Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg , Marburg, Germany.
Department of Adult and Pediatric Cardiovascular Surgery, Justus-Liebig-University Giessen , Gießen, Germany.
Psychol Health Med. 2020 Aug;25(7):781-792. doi: 10.1080/13548506.2019.1659986. Epub 2019 Aug 27.
The aim of this study was to investigate not only preoperative expectations (as shown previously), but also postoperative expectations of patients predict clinical outcomes six months after cardiac surgery. Furthermore, the study sought to examine illness behavior as a possible pathway through which expectations may affect postoperative well-being. Seventy patients scheduled for cardiac surgery were examined one day before surgery, ~7-10 days after surgery, and six months after surgery. Regression analyses indicated that disability at follow-up (primary outcome) was significantly predicted by postoperative ( = -.342, = .008), but not by preoperative expectations ( = -.213, = .069). Similar results were found for the secondary outcomes, i.e. quality of life and depressive symptoms. A bootstrapped mediation analysis showed that although both postoperative expectations and illness behavior had significant unique effects on disability, there was no significant mediation effect. While previous studies have mainly focused on patients' preoperative expectations, the present is the first to emphasize the predictive value of patients' expectations a few days after surgery, pointing to the potential of interventions targeting postoperative expectations. However, given the non-significant results of the mediation analysis, it remains unclear how exactly patients' expectations affect clinical outcomes in cardiac surgery.
这项研究的目的不仅在于调查术前预期（如前所述），还在于调查术后预期对心脏手术后六个月临床结果的预测作用。此外，本研究还试图探究疾病行为是否可能是一种预期影响术后健康的途径。对 70 名拟行心脏手术的患者在术前一天、术后 7-10 天和术后六个月进行了检查。回归分析表明，术后残疾（主要结果）显著预测术后（β=-.342，p=.008），而术前预期（β=-.213，p=.069）则不显著。对于次要结果（即生活质量和抑郁症状）也发现了类似的结果。Bootstrapped 中介分析表明，尽管术后预期和疾病行为对残疾都有显著的独立影响，但不存在显著的中介效应。虽然之前的研究主要集中在患者的术前预期上，但本研究首次强调了术后几天患者预期的预测价值，为针对术后预期的干预措施提供了可能性。然而，鉴于中介分析的非显著性结果，尚不清楚患者的预期如何确切地影响心脏手术的临床结果。
