title: Influences on Post-Discharge Recovery Following Coronary Artery Bypass Graft Surgery
Creators: name: Theobald, Karen
Publisher: name: Griffith University
Year: 2001
Subjects: subject: Coronary artery bypass graft surgery
subject: Nursing heart surgery patients
subject: Heart surgery

description: Many things change following Coronary Artery Bypass Graft (CABG) surgery for both the patient and his/her carer. The major aim of this research was to provide an indepth examination of these changes to investigate influences on recovery. The study was devised on the premise that this information would provide a significant basis for hospital discharge planning. A qualitative research approach, naturalistic inquiry, guided the study. Sixty people were interviewed, including thirty patients and their carers. Interviews were undertaken four to five weeks following discharge from hospital after CABG surgery. Subsequently, twelve months after the initial interview, patients and carers were again contacted to verify the findings generated from the first phase of the study, and to gain further data on his/her current health status. Data analysis revealed a number of maj or themes and sub themes for patients and carers. Almost half the patients stated that heart surgery was a huge personal shock. Adjusting to life after surgery was difficult, and patients experienced some form of physical pain or change. An unexpected finding was the extent to which many of the patients were attuned to their post-operative physical adjustments. They spoke of mental and emotional changes as well as concerns over the financial burden of the surgery. Coming to terms with lifestyle adjustments and worrying about the future were other themes that emerged in patients’ accounts. They offered suggestions to improve support services, like establishing a twenty-four hour telephone chat line and forming community clubs to link up with other patients. In assisting to better prepare for discharge home, they suggested providing more information about what to expect during recovery, like the up and down days that they might experience. Carers experienced a separate set of issues/needs and concerns as they came to terms with their loved one’s cardiac surgical recovery. The major findings for carers fell under four major themes, Events Surrounding Another’s Heart Surgery; Adjusting to the Surgery; Personal Changes Due to Surgery and Discovering Pathways to Recovery. Carers were shocked with the news that a family member required urgent cardiac surgery and theft reactions suggested a sequence of experiences that encountered in coming to terms with the event. Carers adjusted to the situation by taking on the role of watcher or minder and monitored the patient’s recovery. Some of the personal changes that carers dealt with, were changes in their activities and responsibilities; tiredness; experiencing a range of emotions and wonying about the unknown. Carers also offered suggestions for improved support services, like identifying a range of community services in close locality to his/her home. In better preparing for discharge home, some carers wanted more assistance and advice on how to be an effective carer. This research study provides unique insights into the experiences of patients and carers after coronary bypass graft surgery in the first four to five weeks following discharge home from hospital. The study outlines the issues/concerns and needs of CABG patients and their carers after they leave hospital, highlighting those related to age, gender, and family support. For example, many patients commented that they were too young for this to occur. Gender differences included, that the majority of carers were females and male patients reported experiencing more pain following cardiac surgery. Family support was a critical factor in enhancing recovery. Study findings suggest the need for a re-examination of hospital discharge preparation and the further provision and monitoring of home support services.