The Effect of Telephone Nursing Education and Counseling Services Given to Patients With Coronary Artery Bypass Graft on Discharge Satisfaction Level and Self-Care Strength of Patients: A Randomized Controlled Study

Cardiovascular diseases are one of the leading causes of death globally, with an alarming prevalence. The World Health Organization (WHO) stated that 17.9 million people died from cardiovascular diseases in 2019, and this number constituted 32% of the death rates worldwide At the same time, it is emphasized that 14.2% of all deaths by 2030 may be caused by coronary heart diseases There are multiple approaches to the treatment of coronary heart diseases. Healthy lifestyle behaviors form the basis of these approaches. However, in cases where these approaches are not sufficient, surgical treatment is required. In this case, one of the surgical procedures applied is Coronary Artery Bypass Graft (CABG). CABG procedure is a risky and important surgical procedure applied all over the world After CABG, life-threatening complications can be seen after CABG due to reasons such as sternotomy wound, ventilator support lasting 12-24 hours after surgery, hospital stay of 5-10 days on average, and recovery period lasting 6-8 weeks.

In a study, it is stated that more than 200,000 CABG surgeries are performed annually in the United States, and approximately 14% of these patients present to the emergency department with postoperative complications within 30 days of discharge. The golden rule in centers where cardiac surgery is performed in England is the patient's 6-7th postoperative day. day discharge. However, 6-7 days after surgery. It has been reported that the patient's sternotomy wound has not fully healed on the same day, and life-threatening complications may occur if appropriate care is not provided. It is possible to prevent these complications or to ensure their early diagnosis with good nursing care. Good nursing care includes a planned discharge training.

Today, the purpose of health services; In addition to prolonging the life span, it is to help the individual cope with his problems, to increase his self-care power and self-efficacy perception, to improve his independence and quality of life by strengthening his knowledge and skills. Quality/effective care and education to be applied by healthcare professionals to the patient and their relatives undergoing CABG; It plays an important role in preventing repeated hospitalizations, increasing self-care power and self-confidence, and gaining independence of the patient.

Self-care is the continuous participation of an adult in activities aimed at maintaining and maintaining their own health and well-being. Self-care disability occurs when there is an imbalance between caring power and the need for therapeutic self-care. When there is an imbalance between the individual's self-care abilities and needs, the need for nursing intervention arises. Investigation of Self-Care Behaviors in Patients with Chronic Heart Failure After CABG surgery, in addition to physical problems such as pain in the incision area in the chest or leg, weight loss, respiratory distress, sleep disorders, fatigue, exhaustion, loss of appetite, constipation, difficulty in bathing and limitation of body movements, unhappiness, difficulties in coping with stress, Psychosocial problems such as anxiety, even depression, role complexity in the family, decrease in physical activities, changes in work life, changes in social relations and sexual life are observed. These physical and psychosocial problems reduce the self-care power of patients. In the studies, while the surgical patients were discharged, the most; It has been determined that they need information about incision/wound care, pain control, activities of daily living, drug use, possible complications and excretion. In the study of Yılmaz and Çiftçi, it was found that all of the patients experienced activity, 95.6% nutrition, 88.9% sleep and 86.7% excretion problems within a week after discharge.

The nurse has an important role in preparing the patient and family of patients undergoing surgery for discharge and helping them to accept the current situation. Within the scope of discharge planning, the nurse should provide information that can help patients increase their self-care power at home after discharge, adapt to the new situation and prevent possible complications. In the studies conducted, the patients who were given discharge training; It is stated that the recovery processes accelerate, their self-confidence increases in parallel with their self-care abilities, the number of repeated admissions to the hospital/outpatient clinic decreases, and accordingly, patient care costs decrease and the quality of care increases.