title: Physiological, psychological and autonomic responses to pre-operative instructions for patients undergoing cardiac surgery.
abstract: Several studies have reported that the experience may induce emotional reactions before and after surgery. Various Studies have demonstrated that effective pre-operative information reduces stress and anxiety levels. However, little is known about the effect of pre-operative instruction on autonomic responses as measured by heart rate variability (HRV) before cardiac surgery. Ninety-one patients were randomly assigned to video-tape viewing and teaching booklet group. Electrocardiogram was monitored before and after pre-operative instruction. HRV was analyzed with spectral analysis of frequency domains of heart rate and categorized into low and high frequency (LF and HF). After pre-operative instruction, subjects completed a score of perceived stress and helpfulness. In this study, we found that pre-operative instruction with video-tape was similarly effective as teaching booklets on patients' perceived stress, perceived helpfulness and recovery outcomes. The decrease in HF% and increase in LF/HF ratio of HRV indicate a change in sympathovagal balance toward a lower parasympathetic activity after pre-operative instruction in subjects of both groups. However, the perceived helpfulness of pre-operative instruction may often be associated with a relatively less sympathetic activity. Further studies are needed to determine the optimal timing to enhance the positive effects on the sympathovagal balance after pre-operative instruction.
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, Republic of China.
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Liou
authors.forename: Yann-Fen C
authors.initials: YF
authors.lastname: Chao
authors.forename: Terry B J
authors.initials: TB
authors.lastname: Kuo
authors.forename: Hsing I
authors.initials: HI
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000502:physiology*; D006348:Cardiac Surgical Procedures / Q000523:psychology*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D011300:Preoperative Care; D013315:Stress, Psychological / Q000523:psychology*; D014743:Videotape Recording