Lindsay G M, Smith L N, Hanlon P, Wheatley D J
Nursing and Midwifery School, University of Glasgow, Glasgow, Scotland.
J Adv Nurs. 2000 Dec;32(6):1412-21. doi: 10.1046/j.1365-2648.2000.01621.x.
This prospective descriptive study has analysed 214 patient interviews before and 1 year after coronary artery bypass grafting (CABG). The preoperative interview explored issues related to the impact of coronary artery disease upon health and expectations of benefit from the patients' perspective. The postoperative interview examined patients' accounts of the experience of operation and its impact on their health. A thematic analysis of the interview data was undertaken. The main factors relating to health status preoperatively were described in terms of 'dependency' on others and medication, and 'impending doom' of some major life threatening event. Benefits to health postoperatively were viewed in terms of 'removal of a death sentence' and 'freedom of choice'. Expectations of benefit from operation were varied and included 'freedom and independence', 'hope, chance and uncertainty' and 'addition of years to life and life to years'. Undergoing the operation was described by themes of the 'enormity of the experience' and 'the importance of lay support'. These findings provide a greater understanding of the 'lived experience' of both coronary artery disease and undergoing coronary artery bypass grafting. Unrealistic expectations of the benefits of CABG highlights the need for improvement in the way patients are informed about risks and benefits of interventions. In addition, the views and insights suggest that CABG operation is regarded as a significant major life event; thus more information, advice and counselling might help support patients before, during and after surgery.
这项前瞻性描述性研究分析了214例患者在冠状动脉旁路移植术(CABG)前后的访谈情况,术前访谈探讨了从患者角度来看冠状动脉疾病对健康的影响以及对获益的期望等问题。术后访谈考察了患者对手术体验及其对健康影响的描述。对访谈数据进行了主题分析。术前与健康状况相关的主要因素被描述为对他人和药物的“依赖”,以及某些重大危及生命事件的“迫在眉睫的厄运”感。术后对健康的益处被视为“解除死刑”和“选择自由”。对手术获益的期望各不相同,包括“自由与独立”“希望、机会与不确定性”以及“延年益寿”。手术体验的主题包括“经历的重大意义”和“亲友支持的重要性”。这些发现让我们对冠状动脉疾病患者以及接受冠状动脉旁路移植术患者的“实际经历”有了更深入的了解。对冠状动脉旁路移植术益处的不切实际期望凸显了在告知患者干预措施的风险和益处方面需要改进。此外,这些观点和见解表明冠状动脉旁路移植术被视为一项重大的人生事件;因此,更多的信息、建议和咨询可能有助于在手术前、手术期间和手术后为患者提供支持。