Continuous Comprehensive Nursing for Post-CABG Recovery

Hebei Medical University

Status: Completed

Conditions: Coronary Heart Disease (CHD)

Treatments: Other: Routine Postoperative Care; Behavioral: Continuous Comprehensive Nursing System

Study type: Interventional

Funder types: Other

Identifiers

NCT07062432

2019-HBLS-ky038

Details and patient eligibility

About

This study evaluates the effectiveness of a continuous comprehensive nursing (CCN) system compared to routine care for patients after coronary artery bypass graft (CABG) surgery. The primary goal is to determine if the CCN system improves postoperative hemoglobin levels. The study also investigates the effects on quality of life, mental health (anxiety and depression), red blood cell indices, immune markers, and patient satisfaction.

Full description

Coronary artery bypass surgery (CABG) is a major procedure, and the postoperative recovery process is complex, often impacting patients' hemoglobin levels and quality of life. Standard nursing care is often limited to the inpatient period. A continuous comprehensive nursing (CCN) system is a holistic, patient-centered model that extends care beyond hospital discharge. This model includes preoperative education, continuous monitoring, personalized care plans, psychological support, rehabilitation guidance, and structured follow-up. While the benefits of comprehensive nursing are recognized, its specific impact on hemoglobin recovery and quality of life after CABG has not been extensively studied. This randomized controlled trial was designed to compare the outcomes of patients receiving a CCN plan with those receiving routine postoperative care to provide evidence for optimizing post-CABG nursing strategies.

Enrollment: 120 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 70 years.
• Confirmed diagnosis of coronary heart disease and evidence of coronary artery illness requiring CABG.
• Ability to understand the purpose and procedures of the study.
• Willingness to sign the informed consent form.

Exclusion criteria

• Presence of serious complications such as unstable myocardial ischemia or significant arrhythmia.
• Severe lung diseases (e.g., chronic obstructive pulmonary disease GOLD stage III/IV).
• Severe kidney diseases (e.g., chronic kidney disease Stage 4/5).
• Significantly impaired left ventricular ejection fraction (EF < 30%).
• Concurrent participation in other clinical trials or receiving other interventions.
• Presence of severe mental illnesses or cognitive impairments.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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120 participants in 2 patient groups

Continuous Comprehensive Nursing (CCN) System

Experimental group

Description:

Participants received a continuous comprehensive care plan delivered by specifically trained cardiac nurses. This plan included: * Preoperative Phase: Comprehensive education about the surgery, risks, and expected outcomes, along with psychological support. * Intraoperative Phase: Standard intraoperative nursing care including close monitoring. * Postoperative Inpatient Phase: In addition to routine care, this phase focused on pain management, wound care, and individualized rehabilitation guidance. * Post-Discharge Continuous Phase (3 months): This phase included regular follow-up (monthly phone calls, one outpatient visit at 6 weeks), ongoing psychological support, continuous education (medication adherence, diet, activity), structured home-based rehabilitation training, and periodic evaluation of quality of life.

Treatment:

Behavioral: Continuous Comprehensive Nursing System

Routine Care

Active Comparator group

Description:

Participants received standard institutional postoperative care for CABG, which primarily focused on the inpatient period. Key elements included: * Monitoring of vital signs, consciousness, and peripheral circulation. * Management of respiratory tract patency and urinary catheters. * Hourly monitoring of drainage tubes initially. * Wound care and monitoring for bleeding. * Body temperature monitoring and oral care. * Guidance on progressing from liquid diets. * Standard discharge instructions without structured post-discharge follow-up.

Treatment:

Other: Routine Postoperative Care