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This study is a randomized controlled trial aiming to compare targeted individualized nursing care with standard care in frail elderly patients undergoing cardiac surgery.
The hypotheses of the study are:
H1: Targeted individualized nursing care has an effect on the frailty level of frail elderly patients undergoing cardiac surgery.
H2: Targeted individualized nursing care affects the factors influencing frailty in frail elderly patients undergoing cardiac surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | Standard nursing care was provided to patients in this group | |
| Targeted Individualized Nursing Care Group | Experimental | An individualized nursing intervention targeting risk factors associated with frailty was planned for patients in this group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Experimental | Other | Targeted Individualized Nursing Care |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive Function - Standardized Mini-Mental State Examination (MMSE) | Cognitive status will be assessed using the Standardized Mini-Mental State Examination (MMSE). The MMSE evaluates orientation, memory, attention, recall, language, and visuospatial skills. The total score ranges from 0 to 30, with higher scores indicating better cognitive function. Scores of 23 or below are generally considered indicative of cognitive impairment. | Postoperative day 1 and the day of discharge |
| Cognitive Function - Delirium Risk - Nursing Delirium Screening Scale (Nu-DESC) | Delirium risk will be evaluated using the Nursing Delirium Screening Scale (Nu-DESC). The scale assesses five domains: disorientation, inappropriate behavior, inappropriate communication, hallucinations, and psychomotor retardation. Each symptom is scored per shift as follows: 0 points: Symptom absent, 1 point: Symptom present/mild, 2 points: Symptom present and pronounced/severe A total score of 2 points or higher is considered indicative of delirium. | Postoperative day 1 and the day of discharge |
| Physical Status Assessment - Pain Level - Numeric Rating Scale (NRS) | Pain Level - Numeric Rating Scale (NRS): Pain intensity will be assessed using the Numeric Rating Scale (NRS). Patients rate their pain from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. | Postoperative day 1 and the day of discharge |
| Physical Status Assessment - Katz Activities of Daily Living (ADL) Scale | Katz Activities of Daily Living (ADL) Scale: Functional status will be evaluated using the Katz Activities of Daily Living (ADL) Scale, which assesses independence in six activities: bathing, dressing, toileting, transferring, continence, and feeding. Higher scores indicate greater independence in daily activities. Evaluation of the scale is based on the total score obtained from these items: 0-6 points: Dependent, 7-12 points: Partially dependent, 13-18 points: Independent. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Eskişehir Osmangazi University Health, Practice, and Research Hospital | Eskişehir | Turkey (Türkiye) |
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Targeted Individualized Nursing Care Group (Intervention Group) Standard Care Group (Control Group)
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| Postoperative day 1 and the day of discharge |
| Physical Status Assessment - Itaki Fall Risk Scale | Itaki Fall Risk Scale: The Itaki Fall Risk Scale will be used to evaluate patients' risk of falling. The scale assesses various risk factors related to falls in hospitalized patients. The scale consists of 19 risk factors that may contribute to patient falls. The risk factors are categorized as major and minor, with 1 point assigned for each minor risk factor and 5 points for each major risk factor. Based on the total score obtained from evaluating all risk factors, two risk levels are defined: 0-4 points: Low risk, 5 points and above: High risk. | Postoperative day 1 and the day of discharge |
| Nutritional Status - Mini Nutritional Assessment Short Form (MNA-SF) | Mini Nutritional Assessment Short Form (MNA-SF): Nutritional status will be assessed using the Mini Nutritional Assessment-Short Form (MNA-SF). The total score ranges from 0 to 14, with higher scores indicating better nutritional status. | Postoperative day 1 and the day of discharge |
| Psychological Status Assessment - Geriatric Depression Scale (GDS) | Geriatric Depression Scale-15 (Short Form): It is a scale used to screen for depression in older adults. The total score ranges from 0 to 15. Scores of 0-4 indicate no depression, 5-8 indicate mild depression, 9-11 indicate moderate depression, and 12-15 indicate severe depression. | Postoperative day 1 and the day of discharge |