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IRCT20190727044347N6 IRCT 2023-10-18 Shiraz University of Medical Sciences the effect of active cycle breathing technique on pain, anxiety and blood oxygen saturation of patients undergoing coronary artery bypass graft (CABG) Investigating the effect of active cycle breathing technique on pain, anxiety and blood oxygen saturation of patients undergoing coronary artery bypass graft (CABG) 2023-10-23 anticipated 76 Complete https://irct.ir/trial/69954 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: After selecting eligible individuals to participate in the study based on inclusion criteria, these individuals will be assigned to two study groups based on double randomized permutation block with foursome blocks. The random list is generated by a statistician using "Random Allocation" software. Foursome blocks are the combination of different status such as: ABBA, BAAB, BABA, ABAB, BBAA, AABB. Using random list that is generated by computer,19 blocks will be selected to forme the two study groups. N/A patients undergoing coronary artery bypass graft (CABG). Intervention 1: Intervention group:In the intervention group, breathing exercises are taught to the patients one day before the surgery by the researcher or the researcher's assistant. From the second day after the surgery and extubation, in the morning and evening shifts, the patients are encouraged to use incentive spirometry as a routine care. They also practice and implement the active cycle of breathing technique. This technique is performed in three stages; The first step is breathing control. At this stage, breathing is done slowly through the nose. If it is not possible for the patient to breathe through the nose, it is done through the mouth with pursed lips. During this stage, the patient is encouraged to keep his peace by closing his eyes and keeping himself away from any tension. The second step is to practice expanding the chest wall to provide airflow in the small airways. At this stage, air flows deeply, slowly and continuously through the nose into the lungs, so that the chest wall expands. The air is held for 2 to 3 seconds and then slowly exhaled through the mouth. This step is repeated 3 times. The final stage is the coughing stage and an integral part of this technique. In this stage, coughing is done through the mouth and throat. For this purpose, the patient takes a deep breath with the mouth open and with the help of respiratory muscles and then coughs. Active breathing cycle technique will be perform from the day after extubation of each patient in two days and in two shifts, morning and evening. Each time will be 3 sessions and each session will last for 10 minutes with a 15 minute break between them. In addition to the active breathing cycle technique, the patients in the intervention group will receive routine care including the use of an incentive spirometer. The level of anxiety, pain and arterial blood oxygen saturation will be assessed by the researcher or research assistant once before the intervention and then after each time the active breathing cycle technique is performed. Intervention 2: Control group:In the control group, patients receive the usual care, which includes the use of an incentive spirometer, according to the hospital routine. Breathing with a spirometer takes 10 to 20 deep breaths in each shift; This breathing is done in such a way that after the end of inhalation, the patient holds his breath for three seconds and by removing the device, exhales slowly through the mouth. This breathing exercise is performed in every shift until the patient is discharged. It is done sitting or semi-sitting, and after performing this technique, the level of anxiety, pain, and oxygen saturation of the arterial blood of the patients is measured from the day after the extubation of each patient in two days and in two shifts, morning and evening, by the researcher or the researcher's assistant. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no more information
public Fatemeh Shirazi
School of Nursing and Midwifery (SA), Namazi Square
Shiraz Iran (Islamic Republic of) 71393613119 +98 71 3647 4254 shirazi_1393@yahoo.com Shiraz University of Medical Sciences scientific Fatemeh Shirazi
School of Nursing and Midwifery (SA), Namazi Square
Shiraz Iran (Islamic Republic of) 7193613119 +98 71 3647 4254 shirazi_1393@yahoo.com Shiraz University of Medical Sciences Iran (Islamic Republic of) Age above 18 years Candidate for coronary artery bypass surgery according to physician's diagnosis Not having a known history of severe respiratory and lung disease Ability to perform breathing exercises and use the active cycle of breathing No previous history of open heart surgery Not having a history of known mental illness or under treatment with anti-anxiety and sedative drugs before surgery 18 years no limit Both Unwillingness to stay in the study Occurrence of critical complications after surgery including shock, critical hypertension crisis, cardiac tamponade The occurrence of dangerous dysrhythmias such as atrial fibrillation and ventricular tachycardia Mechanical ventilation for more than 48 hours after surgery The need for reoperation during the hospitalization period T82.8 Other specified complications of cardiac and vascular prosthetic devices, implants and grafts Treatment - Other Treatment - Other Intervention group:In the intervention group, breathing exercises are taught to the patients one day before the surgery by the researcher or the researcher's assistant. From the second day after the surgery and extubation, in the morning and evening shifts, the patients are encouraged to use incentive spirometry as a routine care. They also practice and implement the active cycle of breathing technique. This technique is performed in three stages; The first step is breathing control. At this stage, breathing is done slowly through the nose. If it is not possible for the patient to breathe through the nose, it is done through the mouth with pursed lips. During this stage, the patient is encouraged to keep his peace by closing his eyes and keeping himself away from any tension. The second step is to practice expanding the chest wall to provide airflow in the small airways. At this stage, air flows deeply, slowly and continuously through the nose into the lungs, so that the chest wall expands. The air is held for 2 to 3 seconds and then slowly exhaled through the mouth. This step is repeated 3 times. The final stage is the coughing stage and an integral part of this technique. In this stage, coughing is done through the mouth and throat. For this purpose, the patient takes a deep breath with the mouth open and with the help of respiratory muscles and then coughs. Active breathing cycle technique will be perform from the day after extubation of each patient in two days and in two shifts, morning and evening. Each time will be 3 sessions and each session will last for 10 minutes with a 15 minute break between them. In addition to the active breathing cycle technique, the patients in the intervention group will receive routine care including the use of an incentive spirometer. The level of anxiety, pain and arterial blood oxygen saturation will be assessed by the researcher or research assistant once before the intervention and then after each time the active breathing cycle technique is performed. Control group:In the control group, patients receive the usual care, which includes the use of an incentive spirometer, according to the hospital routine. Breathing with a spirometer takes 10 to 20 deep breaths in each shift; This breathing is done in such a way that after the end of inhalation, the patient holds his breath for three seconds and by removing the device, exhales slowly through the mouth. This breathing exercise is performed in every shift until the patient is discharged. It is done sitting or semi-sitting, and after performing this technique, the level of anxiety, pain, and oxygen saturation of the arterial blood of the patients is measured from the day after the extubation of each patient in two days and in two shifts, morning and evening, by the researcher or the researcher's assistant Pain. Timepoint: From the second day after surgery and extubation, once before starting the intervention and then after performing each phase of the active breathing cycle technique. Method of measurement: visual analoge of scale pain. Anxiety. Timepoint: From the second day after surgery and extubation, once before starting the intervention and then after performing each phase of the active breathing cycle technique. Method of measurement: Spielberger questionnaire. Oxygen saturation of arterial blood. Timepoint: From the second day after surgery and extubation, once before starting the intervention and then after performing each phase of the active breathing cycle technique. Method of measurement: Pulse oximetry device. Shiraz University of Medical Sciences Approved 2023-06-17 Research Ethics Committees of Schools of Nursing and Midwifery, Management and Medical Information s Vice-Chancellor for Research, Shiraz University of Medical Sciences, Zand Blvd. Shiraz Fars Iran (Islamic Republic of)