Impact of nurse-initiated preoperative education on postoperative anxiety symptoms and complications after coronary artery bypass grafting

Abstract

Background: Coronary artery bypass grafting (CABG) in high-risk patients is associated with significant perioperative complications and anxiety. Prevention of these postoperative complications and anxiety is important in the improvement of clinical outcomes following CABG.

Objective: The objective of the study was to evaluate the effect of nurse-initiated preoperative education and counseling on postoperative complications and anxiety symptoms following CABG.

Methods: In this prospective and randomized trial, 40 patients were divided into the study and control groups. All patients received standard preoperative and postoperative care, but the study group patients also completed a structured education and counseling course supervised by designated nurses 3 days before the surgery. Anxiety symptoms were assessed by Zung's self-rating anxiety scale (SAS) on the day of admission and at 3 days after the surgery.

Results: There was no statistically significant difference in the baseline characteristics or operational data between the 2 groups (P > .05). Following the surgery, the rate of complications such as lower extremity edema, urinary retention, constipation, respiratory infection, and deep venous thrombosis in the study group was lower than in the control group (P < .05). The mean postoperative SAS scores in the study group was lower than in the control group (40.1 [SD, 6.5] vs 48.9 [SD, 7.3]; P = .01), and the proportion of patients with a SAS score greater than 40 in the study group was also lower than in the control group (15% vs 45%, P = .041).

Conclusions: Nurse-initiated preoperational education and counseling were associated with a reduced rate of perioperative complications and a reduced level of anxiety following CABG.