Artificial Intelligence-Supported Individualized Discharge Education After Coronary Artery Bypass Grafting

Patients undergoing elective isolated coronary artery bypass grafting will be enrolled and allocated to intervention and control groups using stratified randomization based on age, sex, and health literacy level. Randomization within each stratum will be performed using Randomizer.org.

Patients in the control group will receive the routine standard discharge education used in the cardiovascular surgery clinic. This education will include wound care, medication use, nutrition, physical activity, follow-up appointments, and warning signs after discharge.

Patients in the intervention group will receive the same standard education plus artificial intelligence-supported individualized discharge education. Individualized educational content will be prepared using standardized prompts adapted to each patient's age, sex, education level, health literacy, comorbidities, and surgical characteristics. The educational process will be structured according to Gagné's instructional events, including gaining attention, recalling prior knowledge, providing guidance, eliciting performance, and providing feedback. Teach-back questions will also be individualized to evaluate patient understanding and identify learning needs.

Baseline assessments will be performed 24-48 hours before discharge. Post-intervention assessments will be completed on the day of discharge. Follow-up assessments will be conducted on postoperative day 10 and at 1 month after discharge through clinic visits, telephone interviews, and patient records. Clinical outcomes will include postoperative recovery, readiness for discharge, discharge education satisfaction, self-care and medication adherence, complications, emergency department visits, and hospital readmissions.

Personally identifiable patient information will not be entered into the artificial intelligence system. All artificial intelligence-generated educational content will be reviewed by the research nurse and the relevant physician for clinical accuracy, safety, comprehensibility, and appropriateness before being delivered to patients.

Inclusion criteria

• Age 18 years or older.
• Having undergone elective isolated coronary artery bypass grafting.
• Ability to communicate in Turkish.
• No cognitive or communication impairment that would prevent participation in the study.
• Voluntary agreement to participate in the study and provision of written informed consent.

Exclusion criteria

• Refusal to participate in the study or failure to provide written informed consent.
• Age under 18 years.
• Inability to communicate in Turkish.
• Cognitive impairment, delirium, dementia, or a severe psychiatric condition preventing completion of the data collection tools.
• Having undergone emergency surgery.
• Presence of a severe postoperative complication preventing delivery of the planned discharge education.
• Inability to be reached during the follow-up period.
• Incomplete completion of the data collection forms.
• Withdrawal from the study at any stage.