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Events leading to the treatment of coronary artery disease: implications for nursing care
Insights
Patients with severe coronary artery disease (CAD) often choose surgery, with treatment decisions made autonomously. Family support is crucial for surgical patients, though more information is desired.
Area of Science:
- Cardiology
- Health Services Research
Background:
- Coronary artery disease (CAD) management involves pharmacologic, surgical, and lifestyle interventions.
- Patient treatment choices are influenced by illness severity and information access.
Purpose of the Study:
- To investigate factors influencing treatment selection for coronary artery disease (CAD).
- To understand patient decision-making processes and information needs regarding CAD treatments.
Main Methods:
- Retrospective analysis of patient treatment choices for coronary artery disease (CAD).
- Evaluation of information sources and perceived need for additional patient education.
- Assessment of patient autonomy and family involvement in treatment decisions.
Main Results:
- Treatment selection, particularly for surgical intervention, correlated with the severity of angina and documented coronary artery disease (CAD).
- Most patients received information from cardiologists; nurses were a source for surgical patients only.
- A majority of patients made treatment decisions autonomously, with significant family support reported by surgical patients.
- Few patients utilized dietary or exercise programs to manage CAD, despite pharmacologic regimens.
Conclusions:
- Illness severity is a key determinant in choosing between medical and surgical treatments for coronary artery disease (CAD).
- Enhanced patient education and support are needed, especially for those undergoing surgical procedures.
- Patient autonomy in decision-making is prevalent, highlighting the importance of personalized care plans.
Abstract:
The selection of a particular treatment for CAD was found to be related to the severity of illness, patients who were more severely disabled by angina elected surgical treatment after vessel blockage was documented by angiography. Differential access to treatments was not described by study subjects and therefore cannot be evaluated as a contributing factor to the selection of treatment. Although most subjects participated in a therapeutic pharmacologic regimen, few patients in either group employed dietary or exercise programs to ameliorate CAD. Most patients received information about CAD and about surgery as a treatment option. This educational communication was directed by the cardiologist for a large majority of patients. Nurses were cited as information sources for surgical subjects only. In retrospect, more than half of the surgical subjects indicated a need for additional information. The decision regarding which type of treatment to have was made autonomously by most subjects, unlike the usual decision-making styles of families of surgical patients. A significantly greater proportion of surgical patients identified their family as a source of support during the elected treatment. Both groups described family changes specific to the illness and selected treatment.