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American Journal of Critical Care. 2007;16: 248-257
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Stressors and Anxiety in Patients Undergoing Coronary Artery Bypass Surgery

By Robyn Gallagher, RN, PhD and Sharon McKinley, RN, PhD. Robyn Gallagher is Associate Professor, Chronic and Complex Care, at the Faculty of Nursing, Midwifery, and Health at the University of Technology, Sydney, Australia. Sharon McKinley is Professor of Critical Care Nursing at Royal North Shore Hospital and at the Faculty of Nursing, Midwifery, and Health in the University of Technology, both in Sydney, Australia.

Corresponding author: Robyn Gallagher, Faculty of Nursing, Midwifery, and Health, University of Technology, Sydney, PO Box 222 Lindfield, 2070 NSW Australia (e-mail: Robyn.Gallagher{at}uts.edu.au).

Background Patients undergoing coronary artery bypass surgery who have increased anxiety levels have poorer outcomes than patients with lower levels, yet few studies have identified the concerns associated with this anxiety.

Objective To describe the concerns of patients undergoing coronary artery bypass surgery and to identify concerns that were associated with higher levels of anxiety.

Method Patients (n = 172) were interviewed to determine their concerns and anxiety levels before surgery, before discharge, and 10 days after discharge. Multiple regression was used to determine the predictors of anxiety.

Results Although individual concerns changed over time, anxiety levels did not change from before to after surgery, remaining low to moderate. Being female and having more concerns about waiting for the surgery, being in pain/discomfort, and resuming lifestyle were predictors of increased anxiety before surgery. Predictors of increased anxiety while hospitalized after the surgery included taking anxiolytic or antidepressant medications, higher anxiety levels before surgery, concerns about personal things being inaccessible, and difficulty sleeping. Patients with higher anxiety levels after discharge were older, more anxious before surgery, and had concerns about being in pain/discomfort.

Conclusion Patients waiting for coronary artery bypass surgery should be routinely assessed for anxiety before the procedure, and interventions to prevent or reduce anxiety should be provided. Interventions must be multifactorial, including information and support for pain management and realistic information about surgery schedules and resuming lifestyle after the surgery. Women and older patients may need to be targeted for intervention.




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S. S. Pedersen, O. R. F. Smith, J. D. Vries, A. Appels, and J. Denollet
Course of Anxiety Symptoms Over an 18-Month Period in Exhausted Patients Post Percutaneous Coronary Intervention
Psychosom Med, April 1, 2008; 70(3): 349 - 355.
[Abstract] [Full Text] [PDF]


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