Objective: Because of low mortality and shorter hospital stays after coronary artery bypass graft (CABG) surgery, there is a greater need to study home recovery following this common intervention. Women have a demographic and clinical profile that is unique from that of men at the time of CABG. In addition, women have expressed concern about performance of activities associated with life roles (functional status) following CABG, but there is little empirical information available to help them gauge their performance, particularly in terms of usual patterns, during the early period at home after hospital discharge. The purpose of this study, therefore, was to describe women’s recovery during the first 6 weeks at home after hospital discharge from CABG both in terms of changes in functional status over time and the influence of comorbidity, household composition, fatigue and surgical pain on functional status. Design: A longitudinal, panel design was employed for this study. Population, Sample, Setting, and Years: The population of interest was women having first time, uncomplicated CABG surgery. The sample was 61 women recruited from 5 sites –two university teaching hospitals and 3 community hospitals--in eastern Pennsylvania between 1999 and 2001. Variables Studied Together: The dependent variable of interest was functional status. Independent variables were: time, comorbidity, household composition, fatigue, and surgical pain. Methods: Women participants were interviewed face to face before hospital discharge and via telephone at 2, 4, and 6 weeks after discharge. Functional status was assessed using the Inventory of Functional Status in the Elderly and five subscales of the Sickness Impact Profile. The number of comorbid conditions was assessed via simple tally, and fatigue and surgical pain were measured using the Energy/Fatigue and Pain Severity subscales of the Medical Outcomes Study Patient Assessment Questionnaire. Findings: Women in this study experienced significant gains in functional status over the first 6 weeks after hospital discharge, particularly between 2 and 4 weeks. Participants engaged most frequently in personal care and low-level household activities during the study period. Over time, most participants expressed perceived improvement in their overall functional status, some wanted to resume household activities earlier than they did, and some expressed dissatisfaction with help received from others. No participant considered herself completely functionally recovered at 6 weeks, and no participant had returned to baseline functional status by 6 weeks. Participants experienced significant decreases in fatigue and surgical pain over time but continued to experience both at 6 weeks. Fatigue and surgical pain were highly and significantly correlated at 2 and 6 weeks, neither was related to comorbidity or household composition, and a relationship between these four variables and functional status could not be established. Conclusions: Following uncomplicated CABG, women can expect to experience significant gains in functional status during the first 6 weeks after discharge from the hospital, particularly between 2 and 4 weeks. By 6 weeks after discharge, women can expect to perform many of the role activities that they performed prior to surgery. Most women will experience significant reductions in their levels of fatigue and surgical pain during the first 6 weeks after discharge and will perceive improvement in their overall functional status. Women cannot, however, expect to have returned to their baseline functional status or to perceive themselves as fully functionally recovered by 6 weeks after hospital discharge. Implications: This study corroborates some findings from earlier studies but is the first to provide a comprehensive profile of women’s performance of role activities during the early period at home following uncomplicated CABG. This profile can be used in discharge teaching and as a starting point for future research.
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