Effects of postoperative educational interventions on psychological, self-management, and quality-of-life outcomes after coronary artery bypass grafting: a systematic review and meta-analysis

Background: Postoperative education is an important component of recovery after coronary artery bypass grafting (CABG), but its overall effects on psychological, self-management, and quality-of-life outcomes remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of postoperative educational interventions in patients undergoing CABG. Methods: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL were searched from inception to March 2026. Randomized controlled trials (RCTs) enrolling adult patients undergoing CABG were included if they compared postoperative educational interventions with routine care. Meta-analysis was conducted using Stata/MP 18.0. Pooled effects were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). A random-effects model was used when substantial heterogeneity was present; otherwise, a fixed-effect model was applied. Leave-one-out sensitivity analyses were performed when appropriate. Results: Fourteen studies involving 1,669 participants were included. Postoperative educational interventions significantly reduced anxiety (SMD = -0.48, 95% CI: -0.87 to -0.08) and depression (SMD = -0.42, 95% CI: -0.71 to -0.14), and significantly improved physical functioning (SMD = 0.30, 95% CI: 0.08 to 0.52). Mental functioning showed a favorable but non-significant trend (SMD = 0.26, 95% CI: -0.01 to 0.53). The pooled effect on self-efficacy was not statistically significant (SMD = 1.08, 95% CI: -1.12 to 3.29), with substantial heterogeneity. Self-power improved significantly (SMD = 0.54, 95% CI: 0.19 to 0.89), but this finding was based on only two studies. Subgroup analyses suggested that intervention effects varied according to the dominant intervention format. Conclusions: Postoperative educational interventions appear to reduce anxiety and depression and improve physical functioning in patients after CABG. However, the current evidence does not support significant improvements in mental functioning or self-efficacy. Given the limited number of included studies, the finding for self-power should be interpreted cautiously.