Coronary artery bypass graft surgery: discharge planning for successful recovery
Article first published online: 13 AUG 2004
Journal of Advanced Nursing
Volume 47, Issue 5, pages 483–491, September 2004
How to Cite
Theobald, K. and McMurray, A. (2004), Coronary artery bypass graft surgery: discharge planning for successful recovery. Journal of Advanced Nursing, 47: 483–491. doi: 10.1111/j.1365-2648.2004.03127.x
- Issue published online: 13 AUG 2004
- Article first published online: 13 AUG 2004
- Submitted for publication 18 August 2003 Accepted for publication 20 December 2003
- coronary artery bypass graft;
- postdischarge care;
- naturalistic inquiry;
- discharge planning;
Background. Coronary artery bypass graft (CABG) surgery is a lifesaving intervention, but the early recovery period presents a number of challenges for patients, carers and nurses. Early and adequate discharge planning based on in-depth knowledge of the postdischarge experience can help to ensure optimal recovery.
Aim. This paper reports a study to examine the range of postdischarge issues, concerns and needs of patients and their family carers after discharge after CABG surgery, and explore their perceptions of unmet needs 1 year later.
Methods. A two-phase naturalistic inquiry was undertaken. Interviews were conducted with 30 patients and their carers 4–5 weeks after coronary artery bypass grafting (phase 1) and 1 year after the initial interview (phase 2). Thematic analysis was used to identify the major concerns of participants.
Findings. Almost half the patients experienced heart surgery as a huge personal shock. Adjusting to life afterwards was difficult, and they experienced a variety of changes, including pain. An unexpected finding was a heightened sense of body awareness and the need for postoperative physical adjustments. The financial implications of surgery were a major burden. Lifestyle adjustments were important and led to suggestions for support services, using telephone support and/or community patient networks. All participants recommended strengthening discharge planning with more accurate information about what to expect during recovery, to help them anticipate fluctuations in health and wellbeing. Carers experienced a wide range of unanticipated feelings during early recovery and had to deal with a number of personal changes.
Conclusions. The findings suggest a need to improve discharge preparation and provide enhanced home support services. Further research should evaluate models of periodic follow-up and mechanisms for mutual support, and compare the experiences of cardiac patients and their carers with those of other surgical cohorts.