Background:The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft (CABG) and could interfere with their recovery. Therefore, improving the cardiovascular indices and anxiety is essential.Objectives:This study aimed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG.Patients and Methods:In this randomized controlled trial, 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city, Iran, in 2013 were selected using a consecutive sampling method and randomly allocated into the experimental and control groups. In the experimental group, patients received 30 minutes of light music, whereas in the control group, patients had 30 minutes of rest in bed. The cardiovascular indices and anxiety were measured immediately before, immediately after and half an hour after the study. Data were analyzed using the chi-square test and repeated measures analysis of variance.Results:Compared to the immediately before intervention, the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group (P < 0.037) while it did not significantly change in the control group. However, there were no significant differences regarding the cardiovascular indices in the three consecutive measurements (P > 0.05).Conclusions:Music therapy is effective in decreasing anxiety among patients undergoing CABG. However, the intervention was not effective on cardiovascular indices. Music can effectively be used as a non-pharmacological method to manage anxiety after CABG.
Background: Transition from intensive care unit to a general ward is a stressful situation for patients. It is believed that a liaison nurse can prevent adverse events during the transfer process.Objectives: This study aimed to examine the effect of a liaison nurse on anxiety related to the transportation of patients from the cardiac surgery intensive care unit to a general ward. Methods: This randomized clinical trial was conducted on 68 patients that were randomly assigned to the experimental and control groups. The demographic information and disease profile were collected at the baseline of the study. Liaison nurse services were provided for the experimental group during the transfer process. The Spielberger state-trait anxiety inventory (STAI) was used to measure the patients' anxiety at the start of the transfer and two hours after admission to the general ward. Independent samples and paired t-tests were used to compare the anxiety mean scores in the experimental and control groups.Results: Before the intervention, the mean anxiety was 45.61 ± 12.42 and 40.11 ± 10.95 in the experimental and the control groups, respectively (P = 0.057). However, after the intervention, the mean anxiety score was significantly decreased to 33.20 ± 6.22 in the experimental group (P < 0.001) while it increased to 44.17 ± 10.23 in the control group (P < 0.001). Conclusions:Liaison nurse services affected the patients' anxiety in the process of transition from the cardiac surgery intensive care unit to the general ward.
Background & Aim: Reducing readmissions is a major goal of health care systems. This study aimed to identify readmission risk factors following coronary artery bypass graft surgery. Methods & Materials: This case-control study analyzed 540 patients who underwent coronary artery bypass graft surgery between January 2016 and December 2019 at Shahid Beheshti Hospital in Qom, Iran. The case group contained 270 patients who were readmitted to the hospital during the 30-day after discharge and the control group comprised 270 non-readmitted patients. Results: Readmit patients suffered from higher rates of cardiac failure, myocardial infarction, hypertension, myocardial dysrhythmia, and using antiplatelet coagulant medication (P<0.05). Compared with non-readmitted patients, readmitted patients were more likely to have emergency surgery (OR 1.62; CI 1.11-2.38), cardiac arrest (OR 2.52; CI 2.39-2.85), and massive intraoperative hemorrhage during surgery (OR 2.36; CI 2.13-2.67). Postoperative disorders such as surgical site infection, pleural effusion, dysrhythmias, and myocardial infarction were independent risk factors for readmission (P<0.05). Conclusion: Patients at risk for readmission should be closely monitored. Furthermore, careful decision-making about surgical criteria by a multidisciplinary team can help improve outcomes as well as reduce readmissions.
Background & Aim: Delirium is a frequent complication in patients hospitalized in the intensive care unit following cardiac surgery. This study aimed to assess the effect of a tailored delirium preventive intervention on postoperative delirium and agitation reduction and length of intensive care unit stay in patients who underwent coronary artery bypass graf. Methods & Materials: In this single-blinded, single-center, randomized controlled design, 60 patients from a hospital in Qom, Iran, were randomly allocated to an intervention or a control group. In the control group, patients received routine care. In the intervention group, patients received routine care, a video tutorial, and the Hospital Elder Life Program. Outcomes were measured using the Confusion Assessment Method for the intensive care unit, Richmond Agitation-Sedation Scale, and length of intensive care unit stay in the second and third days after coronary artery bypass graft. Results: There were no significant differences in the rate of delirium episodes and mean scores of RASS between both groups in the second (P=0.301; P=0.125) and third days (P=0.389; P=0.057) after surgery, respectively. However, the mean duration of intensive care unit stays after surgery was significantly lower in the intervention group compared with the control group (P=0.042). Conclusion: This study indicated the tailored delirium prevention intervention could reduce the length of intensive care unit stay. However, the intervention did not reduce postoperative delirium episodes, nor did the intervention improve the RASS scores in the second and third days after coronary artery bypass graft. A future large multicenter trial with long-term follow-up is needed to assess further the effect of such an intervention.
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