Nurse Led Transitional Care Model in Cardiac Surgery

Inclusion Criteria: * be hospitalized for the first time and for elective open heart surgery; * have no other surgical intervention other than an open heart surgery, * have no psychological and mental disorders, * have no major chronic problems such as kidney problems, neurological problems or cancer, * be able to speak Turkish, * be available to be communicated by phone, * provide consent to participate in the study, * live at a maximum distance of 50 km from the hospital (for easy access during post-discharge follow-up visits). Exclusion Criteria: * ask to leave the study, * be exposed to a disease or trauma that may affect his/her functional autonomy during the study, * die throughout the study