Abstract
Objective: To evaluate the effectiveness of a program of psychological preparation for invasive procedures in patients with heart disease, candidates for cardiac surgery, to reduce emotional morbidity and improve perception of health related quality of life. Methods: A Quasi-experimental design was used. The study included a non-probabilistic randomized sample of 110 patients treated in the Division of Cardiac Surgery Centro Medico Nacional Siglo XXI Instituto Mexicano del Seguro Social IMSS. They were divided in two groups: Experimental group (n = 44) and Control group (n = 66). Instruments: CHIP Coping Questionnaire, HADS Anxiety and Depression Hospital Scale, Health Related Quality of Life Questionnaire and a Visual Analogue Scale (VAS) to measure postoperative pain. Results: The experimental group showed an increase in instrumental coping style compared to pre (M = 24.55) and post evaluation (M = 25.93); statistically significant differences were found in the variables of stress (p = 0.042), anxiety (p = 0.001), depression (p = 0.056) and health related quality of life (p = 0.000); while in the control group, the distraction coping style (pre M = 25.80, post M = 26.73) is the one that increased; there were no statistically significant differences in the variables stress (p = 0.274), anxiety (p = 0.671) and depression (p = 0.850), except for the health related quality of life (p = 0.000). This study is the first in Mexico to manage emotional comorbidity in this type of population.
Highlights
66 (60%) were assigned to the control group and 44 (40%) to the experimental group; 110 patients candidates for cardiac surgery were evaluated, 55 (61%) of valve replacement, 29 (32%) of coronary revascularization and six (7%) with diagnosis of interauricular communication; 57 men (52%), and 53 women (47%) with a mean age of 62 years and a range of 19 to 81 years . 67% were married; with a high school level or technical career (31%). 35% were dedicated to the home and 87% were Catholics
The results obtained from the pre-evaluation show that the coping strategy most used by the patients in the control group was distraction (X = 25.8), that is, they prefer to do activities such as thinking about better times, being with other people, listening to music, between others, followed by instrumental strategy (X = 25.6), palliative (X = 24. 9) and emotional was the least used by patients (X = 17.7)
A t-test for related samples was performed to measure the significance of the differences in the use of each coping strategy between pre- and post-evaluation, only statistically significant differences were found for the palliative strategy in the experimental group (p = 0.019)
Summary
Identifying the coping styles that patients use when dealing with stressors in the hospital environment could help develop strategies to improve psychological distress. In Mexico, evaluation and psychological intervention protocols have not been implemented to evaluate these psychological variables in patients candidates for cardiac surgery
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