Nurse Navigation Programs Affect to Anxiety, Perception of Quality Nursing Care and Stress Hormone Levels

April 28, 2026 updated by: Zeynep Gürer, Uludag University

The Effect of a Nurse-led Preoperative Navigation Program on Anxiety, Perceived Quality of Perioperative Nursing Care, and Stress Hormone Levels in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

This study aims to evaluate the effect of a nurse-led preoperative navigation program on preoperative anxiety, perceived quality of perioperative nursing care, and serum cortisol levels in patients undergoing coronary artery bypass graft (CABG) surgery. A total of 60 patients scheduled for CABG surgery will be recruited from the cardiovascular surgery clinic and randomly assigned to either the intervention group (n=30) or the control group (n=30). Patients in the intervention group will receive a structured nurse-led preoperative navigation program, including verbal education and an animated video about the surgical and operating room process. Patients in the control group will receive standard perioperative care. Preoperative anxiety, serum cortisol and glucose levels, and perceived quality of perioperative nursing care will be assessed at specified time points.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study is designed as a randomized controlled trial to evaluate the effect of a nurse-led preoperative navigation program in patients undergoing coronary artery bypass graft (CABG) surgery. Participants in the intervention group (n=30) will receive a structured nurse-led preoperative navigation program delivered approximately 7 days prior to surgery. The program includes verbal education about the surgical process and operating room procedures, along with an educational animated video that can be viewed repeatedly until the day of surgery. Participants in the control group (n=30) will receive standard perioperative care without the structured navigation program. Participants will be randomly assigned to either the intervention or control group. Outcome measures will be assessed at predefined time points.

Study Type

Interventional

Enrollment (Actual)

60

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

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • • who is 18 years of age or older

    • Planned to undergo elective coronary artery bypass graft surgery,

    • Who agrees to participate in the research,

      • Whose cognitive functions are in place

    • Communicable • Able to speak and understand Turkish,

Exclusion Criteria:

  • Undergoing emergency surgery

    • Who cannot speak and understand Turkish
    • Having a psychiatric diagnosis

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: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Nursing navigation program
Participants in the intervention group will receive a structured nurse-led preoperative navigation program. After admission to the cardiovascular surgery clinic, patients will receive verbal information about the surgical process and operating room procedures. In addition, an educational animated video will be provided and can be viewed repeatedly until the day of surgery. The intervention will be delivered approximately 7 days prior to surgery.
Other: Nursing navigation program

Participants will receive a structured nurse-led preoperative navigation program delivered approximately 7 days prior to surgery. The program consists of verbal counselling provided by the researcher about the surgical process and operating room procedures, along with an educational animated video designed to explain the perioperative process in a clear and patient-friendly manner.

The animated video (9 minutes and 56 seconds) includes information on the purpose of coronary artery bypass graft surgery, preoperative preparation, transfer to the operating room, the operating room environment and surgical team, and postoperative care in the intensive care unit. The video will be made available to patients and/or their relatives and can be viewed repeatedly until the day of surgery.
No Intervention: Control
Participants in the control group will receive standard perioperative care according to routine clinical practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety
Time Frame: At hospital admission and again 1 day before surgery
Preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The scale consists of 6 items rated on a 5-point Likert scale from 1 (not at all) to 5 (extremely). The total score ranges from 6 to 30, with higher scores indicating higher levels of anxiety.
At hospital admission and again 1 day before surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Quality of Perioperative Nursing Care
Time Frame: Postoperative day 3
Perceived quality of perioperative nursing care was measured using the Good Perioperative Nursing Care Scale (GPNCS). The Turkish version of the scale consists of 32 items rated on a Likert-type scale from 0 to 5. The total score ranges from 0 to 160, with higher scores indicating better perceived quality of perioperative nursing care.
Postoperative day 3
Serum Cortisol
Time Frame: The day before surgery and the morning of surgery
Serum cortisol levels were measured from fasting blood samples collected in the morning under standardized conditions (before mobilization and getting out of bed). Samples will be analyzed using electrochemiluminescence immunoassay (ECLIA), and results will be reported in µg/dL.
The day before surgery and the morning of surgery

Collaborators and Investigators

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

Sponsor

Uludag University

Collaborators

Bursa City Hospital

Investigators

  • Study Director: Neriman Akansel, professor, faculty member

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)

November 1, 2023

Primary Completion (Actual)

June 1, 2024

Study Completion (Actual)

November 1, 2024

Study Registration Dates

First Submitted

May 13, 2024

First Submitted That Met QC Criteria

April 7, 2026

First Posted (Actual)

April 14, 2026

Study Record Updates

Last Update Posted (Actual)

May 5, 2026

Last Update Submitted That Met QC Criteria

April 28, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 20212411

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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