A pilot study on development and feasibility of the 'MyEducation: CABG application' for patients undergoing coronary artery bypass graft (CABG) surgery

Z Noor Hanita, L A Khatijah, S Kamaruzzaman, C Karuthan, R A Raja Mokhtar, Z Noor Hanita, L A Khatijah, S Kamaruzzaman, C Karuthan, R A Raja Mokhtar

Abstract

Background: Patients scheduled for coronary artery bypass graft (CABG) surgery tend to have persistent symptoms of anxiety and depression. Course of hospital stay post-CABG procedure has become increasingly shorter over the last few decades. This pilot study was conducted to develop and test feasibility of MyEducation: CABG application as a learning tool to reduce anxiety and depression levels among patients undergoing CABG Surgery.

Methods: This study was quasi-experimental in design. Forty-five patients scheduled for CABG surgery were recruited via consecutive sampling from a Tertiary Referral Centre at Kuala Lumpur, Malaysia. MyEducation:CABG application (Web-based education application) was administered among the intervention group (N = 23); while the control group (N = 22) underwent standard care. Web-based education application were implemented by nurses at admission and prior to discharge. Patients were assisted in terms of queries and concerns, upon which corresponding information and support was provided. Sociodemographic data were obtained from patients, prior to administration of Hospital Anxiety and Depression Scale which was used to measure levels of anxiety and depression. The educational application was used to obtain satisfaction rating among intervention group. These measures were administered upon admission, on discharge and one-month post-discharge.

Results: Mean anxiety and depression scores among the intervention group were lower compared to the control. This was significant for anxiety upon admission, on discharge and one-month post-discharge (p < 0.05). Reduced mean depression scores was only significant at one month post-discharge (p < 0.05). Intervention group were generally satisfied with design, content and usability of the application.

Conclusions: Utilisation of MyEducation: CABG application as an educational platform were associated with reduced anxiety and depression among CABG patients, which probably explains positive user satisfaction levels reported. Hence, the study recommends implementation of this application among larger sample as a way to support patient scheduled for CABG aside, with further possibility of preventing complications.

Keywords: Anxiety; Coronary artery bypass graft surgery; Depression; Web-based application.

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/ or publication of this article.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Development process of application through ADDIE model

References

    1. Sekhri T, Kanwar R, Wilfred R, Chugh P, Chhillar M, Aggarwal R, et al. Prevalence of risk factors for coronary artery disease in an urban Indian population. BMJ Open. 2014;4(12):e005346. doi: 10.1136/bmjopen-2014-005346.
    1. Feuchtinger J, Burbaum RNC, Heilmann C, Imbery C, Siepe M, Stotz U, Fritzsche K, Beyersdorf F. Anxiety and fear in patients with short waiting times before coronary artery bypass surgery–a qualitative study. J Clin Nurs. 2013;23(13-14):1900–1907. doi: 10.1111/jocn.12467.
    1. Amjadian M, Ehsan HB, Saboni K, Vahedi S, Rostami R, Roshani D. A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery. Ann General Psychiatry. 2020;19:46. doi: 10.1186/s12991-020-00296-1.
    1. Poole L, Ronaldson A, Kidd T, Leigh E, Jahangiri M, Steptoe A. Pre-surgical depression and anxiety and recovery following coronary artery bypass graft surgery. J Behav Med. 2017;40:249–258. doi: 10.1007/s10865-016-9775-1.
    1. Shwetas DP, Hadiya P, Sujata Y. Effect of music intervention on immediate postoperative coronary artery bypass graft surgery (CABG) patients. Ind J Physiother Occup Ther. 2014;8(4):106–111. doi: 10.5958/0973-5674.2014.00021.5.
    1. Tully PJ, Winefield HR, Baker RA, Denollet J, Pedersen SS, Wittert GA, et al. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study. Biopsychosoc Med. 2015;9:14. doi: 10.1186/s13030-015-0041-5.
    1. Simha Ravven M, Bader C, Azar A, Rudolph JL. Depressive symptoms after CABG surgery: a meta-analysis. Harvard Rev Psychiatry. 2013;21(2):59. doi: 10.1097/HRP.0b013e31828a3612.
    1. Sethares KA, Chin E, Costa I. Pain intensity, interference and patient pain management strategies the first 12 weeks after coronary artery bypass graft surgery. Appl Nurs Res. 2013;26(4):174–179. doi: 10.1016/j.apnr.2013.07.005.
    1. Bjørnnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Rustøen T, Leegaard M. The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. Eur J Cardiovasc Nurs. 2017;16(1):18–27. doi: 10.1177/1474515116631680.
    1. Veronovici NR, Lasiuk GC, Rempel GR, Norris CM. Discharge education to promote self-management following cardiovascular surgery: an integrative review. Eur J Cardiovasc Nurs. 2013;13(1):22–31. doi: 10.1177/2F1474515113504863.
    1. Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. J Clin Nurs. 2015;24:34–46. doi: 10.1111/jocn.12618.
    1. Di Giammarco G, Di Mascio T, Di Mauro M, Tarquinio A, SmartHeart VP. CABG Edu: First prototype and preliminary evaluation. In Methodologies and intelligent Systems for Technology Enhanced Learning: Springer International Publishing; 2013. p. 57–66.
    1. Dale JG, Midthus E, Bjørg D. Using information and communication technology in the recovery after a coronary artery bypass graft surgery: patients’ attitudes. J Multidiscip Healthc. 2018;11:417–423. doi: 10.2147/JMDH.S175195.
    1. Weiss Wiesel TR, Nelson CJ, Tew WP, Hardt M, Mohile SG, Owusu C, Hurria A. The relationship between age, anxiety, and depression in older adults with Cancer. Psycho-Oncology. 2015;24(6):712–717. doi: 10.1002/pon.3638.
    1. Wang Q, Dong L, Jian Z, Tang X. Effectiveness of a PRECEDE-based education intervention on quality of life in elderly patients with chronic heart failure. BMC Cardiovasc Disord. 2017;17:262. doi: 10.1186/s12872-017-0698-8.
    1. Melike ETA. Evaluation of depression and anxiety in coronary artery bypass surgery patients: a prospective clinical study. Braz J Cardiovasc Surg. 2019;34(4):389–395. doi: 10.21470/1678-9741-2018-0426.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. ActaPsychiatrScand. 1983;67:361–370.
    1. Min JC, Sim JL, Seon YH. Development of smartphone educational application for patients with coronary artery disease. Healthc Inform Res. 2014;20:117–124. doi: 10.4258/hir.2014.20.2.117.
    1. Hasanah CI, Zaliha AR, Mahiran M. Factors influencing the quality of life in patients with HIV in Malaysia. Qual Life Res. 2011;20:91–100. doi: 10.1007/s11136-010-9729-y.
    1. Kim EJ, Hwang SY. Development of web-based learning program on cardiopulmonary emergency care focused on clinical scenario. J Korean Acad Adult Nurs. 2010;22(1):70–79.
    1. Shahmansouri N, Koivula M, Ahmadi SH, Arjmandi A, Karimi A. Fear, anxiety and beliefs about surgery in candidates patients for coronary artery bypass grafting. Eur J Exp Biol. 2012;2(5):1750–1754.
    1. Rodrigues HF, Furuya RK, Dantas AS, Dessote CAM. Anxiety and depression in cardiac surgery: sex and age differences. Esc Anna Nery. 2016;20(3):1–7. doi: 10.5935/1414-8145.20160072.
    1. Hweidi IM, Gharaibeh BA, Al-Obeisat S, Al-Smadi A. Prevalence of depression and its associated factors in patients post-coronary artery bypass graft surgery. J Res Nurs. 2018;23(1):76–88. doi: 10.1177/1744987117728314.
    1. Norlund F, Wallin E, Oisson EMG, Wallert J, Burell G, Essen LV, Held C. Internet-based cognitive behavioral therapy for symptoms of depression and anxiety among patients with a recent myocardial infarction: the U-CARE heart randomized controlled trial. J Med Internet Res. 2018;20(3):e88. doi: 10.2196/jmir.9710.
    1. Keeping-Burke L, Purden M, Frasure-Smith N, et al. Bridging the transition from hospital to home: effects of the VITAL telehealth program on recovery for CABG surgery patients and their caregivers. Res Nurs Health. 2013;36(6):540–553. doi: 10.1002/nur.21571.
    1. Messerli-Burgy N, Barth J, Berger T. The InterHerz project - a web-based psychological treatment for cardiac patients with depression: study protocol of a randomized controlled trial. Trials. 2012;13:245. doi: 10.1186/1745-6215-13-245.
    1. Sharif F, Shoul A, Janati M, Kojuri J, Zare N. The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran. BMC Cardiovasc Disord. 2012;12(1):40. doi: 10.1186/1471-2261-12-40.
    1. Demircelik MB, Cakmak M, Nazli Y, Sentepe E, Yigit D, Keklik M, et al. Effects of multimedia nursing education on disease-related depression and anxiety in patients staying in a coronary intensive care unit. Appl Nurs Res. 2015;29. 10.1016/j.apnr.2015.03.014.
    1. Watt-Watson J, Stevens B, Costello J, Katz J, Reid G. Impact of preoperative education on pain management outcomes after coronary artery bypass graft surgery: a pilot. Can J Nurs Res Arch. 2016;31(4):41–56.
    1. Heilmann C, Stotz U, Burbaum C, Feuchtinger J, Leonhart R, Siepe M, et al. Short-term intervention to reduce anxiety and depression before coronary artery bypass graft surgery- a randomised controlled trial. J Clin Nurs. 2016;25(3–4):351–361. doi: 10.1111/jocn.13055.
    1. Ventola CL. Mobile devices and apps for health care professionals: uses and benefits. A peer-reviewed journal for managed care and hospital. Formulary Manag. 2014;3995:356–364.
    1. Evelina P, Koutsabasis P. Redesigning websites for older adults: a case study. Behav Inform Technol. 2014;33:6. doi: 10.1080/0144929X.2013.810777.

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