Heart surgery patients physiological and psychological recovery in relation to type of nursing psychological preparation and patients coping style.

This clinical study investigated variations of preparatory instruction and information and consistent supportive care designed to increase postoperative physiological and psychological recovery among patients having aortocoronary bypass graft surgery. Forty-five male patients, aged 50-75, were randomly assigned to one of three treatment conditions: (1) a combination of preparatory sensory and factual information and instruction (audiovisual presentation) and consistent supportive care and at stressful points throughout the hospitalization; (2) a single-session of preparatory sensory and factual information and instruction (audiovisual presentation) conducted after admission; and (3) consistent supportive care given by one nurse throughout the hospitalization at the same stressful points as the first condition, but without systematic preparatory information. In addition, scores on Byrne’s Revised Repression-Sensitization Scale were used to determine coping style. Byrne’s scale identifies three coping styles: sensitizers, neutrals, and repressors. However, in the population selected for this investigation the obtained distribution identified only neutrals and repressors. No sensitizers were present. The major purpose of this investigation was to determine if there is a preferred method to prepare patients having aortocoronary bypass graft surgery. Other areas investigated were general outcomes of patients experiencing aotocoronary bypass graft surgery according to coping style and coping style-intervention interaction. It was hypothesized that patients receiving the combination of preparatory and factual information and instruction and consistent supportive care would have a more favorable postoperative physiological and psychological recovery as measured by recovery indicators, complications, and patient self-ratings than either preparatory information alone or consistent supportive care alone. However, the results did not consistently support this hypothesis. The results consistently indicated that consistent supportive care only, without factual and sensory information of upcoming events is not as effective as preparatory information alone or the combination of preparatory information and consistent supportive care in producing positive results on recovery indicators, complications, and patient self-rating. No significant differences were found between patients receiving the combination of information and supportive care and those receiving only a single preparatory information session. However, evidence suggests that consistent supportive care in addition to preparatory information received in the combination treatment group, was relatively better than a single preparatory information session alone in that comparison of the three treatment intervention groups revealed more significant differences in favor of the combination treatment group. No consistent trend was demonstrated in favor of repressors or neutrals in relation to recovery. Several interactions between intervention and coping style were found.

THE UNIVERSITY OF UTAH GRADUATE SCHOOL SUPERVISORY COMMITTEE APPROVAL of a thesis submitted by Mary Wi 11 i ams I have read this thesis and have found it to be of satisfactory quality for a master's degree. ., t -/} Date bU,/$/J / / ) ,::�>/U;:::rd�P§. � John A. � Wolfer, Chairman. Supervisory Committee �:: �:r / � read this thesis and have found it to b r 4 Dall 1 1<"..1 �f ;' .__ Y / � I�4� ,ft? Junst C. ualitY ror a masters :C /,- >. �e R.N; Ph.D. ' . / Member. Supervisory Committee I have read this thesis and have found it to be of satisfactory quality for a master's degree. Date Charles N. Uhl, Ph.D. Member. Supervisory Committee THE UNIVERSITY OF UTAH GRADUATE SCHOOL FINAL READING APPROV AL To the Graduate Council of The University of Utah: I have read the thesis of Ma ry Wi 11 i ams in its final form and have found that (I) its format, citations. and bibliographic style are consistent and acceptable; (2) its illustrative materials including figures, tables, and charts are in place; and (3) the final manuscript is satisfactory to the Supervisory Committee and is ready for submission to the Graduate School. Date "It Ix 0 / I JeKn A. Wolfer, Ph.� Member, Supervisory Committee Approved for the Major Department Chairmani Dean Approved for the Graduate Council