Effects of a Recovery-Promoting Program in Patients Undergoing CABG Surgery

NCT07392021 | Active Not Recruiting

• 2 other identifiers: COA.No.MURA2025/476, 148/2568TCTR20250915012
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Patients undergoing coronary artery bypass graft (CABG) surgery often experience physical limitations, psychological stress, and challenges during recovery after hospital discharge. Inadequate preparation and limited follow-up support may affect patients' confidence in self-care and overall recovery. The purpose of this study is to evaluate the effects of a recovery-promoting program on self-efficacy, quality of recovery, and clinical outcomes in patients undergoing CABG surgery. Participants will receive standard postoperative care. In addition, participants in the intervention group will receive a recovery-promoting program provided by nurses, which includes structured education, guidance on postoperative activity and symptom management, and follow-up support after discharge. The study will assess changes in self-efficacy, quality of recovery, and selected clinical outcomes to compare recovery between participants who receive the recovery-promoting program and those who receive standard care.

Conditions

Coronary Artery Bypass Graft (CABG); Coronary Artery Disease (CAD); Postoperative Recovery

Keywords

Coronary Artery Bypass Graft; Quality of Recovery; Enhanced Recovery After Cardiac Surgery; Self-Efficacy; Cardiac Rehabilitation; Pulmonary Function; Functional Capacity

Outcome Measures

Primary Outcomes (1)

• Quality of Recovery after CABG.

  Quality of recovery will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire, a validated postoperative recovery instrument consisting of 15 items with a total score ranging from 0 to 150. The questionnaire assesses physical comfort, emotional state, psychological support, and physical independence. Higher scores indicate better postoperative recovery.

  up to 8 weeks after surgery

Secondary Outcomes (4)

• Self Efficacy

  Preoperative, baseline; within 2 weeks prior to surgery and immediately prior to surgery

• Functional capacity

  up to 8 weeks after surgery.

• Pulmonary Function

  Baseline (preoperative, at initial patient assessment); perioperative period (at hospital admission); at hospital discharge (postoperative day 7).

• Duration of mechanical ventilation

  Perioperative period.

Study Arms (2)

Recovery Promotion Program for CABG patients

EXPERIMENTAL

Participants in this arm receive an integrated recovery promotion program combining Cardiac Rehabilitation (CR) and Enhanced Recovery After Cardiac Surgery (ERAS) in addition to standard postoperative care. The program includes structured education, early mobilization, breathing exercises, symptom monitoring, and self-management support delivered by nurses through in-hospital sessions and a LINE Official Account after discharge. The intervention aims to enhance self-efficacy, promote functional recovery, and reduce postoperative complications following coronary artery bypass grafting (CABG).

Behavioral: Recovery Promotion Program for CABG patients

Standard CABG Care

ACTIVE COMPARATOR

Participants in this arm receive standard postoperative care according to hospital protocols for patients undergoing coronary artery bypass grafting (CABG). This includes routine medical and nursing care, usual postoperative monitoring, discharge education, and follow-up appointments without the structured integrated Cardiac Rehabilitation and ERAS program or LINE-based support.

Other: Standard Postoperative CABG Care

Interventions

Recovery Promotion Program for CABG patients BEHAVIORAL

An integrated recovery promotion program combining Cardiac Rehabilitation (CR) and Enhanced Recovery After Cardiac Surgery (ERAS) principles. The intervention is delivered by trained nurses and physiotherapists and consists of three phases: (1) preoperative phase including patient education, breathing exercises, and psychological preparation; (2) postoperative in-hospital phase including early mobilization, pulmonary rehabilitation, symptom monitoring, and individualized guidance; and (3) post-discharge phase including weekly follow-up, self-management support, and remote monitoring via LINE Official Account for six weeks. The program is designed to enhance self-efficacy, promote functional recovery, and reduce postoperative complications following CABG.

Recovery Promotion Program for CABG patients

Standard Postoperative CABG Care OTHER

Standard postoperative care for patients undergoing coronary artery bypass grafting (CABG) according to Rajavithi Hospital protocols. Care includes routine medical and nursing care, postoperative monitoring, physiotherapy, medication management, discharge education, and scheduled follow-up without the structured integrated CR-ERAS program or tele-nursing support.

Standard CABG Care

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Thai patients undergoing elective first-time on-pump coronary artery bypass graft (CABG) surgery alone or combined with valve surgery
• If age \>60 years, participants must pass cognitive screening using the 6-Item Cognitive Impairment Test (6-CIT)
• New York Heart Association (NYHA) functional class I-III
• Left ventricular ejection fraction (LVEF) \>30%
• Independent in activities of daily living and able to perform the 6-minute walk test (6MWT)

You may not qualify if:

• Severe or acute comorbidities within 24 hours prior to surgery (e.g., chronic obstructive pulmonary disease, renal failure, acute myocardial infarction, severe arrhythmia)
• Severe postoperative complications or unstable vital signs (e.g., major bleeding, significant arrhythmia, embolism, need for dialysis, extracorporeal membrane oxygenation)
• Disability or limited ambulation or mobility assessed prior to hospital discharge
• Failure of extubation within 3 days after surgery or requirement for reoperation

Sponsors & Collaborators

• Mahidol University: lead
• The Princess Mantarop Kamalas Foundation, The Nurses' Association of Thailand: collaborator
• Ramathibodi School of Nursing, Mahidol University: collaborator

Study Sites (1)

Rajavithi Hospital, Ministry of Public Health, Thailand

Bangkok, Bangkok, 10400, Thailand

Location

Related Publications (12)

• Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191-215. doi: 10.1037//0033-295x.84.2.191. No abstract available.

  PMID: 847061 BACKGROUND

• Narayanan LT, Hamid SRGS. Incentive spirometry inspiratory capacity changes and predictors after open heart surgery: a 5-day prospective study. Med J Malaysia. 2020 May;75(3):226-234.

  PMID: 32467537 BACKGROUND

• Brown TM, Pack QR, Aberegg E, Brewer LC, Ford YR, Forman DE, Gathright EC, Khadanga S, Ozemek C, Thomas RJ; American Heart Association Exercise, Cardiac Rehabilitation and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Lifestyle and Cardiometabolic Health; and Council on Quality of Care and Outcomes Research. Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2024 Oct 29;150(18):e328-e347. doi: 10.1161/CIR.0000000000001289. Epub 2024 Sep 24.

  PMID: 39315436 BACKGROUND

• Yang L, Kaye AD, Venakatesh AG, Green MS, Asgarian CD, Luedi MM, Liu H. Enhanced Recovery after Cardiac Surgery: An Update on Clinical Implications. Int Anesthesiol Clin. 2017 Fall;55(4):148-162. doi: 10.1097/AIA.0000000000000168. No abstract available.

  PMID: 28901988 BACKGROUND

• McConnell G, Woltz P, Bradford WT, Ledford JE, Williams JB. Enhanced recovery after cardiac surgery program to improve patient outcomes. Nursing. 2018 Nov;48(11):24-31. doi: 10.1097/01.NURSE.0000546453.18005.3f.

  PMID: 30286030 BACKGROUND

• Akowuah EF, Wagnild JM, Bardgett M, Prichard JG, Mathias A, Harrison SL, Ogundimu EO, Hancock HC, Maier RH; PREPs Trial investigators. A randomised controlled trial of prehabilitation in patients undergoing elective cardiac surgery. Anaesthesia. 2023 Sep;78(9):1120-1128. doi: 10.1111/anae.16072. Epub 2023 Jul 4.

  PMID: 37402352 BACKGROUND

• Gibbison B, Pufulete M. Prehabilitation before cardiac surgery. Br J Anaesth. 2025 Jan;134(1):5-7. doi: 10.1016/j.bja.2024.11.001. Epub 2024 Nov 26.

  PMID: 39603851 BACKGROUND

• Steinmetz C, Bjarnason-Wehrens B, Walther T, Schaffland TF, Walther C. Efficacy of Prehabilitation Before Cardiac Surgery: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil. 2023 Apr 1;102(4):323-330. doi: 10.1097/PHM.0000000000002097. Epub 2022 Sep 23.

  PMID: 36149383 BACKGROUND

• Kanejima Y, Shimogai T, Kitamura M, Ishihara K, Izawa KP. Effect of Early Mobilization on Physical Function in Patients after Cardiac Surgery: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 Sep 28;17(19):7091. doi: 10.3390/ijerph17197091.

  PMID: 32998202 BACKGROUND

• Chen B, Xie G, Lin Y, Chen L, Lin Z, You X, Xie X, Dong D, Zheng X, Li D, Lin W. A systematic review and meta-analysis of the effects of early mobilization therapy in patients after cardiac surgery. Medicine (Baltimore). 2021 Apr 16;100(15):e25314. doi: 10.1097/MD.0000000000025314.

  PMID: 33847630 BACKGROUND

• Borges MGB, Borges DL, Ribeiro MO, Lima LSS, Macedo KCM, Nina VJDS. Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review. Braz J Cardiovasc Surg. 2022 May 2;37(2):227-238. doi: 10.21470/1678-9741-2021-0140.

  PMID: 35244377 BACKGROUND

• Zhang Y, Chong JH, Harky A. Enhanced recovery after cardiac surgery and its impact on outcomes: A systematic review. Perfusion. 2022 Mar;37(2):162-174. doi: 10.1177/0267659121988957. Epub 2021 Jan 19.

  PMID: 33468017 BACKGROUND

MeSH Terms

Conditions

Coronary Artery Disease

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Masking Details: This is an open-label study. No masking is applied to participants, care providers, investigators, or outcome assessors.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Registered Nurse and Graduate Student (Master of Nursing Science)

Model Details: This study uses a parallel-group design comparing two groups of patients undergoing coronary artery bypass graft surgery. Participants in the control group receive standard postoperative care, while participants in the experimental group receive a recovery-promoting program in addition to standard care. Outcomes are assessed and compared between groups at predefined time points.

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: February 6, 2026
• Study Start: August 22, 2025
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: February 6, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)