An interventional pilot study to provide telephone follow-up support to open-heart surgery patients during recovery

Tuesday, 19 November 2013: 10:20 AM

Kristy S. Chunta, PhD, RN, ACNS, BC, CMC
Department of Nursing, Indiana University of Pennsylvania, Indiana, PA

Learning Objective 1: The learner will be able to: recognize common psychosocial and physical limitations after open-heart surgery.

Learning Objective 2: The learner will be able to: discuss the benefits of a telephone follow-up intervention with open-heart surgery patients.

Background

Open-heart (OH) surgery has been used to routinely treat cardiovascular and valvular heart disorders.  Although the outcomes are beneficial, research has suggested that the recovery process after OH surgery may be complex and present physical and psychosocial challenges such as anxiety, depression, and Physical Health Status (PHS) limitations that continue well after discharge.

 Objective

The aim of this experimental pilot study was to improve psychosocial and physical outcomes in OH surgery patients.  The longitudinal study provided a supportive intervention via telephone follow-up calls during recovery, and measured anxiety, depression, expectations, and PHS preoperatively and postoperatively, three days after discharge, and at 4 weeks and 3 months after surgery. 

 Methods

A convenience sample of N = 28 subjects who underwent elective coronary artery bypass grafting or valve replacement were recruited from a medical center in Pennsylvania.  Participants were randomly assigned to an experimental or control group. A registered nurse provided the telephone follow-up supportive intervention to the experimental group on the day of discharge, and weeks 2, 4, 6, 8, and 10 after surgery. 

 Results

The study did not determine that a telephone follow-up intervention decreased anxiety and depression scores and improved expectation and PHS scores.  However, mean anxiety and depression scores for this sample of OH patients were normal.  The study found that mean expectation scores for the experimental group improved while scores for the control group decreased slightly, and PHS mean scores increased to above baseline scores for the experimental and control groups.

 Conclusions

The findings support the need for continued research to examine supportive postoperative measures in a larger sample of OH surgery patients.  Future research should also consider patients who require emergent surgery in comparison to patients undergoing elective surgery and measurement of PHS using other tools to identify continued limitations after surgery.