Understanding the process of living as signified by myocardial revascularization surgery patients

Abstract

Objective: To understand the meanings for the process of living, for patients undergoing myocardial revascularization surgery, and to construct an explanatory theoretical model. Method: Grounded Theory was used, with data collection undertaken between October 2010 and May 2012, in a health institution which specializes in cardiac surgery, located in the south of Brazil. Thirty-three subjects were interviewed (patients, health care professionals and family members), distributed in four sample groups. Result: The explanatory theoretical model was comprised of 11 categories and the central phenomenon. The specialized service and the cardiac rehabilitation program formed the context, the discovery of the cardiac disease and the feelings experienced during the perioperative period were the cause and intervening conditions in the process of experiencing the myocardial revascularization surgery. The strategies were relying on the family's support, having faith and hope, and participating in the rehabilitation program. This process's main consequences were the confrontation of the changes and the resulting limitations, difficulties and adaptations to the new lifestyle after surgery. Conclusion: The process of experiencing the myocardial revascularization surgery constitutes an opportunity for maintaining the patient's life associated with the needs for confronting the significant changes in lifestyle.

Rede Pessoal Significativa de Pacientes Submetidos à Cirurgia Cardíaca

“…Analogous data were observed in the study of Erdmann, Lanzoni, Callegaro, Baggio and Koerich (2013), which observed that the postsurgical condition can accentuate situations of family conflict, mainly regarding the family's demands in relation to changes in the patient's lifestyle.…”

“…As a resource for understanding this panorama, it is appropriate to mention that, of the 12 interviewees, six were not undertaking work activities at the time of the interview, due to the surgical process itself or to the phase of their life cycle the participants were experiencing (two were retired due to length of service). The difficulty in the scenario of professional life after surgery is a context corroborated by other studies, according to which restrictions in relation to carrying out work activities after cardiac surgery entail emotional and financial repercussions for the patients (Callegaro, Koerich, Lanzoni, Baggio, & Erdmann, 2012;Erdmann et al, 2013).…”

Spiritual well-being and hope in the preoperative period of cardiac surgery

“…In Brazil, research that considers hope of chronic patients and their relationship with the clinic are relatively recent, keeping in mind that the authors who translated and validated the scale stated that until 2005 there was no instrument available in Portuguese for such (9) . However, the hope construct has emerged in qualitative research to understand the meanings and factors that influence the process of going through cardiac revascularization surgery for patients, families and healthcare professionals (20)(21)(22)(23) . In these studies, spirituality is referred as important in the participation in the surgical experience, since patients can share their anguishes with God and have, in faith, the hope of achieving good results after surgery (20)(21)(22)(23) .…”

“…However, the hope construct has emerged in qualitative research to understand the meanings and factors that influence the process of going through cardiac revascularization surgery for patients, families and healthcare professionals (20)(21)(22)(23) . In these studies, spirituality is referred as important in the participation in the surgical experience, since patients can share their anguishes with God and have, in faith, the hope of achieving good results after surgery (20)(21)(22)(23) . Lastly, although the relation between hope, faith and religiosity and the expectation about the surgery is frequent, patients can refer to it without making such correlation, just by knowing that the prognosis without surgery would be worse, despite the arising risks (23) .…”

Relação entre estresse percebido com coping e estressores de pacientes em pré-operatório de revascularização miocárdica

“…Paralelamente, nessa amostra, Apoio da família, dos amigos e de outros também se sobressaiu entre os relatos (42,9 %), o que corrobora resultados da literatura (32). Quanto ao domínio Resolução de problemas, ao observar seu destaque no IEC, compreendeu-se que, para essa amostra, a realização do procedimento cirúrgico parece ter significado de resolução da obstrução coronariana, o que corrobora resultados da literatura (33).…”