Telenursing and patients' recovery from bypass surgery

This paper reports the qualitative findings of qualitative interviews conducted as part of a study assessing the effectiveness of structured, postdischarge, telephone intervention for patients and their partners recovering from bypass surgery. The data reported here describe the postoperative recovery experiences of a small sample of patients (n = 10) and the intervention role of the specialist nurse delivering the intervention.

Reduced length of hospital stay for bypass patients means that there are fewer opportunities to provide necessary information and respond to patient concerns in hospital, and much of the process of wound healing and regaining functioning that would once have taken place in hospital now takes place at home and place additional burdens on patients and their caregivers.

The study was a randomized controlled trial of a telephone intervention aimed at reducing anxiety for patients experiencing a first bypass, and for their caregivers. The intervention consisted of a series of protocols delivered by a nurse with cardiac experience. It was conducted via telephone at discharge and on days 1, 2, 4, 7 and weeks 2 and 7 postdischarge. In the qualitative component of the study, a purposive sample of telephone calls in the treatment group was analysed and data saturation was achieved with 10 transcripts.

Three major patient concerns emerged: physical, affective and lifestyle changes. Anxiety about speed of discharge was a common concern at discharge and at day 1. Otherwise, physical concerns predominated during the first week. At day 7 and after, a shift began to occur to longer term, future-oriented concerns. By week 7, most patients were planning for return to normal activities, and several were making lifestyle changes. The specialist nurse was able to give personalized health promotion information at a time that was appropriate for individual patients.

Using a qualitative interview method made it possible to understand patients' concerns and study the working of telenursing interventions in terms of providing timely reassurance and health promotion. Further research is needed to test the generalizability of the findings.