Document Type : Case Series

Authors

1 Nursing Care Research Center in Chronic Disease Care, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Behavioral Sciences Research Center, Life Style Institute, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Open-heart surgery is a stressful experience for the patients and their families. From the moment that patients are told they must undergo surgery until discharge, they experience different degrees of worry and nervousness. This study was conducted with the aim of identifying stress factors in heart surgery patients.METHODS: This study was performed using a qualitative method on 21 participants (14 patients and 7 caregivers). The research environment was open-heart surgery wards of two educational hospitals in Ahwaz (south of Iran) in 2017. The participants were selected through purposive sampling. The data were collected through semi-structured interviews, and then, analyzed using the qualitative approach of content analysis proposed by Graneheim and Lundmnan (2004).RESULTS: The 5 themes of “physical stressors”, “self-care stressors”, “psychological stressors”, “religious stressors”, and “hospital stressors” were obtained. These themes were the result of the patients’ experiences and dimensions of patients’ perceptions regarding stressors in open-heart surgery.CONCLUSION: Stress in patients undergoing open-heart surgery is a contextual and relative concept and a subjective experience, which is experienced as a sense of worry. Identifying and clarifying stressors in open-heart surgery patients for nurses is vital, like a key for improving care quality. Nursing managers in clinical practice can also benefit from these findings regarding heart surgery in improving the care quality and professional performance of nurses. 

Keywords

  1. Lapum JL, Fredericks S, Liu L, Yau TM, Retta B, Jones VM, et al. Facilitators and barriers of heart surgery discharge: Patients' and nurses' narrative accounts. J Cardiovasc Nurs 2016; 31(4): 350-6.
  2. Taghadosi M, Memarian R, Ahmadi F. The experiences of "difficult life" in heart valve replaced patients. Iran Red Crescent Med J 2014; 16(8): e19147.
  3. Shafipour V, Mohammadi E, Ahmadi F. Experience of open heart surgery patients from admission to discharge: a qualitative study. Iran J Crit Care Nurs 2013; 6(1): 1-10. [In Persian].
  4. Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J 2010; 31(6): 642-8.
  5. Ivarsson B, Larsson S, Sjoberg T. Patients' experiences of support while waiting for cardiac surgery. A critical incident technique analysis. Eur J Cardiovasc Nurs 2004; 3(2): 183-91.
  6. Robley L, Ballard N, Holtzman D, Cooper W. The experience of stress for open heart surgery patients and their caregivers. West J Nurs Res 2010; 32(6): 794-813.
  7. Nasiri M, Rahimiyan B, Jahanshahi M, Hajiyan K, Nikfar J. Stressors associated with hospitalization in the stressful cardiac care unit. Iran J Crit Care Nurs 2011; 4(3): 141-8. [In Persian].
  8. Doering LV, McGuire AW, Rourke D. Recovering from cardiac surgery: What patients want you to know. Am J Crit Care 2002; 11(4): 333-43.
  9. Abuatiq A. Patients' and health care providers' perception of stressors in the intensive care units. Dimens Crit Care Nurs 2015; 34(4): 205-14.
  10. Gallagher R, McKinley S. Stressors and anxiety in patients undergoing coronary artery bypass surgery. Am J Crit Care 2007; 16(3): 248-57.
  11. Carr JA, Powers MJ. Stressors associated with coronary bypass surgery. Nurs Res 1986; 35(4): 243-6.
  12. Yarcheski A, Knapp-Spooner C. Stressors associated with coronary bypass surgery. Clin Nurs Res 1994; 3(1): 57-68.
  13. White RM. Nurse-patient perception of stressors associated with coronary artery bypass surgery [Thesis]. Las Vegas, NV: University of Nevada; 1998.
  14. Sammons A. Culture and Stress [Online]. [cited 2019]; Available from: URL: http://www.psychlotron.org.uk/resources/physiological/aqa_as_stress_culturearticle
  15. HassanpourDehkordi A, Mohammadi N, NikbakhatNasrabadi A. Hepatitis-related stigma in chronic patients: A qualitative study. Appl Nurs Res 2016; 29: 206-10.
  16. Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.
  17. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs 2008; 62(1): 107-15.
  18. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2): 105-12.
  19. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.
  20. Yava A, Tosun N, Unver V, Cicek H. Patient and nurse perceptions of stressors in the intensive care unit. Stress Health 2011; 27(2): e36-e47.
  21. Blair J, Volpe M, Aggarwal B. Challenges, needs, and experiences of recently hospitalized cardiac patients and their informal caregivers. J Cardiovasc Nurs 2014; 29(1): 29-37.
  22. Mooney M, Fitzsimons D, Richardson G. "No more couch-potato!" Patients' experiences of a pre-operative programme of cardiac rehabilitation for those awaiting coronary artery bypass surgery. Eur J Cardiovasc Nurs 2007; 6(1): 77-83.
  23. Gholi Nasab M, Jahani Y, Hosseinrezaei H. Study of stressors and adjustme nt strategies from viewpoint of patients undergoing open heart surgery. J Iran Society Anaesthesiol Intensive Care 2016; 38(2): 61-71. [In Persian].
  24. Rosenfeldt F, Braun L, Spitzer O, Bradley S, Shepherd J, Bailey M, et al. Physical conditioning and mental stress reduction-a randomised trial in patients undergoing cardiac surgery. BMC Complement Altern Med 2011; 11: 20.
  25. Shih FJ, Meleis AI, Yu PJ, Hu WY, Lou MF, Huang GS. Taiwanese patients' concerns and coping strategies: transition to cardiac surgery. Heart Lung 1998; 27(2): 82-98.
  26. Kantoch MJ, Eustace J, Collins-Nakai RL, Taylor DA, Bolsvert JA, Lysak PS. The significance of cardiac surgery scars in adult patients with congenital heart disease. Kardiol Pol 2006; 64(1): 51-6.
  27. Gomes ET, Espinha DC, Bezerra SM. Religion and belief in God in the preoperative period of cardiac surgery: an exploratory study. Online Braz J Nurs 2015; 14(3): 273-83.
  28. Ghanbari Jahromi M, Khammarnia M, Jafari A, Sotodeh Zadeh F. Investigation of food services quality in hospitals and strategies for its improvement, a review study. Sadra Medical Sciences Journal 2014; 2(2): 195-206. [In Persian].
  29. Aslan O, Tosun B. Cardiovascular surgery patients: Intensive care experiences and associated factors. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9(4): 336-41.
  30. Molazem Z, Ahmadi F, Mohammadi E, Bolandparvaz S. Nursing presence:Essential element of caring of patients'perceptions. Iran J Med Ethics Hist Med 2010; 3(3): 44-55. [In Persian].