Effects of Interventions Based on Patient Expectations on Coronary Surgery Outcomes: A Randomized Clinical Trial

Kobra Noruzi Larki; Tayeb Mohammadi; Masoumeh Zakerimoghadam; Leila Sayadi

doi:10.18502/jthc.v18i4.14826

Kobra Noruzi Larki School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Tayeb Mohammadi Departments of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Masoumeh Zakerimoghadam School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Leila Sayadi Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v18i4.14826

Keywords: Expectations; Anxiety; Pain; Disability; Coronary artery bypass surgery

Abstract

Background: Coronary surgery can have various outcomes, such as fear of death, cardiac anxiety, and pain disability. This study aimed to evaluate the effects of interventions based on patient expectations on different outcomes of coronary surgery, including expectations, cardiac anxiety, and pain-induced disability.

Methods: This randomized clinical trial evaluated 60 coronary surgery candidates. Patients meeting the inclusion criteria were randomly assigned to control and intervention groups. The patients were contacted 1 to 2 weeks before coronary surgery to complete the Cardiac Surgery Patient Expectations Questionnaire (C-SPEQ). Based on the analysis of expectations, the intervention group underwent interventions to optimize expectations, whereas the control group received only routine care. The Cardiac Anxiety Questionnaire (CAQ) and the Pain Disability Index (PDI) were completed on the day of hospitalization. Three months later, the participants recompleted all 3 questionnaires. The data were analyzed with descriptive and analytical statistics in SPSS 16.0.

Results: There were no significant differences between the control and intervention groups in baseline variables, pain-induced disability (P=0.353), and cardiac anxiety (P=0.479). After the intervention, no significant differences were observed between the groups concerning expectations (P=0.554) and pain-induced disability (P=0.557) when the confounding variables were adjusted. Nevertheless, cardiac anxiety decreased significantly (P=0.027).

Conclusion: Our interventions improved expectations and mitigated anxiety among coronary surgery patients. Actualization and optimization of patient expectations should be considered in the care of coronary surgery candidates.