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Postponement of elective cardiac surgery: A prospective observational analysis of anxiety, depression, social support and clinical complications

To investigate patients' psychological reactions to postponement of elective cardiac surgery, and whether postponement was associated with increased complications post-operative and while waiting. A single-centre observational prospective cohort study. All adult patients referred for elective c...

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Bibliographic Details
Published in:Journal of clinical nursing 2023-10, Vol.32 (19-20), p.7346-7357
Main Authors: Spindler, Helle, Thorup, Charlotte Brun, Nøhr, Dorte, Andreasen, Jan Jesper
Format: Article
Language:English
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Summary:To investigate patients' psychological reactions to postponement of elective cardiac surgery, and whether postponement was associated with increased complications post-operative and while waiting. A single-centre observational prospective cohort study. All adult patients referred for elective cardiac surgery during the study period were considered for inclusion. Psychological data were collected using a survey distributed to patients prior to surgery and at 6 months post-operative. Clinical data were obtained from patient records. A total of 83 postponed and 132 non-postponed patients were included. Postponed patients displayed more avoidance behaviour, but only immediately before surgery. Postponed patients maintained their satisfaction with perceived social support, whereas non-postponed patients became more dissatisfied over time. Waiting 0-14 days was associated with increased symptoms of depression before surgery compared to non-postponed patients or those waiting more than 14 days. Surgical complications were the same in both groups. No patients experienced aggravation of their disease leading to urgent or emergent surgery while waiting for surgery. Hospital-related reasons were the most common cause for postponement of surgery. Postponement of selected patients is not associated with increased risk of psychological distress or complications related to the patient's disease. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Pre- and post-psychological interventions may be relevant to consider in relation to elective cardiac surgery as it has been shown to positively affect outcome. Organisational/hospital-related reasons are still very common causes for postponement of elective surgeries, and hospital administrations should focus upon eliminating/decreasing this. Questionnaires filled by patients were used to understand an association between postponement of cardiac surgery and psychological distress.
ISSN:0962-1067
1365-2702
DOI:10.1111/jocn.16818