Phases of recovery from open heart surgery : a descriptive study of postoperative patterns in adult cardiac surgery patients prior to discharge from hospital

This descriptive study was designed to investigate the problem of inadequate emotional recovery from open heart surgery. This problem has been defined by a number of earlier researchers who have noted adverse emotional reactions to the experience of cardiac surgery in both the early postoperative and the post-discharge periods. This investigation had as its purpose the examination of the pre-discharge recovery of patients, and the investigator intended to note whether there existed a common pattern of recovery among the patients studied (hence, a pattern of emotional response to surgery). It was anticipated that the discovery of similarities of behaviour might give insight into the responses to open heart surgery and provide information important to the study of long-term rehabilitation. Twenty adult patients scheduled for open heart surgery were selected as the sample for study. The principal setting for the investigation was the Cardiac Surgery Unit of a large metropolitan hospital. Subjects were interviewed one to two days prior to surgery and then every two to three days postoperatively until the time of discharge. The investigator obtained qualitative data with the aid of a data collection tool, noting the physiological status of the subjects but focusing most directly on verbal and nonverbal behaviours exhibited. The latter observations included focus of conversation, patterns of communication, affect, orientation, level of anxiety, and activity. Following analysis of the data, it was noted that a common pattern of recovery was indeed evident. Three phases of recovery - Somatic, Transition and Resolution - could be described for each subject in the sample. The phases indicated the subjects' general responses to surgery and their progression toward increased activity and independence at the time of discharge. In effect, the phases served to define the hospital course of emotional recovery from open heart surgery. The length and onset of these three phases were similar for patients with an uncomplicated recovery but varied with patients who experienced major physiologic difficulties. The implications of a recovery pattern have been discussed relative to nursing care of the cardiac surgical patient and specific recommendations for nursing intervention have been made. Subject areas worthy of further investigation have been enumerated by the investigator in light of the conclusions of the present study.Applied Science, Faculty ofNursing, School ofGraduat