The effect of comfort-based care (Reflective massage and education to patient) on comfort in patients undergoing coronary artery bypass grafting

Introduction: Growing incidence of cardiovascular disease and various treatment procedures, including coronary artery bypass graft surgery, is a stressful experience for the patient and the family. The multiple complications of surgery during hospitalization can have impacts on the patient comfort, which may require comfort-centered nursing care. Studies in this regard report conflicting results concerning the effects of these interventions. Considering the importance of nursing care and its impact on elimination of the needs and reduction of the patient's problems in cardiac surgery, this study was designed to determine the effect of comfort-centered nursing care, including reflective massage and education, on the comfort of patients undergoing coronary artery bypass grafting (CABG). Methods: In this randomized clinical trial, ۷۰ CABG patients were selected with convenience sampling method and allocated into intervention and control groups via permuted block randomization. The data collection tools comprised of demographics form and Hospice Comfort Questionnaire (HCQ) the reliability of the latter was calculated by Cronbach's alpha as ۰.۷۵. Initially, the prevalent needs of the patients were determined including pain in the sternum, anxiety, lack of awareness of post-operative care, sleep disturbance. Also, disruptions in comfort were assessed using the HCQ. The intervention group received the comfort-centered care program once a day for ۶ days. The program included foot reflective massage and education to patients, whereas the controls received the routine cares. In the end of the sixth session, both groups completed the comfort questionnaire. Data were analyzed by SPSS software version ۲۳ using descriptive (mean, standard deviation, frequency and percentage) and inferential statistics (independent t, Mann-Whitney U, and Wilcoxon). The significant level was set at P <۰.۰۵. Results: The mean of comfort score increased in the intervention group after intervention (P <۰.۰۰۱). Also, in the control group, the mean score of comfort and its dimensions significantly improve after intervention (P <۰.۰۰۱). However, the mean scores of changes in comfort and its dimensions was not significantly different in the intervention and control groups after intervention relative to before intervention (P >۰.۰۵). Conclusions: This study reported significant increase of comfort in both groups, positive effect of care implementation and nurse`s presence on better communication with patient and comfort in critical conditions after surgery.

Keywords:

Comfort-centered care , Comfort , Reflective massage , Education to patient , Coronary artery bypass graft