[More psychological preparation in heart surgery for certain patients is beneficial]

To estimate the effects of extensive psychic preparation for cardiac surgery and to see whether personality characteristics modify these effects.

Randomized.

St. Antonius Ziekenhuis, Nieuwegein and the center of the Dutch Heart Foundation for patient projects 'Hartenark', Bilthoven, the Netherlands.

Patients waiting for cardiac surgery were randomly assigned to a preparatory programme: a 2-hour information programme in the hospital or a 2-day programme in the Hartenark, comprising medical information, relaxation exercises and group discussions. Psychological assessments were made by questionnaires preoperatively and at 4-month follow-up.

Of 223 patients, II were lost, 94 joined the informative programme and II8 the more extensive preparation. There were 174 men and 38 women, whose average ages were 58.6 and 60.3 years, respectively. The scores in the preoperative preparatory programmes were the same. After-surgery scores on 'subjective invalidity' and 'vital exhaustion' were improved, while those on 'somatic neurosis' and especially 'anxiety' were deteriorated, in both programmes. When taking in account the preoperative psychic condition, it was shown that the more extensive programme benefited patients who preoperatively had relatively few psychosomatic complaints or relatively strong anxiety.

Extensive preparation for cardiac surgery had a positive effect on physical wellbeing and anxiety in patients who before the operation had relatively few complaints or indicated that they were anxious. Patients who reported less anxiety and patients who felt less well physically before the operation benefited more from a information programme.