Preoperative and late postoperative psychosocial state following coronary artery bypass surgery.
In a prospective study of psychological and neurological reactions to coronary artery bypass surgery, 45 patients were examined preoperatively, postoperatively, and 21 to 27 months after, using a variety of neurological, psychiatric, and psychological investigations. Within the follow-up sample, three subgroups of patients could be identified by cluster analysis who differed with respect to their emotional status and life satisfaction. One group (24% of the total sample) was characterized by high levels of anxiety, depression and life dissatisfaction and appears as a risk population. The other groups could be described as either average (42%) or stable (33%). At the follow up, the risk group further indicated a preference for depressive coping styles, a slightly higher degree of cognitive impairment, more neurological and psychopathological symptoms (specifically giving-up and hostility), a considerably lower return-to-work rate, more subjective physical complaints and a poorer attitude toward the outcome. While postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as intraoperative parameters did not reveal significant group differences, the analysis yielded an increased impairment within the risk group already prior to surgery, especially emotional problems, specific health-related cognitions and a more fatalistic attitude. The results are in line with those of other studies investigating the late postoperative psychological status with regard to the proportion of patients showing psychological impairments as well as to their specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
Strauss
B
B
Dept. of Psychotherapy and Psychosomatics, University of Kiel, Germany.
Paulsen
G
G
Strenge
H
H
Graetz
S
S
Regensburger
D
D
Speidel
H
H
D000223:Adaptation, Psychological; D016000:Cluster Analysis; D001026:Coronary Artery Bypass / Q000523:psychology* / Q000534:rehabilitation; D005500:Follow-Up Studies; D006801:Humans; D009483:Neuropsychological Tests; D010549:Personal Satisfaction; D011183:Postoperative Complications / Q000523:psychology*; D011300:Preoperative Care / Q000523:psychology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires