed important by the physician and/or nurse to the patient. No intervention was made in this group.
Experimental: Education Booklet Group
Discharge training was given by the researcher the day before the surgery in an average of 60 minutes in the meeting room of the clinic through the booklet.
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.
Experimental: Mobile Application Group
The mobile application was introduced to the patient by the researcher the day before the surgery. During the presentation phase, the patient was informed about the titles and contents of the training videos, and after explaining the technical features related to turning the tablet on and off, raising and lowering the volume, logging into the account using the username and password for training, using the buttons on the main screen and the keyboard, the patient was asked to apply them. All these stages took an average of 20 minutes. In addition, information about logging in, such as how to switch on and off the device, the patient's user name and password, were added to the back of the tablet in writing.
Other: 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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Barnason Efficacy Expectation Scale (BEES) - Cardiac Surgery Version
Time Frame: on the day of discharge after standard care, estimated average 7 days and one month after discharge
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
Readiness for Hospital Discharge Scale
Time Frame: on the day of discharge after standard care, estimated average 7 days
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 Outcome Measures

Outcome Measure
Measure Description
Time Frame
System Usability Scale (SUS)
Time Frame: on the day of discharge after standard care, estimated average 7 days
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
Net Promoter Score
Time Frame: on the day of discharge after standard care, estimated average 7 days
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

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Aydin Adnan Menderes University

Collaborators

Aydin Adnan Menderes University Member Training Program
Aydın Adnan Menderes University Scientific Research Projects Unit

Investigators

  • Principal Investigator: Dilara ŞAHAN, PhD, Aydin Adnan Menderes University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 15, 2019

Primary Completion (Actual)

October 3, 2019

Study Completion (Actual)

March 1, 2022

Study Registration Dates

First Submitted

January 31, 2023

First Submitted That Met QC Criteria

February 17, 2023

First Posted (Actual)

February 21, 2023

Study Record Updates

Last Update Posted (Actual)

July 20, 2023

Last Update Submitted That Met QC Criteria

July 19, 2023

Last Verified

July 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • AdnanU

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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