Is it important to give patients verbal-visual information about the operation to improve their psychological functions in coronary artery bypass graft surgery?

Yıl 2022, Cilt: 15 Sayı: 3, 555 - 562, 01.07.2022

Osman Zülkif Topak Ahmet Baltalarlı Gökhan Önem Osman Özdel

https://doi.org/10.31362/patd.1103198

Öz

Purpose: Being well informed can help with developing strategies to cope, can contribute to the psychological well-being of patients and improve their quality of life. It is aimed to investigate the effect of verbal-visual information compared to only written information before the procedure on coping methods, quality of life and disability in patients who will undergo coronary artery bypass surgery.
Materials and methods: Forty-eight patients were divided into two equal groups. While the first group was informed about the risks of the operation process and postoperative care verbally and visually, the other group was given only written information. All patients underwent standardized psychiatric interviews according to DSM V, before and after surgery The Brief Disability Questionnaire (BDQ), Coping Scale (COPE), Hospital Anxiety and Depression Scale (HADS), Health Related Quality of life Short-Form 36 (HRQOL-BRIEF SF-36) was applied.
Results: Although psychiatric disorders are more common in women than men, no statistical difference was found. It was observed that the most common diagnosis was adjustment disorder. Although there was no significant difference between the groups in terms of anxiety and depressive symptoms and quality of life, it was observed that the use of religious coping decreased and disability increased after surgery only in the written-informed group. Further, disability scores were positively correlated with the endpoint depression and anxiety scores in the group given only written information.
Conclusion: Being well-informed verbally and visually about the surgery process positively affects patients’ coping strategies and adjustment while decreasing psychiatric comorbidity and disability rates. Further longitudinal research is recommended in various cultures to identify patients’ modifiable risk factors in terms of psychological outcomes. 

Anahtar Kelimeler

coronary artery bypass grafting surgery, disability, coping skills, quality of life.

Koroner arter bypass greft cerrahisinde hastalara işlem hakkında sözel-görsel bilgilendirme yapmak psikolojik fonksiyonlar açısından önemli midir?

Öz

Amaç: İyi bilgilendirilmiş olmak, başa çıkma stratejileri geliştirmeye yardımcı olabilir, hastaların psikolojik iyilik hallerine katkıda bulunabilir ve yaşam kalitelerini iyileştirebilir. Bu çalışmada koroner arter by-pass cerrahisi yapılacak hastalarda işlem öncesi sözel-görsel bilgilendirme yapılmasının sadece yazılı bilgilendirme yapılmasına kıyasla hayat kalitesi, yeti yitimi ve başetme yöntemleri üzerine nasıl bir etkisinin olacağının araştırılması amaçlanmıştır.
Gereç ve yöntem: Çalışmamıza 48 hasta alınmış ve hastalar iki eşit gruba bölünmüştür. Birinci gruba, ameliyat süreci ve olası riskler ayrıntılı bir şekilde sözel-görsel olarak anlatılmış, ikinci grup ise yalnızca yazılı olarak bilgilendirilmiştir. Tüm hastalara DSM V’e göre standardize psikiyatrik görüşme yapılmış, ameliyat öncesinde ve sonrasında Kısa Yeti Yitimi Anketi (KYA), Başa Çıkma Tutumlarını Değerlendirme Ölçeği (COPE), Hastane Anksiyete ve Depresyon Ölçeği (HAD), Kısa form 36 Yaşam Kalitesi Ölçeği (SF-36) uygulanmıştır.
Bulgular: Psikiyatrik bozukluklar genel olarak kadınlarda erkeklere göre daha fazla olmakla birlikte istatiksel fark saptanmamıştır. En sık konulan tanının, uyum bozukluğu olduğu gözlenmiştir. Gruplar arasında anksiyete ve depresif semptomlar ile yaşam kalitesi açısından anlamlı fark saptanmamasına ragmen, yalnızca yazılı olarak bilgilendirilmiş grupta ameliyat sonrası dini olarak başa çıkma kullanımının azaldığı ve yeti yitiminin arttığı gözlenmiştir. Ayrıca, yazılı bilgilendirilmiş grupta depresyon ve anksiyete puanları ile yeti yitimi arasında pozitif yönde korelasyon olduğu saptandı.
Sonuç: Ameliyat hakkında ayrıntılı sözel-görsel bilgilendirme yapılması hastaların ameliyat sonrası süreçte başetme stratejilerini etkilemekte ve daha sağlıklı bir şekilde uyum sağlamalarına yardımcı olarak yeti yitimini azaltmaktadır. Ameliyat sonrası dönemde hastaların psikolojik fonksiyonlarını etkileyebilecek modifiye edilebilir risk faktörlerinin de belirlenmesi açısından farklı kültürlerde uzun dönem çalışmalara ihtiyaç duyulmaktadır. 

Anahtar Kelimeler

Koroner arter bypass greft ameliyatı, yeti yitimi, başetme becerileri, yaşam kalitesi

Kaynakça

• 1. Ben Zur H, Rappaport B, Ammar R, Uretzky G. Coping strategies, life-style changes, and pessimism after open-heart surgery, Health & Social Work 2000;7:210-209.
• 2. Lee GA, Patients reported health-related quality of life five years post coronary artery bypass graft surgery a methodological study, Eur J Cardiovasc Nurs. 2008;7:67-72.
• 3. Rantanen A, Tarkka MT, Kaunonen M, Tarkka M, Sintonen H, Koivisto AM, et al. Health-related quality of life after coronary artery bypass grafting, J Adv Nurs 2009;65:1926-36.
• 4. Wray J, Al-Ruzzeh S, Mazrani W, Nakamura K, et al. Quality of life and coping following minimally invasive direct coronary artery bypass (MIDCAB) surgery, Quality of Life Res. 2004;13:915–924.
• 5. Korkmaz FD, Alcan AO, Aslan FE, Çakmakçı H. Evaluation of quality of life after coronary artery bypass graft surgery, The Turkısh Journal of Thoracic and Cardiovascular Surgery 2015;23(2):285-294.
• 6. Andrew MJ, Baker RA, Kneebone AC, Knight JL, Mood state as a predictor of neuropsychological deficits following cardiac surgery, J Psychosom Res. 2000;48:537-46.
• 7. Connerney I, Shapiro PA, McLaughlin JS, Bagiella E, Sloan RP. Relation between depression after coronary artery bypass surgery and 12-month outcome: A prospective study. The Lancet 2001;358:1766-1771.
• 8. Borowicz L, Royall R, Grega M, Selnes O, Lyketsos C, McKhann G. Depression and cardiac morbidity 5 years after coronary artery bypass surgery, Psychosomatics 2002;43:464–471.
• 9. Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, et al. Depression as a risk factor for mortality after coronary artery bypass surgery, Lancet 2003;362:604–609.
• 10. McKhann GM, Borowicz LM, Goldsborough MA, Enger C , Selnes OA. Depression and cognitive decline after coronary artery bypass grafting, Lancet 1997;349:1282-4.
• 11. Rymaszewska J, Kiejna A, Hadrys T. Depression and anxiety in coronary artery bypass grafting patients, European Psychiatry 2003;18:155–160.
• 12. Nelson FV, Zimmerman L, Barnason S, Nieveen J, Schmaderer M. The relationship and influence of anxiety on postoperative pain in the coronary artery bypass graft patient, Journal of Pain & Symptom Management 1998;15:102-109.
• 13. Pintor P, Torta R, Bartolozzi S, Borio R, Caruzzo E, Cicolin A. et al. Clinical outcomes and emotional-behavioural status after isolated coronary surgery, Quality of Life Res 1992;1:177-185.
• 14. Oxlad M, Wade TD, Longitudinal Risk Factors for Adverse Psychological Functioning Six Months after Coronary Artery Bypass Graft Surgery, Journal of Health Psychology 2008;13(1):79–92.
• 15. Zigmond AS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatr Scand 1982 ;67:361-370.
• 16. Ware JE, Sherbourne CD. The MOS 36-item ShortForm Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
• 17. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J pers Soc Psychol 1989 ;56(2):267-83.
• 18. Steward AL, Hays RD, Ware JEJ, et al. The MOS short form general health survey: reliability and validity in a patient population. Med Care 1988;26:724-732.
• 19. Kaplan I, Relation between disability and mental disorders in patients admitted to a semi-rural health center. (Reliability study of Turkish form of BDQ).Turkish Journal of Psychiatry 1995;6:169-79.
• 20. Acargun MY, Besiroğlu L, Kiran UK, Özer OA, Kara H. A preliminary study of psychometric properties, (Reliability and validity study of Turkish form of COPE), Anatolian Journal of Psychiatry 2005;6:221-226.
• 21. Lowe R, Norman P, Bennett P. Coping, emotion and perceived health following myocardial infarction: Concurrent and predictive associations. Br J Health Psychol 2000;5:337–350.
• 22. Koçyigit H, Aydemir Ö, Ölmez N, et al. Reliability and validity study of Turkish form of SF-36), Drug and Treatment Journal 1999;12:102-106. 23. Aydemir Ö, Measurement of quality of life in consultation-liaison psychiatry: Short Form-36 (SF-36), 3 P Journal 1999;7(2):14-22.
• 24. Smith HJ, Taylor R, Mitchell A. A comparison of four quality-of-life instruments in cardiac patients: SF-36, QLI, QLMI and SEIQoL, Heart 2000;84:390–394.
• 25. Aydemir Ö, Güvenir T, Kuey L, Kültür S. Reliability and validity study of Turkish form of Hospital Anxiety and Depression Scale (HADS), Turkish Journal of Psychiatry 1997;8:280-287.
• 26. Stengrevics S, Sirois C, Schwartz CE, Friedman R, Domar AD. The prediction of cardiac surgery outcome based upon preoperative psychological factors, Psychol Health 1996;11:471-477.
• 27. Skodova Z , Van Dijk JP, Nagyova I, Rosenberger J, Ondusova D, Middel B, et al. Psychosocial predictors of change in quality of life in patients after coronary interventions, Heart Lung 2011;40:331-9.
• 28. Vingerhoets G. Cognitive, emotional and psychsomatic complaints and their relation to emotional status and personality following cardiac surgery, Br J Health Psychol 1998;3:159-169.
• 29. Duits AA, Boeke S, Taams MA, et al. Prediction of quality of life after coronary artery bypass graft surgery: A review and evaluation of multiple, recent studies, Psychosom Med 1997;59:257–268.
• 30. Sjoland H, Caidahl K, Wiklund I, Haglid M, Hartford M, Karlson BW, et al. Impact of coronary artery bypass grafting on various aspects of quality of life, Eur J Cardiothorac Surg 1997;12:612-9.
• 31. Jenkins CD, Stanton BA, Savageau JA, et al. Coronary artery bypass surgery: Physical, psychological, social, and economic outcomes six months later, J Am Med Assoc 1983;250:782–788.
• 32. King KB, Reis HT, Porter LA, Norsen LH. Social support and long-term recovery from coronary artery surgery: Effects on patients and spouses, Health Psychol 1993;12:56-63.
• 33. Allen JK. Physical and psychosocial outcomes after coronary artery bypass graft surgery: Review of the literatüre, Heart Lung 1990;19:49–54.
• 34. Beresford N, Seymour L,Vincent C, Moat N. Risks of elective cardiac surgery: what do patients want to know? Heart 2001;86:626-631.