Investigating the effect of the transitional nursing care on functional independence, quality of life, and cardiac self-efficacy of the elderly undergoing coronary artery bypass graft surgery

To determine the effect of transitional nursing care on functional independence, quality of life, and cardiac self efficacy in elderly patients undergoing coronary artery bypass graft surgery.

A block-randomized clinical trial with a control group and no blinding, conducted on 70 patients

This randomized controlled trial is conducted in collaboration with Shahid Sadoughi School of Nursing and Midwifery and Afshar Cardiac Rehabilitation Center. The study population includes adults aged ≥60 years undergoing CABG and receiving cardiac rehabilitation services at Afshar Hospital. The intervention lasts 8 weeks with a 16-week follow-up. Due to the nature of the intervention, blinding of researchers and participants is not feasible.

Inclusion criteria: -Willingness to participate. -Age 60–75 years. -Intact consciousness and cognitive competence. -First-time, non-emergency CABG surgery. -No history of psychiatric disorders. -Literacy of the patient or an active caregiver. -Access to a smartphone and the internet by the patient or caregiver. Exclusion criteria: -Inability to attend required in-person visits, especially during the first two weeks (if stated at enrollment).

-The intervention group includes older patients (≥60 years) undergoing CABG who receive a four-phase program consisting of preoperative education, in-person counseling in the first postoperative week, telephone follow-ups in weeks 2, 4, 6, and 8, and final follow-ups in weeks 12–16. -The comparison group includes older patients (≥60 years) undergoing CABG who receive routine cardiac rehabilitation care, including preoperative psychological counseling, standard postoperative education, and usual post-discharge follow-ups.

Quality of life, functional independence; cardiac self efficacy; hospital readmission

Participants will be allocated to the intervention or control group using block randomization. The random allocation sequence will be generated by the third researcher using the online tool available at www.random.org/sequences/ . This sequence will then be placed as coded assignment labels inside 70 opaque, sealed envelopes. The allocation order will only be revealed upon opening each envelope at the time of a participant’s entry into the study. In this way, allocation concealment is ensured, minimizing the risk of selection bias. To prevent contamination between the two study groups, patients in the control and intervention groups will be accommodated in separate rooms from admission until discharge. Additionally, participants in the intervention group will be instructed not to share any educational materials with other patients during the study period. Patients and their companions will be reminded not to disclose the educational content or study procedures to other patients, especially to those who are candidates for CABG surgery.

All participant personal data in the study can be shared after anonymization. Data sharing can be done by uploading to official data repositories or upon request by the applicant via email to the corresponding author.

6 months after publication of the article

The data will be available to researchers working in universities and scientific institutions.

For scientific application and use for systematic review studies

Fatemeh Bakhshi, Yazd, Bouali St., Safaieh, Shahid Sadoughi Nursing and Midwifery School, Yazd, Nursing and Midwifery Care Research Center, Postal Code: 8916877443, Contact Phone: 00989139684626, Email Addresses: fateme.bakhshii@gmail.com - f.bakhshi@ssu.ac.ir

One week after the applicant's email