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Predictors of capacity to direct attention in cardiac surgery patients

Marilyn S Stapleton, University of Massachusetts - Amherst

Abstract

The purpose of this descriptive correlational study was to examine the relationship between psychologic, physiologic and situational factors and the extent to which these impact a cardiac surgery patient's capacity to direct attention. The theory of unpleasant symptoms (Lenz, Pugh, Milligan, Gift and Suppe, 1997) was used to explore the influence of psychologic, physiologic, and situational factors on the CABG surgery patient's symptoms of pain and fatigue and consequently the impact of these symptoms on capacity to direct attention (CDA). ^ Data was collected from 41 participants at two points in time, (1) from the subject during Preadmission Testing, and (2) while recovering on the cardiac step down unit. Self report scales (Chalder Fatigue Scale, Self-Efficacy Expectation Scale, MOS Social Support Scale, Hospital Anxiety, Depression Scale-D, Lewis Anxiety Scale, pain visual analog scale), interviews, medical record review and the cognitive measures of DSF, DSB, SDMT, Trail Making Test, Part A and subsets of the Folstein Mini-Mental State questionnaire were used to obtain data. ^ There was a significant difference in the capacity to direct attention before and after surgery (p < .001). The SDMT and Trail Making Test, Part A were the most sensitive measures of attentional decline. There was no statistical difference in attention between the group on the bypass pump versus off the bypass pump (p < .639). Of the physiological, psychological and situational factors, length of anesthesia and years of formal education were significantly correlated with attention. The regression of preoperative Total Attention Score (TAS) on social support and years of formal education, accounted for 21% of the variance. Years of formal education contributed most significantly at the.01 level of significance. The regression of postoperative TAS on seven predictor variables (TAS preoperative z score, anxiety, hours since analgesia, pain, self-efficacy, hours on anesthesia and total fatigue) accounted for 60% of the variance and was significant at the .000 level; preoperative attention and length of anesthesia contributed most significantly (p < .01) to explaining the variance in postoperative attention. ^

Subject Area

Health Sciences, Medicine and Surgery|Health Sciences, Nursing

Recommended Citation

Marilyn S Stapleton, "Predictors of capacity to direct attention in cardiac surgery patients" (January 1, 2004). Doctoral Dissertations Available from Proquest. Paper AAI3152749.
http://scholarworks.umass.edu/dissertations/AAI3152749

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