Anxiety and fear in patients with short waiting times before coronary artery bypass surgery--a qualitative study

Abstract

Aims and objectives: To obtain qualitative information on fears and anxieties of coronary artery bypass grafting patients with short waiting periods (up to a maximum of four weeks) before surgery.

Background: Coronary artery bypass grafting is a standard procedure in cardiac surgery. However, many patients suffer significant anxiety and fear before the operation. Preoperative anxiety and fear correlate with adverse outcomes, but there is a lack of data on the emotional stressors for patients with short waiting periods as applicable in Germany. This knowledge would be a prerequisite for the development of in-hospital interventions to reduce patients' anxieties and fears.

Design: An exploratory study was chosen to learn about patients' anxieties and fears.

Method: The day before coronary artery bypass grafting, 24 patients were examined with respect to their emotional experience using semi-structured interviews. The results were categorised by inductive content analysis.

Results: The overall waiting time for coronary artery bypass grafting was 6 ± 6 days. According to the analysis, the patients' statements were grouped in 'fears', 'negation of fears' and 'other emotional and physical conditions'. The interviews could cover all categories simultaneously. Eighteen patients mentioned fears, and most of them referred to specific issues. However, 16 of the 18 patients also named nonspecific fears and uncertainties. Fifteen patients negated fear. Twenty-three patients described their emotions and/or somatic conditions.

Conclusions: Patients with short waiting periods before coronary artery bypass grafting experience specific as well as nonspecific fears on the day before surgery. In contrast to patients with long waiting (longer than four weeks), uncertainty and frustration about waiting time and feelings of disability are no concerns.

Relevance to clinical practice: The detailed insight into the emotional experiences of patients with a short waiting time before coronary artery bypass grafting surgery is a basis for targeted anxiety-reducing interventions.

Keywords: anxiety; coronary artery bypass grafting; emotional conditions; fear; qualitative analysis.