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Anxiety and fear in patients with short waiting times before coronary artery bypass surgery – a qualitative study

Authors

  • Johanna Feuchtinger PhD, RN,

    Leader, Corresponding author
    1. Quality and Development in Nursing Care, University Medical Center Freiburg, Freiburg, Germany
    • Correspondence: Johanna Feuchtinger, Leader, Quality and Development in Nursing Care, University Medical Center Freiburg, Breisacher Strasse 62, PH 4, 79106 Freiburg, Germany. Telephone: +49 761 270 19020.

      E-mail: johanna.feuchtinger@uniklinik-freiburg.de

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  • Christina Burbaum PhD,

    Psychologist
    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
    Current affiliation:
    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, 79104 Freiburg, Germany
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  • Claudia Heilmann MD,

    Leader
    1. Department of Research, Department of Cardiovascular Surgery, University Heart Center Freiburg – Bad Krozingen, Freiburg, Germany
    Current affiliation:
    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, 79104 Freiburg, Germany
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  • Claudia Imbery RN,

    Quality Manager
    1. Department of Cardiovascular Surgery, University Heart Center Freiburg – Bad Krozingen, Freiburg, Germany
    Current affiliation:
    1. Hirslanden Klinik St. Anna, 6006 Luzern, Switzerland
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  • Matthias Siepe MD,

    Assistant Medical Director
    1. Department of Cardiovascular Surgery, University Heart Center Freiburg – Bad Krozingen, Freiburg, Germany
    Current affiliation:
    1. Department of Cardiovascular Surgery Freiburg, Heart Center Freiburg University, 79106 Freiburg, Germany
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  • Ulrike Stotz MSc,

    Psychologist
    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
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  • Kurt Fritzsche MD,

    Senior Physician (retired)
    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
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  • Friedhelm Beyersdorf MD

    Medical Director
    1. Department of Cardiovascular Surgery, University Heart Center Freiburg – Bad Krozingen, Freiburg, Germany
    Current affiliation:
    1. Department of Cardiovascular Surgery Freiburg, Heart Center Freiburg University, 79106 Freiburg, Germany
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Abstract

Aims and objectives

To obtain qualitative information on fears and anxieties of coronary artery bypass grafting patients with short waiting periods (up to a maximum of four weeks) before surgery.

Background

Coronary artery bypass grafting is a standard procedure in cardiac surgery. However, many patients suffer significant anxiety and fear before the operation. Preoperative anxiety and fear correlate with adverse outcomes, but there is a lack of data on the emotional stressors for patients with short waiting periods as applicable in Germany. This knowledge would be a prerequisite for the development of in-hospital interventions to reduce patients' anxieties and fears.

Design

An exploratory study was chosen to learn about patients' anxieties and fears.

Method

The day before coronary artery bypass grafting, 24 patients were examined with respect to their emotional experience using semi-structured interviews. The results were categorised by inductive content analysis.

Results

The overall waiting time for coronary artery bypass grafting was 6 ± 6 days. According to the analysis, the patients' statements were grouped in ‘fears', ‘negation of fears' and ‘other emotional and physical conditions'. The interviews could cover all categories simultaneously. Eighteen patients mentioned fears, and most of them referred to specific issues. However, 16 of the 18 patients also named nonspecific fears and uncertainties. Fifteen patients negated fear. Twenty-three patients described their emotions and/or somatic conditions.

Conclusions

Patients with short waiting periods before coronary artery bypass grafting experience specific as well as nonspecific fears on the day before surgery. In contrast to patients with long waiting (longer than four weeks), uncertainty and frustration about waiting time and feelings of disability are no concerns.

Relevance to clinical practice

The detailed insight into the emotional experiences of patients with a short waiting time before coronary artery bypass grafting surgery is a basis for targeted anxiety-reducing interventions.

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