title: Coronary artery disease patients' perception of their health and expectations of benefit following coronary artery bypass grafting.
abstract: This prospective descriptive study has analysed 214 patient interviews before and 1 year after coronary artery bypass grafting (CABG). The preoperative interview explored issues related to the impact of coronary artery disease upon health and expectations of benefit from the patients' perspective. The postoperative interview examined patients' accounts of the experience of operation and its impact on their health. A thematic analysis of the interview data was undertaken. The main factors relating to health status preoperatively were described in terms of 'dependency' on others and medication, and 'impending doom' of some major life threatening event. Benefits to health postoperatively were viewed in terms of 'removal of a death sentence' and 'freedom of choice'. Expectations of benefit from operation were varied and included 'freedom and independence', 'hope, chance and uncertainty' and 'addition of years to life and life to years'. Undergoing the operation was described by themes of the 'enormity of the experience' and 'the importance of lay support'. These findings provide a greater understanding of the 'lived experience' of both coronary artery disease and undergoing coronary artery bypass grafting. Unrealistic expectations of the benefits of CABG highlights the need for improvement in the way patients are informed about risks and benefits of interventions. In addition, the views and insights suggest that CABG operation is regarded as a significant major life event; thus more information, advice and counselling might help support patients before, during and after surgery.
authors.affiliation: Nursing and Midwifery School, University of Glasgow, Glasgow, Scotland. gl1z@clinmed.gla.ac.uk
authors.forename: G M
authors.initials: GM
authors.lastname: Lindsay
authors.forename: L N
authors.initials: LN
authors.lastname: Smith
authors.forename: P
authors.initials: P
authors.lastname: Hanlon
authors.forename: D J
authors.initials: DJ
authors.lastname: Wheatley
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000523:psychology*; D003327:Coronary Disease / Q000523:psychology / Q000601:surgery*; D005260:Female; D005610:Freedom; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012606:Scotland; D012647:Self-Assessment; D012944:Social Support