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Unmet information and communication needs in the intermediate recovery from coronary artery bypass surgery

Martinsen, Randi; Moen, Anne
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/134278
Date
2010
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  • Artikkel - fagfellevurdert vitenskapelig / Articles - peer-reviewed [1618]
Original version
Martinsen, R. & Moen, A. (2010) Unmet information and communication needs in the intermediate recovery from coronary artery bypass surger. Vård I Norden. 30(4) s.15-19.  
Abstract
Coronary artery bypass graft (CABG) is a common surgical procedure

for CHD (1). Compared to less invasive treatments, such as lifestyle

modifications, or percutaneous transluminal coronary angioplasty

(PTCA), undergoing CABG is a more challenging experience (2) that

influences well-being before and after surgery (3).

CABG convalescents are expected to incorporate sophisticated

regiments into their daily lives as they manage their own recovery.

During preparation for surgery and the few days of hospitalization

after surgery, the convalescent receives large quantities of information:

verbal and written. This includes information about the procedure,

the wounds on the sternum and legs, the sternum incision, and

specifically, temporary activity restrictions during the immediate recovery

period. During the immediate recovery, the convalescent’s capacity

to comprehend, process, and incorporate new information is most

likely constrained, and their attention is not paid towards learning and

information processing (4). The amount and timing of given information

are significant, and capacity to comprehend can influence the

‘sense of coherence’ (5).

Much of the pre- and post-surgery information explains the procedure,

specifically self-monitoring in the immediate recovery and

recommended lifestyle changes, such as smoking cessation, ‘healthy

eating’ and ‘regular exercise’ (6). Lifestyle changes are usually

required to fully benefit from CABG and to reduce symptoms that

may require additional treatment. Convalescents may experience anxiety

and symptoms of depression in this early recovery period (1,7).

In addition, ‘the heart’ carries a significant, existentially oriented

meaning to many of us. The capacity to comprehend; process the relevance

of or evaluate the usefulness of provided information can be

inhibited (1,4,7). Hence, convalescents can report information dearth

and a lack of information following CABG (8).

During the recovery from CABG, convalescents monitor their own

healing and are encouraged to adopt sophisticated regiments for

secondary prevention as part of their daily routines. Recovery experiences

alter during recovery (3,9). Women report setbacks from unexpected

muscular pain in the chest and problems with maintaining

recommended activity levels after surgery (10,11,12). Men can experience

the recovery process more smoothly than women, and they attribute

this to family support, especially from a wife, partner or significant

other (10).

According to Antonovsky’s salutogenic model (5,13), the individual’s

experience of comprehensibility, manageability and meaningfulness

is a core premise to handling every day situations. A convalescent’s

‘sense of coherence’ is likely to influence his ability to engage in

recovery management on a daily basis, as he incorporates recommendations

for secondary prevention of CHD. Acknowledging that CABG

recovery may be challenging, this study was theoretically inspired by

attention, patient education (4) and ‘sense of coherence’ (5). We have

only identified previous studies setting out to measure SOC as an

aspect of assessment of quality of life studies following heart surgery.

To the best of our knowledge, there are no previous studies applying

this construct to elaborate challenges the convalescents are facing in

the intermediate recovery period. To better understand recovery challenges

and information needs during CABG recovery, we need to elicit

the CABG convalescents’ information and communication needs in

the intermediate recovery period.
Description
The original publication is available at: http://www.artikel.nu/Bob/GetBob.aspx?bobID=3312
Publisher
Vård i Norden

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