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    Challenges experienced by cardiac intensive care nurses during first out-of-bed patient mobilization after open-heart surgery: A descriptive phenomenological qualitative study
    (Wiley, 2024) Unver, Seher; Yildirim, Meltem; Akbal, Sevim; Sever, Seda
    Aim To investigate the potential challenges experienced by cardiac intensive care unit (ICU) nurses in the first out-of-bed patient mobilization after open-heart surgery and propose solutions. Design A qualitative study design using the descriptive phenomenological approach. Methods Individual face-to-face interviews were conducted via a widely used videoconferencing program between 28 July and 22 October 2022, in the tertiary cardiac ICU of a university hospital. Nurses who had at least 1 year of cardiac ICU experience and actively participating in patient care were included. The COREQ criteria and checklist were followed in this investigation and the data were analysed by using the ATLAS.ti 8.0. Findings Nurses reported that they experience challenges when mobilizing patients, such as patients' fear, reluctance or resistance; nurses having insufficient experience, strength or lack of team members. Despite these challenges, they highlighted some positive outcomes of mobilization, such as feeling happy, reinforced team communication and nurse-patient relationship. The nurses also suggested some facilitators, such as patient motivation and an explanation of the process. Conclusion Nurses experience various patient-related and nurse-related challenges during the first out-of-bed mobilization of the patient after open-heart surgery. It is recommended that healthcare institutions should implement effective strategies to address the staffing shortages and to support nurse motivation to ensure adequate nursing care. Impact This study provides valuable insights into the existing literature by examining the potential challenges and strategies of the first out-of-bed patient mobilization in the cardiac ICU. It shows that patient education and organizational adaptations are effective ways to overcome the challenges. It also suggests that motivating and informing patients before the mobilization can make the process easier. Moreover, it reveals that successful patient mobilization makes nurses happy, improves team communication and strengthens nurse-patient relationship. Patient and Public Involvement and EngagementNo patient or public contribution.
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    The effect of self-affirmation on anxiety and perceived discomfort in patients who have undergone open-heart surgery. A randomized controlled trial
    (W B Saunders Co-Elsevier Inc, 2023) Yildirim, Meltem; Akbal, Sevim; Turkoglu, Meryem
    Background: Self-affirmations help one focus on positive outcomes and adapt to new situations both psycho-logically and physiologically by the repetition of positive affirmation sentences. This method, which has promising results in symptom management, is predicted to have effective results in the management of pain and discomfort in patients undergoing open-heart surgery.Aim: To investigate the effect of self-affirmation on anxiety and perceived discomfort in patients who have undergone open-heart surgery.Methods: This study adopted a randomized controlled pretest-posttest follow-up research design. The study was conducted at a public training and research hospital (Istanbul, Turkey) specialized in thoracic and cardiovascular surgery. The sample consisted of 61 patients randomized into two groups: intervention (n = 34) and control (n = 27). The participants of the intervention group listened to a self-affirmation audio recording for three days after surgery. Anxiety levels and perceived discomfort regarding pain, dyspnoea, palpitations, fatigue and nausea were measured daily. The State Trait Anxiety Inventory (STAI) was used to measure the level of anxiety, meanwhile perceived discomfort regarding pain, dyspnoea, palpitations, fatigue and nausea were measured by a 0 to 10 Numeric Rating Scale (NRS).Results: The control group had significantly higher anxiety than the intervention group three days after surgery (P < 0.001). The intervention group had less pain (P < 0.01), dyspnoea (P < 0.01), palpitations (P < 0.01), fatigue (P < 0.001) and nausea (P < 0.01) than the control group.Conclusions: Positive self-affirmation helped reduce anxiety and perceived discomfort in patients who underwent open-heart surgery. ClinicalTrials.gov Identifier: NCT05487430.