Comparison of the effectiveness of training booklet and mobile application used ın coronary artery bypass graft surgery discharge education on patıents' discharge readiness and self-efficacy

Objective: It was aimed to compare the effects of the training booklet and mobile application used in coronary artery bypass graft surgery discharge training on patients' readiness for discharge and self-efficacy. Material and Methods: The study was conducted with patients who had undergone coronary artery bypass graft surgery for the first time in the cardiovascular surgery clinic of a university hospital between October 2019 and March 1, 2022. The sample size was "G. With the Power-3.1.9.2" package program, the effect size (d) was 0.40; In the calculation made by taking alpha value (α) 0.05 and power (1-β) 0.80, a total of 72 patients, 24 in each group, were included. The study was carried out with three separate groups: control group (standard care), study group 1 (trained by training booklet) and study group 2 (trained by mobile application). A "Patient Identification Form" was filled in for all patients the day before the surgery, and the "Post-Operative Patient Follow-up Form", "Readiness to Discharge Scale" and "Cardiac surgery version of the Barnason Efficacy Expectation Scale (BEES)" were applied face-to-face on the day the patients would be discharged. In addition, one month after discharge, all patients were contacted by phone, and the follow-up was completed by applying the "BEES" and the "Post-Discharge Follow-up Form". The materials were evaluated with the "Educational Material Evaluation Form" on the day of discharge in patients in study groups 1 and 2. The usability of the mobile application was evaluated by the System Usability Scale and the recommendation status by the NET promoter score.While the patients in the control group were not trained by the researcher; With the training booklet prepared by taking expert opinion for the patients in study group 1; Patients in study group 2 were given discharge training through the mobile application integrated into the tablet computer. The training in the mobile application was converted into videos and the content was enriched in line with the text of the training booklet prepared for working group 1. Descriptive statistical methods (number, percentage, mean, standard deviation) were used while evaluating the data. Data were analyzed using one-way analysis of variance, Bonferroni test, Paired t test, Pearson correlation and chi-square test, and IBM SPSS Statistics 25.0 package program. The significance level was taken as 0.05 in all analyzes. Results: The mean scores of the patients in the control, study group 1, and study group 2 readiness to discharge scale were 7.34±1.39, respectively; 8.68±1.01; It was found to be 8.65±0.97 (p=0.000). It was observed that there was a statistically significant difference (p<0.05) between the mean scores of the patients in the control, study group 1 and study group 2 on the readiness for discharge scale, and this difference was caused by study group 1 and study group 2. The mean total score of the patients in the control, study group 1 and study group 2 at the time of discharge from BEES was 40.29±7.00; 47.33±8.52; It was found to be 49.91±5.33 (p=0.000). It was observed that there was a statistically significant difference (p<0.05) between the groups in terms of the total mean scores at the time of discharge from BEES, and this difference was caused by study group 1 and study group 2. However, no statistically significant difference was found between study groups 1 and 2 in terms of readiness for discharge and self-efficacy. A statistically significant, positive and moderate relationship was found between the mean self-efficacy total score at discharge and the mean score of the readiness to discharge scale of the patients in all groups. The rate of having problems in the first month after discharge of the patients in study group 2 was found to be lower than that of the control and study group 1. The usability and recommendability of the mobile application used by the patients in study group 2 for educational purposes were found to be high. Conclusion: In the study, it was determined that there was no difference in terms of readiness for discharge and self-efficacy between the group that received training with the mobile application and the booklet, but the scores of both groups were significantly higher than the control group. In addition, it was concluded that the usability level and recommendation rate of the developed mobile application were high.