Investigation of the effects of tele-nursing training and counseling on postoperative anxiety and complications after open heart surgery

The fact that the post-discharge period, which requires many care, takes place without monitoring by home health professionals, may increase the development of anxiety and complications in patients. In this study, it was aimed to determine the effect of using the tele-nursing method, which provides care service and patient follow-up despite distances, on anxiety and complications in these patients after discharge. It was conducted as a randomized controlled trials between November 2020 and April 2021 in the Cardiovascular Surgery clinic of Gaziantep Medical Park Hospital. The study was completed with 75 patients, 38 of whom were in the Intervention Group (IG) and 37 from the Control Group (CG), who met the sampling criteria. Except for routine treatment and care, CG patients were not intervened during the study. In addition to the routine treatment and care practices in IG, training and counseling were provided by the researcher by calling four times between the end of the first week after discharge and the end of the first month. The Introductory Information Form and the Stait Trait Anxiety Inventory (STAI) were administered to the patients in both groups 24 hours before discharge, and the STAI State Anxiety Inventory was administered at the end of the first month after discharge. Wound areas of the patients were photographed with the doctor's phone 24 hours before discharge, during the first week and at the end of the first month, when they came for the control. Post-discharge complications and INR values were evaluated by the physician in both groups. These data, number of hospital admissions and readmission rates were obtained from doctor's records by the researcher. SPSS 25.0 program was used for statistical analysis, and the significance value was accepted as p<0.05. The patients were similar in terms of introductory information (p>0.05). The pre-test trait anxiety mean scores of the patients in IG and CG were similar, but there was a statistically significant difference in favor of CG between the mean scores of state anxiety (p<0.05). At the end of the first month after discharge, the difference between the state anxiety scores in the posttest was significant. When the difference between the pre-test and post-test state anxiety scores within the groups was examined, it was determined that there was a significant difference in IG and no significant difference in CG. There was no difference between the two groups in terms of complication development, INR value in the therapeutic range, and hospital readmission in the first week (p>0.05). It was determined that there was a significant difference in favor of IG in terms of complication development, INR value being in the therapeutic range, and hospital readmission between the first week and the first month after discharge (p<0.05). It was determined that the total number of readmissions within a month after discharge was higher in CG, and the total number of re-admissions to the hospital was higher in IG. Between the first week and the first month after discharge, leg incision infection on CG and effusion on IG were the most common complications. It was concluded that education and counseling provided by tele-nursing after discharge to patients with open heart surgery had a positive effect on anxiety, complications and readmission rates. Keywords: Open Heart Surgery, Anxiety, Telenursing, Complication, Hospital Readmission