Preference for information, perceived control, coping and outcomes following first time open heart surgery in older adults
Significance Cardiovascular disease is the number one killer of adults aged 65 years and older. Over 55% of all coronary artery bypass surgeries (CABS) are on older adults. Older adults have more complications after CABS. Educational nursing interventions are important to facilitate coping, but nurses do not assess for patient preference for information. Given that older adults are known to have poorer outcomes after CABS, current nursing practices of providing detailed, intense information may be deterring coping and contributing to poorer outcomes. Method In this prospective descriptive study, older adult CABS patients were interviewed preoperatively and 6 weeks postoperatively. Instruments: Krantz Health Opinion Survey, Control Attitudes Scale, Ways of Coping Questionnaire, 15-item Geriatric Depression Scale, and Medical Outcomes Study Short Form-12. Reliabilities ranged from 0.55 to 0.74. Results N = 70; age 71.97 years, White (94.3%) and male (65.7%); averaged 4.67 co-morbidities, 3.14 coronary artery bypasses, and 7.63 days of hospital stay (PLOS). Age was significantly related to postoperative physical function. Women had greater depression and poorer physical and mental function. Participants preferred moderate information, perceived moderate control, and used positive reappraisal to cope. Preference for information was related to better postoperative physical function. Seeking social support and positive reappraisal were related to shorter PLOS. Escape-avoidance was related to poorer postoperative mental function. Although depression was low overall, preoperative depression was significantly related to coping, functional status, and depression. Canonical relationships were not statistically significant. Conclusion The theoretical model did not effectively predict older adults’ experiences. Reliable research instruments need to be developed for older adults. Nurses caring for CABS patients need to be aware of gender differences and need to assess for depression.
School:The Ohio State University
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:older adults elderly coronary artery bypass surgery nursing preference for information perceived control coping depression functional status krantz health opinion survey attitudes scale ways of questionnaire geriatric
Date of Publication:01/01/2004