Preoperative and Late Postoperative Psychosocial State Following Coronary Artery Bypass Surgery

Abstract

In a prospective study of psychological and neurological reactions to coronary artery bypass surgery, 45 patients were examined preoperatively, postoperatively, and 21 to 27 months after, using a variety of neurological, psychiatric, and psychological investigations. Within the follow-up sample, three subgroups of patients could be identified by cluster analysis who differed with respect to their emotional status and life satisfaction. One group (24% of the total sample) was characterized by high levels of anxiety, depression and life dissatisfaction and appears as a risk population. The other groups could be described as either average (42%) or stable (33%). At the follow up, the risk group further indicated a preference for depressive coping styles, a slightly higher degree of cognitive impairment, more neurological and psychopathological symptoms (specifically giving-up and hostility), a considerably lower return-to-work rate, more subjective physical complaints and a poorer attitude toward the outcome. While postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as intraoperative parameters did not reveal significant group differences, the analysis yielded an increased impairment within the risk group already prior to surgery, especially emotional problems, specific health-related cognitions and a more fatalistic attitude. The results are in line with those of other studies investigating the late postoperative psychological status with regard to the proportion of patients showing psychological impairments as well as to their specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

The experience of people awaiting coronary artery bypass graft surgery: the Icelandic experience

“…The younger participants appeared more depressed and they reported more anxiety than did older participants in this study. Patients who have moderate or severe depression and anxiety pre‐operatively are shown to have a high risk of psychological disturbances up to 2 years postoperatively ( Strauss et al . 1992 ).…”

“…1990 ). Patients who have moderate or severe depression and anxiety pre‐operatively are shown to have a high risk of psychological disturbance up to 2 years postoperatively ( Strauss et al . 1992 ).…”

Information level of patients in discharge training given by nurses following open heart surgery

“…Open heart surgeries improve the quality of life of patients and help them return to their normal lives. It is stated that during the postoperative period, patients are more active, exercise performance increases, they experience less chest pain, less disease‐related symptoms, and they become more socially interactive 1,2 . However, despite the remedial and positive effects of open heart surgery, it can cause some physical, emotional and social problems for patients for ≈6 months during the postoperative period.…”

“…It is stated that during the postoperative period, patients are more active, exercise performance increases, they experience less chest pain, less disease-related symptoms, and they become more socially interactive. 1,2 However, despite the remedial and positive effects of open heart surgery, it can cause some physical, emotional and social problems for patients for ª6 months during the postoperative period. Furthermore, the increasing tendency towards early discharge (3-4 days) with a view to reducing the stay period and hospital costs can result in increased nursing needs during the home stay period.…”

Post–traumatic stress disorder in patients with coronary artery disease: A review and evaluation of the risk

“…However, most studies on PTSD have focused on external events, such as combat, rape, and natural disaster, as precursors of the disorder. This is surprising, since 20 to 40% of patients with coronary artery disease (CAD) have difficulty with emotional adjustment, and suffer from depression, anxiety, and other emotional disturbances up to several years after the cardiac event (Ladwig, Kieser, KoÈ nig, Breithardt & Borggrefe, 1991;Magni et al, 1987;Duits, Boeke, Taams, Passchier & Erdman, 1997;Strauss et al, 1991). Secondly, these emotional disturbances are often found as comorbid diagnoses in individuals with PTSD (O'Brien, 1998).…”