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Coronary artery bypass graft surgery: discharge planning for successful recovery

Theobald, Karen A. & McMurray, Anne (2004) Coronary artery bypass graft surgery: discharge planning for successful recovery. Journal of Advanced Nursing, 47(5), pp. 483-491.

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Abstract

Background. Coronary artery bypass graft (CABG) surgery is a lifesaving intervention, but the early recovery period presents a number of challenges for patients, carers and nurses. Early and adequate discharge planning based on in-depth knowledge of the post discharge experience can help to ensure optimal recovery.

Aim. This paper reports a study to examine the range of postdischarge issues, concerns and needs of patients and their family carers after discharge after CABG surgery, and explore their perceptions of unmet needs 1 year later.

Methods. A two-phase naturalistic inquiry was undertaken. Interviews were conducted with 30 patients and their carers 45 weeks after coronary artery bypass grafting (phase 1) and 1 year after the initial interview (phase 2). Thematic analysis was used to identify the major concerns of participants.

Findings. Almost half the patients experienced heart surgery as a huge personal shock. Adjusting to life afterwards was difficult, and they experienced a variety of changes, including pain. An unexpected finding was a heightened sense of body awareness and the need for postoperative physical adjustments. The financial implications of surgery were a major burden. Lifestyle adjustments were important and led to suggestions for support services, using telephone support and/or community patient networks. All participants recommended strengthening discharge planning with more accurate information about what to expect during recovery, to help them anticipate fluctuations in health and wellbeing. Carers experienced a wide range of unanticipated feelings during early recovery and had to deal with a number of personal changes.

Conclusions. The findings suggest a need to improve discharge preparation and provide enhanced home support services. Further research should evaluate models of periodic follow-up and mechanisms for mutual support, and compare the experiences of cardiac patients and their carers with those of other surgical cohorts.

What is already known about this topic The numbers of surgical interventions for cardiac disease will continue to increase, given the effectiveness of surgery in reducing mortality.

Discharge plans addressing the early recovery phase after coronary artery bypass graft surgery have thus far overlooked a broad range of longer-term patient needs.

Little attention has been to the self-defined needs of carers of these patients.

What this paper adds Patients' and carers' needs for information and support following coronary artery bypass graft surgery are not being met.

Patients' and carers' would like more professional support and follow-up after discharge.

Heightened body awareness and adjustment to postoperative physical changes are important issues in this client group.

Impact and interest:

43 citations in Scopus
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35 citations in Web of Science®

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ID Code: 1577
Item Type: Journal Article
DOI: 10.1111/j.1365-2648.2004.03127.x
ISSN: 0309-2402
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Tertiary (Rehabilitative) (111004)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2004 Blackwell Publishing
Copyright Statement: The definitive version is available at www.blackwell-synergy.com
Deposited On: 17 Jun 2005
Last Modified: 29 Feb 2012 13:10

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