The effects of multimedia education on postoperative delirium in patients undergoing coronary artery bypass graft: A randomized clinical trial

Abstract

Background: Patients undergoing cardiac surgeries are at high risk of developing delirium. Aims and objectives: The present study aimed to determine the effects of multimedia education on postoperative delirium in patients undergoing a coronary artery bypass graft. Design: This study was a randomized clinical trial. Methods: In this study, 110 patients undergoing a coronary artery bypass graft were assigned to two groups, control and intervention. Patients in the intervention group received multimedia education, and those in the control group received routine training. The inclusion criteria were experiencing the coronary artery bypass graft for the first time and non-development of post-operative cardiogenic shock or myocardial rupture. After measuring the level of consciousness, patients were examined in terms of delirium using the confusion assessment method for the ICU scale twice a day from admission to discharge from the ICU. The data were statistically analysed using χ 2 test and Fisher 0 s exact test. Results: Patients of both groups were matched in terms of demographics. The highest incidence of delirium was observed on the first day after surgery in the intervention group (14.5%) and in the morning of the second day after surgery (29.1%) in the control group. Moreover, there was a significant difference between the two groups in the incidence of delirium in the morning of the second, third, and fourth days after surgery as it was higher in the control group over these days. Conclusion: Considering the lower incidence of post-operative delirium in patients who experienced multimedia education rather than control group, the use of this non-pharmaceutical method is recommended to prevent delirium in such patients.

Non-Pharmacological Nursing Interventions for Prevention and Treatment of Delirium in Hospitalized Adult Patients: Systematic Review of Randomized Controlled Trials

“…The quality assessment results of the eight selected studies are presented in Figures 2 and 3. Regarding the overall bias, four studies had a low risk [10,12,13,22], and five studies had high risk [8,9,11,14,23]. Regarding the randomization process, eight studies had a low risk of bias [8,[10][11][12][13][14]22,23], and one study had some concerns [9].…”

“…The characteristics of the nine studies included in this systematic review are summarized in Table 1. Six studies were published within the last five years [8][9][10][11][12]14] and three studies were published more than 5 years ago [13,22,23]. The studies were based in Belgium [23], Spain [12], Canada [10,13], Iran [8], China [14], the United States [9,11], and Japan [22].…”

“…Six studies were published within the last five years [8][9][10][11][12]14] and three studies were published more than 5 years ago [13,22,23]. The studies were based in Belgium [23], Spain [12], Canada [10,13], Iran [8], China [14], the United States [9,11], and Japan [22]. There were a total of 877 participants across all studies, and the number of participants per study ranged from 10 to 112.…”

“…Non-pharmacological interventions applied to reduce these risk factors have been studied as single [8][9][10][11] or multi-component interventions [12][13][14]. In addition, intervention providers have been diverse, including primary care nurses, geriatric internists, psychiatrists, cardiologists, caregivers, and family members [1,13,15].…”

What's in this issue

“…Lower cerebral perfusion states during surgery and comorbidities such as atherosclerotic lesions in carotid vessels may exacerbate impaired cerebral blood flow combined with the general increased age of this population 8 . In this paper, Fahimi and colleagues report a clinical trial of a non‐pharmacological intervention (multi‐media [MM] education) to reduce the incident of delirium in this population in Iran 9 . In this study, 110 adults undergoing elective coronary artery bypass graft surgery were allocated to receive this MM education (n = 55) or control training (n = 55).…”