title: Enhancing the efficacy of heart surgery by optimizing patients' preoperative expectations: study protocol of a randomized controlled trial.
abstract: In coronary heart disease (CHD) and heart surgery, there is sound evidence for the relationship between patients' expectations and treatment outcome, especially for outcome variables such as disability and quality of life. In addition, patients' expectations have been shown to be modifiable through psychological interventions. Therefore, targeting patients' expectations might offer a promising opportunity to enhance heart surgery outcome. However, few studies have tried to actively change patients' expectations before surgery. The purpose of this clinical trial is to optimize patients' outcome expectations before undergoing coronary artery bypass graft surgery (CABG) through a brief psychoeducational program. The present article describes the study protocol and reports preliminary data on feasibility. Using a randomized controlled design, 180 patients who are scheduled to undergo elective CABG are randomly assigned to either (1) standard medical care (SMC) alone, (2) to an additional expectation manipulation intervention during the 2 weeks before surgery, and (3) to an additional attention-control group ("supportive therapy"). The main goal is to test (a) whether expectation manipulation intervention can optimize patients' expectations and (b) whether optimized expectations lead to enhanced surgery efficacy. The primary outcome variable is illness-related disability 6 months after surgery, whereas secondary outcome variables will be quality of life, return to work, physical activity, and medical outcome variables. First, feasibility data of 36 patients show that the patients appreciated the additional psychological intervention before CABG. Satisfaction of those who received psychological interventions was very high.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Gutenbergstraße 18, Marburg, Germany. laferton@staff.uni-marburg.de
authors.forename: Johannes A C
authors.initials: JA
authors.lastname: Laferton
authors.forename: Meike
authors.initials: M
authors.lastname: Shedden Mora
authors.forename: Charlotte J
authors.initials: CJ
authors.lastname: Auer
authors.forename: Rainer
authors.initials: R
authors.lastname: Moosdorf
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000523:psychology*; D001026:Coronary Artery Bypass / Q000523:psychology*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology*; D011300:Preoperative Care; D011788:Quality of Life; D062707:Return to Work; D012657:Self-Help Groups; D016896:Treatment Outcome; D055815:Young Adult