School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Australian Centre for Heart Health, Melbourne, Australia.
J Med Internet Res. 2021 Dec 10;23(12):e22557. doi: 10.2196/22557.
Patients undergoing coronary artery bypass graft surgery (CABGS) may fail to adhere to their treatment regimen for many reasons. Among these, one of the most important reasons for nonadherence is the inadequate training of such patients or training using inappropriate methods.
This study aimed to compare the effect of gamification and teach-back training methods on adherence to a therapeutic regimen in patients after CABGS.
This randomized clinical trial was conducted on 123 patients undergoing CABGS in Tehran, Iran, in 2019. Training was provided to the teach-back group individually. In the gamification group, an app developed for the purpose was installed on each patient's smartphone, with training given via this device. The control group received usual care, or routine training. Adherence to the therapeutic regimen was assessed using a questionnaire on adherence to a therapeutic regimen (physical activity and dietary regimen) and an adherence scale as a pretest and a 1-month posttest.
One-way analysis of variance (ANOVA) for comparing the mean scores of teach-back and gamification training methods showed that the mean normalized scores for the dietary regimen (P<.001, F=71.80), movement regimen (P<.001, F=124.53), and medication regimen (P<.001, F=9.66) before and after intervention were significantly different between the teach-back, gamification, and control groups. In addition, the results of the Dunnett test showed that the teach-back and gamification groups were significantly different from the control group in all three treatment regimen methods. There was no statistically significant difference in adherence to the therapeutic regimen between the teach-back and control groups.
Based on the results of this study, the use of teach-back and gamification training approaches may be suggested for patients after CABGS to facilitate adherence to the therapeutic regimen.
Iranian Registry of Clinical Trials IRCT20111203008286N8; https://en.irct.ir/trial/41507.
接受冠状动脉旁路移植术（CABGS）的患者可能由于多种原因无法坚持其治疗方案。其中，不遵医嘱最重要的原因之一是对这些患者的培训不足或培训方法不当。
本研究旨在比较游戏化和回授培训方法对 CABGS 后患者治疗方案依从性的影响。
这是 2019 年在伊朗德黑兰进行的一项随机临床试验，共纳入 123 名接受 CABGS 的患者。对回授组进行个体培训。在游戏化组中，为每位患者的智能手机安装了一个专门开发的应用程序，通过该设备进行培训。对照组接受常规护理或常规培训。使用治疗方案依从性问卷（体力活动和饮食方案）和依从性量表评估治疗方案的依从性，作为预测试和 1 个月后测试。
单向方差分析（ANOVA）比较回授和游戏化培训方法的平均得分显示，饮食方案（P<.001，F=71.80）、运动方案（P<.001，F=124.53）和药物方案（P<.001，F=9.66）在干预前后的平均标准化得分在回授、游戏化和对照组之间有显著差异。此外，Dunnett 检验结果表明，在所有三种治疗方案中，回授组和游戏化组与对照组均有显著差异。回授组和对照组在治疗方案的依从性方面无统计学差异。
根据本研究结果，建议 CABGS 后患者使用回授和游戏化培训方法，以促进治疗方案的依从性。
伊朗临床试验注册中心 IRCT20111203008286N8；https://en.irct.ir/trial/41507.
