CABG-AI-Supported Discharge Education

NCT07503678 | Not Yet Recruiting DMC

• 1 other identifier: SBUVAN-KABG-AI-DISCHARGE-EDU-0
• Study Type: interventional
• Target: 128
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized controlled trial will evaluate the effectiveness of artificial intelligence-supported individualized discharge education for patients undergoing coronary artery bypass graft (CABG) surgery. Participants will be assigned to either the intervention group, which will receive personalized AI-generated discharge education delivered through a nurse-avatar video in addition to standard verbal education, or the control group, which will receive standard discharge education only. The study will compare postoperative pain, anxiety, physiological stress response, recovery, and satisfaction with discharge education between the two groups. Outcomes will be measured during hospitalization and at the routine postoperative follow-up visit. The findings may help improve patient education methods and postoperative recovery in cardiac surgery patients.

Conditions

Coronary Artery Disease; Postoperative Care; Patient Discharge; Recovery of Function; Anxiety; Pain; Stress, Physiological; Surgical Nursing; Nursing; Discharge Education

Keywords

Coronary Artery Disease; Postoperative Care; Patient Discharge; discharge education; Surgical Nursing

Outcome Measures

Primary Outcomes (10)

• Pain Intensity

  Anxiety will be measured using a 10-cm Visual Analog Scale (VAS). Participants will indicate their perceived level of anxiety on a horizontal line ranging from 0 to 10, where 0 represents "no anxiety" and 10 represents "the highest possible level of anxiety." The score is obtained by measuring the distance in centimeters from the left end of the scale to the participant's mark, producing a continuous value between 0 and 10. Higher scores indicate higher levels of anxiety. This measure allows for sensitive detection of changes in anxiety over time. No threshold or categorical classification is used; all results are reported as continuous VAS scores.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Anxiety Level

  Anxiety will be assessed using the Visual Analog Scale (VAS). The scale ranges from 0 to 10, where higher scores indicate greater anxiety levels.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Serum Cortisol Level

  Physiological stress will be evaluated by measuring serum cortisol levels obtained from venous blood samples. Higher cortisol levels indicate increased physiological stress response.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Postoperative Recovery

  Postoperative recovery will be evaluated using a validated postoperative recovery scale assessing physical, emotional, and functional recovery. Higher scores indicate better postoperative recovery.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Satisfaction with Discharge Education

  Satisfaction with discharge education will be measured using a validated satisfaction scale assessing patients' satisfaction with the information received before discharge. Higher scores indicate greater satisfaction.

  Pre-discharge (within 24 hours before discharge) and 4 weeks (±3 days) post-discharge

• Blood Pressure - Systolic

  Systolic blood pressure will be measured using a calibrated clinical blood pressure monitor and recorded in mmHg. Higher values indicate higher arterial pressure during cardiac contraction.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Blood Pressure - Diastolic

  Diastolic blood pressure will be measured using a calibrated clinical blood pressure monitor and recorded in mmHg. Higher values indicate arterial pressure during cardiac relaxation.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Respiratory Rate

  Respiratory rate will be measured by counting the number of chest rises over one minute and recorded as breaths per minute (breaths/min). Higher values indicate increased respiratory effort or possible respiratory distress.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Oxygen Saturation (SpO₂)

  Oxygen saturation will be measured using pulse oximetry and recorded as the percentage of oxygen-saturated hemoglobin in arterial blood. Lower values indicate impaired oxygenation.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

• Body Temperature

  Body temperature will be measured using a digital thermometer and recorded in degrees Celsius (°C). Deviations from normal temperature may indicate infection or inflammatory response.

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

Secondary Outcomes (1)

• Heart Rate

  Baseline (1 day before discharge), pre-discharge (within 24 hours before discharge), and 4 weeks (±3 days) post-discharge

Study Arms (2)

AI-Supported Discharge Education

EXPERIMENTAL

Participants in this arm will receive individualized discharge education generated by an artificial intelligence system (ChatGPT) and delivered through a nurse-avatar video. This education covers 6 main topics and 24 subcomponents tailored to the patient's clinical, social, and psychosocial characteristics. Participants will also receive the standard verbal discharge education routinely provided by cardiovascular surgery nurses.

Behavioral: AI-Supported Individualized Discharge Education; Behavioral: Standard Discharge Education

Standard Discharge Education

ACTIVE COMPARATOR

Participants in this arm will receive only the standard verbal discharge education routinely provided by cardiovascular surgery nurses, based on hospital discharge protocols. No AI-generated or video-based educational materials will be used in this group.

Behavioral: Standard Discharge Education

Interventions

AI-Supported Individualized Discharge Education BEHAVIORAL

This intervention consists of personalized discharge education generated by an advanced artificial intelligence system (ChatGPT) based on the patient's clinical, social, and psychosocial characteristics. The content is structured into 6 main topics and 24 sub-sections. The script is converted into a nurse-avatar video and delivered to the patient via a mobile device. This intervention is provided in addition to the standard verbal discharge education routinely given by cardiovascular surgery nurses.

AI-Supported Discharge Education

Standard Discharge Education BEHAVIORAL

This intervention consists of routine verbal discharge education provided by cardiovascular surgery nurses according to standard hospital protocols. It includes essential postoperative instructions, medication guidance, wound care instructions, activity recommendations, and follow-up information. No AI-generated or video-based educational materials are provided in this intervention.

AI-Supported Discharge Education; Standard Discharge Education

Eligibility Criteria

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

You may qualify if:

• Patients who have undergone coronary artery bypass graft (CABG) surgery.
• Age 18 years or older.
• Hemodynamically stable at the time of enrollment.
• Able to understand and communicate in Turkish.
• Able to use or have access to a mobile phone capable of viewing the educational video.
• Able to provide informed consent.
• Scheduled for routine postoperative follow-up at the study hospital.

You may not qualify if:

• Patients undergoing emergency CABG surgery.
• Presence of severe cognitive impairment that prevents understanding or following instructions.
• Diagnosed psychiatric disorders (e.g., schizophrenia, severe depression) that interfere with study participation.
• Severe vision or hearing impairment that prevents receiving the education.
• Presence of postoperative complications requiring intensive care readmission.
• Patients with endocrine disorders affecting stress biomarkers (e.g., Cushing's syndrome, Addison's disease).
• Chronic use of corticosteroids or medications that significantly alter cortisol levels.
• Patients who decline to participate or withdraw consent.
• Patients who are unable to complete follow-up assessments.

Sponsors & Collaborators

• Hasan Kalyoncu University: lead

Related Publications (5)

• Ronaldson S., et al. (2022). Patient-centered education in postoperative cardiac care: A systematic review. Heart & Lung, 55, 54-62.

  BACKGROUND

• Akbari M., Çelik S. (2015). Effects of nurse-led discharge training on anxiety and recovery in surgical patients. Journal of Perioperative Nursing, 28(4), 215-223.

  BACKGROUND

• Minami K., et al. (2020). Effects of discharge education on postoperative recovery in cardiac surgery patients. European Journal of Cardiovascular Nursing, 19(7), 660-668.

  BACKGROUND

• Hwang B., et al. (2023). Artificial intelligence in patient education: A scoping review. Patient Education and Counseling, 112, 107-115.

  BACKGROUND

• Fredericks S., Guruge S. (2012). Postoperative patient education: A systematic review. Clinical Nursing Research, 21(4), 379-402. doi:10.1177/1054773812440814

  BACKGROUND

MeSH Terms

Conditions

Coronary Artery Disease; Anxiety Disorders; Pain

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases; Mental Disorders; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Uğur Akman, RN, MSc

CONTACT

+905428155049; ugurkman@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: No masking was used. This is an open-label trial, and no parties were blinded to group assignment.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director

Model Details: Participants will be randomly assigned to one of two parallel groups. The intervention group will receive AI-supported individualized discharge education delivered through a nurse-avatar video in addition to standard verbal education. The control group will receive standard discharge education only. Each participant will remain in the group to which they were originally assigned throughout the study.

Study Record Dates

• First Submitted: November 25, 2025
• First Posted: March 31, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): February 1, 2027
• Last Updated: March 31, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share