title: Early illness experiences related to unexpected heart surgery: A qualitative descriptive study.
abstract: BACKGROUND
  Most studies on patients' experiences following emergency cardiac surgery focus on evaluation of patients after their discharge. Few studies have evaluated patients' experiences after being transferred from intensive care and before being discharged.
  
  
  OBJECTIVE
  This study aimed to describe patients' experiences in the early stages of recovery following emergency heart surgery.
  
  
  METHODS
  For this exploratory qualitative descriptive study, 13 patients were recruited from a medical centre in northern Taiwan. Participants had undergone emergency heart surgery and had resided in the cardiothoracic surgical ward for ≥6 days following transfer from the ICU; all expected to be discharged from the hospital within 3 days. Semi-structured, face-to-face interviews were conducted in private after the patients had been transferred to the cardiothoracic surgical wards. Audiotaped interviews were transcribed and analysed using content analysis.
  
  
  RESULTS
  Data analysis identified four themes, which represented different recovery stages: sudden and serious symptoms, nightmares and vivid dreams, physical and emotional disturbances, and establishing a new life after emergency surgery. A fifth theme, support for a new lifestyle, occurred between the four stages.
  
  
  CONCLUSIONS
  Participants experienced symptoms of physical and psychological stress during the early recovery stages following emergency heart surgery. A lack of understanding of the process of recovery increased these difficulties; participants wanted and needed multidisciplinary care and education. Emergency heart surgery does not allow healthcare professionals to inform patients of what to expect post-surgery. Our findings suggest that rather than waiting until discharge to offer disease information and treatment plans, multidisciplinary care should be initiated as soon as possible to facilitate recovery.
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Taiwan. Electronic address: witch4011@adm.cgmh.org.tw.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Chang
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Taiwan. Electronic address: yftsai@mail.cgu.edu.tw.
authors.forename: Yun-Fang
authors.initials: YF
authors.lastname: Tsai
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D002318:Cardiovascular Diseases / Q000523:psychology* / Q000601:surgery*; D003422:Critical Care; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D020127:Recovery of Function; D013624:Taiwan
keywords: Early recovery stages; Emergency cardiac surgery; Physical and psychological stress; Qualitative research