The Effectiveness of ICOUGH Care Program on Dyspnea, Respiratory Parameters, Mobility, and Pain After Major Abdominal Surgery: Randomized Controlled Study

Abstract

This study evaluated the effectiveness of the ICOUGH care program in improving pulmonary function, mobility, dyspnea, and pain after major abdominal surgery. A randomized clinical trial was conducted in tertiary hospitals in Tripoli, Libya, including 60 patients assigned to an experimental group (n = 30) and a control group (n = 30). The experimental group received the ICOUGH program, which included incentive spirometry, oral care, coughing and breathing exercises, patient and family education, early mobilization, and head-of-bed elevation, while the control group received routine care. Outcomes included vital signs, pulmonary function (FEV1, FVC, FEV1/FVC, PEF), dyspnea (Modified Borg Dyspnea Scale), mobility (AMP tool), and pain (VAS). The experimental group demonstrated significant improvements in dyspnea (p = 0.002), FEV1 (p = 0.026), FEV1/FVC (p = 0.010), PEF (p < 0.001), and pain (p = 0.002) compared to the control group. No significant differences were observed in FVC (p = 0.159) or mobility (p = 0.874). The ICOUGH program significantly improved respiratory outcomes and reduced postoperative symptoms, supporting its integration into routine postoperative care to enhance recovery and reduce complications.