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无人区中的弃儿:一项关于等待择期冠状动脉搭桥手术患者经历的定性研究

Abandoned in No Man's Land: A Qualitative Study on Patient Experiences While Waiting for Elective Coronary Artery Bypass Surgery.

作者信息

Olsen Dorte Baek, Hoejskov Ida Elisabeth, Missel Malene

机构信息

Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

IMPACT-Research & Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Nurs Res Pract. 2025 Sep 2;2025:3139277. doi: 10.1155/nrp/3139277. eCollection 2025.

Abstract

Coronary artery bypass grafting is the primary treatment for patients with ischemic heart disease and multivessel disease to improve survival, symptoms, and quality of life. However, patients waiting for coronary artery bypass grafting surgery often struggle with advanced age, frailty, and inactivity, leading to anxiety and uncertainty. Psychological distress, pain, and sedentary behavior can worsen their condition. Prehabilitation, combining exercise, education, and support, aims to improve readiness for surgery, but its success depends on understanding patients' perspectives, while this study explores the experiences of patients awaiting coronary artery bypass grafting surgery to contribute insights into the design of future prehabilitation programs. This qualitative study aimed to explore the phenomenon of waiting to have elective coronary artery bypass grafting surgery based on patients' lived experiences. The study used a hermeneutic-phenomenological approach and conducted purposely selected in-depth interviews with one female and nine men the day before surgery. Analysis of the data revealed themes based on experiences of being abandoned in no man's land, balancing between feeling imprisoned and hoping to escape, preparing to fight, and feeling weak and dependent on social support. The phenomena this study uncovered underscore the complexities inherent to the lived experience of waiting for coronary artery bypass grafting surgery. Understanding and integrating these aspects when planning prehabilitation programs for patients waiting for coronary artery bypass grafting surgery have substantial clinical relevance, particularly for enhancing healthcare practice when developing targeted interventions.

摘要

冠状动脉搭桥术是缺血性心脏病和多支血管病变患者改善生存、缓解症状及提高生活质量的主要治疗方法。然而,等待冠状动脉搭桥手术的患者常常面临高龄、身体虚弱和缺乏活动等问题,从而导致焦虑和不确定性。心理困扰、疼痛和久坐行为会使他们的病情恶化。术前康复,即结合运动、教育和支持,旨在提高患者对手术的准备程度,但其成功与否取决于对患者观点的理解,而本研究探讨等待冠状动脉搭桥手术患者的经历,以期为未来术前康复计划的设计提供见解。这项定性研究旨在基于患者的生活经历探讨等待择期冠状动脉搭桥手术这一现象。该研究采用诠释现象学方法,在手术前一天对1名女性和9名男性进行了有目的的深入访谈。数据分析揭示了基于在无人地带被遗弃的经历、在感觉被困和希望逃脱之间保持平衡、准备战斗以及感到虚弱并依赖社会支持等经历的主题。本研究发现的这些现象凸显了等待冠状动脉搭桥手术生活经历中固有的复杂性。在为等待冠状动脉搭桥手术的患者制定术前康复计划时,理解并整合这些方面具有重要的临床意义,特别是在制定有针对性的干预措施以加强医疗实践方面。

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