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Patients' expected and actual functional status after coronary artery bypass graft surgery
The purpose of this study was to examine coronary artery disease (CAD) patients' expectations regarding the effect of surgery on their postoperative functional status. Bandura's theory of expectations provided the framework: patients' capacity and outcome expectations would significantly impact their decision to have coronary artery bypass graft (CABG) surgery and contribute to their actual functional status after surgery. ^ The study's goals were to: (1) establish functional status levels for CAD patients prior to CABG surgery, and at six and 12 weeks postoperatively; (2) identify which physical functional activities CABG patients consider most important; and (3) determine the degree of congruence between patients' expected and actual functional status at 12 weeks post-CABG surgery. A prospective, repeated measures design was used. ^ Seventy-eight consenting adults completed the SF-36 health status survey during pre-testing for CABG surgery, and at six and 12 weeks post-CABG surgery. At 12 weeks post-CABG surgery patients identified the functional status they had expected at that time. Additionally, patients rated the importance of eight physical activities on the SF-36 health status survey. Parsonnet Risk score, New York Heart Association classification, and left ventricular ejection fraction were used to describe pre-surgical physiological status. Data analysis included descriptive statistics, rank order of mean importance scores for each activity, ANOVA, Chronbach's alpha, and paired t-test. ^ Results indicated a significant relationship between actual and expected functioning at 12 weeks after surgery. Patients ranked having enough energy to perform normal activities of daily living as most important to them. Patients whose preoperative functional status scores ranged from 59 to 100% of U.S. adult norms had postoperative scores that approached 79 to 100% of U.S. norms at six weeks and 90 to 100% at 12 weeks after surgery. Return of physical functioning, role-physical and role-emotional activities to adult norms did not occur in 12 weeks. ^ This study has contributed to nursing practice by providing empirical data about pre- and post-CABG surgery functional status in elective cases, which expands the information available for pre-CABG patient counseling, coaching patient progress during recovery, setting postoperative goals and predicting CABG patients' resource utilization during the postoperative and post-discharge (12-week) period. ^
Health Sciences, Nursing
Paulette Ann Seymour Route,
"Patients' expected and actual functional status after coronary artery bypass graft surgery"
(January 1, 2001).
Electronic Doctoral Dissertations for UMass Amherst.