Learning Objective #1: describe five themes related to patient expectations of CABG surgery and recovery.

Learning Objective #2: discuss nursing implications to prepare patients for a more realistic perioperative surgical experience.

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Abstract Background: The concept of expectations has been described as a determinant of patient satisfaction but insufficient findings support this conclusion. Prior research has examined expectations of open-heart surgical patients in terms of satisfaction of care. Studies have identified that patients experienced unrealistic expectations that resulted in feelings of distress and anger. With almost half a million open-heart surgeries performed each year, further work is needed to clearly define those expectations and to understand patients’ perceptions of their surgical event. Purpose: The purpose of this research was to explore patient expectations of open-heart surgery and recovery using focus group techniques. Methods: A convenience sample (N = 19) was recruited from the Cardiac Rehabilitation and Wellness Department at a mid-size teaching hospital in rural, western Pennsylvania. The sample included participants who underwent CABG or valve replacement surgery within the past five years. Three focus group sessions were conducted to gather audio-taped discussions of patients’ expectations of open-heart surgery. Participants responded to questions about their expectations of surgery, expectations that were most important, unrealistic expectations of recovery, and expectations that changed over time. The audio-taped interviews were transcribed for analysis. Data was clustered according to categories. Further analysis of the categories produced conceptual themes. Findings: Five common themes occurred among all three focus groups: acknowledging the disease, preoperative perceptions, identifying expectations, health and illness transitions, and accepting recovery. Patients’ described feelings of frustration with unrealistic expectations when transitioning from hospital to home. Conclusions: The findings support the need for improved teaching methods that focus on realistic outcomes and follow-up services that continue after discharge. Additional research is needed to further explore the gaps that exist during transition from hospital to home, and to better understand the impact of patient expectations on recovery outcomes.