Determining Preoperative and Postoperative Predictors of Recovery in Open-Heart Surgery Patients

Thursday, 15 July 2010: 2:25 PM

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

Learning Objective 1: describe preoperative and postoperative predictors of recovery after open-heart surgery.

Learning Objective 2: discuss nursing implications to better care for the patient recovering from open-heart surgery.

Purpose: The purpose of this research was to examine the relationship among expectations, anxiety, depression, and physical health status (PHS) and to determine predictors of postoperative PHS in open-heart surgery patients.

Methods: A convenience sample (N = 54) was recruited from two hospitals in rural regions from two different states.  The sample included participants who underwent coronary artery bypass graft (CABG) or valve replacement surgery for the first time.  The study used a longitudinal design and data was collected preoperatively in the hospital or surgeons’ offices and four weeks postoperatively by phone interviews.  Participants were interviewed using the following questionnaires: "The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)", "The Future Expectations Regarding Life with Heart Disease Scale", and "The Hospital Anxiety and Depression (HAD) Scale."  Subjects were also asked three open-ended questions postoperatively regarding their expectations of surgery and recovery.  Repeated measures ANOVA, Pearson Product Moment Correlations, and Multiple Regression were used for data analyses.  Qualitative data was review used content analysis.

Results: Repeated measures ANOVA indicated that anxiety (p = .002) and depression (p = .026) scores decreased postoperatively. Pearson Product Moment Correlations revealed significant relationships among the preoperative and postoperative variables expectations, anxiety, depression, and physical health status. Multiple regression analyses indicated that preoperative expectations, anxiety, depression, and PHS contributed to 38% of the variance of postoperative PHS (p = .000).  The regression analysis for the postoperative variables was not significant (p = .075).

Conclusion: The findings support the need for interventions to assist patients in developing realistic expectations, and for clinicians to screen patients for anxiety and depression before and after surgery.  Future research needs to measure PHS at various times postoperatively to identify continued limitations after surgery.