The effects of discharge training and counseling on post-discharge problems in patients undergoing coronary artery bypass graft surgery

Abstract

Background:Advances in coronary artery surgery have reduced morbidity, mortality, and rates of graft occlusion. Discharge programs are important services for the continuity of treatment and must encompass physical, psychological, and social aspects of individual patient care. This study aimed at investigating the effect of planned discharge training and counseling on the problems experienced by patients undergoing coronary artery bypass graft (CABG) surgery.Materials and Methods:A semi-experimental study was performed on 100 patients undergoing CABG surgery in the surgery department. During a period of 9 months from January to September 2013, the patients in the intervention group were provided with adequate discharge training and counseling with a booklet before surgery and counseling until 6 weeks after discharge, while the control group patients received only routine clinical procedures, i.e. prescribing medicine, controlling vital signs, and wound dressing. The data were analyzed using Statistical Package for the Social Sciences (SPSS) 23. Frequency and distribution were used to describe the data, and paired sample t-test, variance analysis, Fisher's exact test, and Chi-squared tests were also used.Results:The reported problems for both groups had a descending pattern during the three follow-ups. However, this pattern had a greater slope in the intervention group compared to the control one. As a result of these education programs, problems were fewer in the intervention group than in the control group (P < 0.05).Conclusions:Discharge training and counseling given to the intervention group had a positive impact on decreasing the problems that the patients had. Therefore, the institutions may be recommended to support multidisciplinary patient training and counseling activities using the methods described in this study.

The effects of health promotion model-based educational program on self-care behaviors in patients undergoing coronary artery bypass grafting in Iran

“…Since educational programs and consultancy services can positively influence the patients’ performance and reduce their postoperative problems, the educational programs and patients’ counseling regarding self-care must be carried out and pursued at home ( 18 ). In a study by Tuna et al ( 18 ), and Akbari and Celik ( 2 ), the findings indicated the positive effect of education and consultancy services offered to the patients on enhancing their performance and decreasing their problems after discharge. The self-care-related problems already experienced by the patients emphasize the need for employment of behavior-change theories in the field since such theories can explore the factors affecting self-care, find their relationship with self-care behaviors, and explore the details, conditions, method, and timings related to these relationships ( 19 ).…”

“…The common treatment for coronary artery disease is coronary artery bypass graft ( 1 ), which, as the most common surgery for coronary heart disease in the United States, was performed on more than 300,000 patients in 2001. The initial cost of this surgery is estimated to be $30,000 for every patient ( 2 ). Coronary artery operations constitute 60% of the total 50,000 heart surgeries performed in Iran according to the Association of Iranian Heart Surgeons ( 3 ).…”

“…One reason why patients do not display proper self-care behaviors is that they are not fully informed of the positive effects and thus consider them to be inefficient; hence the need for training ( 13 ). Studies also show that the counseling services and nursing care delivered at the time of discharge are not efficient, and postoperative self-care behaviors are not performed properly at home ( 2 ). The important principle with regard to self-care behaviors is the patient’s contribution and taking responsibility so that they can help control the symptoms ( 14 ).…”

The effect of a structured patient education intervention on the quality of life for coronary artery bypass grafting patients: A prospective randomised controlled study

“…This result is in accordance with a study conducted by Varaei et al (2017), which claimed that educational intervention is effective in promoting cardiac self-efficacy in patients who are candidates for CABG surgery. In a study conducted by Akbari and Çelik (2015), they applied discharge training and counselling on the problems experienced by patients undergoing CABG surgery and determined that it had a positive impact on decreasing the patients’ problems. Rief et al (2017) found that ‘optimising’ CABG patients’ expectations pre-surgery helps to improve outcomes, in particular disability and quality of life, six months after treatment.…”

Patients’ and Nurses’ Perceptions of Post-Coronary Artery Bypass Graft Learning Needs in Two Omani Hospitals

“…Recent studies have focused on the impact of health education (e.g. self-care, medication adherence and sleep quality) on patients’ post-CABG outcomes 6,7. Additionally, many patients with heart disease who have received CABG have expressed the importance of intensive education regarding post-discharge home-based self-care and management 2,8.…”