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IRCT20230902059333N1 IRCT 2024-01-02 Hamedan University of Medical Sciences The effect of blended learning in cardiac rehabilitation The effect of blended learning in cardiac rehabilitation based on the model of knowledge, attitude, and performance on medication adherence and self-efficacy of patients undergoing coronary artery bypass graft surgery 2024-01-20 anticipated 70 Complete https://irct.ir/trial/72694 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Randomization description: First, among the patients who have undergone coronary artery bypass surgery and meet the inclusion criteria, they were selected by the available sampling method and based on the random block method in the cardiac rehabilitation group based on the knowledge, attitude, and performance model (intervention) and the routine cardiac rehabilitation group (control). For this purpose, the researcher will prepare 4 sheets, the number "1" will be written on two sheets for the first group, and the number "2" will be written on the two sheets for the second group. The cards are mixed in a container and randomly drawn one at a time for each patient without replacement until all four cards are drawn. Then four sheets are returned to the container, which is repeated until the sample volume is reached, Blinding description: A cardiac rehabilitation nurse will perform assessments at each stage, blinded to random allocation. Also, the statistical analysis and outcome assessment will not know about the assignment of patients to two intervention and control groups during the analysis. N/A Patients undergoing coronary artery bypass surgery. Intervention 1: Intervention group: After introducing the study and stating its objectives, if desired, the patients will complete the informed consent form, the demographic information form, the drug treatment adherence, and cardiac self-efficacy questionnaires. In addition to receiving routine cardiac rehabilitation provided at the hospital's cardiac rehabilitation center, this group of patients will receive the necessary training and care in the form of combined learning in both face-to-face and virtual departments. In the face-to-face department, patients will receive face-to-face training in various fields such as heart disease, diet, physical activity, and the benefits of cardiac rehabilitation for 1 month. In the virtual department, after completing the routine rehabilitation in the hospital, the patients will receive training and support for 3 months based on an application developed by the research team which will be installed on the phones of the patients or a family member who lives with them. This application will be designed based on the model of knowledge, attitude, and performance so that for each part of the model, a part will be seen in this application. Besides improving patients' knowledge in this way, they can communicate with the researcher and send their questions through it. At the same time as improves the knowledge of patients in the field of heart disease and cardiac rehabilitation and trying to change their attitude. The researcher changes their performance through this software by providing action plans, including sports activities, tailored to each person. The study's results will be examined through a questionnaire before the study, immediately after the completion of cardiac rehabilitation in the hospital, and 3 months later. Intervention 2: Control group: In this group, patients will enter the study after receiving informed consent and will complete the questionnaires. These people will only undergo routine cardiac rehabilitation in the hospital for one month (12 sessions, 3 times a week) and will not receive face-to-face and virtual training and care. At the end of the study, the training booklet will be given to this group. The study's results will be examined through a questionnaire before the study, immediately after the completion of cardiac rehabilitation in the hospital, and 3 months later. No - There is not a plan to make this available Justification or reason for not sharing IPD is I must provide all information for the sponsoring institution.
public Gazal Veisi
Shahid Fahmideh Blvd., Pajouhesh Sq.
Hamadan Iran (Islamic Republic of) 6517838698 +98 81 3838 0535 ghazallv98@gmail.com Hamedan University of Medical Sciences scientific Fatemeh Pakrad
Shahid Fahmideh Blvd., Pajouhesh Sq.
Hamadan Iran (Islamic Republic of) 6517838698 +98 81 3838 0535 f_pakrad@yahoo.com Hamedan University of Medical Sciences Iran (Islamic Republic of) Reading and writing literacy Patients after coronary artery bypass graft Desire to participate in the study Performing coronary artery bypass graft surgery for the first time Ejection fraction above 35% Physical ability to perform exercise test Access to a smartphone Internet access no limit no limit Both Heart Failure class III and IV Presence of severe musculoskeletal problems I25.1 Atherosclerotic heart disease of native coronary artery Rehabilitation Rehabilitation Intervention group: After introducing the study and stating its objectives, if desired, the patients will complete the informed consent form, the demographic information form, the drug treatment adherence, and cardiac self-efficacy questionnaires. In addition to receiving routine cardiac rehabilitation provided at the hospital's cardiac rehabilitation center, this group of patients will receive the necessary training and care in the form of combined learning in both face-to-face and virtual departments. In the face-to-face department, patients will receive face-to-face training in various fields such as heart disease, diet, physical activity, and the benefits of cardiac rehabilitation for 1 month. In the virtual department, after completing the routine rehabilitation in the hospital, the patients will receive training and support for 3 months based on an application developed by the research team which will be installed on the phones of the patients or a family member who lives with them. This application will be designed based on the model of knowledge, attitude, and performance so that for each part of the model, a part will be seen in this application. Besides improving patients' knowledge in this way, they can communicate with the researcher and send their questions through it. At the same time as improves the knowledge of patients in the field of heart disease and cardiac rehabilitation and trying to change their attitude. The researcher changes their performance through this software by providing action plans, including sports activities, tailored to each person. The study's results will be examined through a questionnaire before the study, immediately after the completion of cardiac rehabilitation in the hospital, and 3 months later. Control group: In this group, patients will enter the study after receiving informed consent and will complete the questionnaires. These people will only undergo routine cardiac rehabilitation in the hospital for one month (12 sessions, 3 times a week) and will not receive face-to-face and virtual training and care. At the end of the study, the training booklet will be given to this group. The study's results will be examined through a questionnaire before the study, immediately after the completion of cardiac rehabilitation in the hospital, and 3 months later. Self-efficacy. Timepoint: Before, immediately after, and 3 months after the end of the intervention. Method of measurement: Using the cardiovascular disease management self-efficacy questionnaire of Steca et alii: The cardiovascular disease management self-efficacy questionnaire was designed and compiled by Steca et alii in 2015 to measure the self-efficacy of cardiovascular disease management. This questionnaire has 9 questions and 3 components of heart risk self-efficacy, treatment adherence self-efficacy, and symptom recognition self-efficacy. It is based on the Likert spectrum with questions such as (you can avoid life problems and difficult situations and daily stress well) Minimize stress well.). It measures the self-efficacy of cardiovascular disease management. The distribution of questionnaire questions is such that questions 1 to 4 examine the self-efficacy of heart risk, questions 5 and 6 examine the self-efficacy of following the treatment, and questions 7, 8, and 9 examine the self-efficacy of detecting symptoms. Medication adherence. Timepoint: Before, immediately after, and 3 months after the end of the intervention. Method of measurement: Using the medication adherence reporting scale by Yan Chen et alii: The medication adherence reporting scale was compiled by Yan Chen et alii in 2019. This questionnaire contains 5 questions, and the frequency rating of each behavior in this questionnaire is based on a 5-point scale that is graded from never to always. The total score of the scale ranges from 5, which indicates the lowest level of adherence, to 25, which indicates the highest level of adherence. Hamedan University of Medical Sciences Approved 2023-12-11 Hamadan University of Medical Sciences Shahid Fahmideh Blvd., Pajouhesh Sq. Hamadan Hamadan Iran (Islamic Republic of)