Family-centered empowerment model-based cardiac rehabilitation and cardiac self-efficacy after CABG: a randomized controlled trial

Recovery following coronary artery bypass graft (CABG) surgery is a complex process extending into the home environment, where patients often lack confidence to manage rehabilitation behaviors. Traditional cardiac rehabilitation frequently overlooks the family as a collaborative unit of care. This study aimed to evaluate the effect of a Family-Centered Empowerment Model (FCEM)-based cardiac rehabilitation program on cardiac self-efficacy in patients after CABG surgery. This prospective, two-arm, parallel-group, randomized controlled trial was conducted in the cardiac rehabilitation unit of Afshar Heart Hospital, Yazd, Iran, from October 2022 to October 2023. Seventy patients were recruited via consecutive sampling and randomly allocated (1:1) to either the FCEM group (n=35) or a routine care group (n=35) using a computer-generated sequence. The FCEM group received two 40-min structured, small-group sessions involving the patient-family dyad, followed by a two-week telephone follow-up. The control group received routine care. Cardiac self-efficacy (CSES) was measured at baseline and two weeks post-intervention. Between-group differences were analyzed using independent-samples t-tests and baseline-adjusted comparisons. Sixty-nine patients (FCEM: 34, Control: 35) completed the study. Post-intervention, the FCEM group demonstrated significantly higher cardiac self-efficacy scores compared with the control group (37.72 ± 6.85 vs 29.69 ± 3.13; p < 0.001). The mean difference between groups was 8.03 (95% CI: 5.44 to 10.62), with a large effect size (Cohen’s d = 1.51). A nurse-led, FCEM-based intervention was associated with significantly improved cardiac self-efficacy in post-CABG patients. By integrating structured family participation and collaborative problem-solving into clinical practice, healthcare providers may mitigate the uncertainty of home-based recovery and optimize long-term adherence to cardiac rehabilitation. Iranian Registry of Clinical Trials (IRCT), https://www.irct.ir , Registration No. IRCT20210622051663N1.