Preventive Care in Nursing and Midwifery Journal
Volume 16, Issue 2 (4-2026)
Prev Care Nurs Midwifery J 2026, 16(2): 118-134 |
Back to browse issues page
Ethics code: N/A
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Kalantari S, mohammadi M, Alipour R, Aligholipour M, Khezerlou Z, Esmaeilbeigi D, et al . Effect of Telenursing Based Interventions on Health Outcomes After Cardiac Surgery: A Systematic Review. Prev Care Nurs Midwifery J 2026; 16 (2) :118-134
URL: http://nmcjournal.zums.ac.ir/article-1-1056-en.html
URL: http://nmcjournal.zums.ac.ir/article-1-1056-en.html
Saba Kalantari 
, Maryam Mohammadi * , Razie Alipour , Mahtab Aligholipour , Zahra Khezerlou , Darya Esmaeilbeigi , Kazem Hajimohammadi , Nima Sohrabi
, Maryam Mohammadi * , Razie Alipour , Mahtab Aligholipour , Zahra Khezerlou , Darya Esmaeilbeigi , Kazem Hajimohammadi , Nima Sohrabi
Pediatric Nursing Department, Nursing and Midwifery School, Zanjan University of Medical Sciences, Zanjan, Iran , Mmohammadi@zums.ac.ir
Abstract: (202 Views)
Background: Patients undergoing cardiac surgery are at risk of adverse outcomes, including hospital readmission, postoperative complications, psychological distress, and reduced quality of life. Telenursing-based interventions, including patient education, remote monitoring, and post-discharge follow-up, may improve recovery; however, their effectiveness has not been comprehensively synthesized.
Objectives: This systematic review aimed to evaluate the effectiveness of telenursing‑based interventions on health outcomes following cardiac surgery in adult patients.
Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, SID, MagIran, and Google Scholar from inception to June 28, 2026. We included interventional studies that investigated telenursing‑based interventions in patients after cardiac surgery and assessed at least one health‑related outcome. Risk of bias was evaluated using the Cochrane RoB 2 tool. A narrative synthesis was undertaken due to substantial heterogeneity.
Results: Of 535 records identified, 11 studies involving 3,262 participants met the inclusion criteria. Outcomes included quality of life, psychological outcomes, self‑care behaviors, physical functioning, pain, hospital readmission, and healthcare utilization. Most studies reported beneficial effects of telenursing interventions, particularly on quality of life, psychological outcomes, self‑care, physical functioning, and reduced readmissions. Two studies had a high risk of bias; nine raised some methodological concerns.
Conclusion: Telenursing-based interventions may complement post-cardiac surgery care by improving patient-centered outcomes and reducing healthcare utilization. However, methodological limitations and heterogeneity warrant further high‑quality studies to confirm these findings and identify optimal implementation strategies.
Objectives: This systematic review aimed to evaluate the effectiveness of telenursing‑based interventions on health outcomes following cardiac surgery in adult patients.
Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, SID, MagIran, and Google Scholar from inception to June 28, 2026. We included interventional studies that investigated telenursing‑based interventions in patients after cardiac surgery and assessed at least one health‑related outcome. Risk of bias was evaluated using the Cochrane RoB 2 tool. A narrative synthesis was undertaken due to substantial heterogeneity.
Results: Of 535 records identified, 11 studies involving 3,262 participants met the inclusion criteria. Outcomes included quality of life, psychological outcomes, self‑care behaviors, physical functioning, pain, hospital readmission, and healthcare utilization. Most studies reported beneficial effects of telenursing interventions, particularly on quality of life, psychological outcomes, self‑care, physical functioning, and reduced readmissions. Two studies had a high risk of bias; nine raised some methodological concerns.
Conclusion: Telenursing-based interventions may complement post-cardiac surgery care by improving patient-centered outcomes and reducing healthcare utilization. However, methodological limitations and heterogeneity warrant further high‑quality studies to confirm these findings and identify optimal implementation strategies.
Full-Text [PDF 843 kb]
(72 Downloads)
| | Full-Text (HTML) (35 Views)
Knowledge Translation Statement
Audience: Nursing managers, cardiac surgery ward administrators, and post-discharge care coordinators
Telenursing interventions were associated with improved psychological outcomes, self-care, and functional status, and with reduced healthcare utilization after cardiac surgery. Managers may consider telenursing as a complementary approach in structured post-discharge care.
Type of Study: Review Articels |
Subject:
Nursing
References
1. World Health Organization. Cardiovascular diseases (CVDs) [Internet]. Geneva: World Health Organization; 2025. [https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)]
2. Tsao CW, Aday AW, Almarzooq ZI, Anderson CA, Arora P, Avery CL, et al. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93. [https://doi.org/10.1161/CIR.0000000000001123] [PMID]
3. Lilly LS. Braunwald's heart disease review and assessment e-book: a companion to Braunwald's heart disease. Philadelphia: Elsevier Health Sciences; 2022. [https://shop.elsevier.com/books/braunwalds-heart-disease-review-and-assessment/lilly/978-0-323-83513]
4. Wu KA, Kunte S, Rajkumar S, Venkatraman V, Kim G, Kaplan S, et al. Digital health for patients undergoing cardiac surgery: a systematic review. Healthcare. 2023;11(17):2411. [https://doi.org/10.3390/healthcare11172411] [PMID]
5. Audet L-A, Paquette L, Bordeleau S, Lavoie-Tremblay M, Kilpatrick K. The association between advanced practice nursing roles and outcomes in adults following cardiac surgery: a systematic review of randomized controlled trials. International Journal of Nursing Studies. 2021; 122:104028. [https://doi.org/10.1016/j.ijnurstu.2021.104028] [PMID]
6. Matthews S, Fredericks S, Delaney L, Abbs M, Guiriba GM, Nasrawi D, et al. Nurse-led postoperative interventions in adult cardiac surgery: a systematic review. European Journal of Cardiovascular Nursing. 2026; zvag112. [https://doi.org/10.1093/eurjcn/zvag112] [PMID]
7. Ni R, Liu M, Huang S, Yang J. Effects of eHealth interventions on quality of life and psychological outcomes in cardiac surgery patients: systematic review and meta-analysis. Journal of Medical Internet Research. 2022;24(8): e40090. [https://doi.org/10.2196/40090] [PMID]
8. Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, et al. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA Surgery. 2019;154(8):755-766. [https://doi.org/10.1001/jamasurg.2019.1153] [PMID]
9. Kajti E, Selçuk I, Selçuk ÜN, Toköz H, Özbaş A. Effects of discharge education program on recovery and quality of life after cardiac surgery: a 12-week follow-up single-blind randomized controlled trial. BMC Surgery. 2026;26: e03939. [https://doi.org/10.1186/s12893-026-03939-4] [PMID]
10. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2023;44(37):3627-3639. [https://doi.org/10.1002/ejhf.3024] [PMID]
11. Chu T-L, Farhadi B, Couper AL. Effect of telenursing on prevention of readmission in patients with heart failure: a systematic review. Journal of Nursing Reports in Clinical Practice. 2025;3(6):591-600. [https://doi.org/10.32598/JNRCP.2411.1192]
12. Srivastava A, Do J-M, Sales VL, Ly S, Joseph J. Impact of patient-centred home telehealth programme on outcomes in heart failure. Journal of Telemedicine and Telecare. 2019;25(7):425-430. [https://doi.org/10.1177/1357633X18775852] [PMID]
13. Cao G, Fan C, Liu Y, Huang H, Li J, Liang J, et al. A telehealth program benefits discharged patients with heart failure. Acta Cardiologica. 2023;78(2):195-202. [https://doi.org/10.1080/00015385.2021.1999571] [PMID]
14. Wynne R, Nolte J, Angel J, Moore A, Campbell T, Ferguson C. A pilot randomized controlled trial to test the feasibility of a mobile health (mHealth) self-help intervention for adults after cardiac surgery. European Journal of Cardiovascular Nursing. 2026;25(2):354-363. [https://doi.org/10.1093/eurjcn/zvaf190] [PMID]
15. Al-Tamimi MA-A, Gillani SW, Abd Alhakam ME, Sam KG. Factors associated with hospital readmission of heart failure patients. Frontiers in Pharmacology. 2021; 12:732760. [https://doi.org/10.3389/fphar.2021.732760] [PMID]
16. Zhang Y-y, Cui L-X, Zhang L, Wang Y. Continuous nursing care improving outcomes of patients after percutaneous coronary intervention. Medicine. 2024;103(48):e40807. [https://doi.org/10.1097/MD.0000000000040807] [PMID]
17. Yadav S, Sethi R, Pradhan A, Vishwakarma P, Bhandari M, Gattani R, et al. Routine versus smartphone application-based intense follow-up of patients with acute coronary syndrome undergoing percutaneous coronary intervention: impact on clinical outcomes and patient satisfaction. IJC Heart & Vasculature. 2021; 35:100832. [https://doi.org/10.1016/j.ijcha.2021.100832] [PMID]
18. Gimenez VCdA, Almeida GMFd, Cyrino CMS, Lemos CdS, Favoretto C, Avila MAGd. Teleenfermería posoperatoria: revisión del alcance. Revista Brasileira de Enfermagem. 2024;77(3):e20240066. [https://doi.org/10.1590/0034-7167-2024-0066] [PMID]
19. World Health Organization. Global strategy on digital health 2020-2027 [Internet]. Geneva: World Health Organization; 2025. [https://www.who.int/publications/i/item/9789240116870]
20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: n71. [https://doi.org/10.1136/bmj.n71] [PMID]
21. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366: l489. [https://doi.org/10.1136/bmj.l4898] [PMID]
22. Jin L, Pan R, Huang L, Zhang H, Jiang M, Zhao H. Family nursing with the assistance of network improves clinical outcome and life quality in patients underwent coronary artery bypass grafting: a consolidated standard of reporting trials-compliant randomized controlled trial. Medicine. 2020;99(50): e23488. [https://doi.org/10.1097/MD.0000000000023488] [PMID]
23. Bikmoradi A, Omidvar S, Roshanaei G, Khatiban M, Harorani M. The impact of telenursing on level of depression, stress and anxiety in discharged patients after coronary artery bypass graft surgery: a randomized clinical trial. Journal of Vascular Nursing. 2023;41(3):89-94. [https://doi.org/10.1016/j.jvn.2023.05.003] [PMID]
24. Mala J, Asdornwised U, Wongkongkam K, Chansatitporn N, Thongcharoen P. Effectiveness of a telehealth intervention on functional status, anxiety, depression, and rehospitalization among older adults undergoing coronary artery bypass grafting: randomized controlled trial. JMIR Cardio. 2026;10(1): e81777. [https://doi.org/10.2196/81777] [PMID]
25. Nilsson O, Stenman M, Letterstål A, Hultgren R. A randomized clinical trial of an eHealth intervention on anxiety in patients undergoing abdominal aortic aneurysm surgery. British Journal of Surgery. 2021;108(8):917-924. [https://doi.org/10.1093/bjs/znab151] [PMID]
26. Martorella G, Côté J, Racine M, Choinière M. Web-based nursing intervention for self-management of pain after cardiac surgery: pilot randomized controlled trial. Journal of Medical Internet Research. 2012;14(6): e130. [https://doi.org/10.2196/jmir.2070] [PMID]
27. van Steenbergen G, van Veghel D, van Lieshout D, Sperwer M, ter Woorst J, Dekker L. Effects of video-based patient education and consultation on unplanned health care utilization and early recovery after coronary artery bypass surgery (IMPROV-ED): randomized controlled trial. Journal of Medical Internet Research. 2022;24(8): e37728. [https://doi.org/10.2196/37728] [PMID]
28. Ding N, Luo X, Zhou J, Jiang X, Wang X. Intervention effect of the mobile phone APP based continuous care on patients after mechanical heart valve replacement: a randomised controlled trial. Reviews in Cardiovascular Medicine. 2024;25(9):314. [https://doi.org/10.31083/j.rcm2509314] [PMID]
29. Barnason S, Zimmerman L, Schulz P, Tu C. Influence of an early recovery telehealth intervention on physical activity and functioning after coronary artery bypass surgery among older adults with high disease burden. Heart & Lung. 2009;38(6):459-468. [https://doi.org/10.1016/j.hrtlng.2009.01.010] [PMID]
30. İlgin VE, Oral SE, Gürkan Z, Özer N. Effects of telephone nursing education and counselling on discharge satisfaction level and self-care strength of patients after coronary artery bypass grafting. ANZ Journal of Surgery. 2024;94(10):1768-1775. [https://doi.org/10.1111/ans.19175] [PMID]
31. Yu X, Cao J, Xu J, Xu Q, Chen H, Yu D, et al. Efficacy of telemedical interventional management in patients with coronary heart disease undergoing percutaneous coronary intervention: randomized controlled trial. Journal of Medical Internet Research. 2025;27: e63350. [https://doi.org/10.2196/63350] [PMID]
32. Alqahtani AS. Telehealth-based cardiac rehabilitation for heart failure: a systematic review of effectiveness, access, and patient-centred outcome. Medicina. 2025;62(1):25. [https://doi.org/10.3390/medicina62010025] [PMID]
33. Zhong W, Fu C, Xu L, Sun X, Wang S, He C, et al. Effects of home-based cardiac telerehabilitation programs in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. BMC Cardiovascular Disorders. 2023;23(1):101. [https://doi.org/10.1186/s12872-023-03120-2] [PMID]
34. Ariyanto H, Rosa EM. Effectiveness of telenursing in improving quality of life in patients with heart failure: a systematic review and meta-analysis. Journal of Taibah University Medical Sciences. 2024;19(3):664-676. [https://doi.org/10.1016/j.jtumed.2024.04.009] [PMID]
35. Ma C, Wang B, Zhao X, Fu F, Zheng L, Li G, et al. WeChat-based education and rehabilitation program in unprotected left main coronary artery disease patients after coronary artery bypass grafting: an effective approach in reducing anxiety, depression, loss to follow-up, and improving quality of life. Brazilian Journal of Medical and Biological Research. 2021;54(4): e10370. [https://doi.org/10.1590/1414-431x202010370] [PMID]
36. Zhong W, Liu R, Cheng H, Xu L, Wang L, He C, et al. Longer-term effects of cardiac telerehabilitation on patients with coronary artery disease: systematic review and meta-analysis. JMIR mHealth and uHealth. 2023;11: e46359. [https://doi.org/10.2196/46359] [PMID]
37. Hou QL, Liu LY, Wu Y. The effects of mHealth interventions on quality of life, anxiety, and depression in patients with coronary heart disease: meta-analysis of randomized controlled trials. Journal of Medical Internet Research. 2024;26: e52341. [https://doi.org/10.2196/52341] [PMID]
38. Creber RM, Dimagli A, Spadaccio C, Myers A, Moscarelli M, Demetres M, et al. Effect of coronary artery bypass grafting on quality of life: a meta-analysis of randomized trials. European Heart Journal - Quality of Care and Clinical Outcomes. 2022;8(3):259-268. [https://doi.org/10.1093/ehjqcco/qcab075] [PMID]
39. Leutualy V, Trisyany Y, Nurlaeci N. Effectivity of health education with telenursing on the self-care ability of coronary artery disease patients: a systematic review. Open Access Macedonian Journal of Medical Sciences. 2021;9(F):690-698. [https://doi.org/10.3889/oamjms.2021.7619]
40. Li R, Wang M, Chen S, Zhang L. Comparative efficacy and adherence of telehealth cardiac rehabilitation interventions for patients with cardiovascular disease: a systematic review and network meta-analysis. International Journal of Nursing Studies. 2024; 158:104845. [https://doi.org/10.1016/j.ijnurstu.2024.104845] [PMID]
41. Kalpesh S, Mukkamala N, Kumar P, Jha PR. Effects of a cardiac telerehabilitation program on the quality of life and functional independence of patients with coronary artery bypass graft: a non-randomized controlled trial. Cureus. 2025;17(2): e78548. [https://doi.org/10.7759/cureus.78548] [PMID]
42. Alshahrani NS, Hartley A, Howard J, Hajhosseiny R, Khawaja S, Seligman H, et al. Randomized trial of remote assessment of patients after an acute coronary syndrome. Journal of the American College of Cardiology. 2024;83(23):2250-2259. [https://doi.org/10.1016/j.jacc.2024.03.398] [PMID]
43. Braver J, Marwick TH, Oldenburg B, Issaka A, Carrington MJ. Digital health programs to reduce readmissions in coronary artery disease: a systematic review and meta-analysis. JACC: Advances. 2023;2(8):100591. [https://doi.org/10.1016/j.jacadv.2023.100591] [PMID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |