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Abandoned in No Man's Land: A Qualitative Study on Patient Experiences While Waiting for Elective Coronary Artery
Dorte Baek Olsen1,2, Ida Elisabeth Hoejskov2,3, Malene Missel1,2,4
1Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
Patients awaiting coronary artery bypass grafting (CABG) surgery experience significant psychological distress and physical challenges. Understanding their lived experiences is crucial for developing effective prehabilitation programs to improve surgical readiness and outcomes.
Area of Science:
- Cardiology
- Psychology
- Qualitative Health Research
Background:
- Coronary artery bypass grafting (CABG) is a vital treatment for ischemic heart disease.
- Patients awaiting CABG often face advanced age, frailty, and psychological distress.
- Prehabilitation programs aim to optimize surgical readiness but require patient-centered insights.
Purpose of the Study:
- To explore the lived experiences of patients awaiting elective coronary artery bypass grafting surgery.
- To identify key themes and challenges faced by patients during the waiting period.
- To inform the development of patient-centered prehabilitation programs for CABG patients.
Main Methods:
- Qualitative study utilizing a hermeneutic-phenomenological approach.
- In-depth interviews conducted with ten patients (1 female, 9 male) the day before surgery.
- Thematic analysis of interview data to uncover patient experiences.
Main Results:
- Patients described feeling abandoned in a 'no man's land' during their wait.
- Experiences included a dichotomy of feeling imprisoned yet hopeful for escape.
- Themes of preparing for a 'fight,' feeling weak, and relying on social support emerged.
Conclusions:
- The waiting period for CABG surgery is complex, marked by significant psychological and physical challenges.
- Understanding these patient experiences is essential for designing effective prehabilitation interventions.
- Integrating patient perspectives into prehabilitation can enhance healthcare practice and improve surgical outcomes.
Abstract:
Coronary artery bypass grafting is the primary treatment for patients with ischemic heart disease and multivessel disease to improve survival, symptoms, and quality of life. However, patients waiting for coronary artery bypass grafting surgery often struggle with advanced age, frailty, and inactivity, leading to anxiety and uncertainty. Psychological distress, pain, and sedentary behavior can worsen their condition. Prehabilitation, combining exercise, education, and support, aims to improve readiness for surgery, but its success depends on understanding patients' perspectives, while this study explores the experiences of patients awaiting coronary artery bypass grafting surgery to contribute insights into the design of future prehabilitation programs. This qualitative study aimed to explore the phenomenon of waiting to have elective coronary artery bypass grafting surgery based on patients' lived experiences. The study used a hermeneutic-phenomenological approach and conducted purposely selected in-depth interviews with one female and nine men the day before surgery. Analysis of the data revealed themes based on experiences of being abandoned in no man's land, balancing between feeling imprisoned and hoping to escape, preparing to fight, and feeling weak and dependent on social support. The phenomena this study uncovered underscore the complexities inherent to the lived experience of waiting for coronary artery bypass grafting surgery. Understanding and integrating these aspects when planning prehabilitation programs for patients waiting for coronary artery bypass grafting surgery have substantial clinical relevance, particularly for enhancing healthcare practice when developing targeted interventions.
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