The Effect of Therapeutic Approach-Based Education on Intubation and Agitation in Open-Heart Surgery Patients: A Randomized Controlled Trial

Research Hypotheses
H-1: The intubation responses of patients in the experimental group who received pre- and post-operative education
will differ from those of patients in the control group.
H-1-1: The intubation responses of patients in the experimental group who received pre- and post-operative education
will be less than those of patients in the control group.
H-2: The agitation behaviours of patients in the experimental group who received pre- and post-operative education, as measured by the RASS scale,
will differ from those of patients in the control group.
H-2-1: The agitation behaviours of patients in the experimental group who received pre- and post-operative education, as measured by the RASS scale,
will be less than those of patients in the control group.
H-3: The intubation time of the experimental group patients who received pre- and post-surgery education will be different from that of the control group patients.
H-3-1: The intubation time of the experimental group patients who received pre- and post-surgery education will be shorter than that of the control group patients.

Place and Time of the Research
The study was conducted between 10 October 2022 and 7 January 2023 at a foundation university hospital in Istanbul, in the intensive care unit and inpatient ward of the Department of Cardiovascular Surgery.

All participants completed a sociodemographic information form and a numerical anxiety scale before surgery. Four hours after awakening, the researcher completed the RASS and Intubation Response Form for all participants and recorded the duration of intubation.

Differences in the proportions of categorical variables between independent groups were analysed using the Chi-square and Fisher's exact tests. Differences in continuous variables between groups were analysed using the independent groups t-test.
The experimental and control groups were determined to be homogeneous in terms of sampling. When analysed, the intubation responses of the experimental and control groups showed significant differences in terms of wrinkled facial expression and blanket-pulling response.
No differences were observed between the groups in terms of other parameters. A statistically significant difference was found between the experimental and control groups in terms of the wrinkled facial expression response (X² = 5.000; p = 0.030 < 0.05). The percentage of participants exhibiting a wrinkled facial expression in the control group (80.0%) was higher than that in the experimental group (40.0%). A significant difference was also found between the groups in terms of the response of gathering the sheet with their hands (X² = 6.652; p = 0.013 < 0.05). The rate of this response in the control group (66.7%) was higher than that in the experimental group (20.0%). The results indicate that the control group exhibited these two behavioural responses more frequently than the experimental group.