Expected Benefits, Realized Benefits and Quality of Life Among Elderly Undergoing Coronary Artery Bypass Surgery

The purposes of this prospective, descriptive, comparative study were to describe differences between the expected and realized benefits of elderly patients undergoing coronary bypass surgery and to explore the relationships between expected benefits, realized benefits and quality of life. A convenience sample of 24 elderly patients were chosen from a large cardiovascular surgical practice in the Midwest. The subjects ages ranged between 65-86 years; they were undergoing coronary artery bypass surgery for the first time. Data were collected using the Homegoing/Expected Benefits and Recovery (HEBR) Preoperative Interview Guide, Medical Record Data Form, Homegoing/Realized Benefits and Recovery (HRBR) Postoperative Interview Guide developed by Gartner (Gartner, Rankin, and Wolfe, 1988), and the Quality of Life Index (QLI) developed by Ferrans and Powers (1985). The interviews were conducted preoperatively in person on the day before surgery and eight weeks postoperatively on the telephone. Analysis of data demonstrated the subjects identified a total of 134 expected benefits and 106 realized benefits. The ratio of total expected benefits to total realized benefits was 79%. Preoperative overall quality of life was not significantly different from postoperative overall quality of life. Of the four QLI subscales; health and functioning; socioeconomic; psychological/spiritual; and family; only the health and functioning subscale indicated a significant difference between subjects preoperatively and postoperatively. Pearson product moment correlations were performed between the QLI and the constructs of health state, quality of life and life satisfaction from the HEBR and HRBR. Moderate positive correlations (p \u3c .01) existed between satisfaction with family and health and expected health state (r = .52); amount of chest pain, quality of life and life satisfaction (r = .59; r = .49); and satisfaction with physical independence, quality of life and life satisfaction (r = .49; r = .57). Robust correlations were found postoperatively between the quality of life index, quality of life and life satisfaction (r = .70, p \u3c .001). There were no significant associations between age, sex, realized benefits, and quality of life. There were no significant relationships between the variables of sex, realized benefits and the quality of life index. Six subjects identified unrealized benefits at the end of eight weeks. Pain or discomfort and coping responses to surgical recovery were identified as factors contributing to unrealized benefits. Implications of this study suggest elderly patients undergoing coronary artery bypass surgery realized a majority of their expectations, and overall quality of life especially in the area of health and functioning, was decreased at the end of eight weeks