Salehi Mansour, Froutan Razieh, Mazlom Seyed Reza
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Nurs Midwifery Res. 2024 Sep 4;29(5):568-576. doi: 10.4103/ijnmr.ijnmr_335_23. eCollection 2024 Sep-Oct.
Many patients with advanced cardiovascular disease need Coronary Artery Bypass Graft (CABG) surgery, indicating the importance of cardiac rehabilitation. Our study explored the combined efficacy of simulation (using demonstration and return-demonstration approach) with music on post-Open Heart Surgery (OHS) outcomes.
This randomized, controlled trial was conducted at Imam Reza Hospital, Mashhad, Iran, on 90 patients awaiting OHS. The participants were allocated to 3 groups: education via simulation, education via simulation enhanced by instrumental music, and conventional instruction. Evaluations were performed pre-education and 2-days post-surgery using the activity measure for post-acute care (AM-PAC) "6-Clicks" Questionnaire, 18-item Nursing Outcomes Classification (NOC) index, and State-Trait Anxiety Inventory (STAI). JASP software (JASP Team, 2023, Version 0.17.3) was employed for statistical analyses, using RM-ANOVA and ANCOVA test.
The results revealed a significant effect in immediate post-intervention and 2-day follow-up periods across all outcome measures (all < 0.05), except for activity. tests demonstrated substantial variations in effect sizes between intervention and control groups. Both intervention groups had significantly greater impact than the control group, particularly the composite group, showing heightened effects in state and trait anxiety and respiratory scores ( < 0.05).
The combined use of the simulation with rhythmic music in phase one cardiac rehabilitation notably improved post-surgical outcomes, outperforming the method without music. This approach shows promise as an effective instructional strategy in cardiac rehabilitation stages.
许多晚期心血管疾病患者需要进行冠状动脉旁路移植术（CABG）手术，这表明心脏康复的重要性。我们的研究探讨了模拟（采用示范和回示方法）与音乐相结合对心脏直视手术后（OHS）结果的综合疗效。
这项随机对照试验在伊朗马什哈德的伊玛目礼萨医院对90名等待心脏直视手术的患者进行。参与者被分为3组：通过模拟进行教育、通过器乐音乐增强模拟进行教育以及传统指导。在教育前和手术后2天使用急性后期护理活动测量（AM-PAC）“6次点击”问卷、18项护理结果分类（NOC）指标和状态-特质焦虑量表（STAI）进行评估。使用JASP软件（JASP团队，2023年，版本0.17.3）进行统计分析，采用重复测量方差分析和协方差分析测试。
结果显示，除活动外，在所有结果测量的干预后即刻和2天随访期均有显著效果（均<0.05）。检验表明干预组和对照组之间的效应大小存在显著差异。两个干预组的影响均显著大于对照组，尤其是综合组，在状态和特质焦虑以及呼吸评分方面显示出更大的效果（<0.05）。
在心脏康复第一阶段将模拟与节奏音乐结合使用显著改善了术后结果，优于无音乐的方法。这种方法有望成为心脏康复阶段一种有效的指导策略。
