Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
Mind Over Matter: Does a Patient's Perception of Their Health and Well-Being Affect Outcomes of Coronary Artery Bypass Grafting?
Patti McCluskey-Andre, RN, MSN, CCNS, ACNP-C, Cardiac Surgery Department, Cardiac Surgery Department, Hoag Memorial Hospital, Newport Beach, CA, USA
OBJECTIVE: To determine the role a patient’s perception of their physical and mental health has on outcomes of coronary artery bypass grafting (CABG) surgery. DESIGN: Retrospective and prospective descriptive study. POPULATION: All patients undergoing isolated coronary artery bypass grafting from June 2002 to July 2004 at a California community hospital. OUTCOME VARIABLES(s): (1) Patient’s actual (observed) postoperative outcome of mortality and morbidity correlated with the STS risk model predicted (expected) morbidity and mortality for CABG patients. (2) Summary scale SF12v2 (Health Survey-Standard Form, 4-week recall) of physical and mental components. METHODS: Preoperative patient survey SF12v2 (Patient’s view on his/her health) and completed STS (version 2.41) data collection document. Both SF12v2 survey and STS patient data entered into “PATS” (patient analysis and tracking system). Outcome variables calculated within the system for each entry set. SELECTION: All CABG patients with completed SF12v2 survey form. EXCLUSION: Patients who are mentally or physically unable to complete SF12v2 prior to surgery. STATISTICAL ANALYSIS: T-testing of data to include STS expected over observed mortality and morbidity numbers with SF12v2 mental and physical component summary scales. FINDINGS: There is a correlation between a patient’s preoperative rating of their mental and physical health with postoperative CABG morbidity and mortality, independent of actual predicted risks. CONCLUSIONS: The patient’s perception of their health state is valuable information for further predicting outcomes after CABG surgery. IMPLICATIONS: Preoperative availability of a patient's perception of their health can lead to interventions such as screening or treatment of underlying confounding issues (i.e. depression) to further improve outcomes. This work opens up multiple future research questions.
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Sigma Theta Tau International
July 22-24, 2004