Coronary artery bypass graft surgery: discharge planning for successful recovery.
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 postdischarge experience can help to ensure optimal recovery.


OBJECTIVE
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 4-5 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.


RESULTS
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.
Theobald
Karen
K
School of Nursing, Queensland University of Technology, Brisbane, Australia. k.theobald@qut.edu.au
McMurray
Anne
A
D000368:Aged; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D001026:Coronary Artery Bypass / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000592:standards; D010351:Patient Discharge / Q000592:standards; D017060:Patient Satisfaction; D010465:Perception; D011182:Postoperative Care; D012944:Social Support; D016896:Treatment Outcome