The purposes of this study were to explore the relationships between uncertainty and quality of life indicators in patients recovering from coronary artery bypass graft (CABG) surgery and to investigate the differences in uncertainty and quality of life indicators between primary CABG patients and reoperation patients. The indicators of quality of life selected for this study were the patient's perception of health status and life satisfaction. A convenience sample of 41 primary CABG patients and 11 reoperation patients who were five to ten months postoperative completed the Mishel Uncertainty in Illness Scale (Community Version) (MUISCV), the General Health Rating Index (GHRI), the Cantril Self-Anchoring Scale, and a patient information sheet. Uncertainty, past life satisfaction, and present life satisfaction did not significantly differ between the primary and reoperation patients. Both groups of patients perceived moderately low uncertainty, and were moderately satisfied with their present lives. Trends in the ratings of past, present, and future life satisfaction suggested that CABG surgery was associated with an improvement in life satisfaction and optimism for the future in both primary CABG patients and reoperation patients. Reoperation patients' perceptions of health status and projections of future life satisfaction were significantly less favorable than those of the primary CABG patients suggesting that the quality of life following CABG surgery is lower for the reoperation patients. Uncertainty was significantly negatively associated with perceptions of health status, present life satisfaction, and future life satisfaction. This finding suggests that higher uncertainty is associated with a lower quality of life in CABG patients who are five to ten months postoperative. The findings were discussed in relation to theoretical expectations, other research studies, and the methodological problems inherent in the study. Implications of the findings for nursing practice were suggested. Recommendations for future research were made. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis (M.S.)--University of Michigan, 1986.

Thesis (M.S.)--University of Michigan, 1986.

M.Cur. / The emotional state of health of pre-operative patients about to have coronary artery bypass graft (CABG) is a decisive factor in the outcome of the procedure. Nel (1989) carried out quantitative research to determine the effect of a pre-operative education programme on CABG patients. This education programme is based on the fact that a person's emotional disposition is a critical variable in his successful recovery from coronary disease. However, the researcher is of the opinion that although Nel's study made a positive contribution regarding this phenomenon, a quantitative research design does not reflect the real experience of the patients that follow a pre-operative education programme. In the researcher's view, a qualitative research design is more appropriate. The aim of the present qualitative, exploring, descriptive, contextual research is to explore and describe the experience of CABG patients exposed to a pre-operative education programme and to lay down guidelines for nursing staff in practice The research was conducted in three phases. One private hospital in Pretoria was use for the research.

M.Phil. (Biokinetics) / Although coronary artery bypass graft (CABG) is well-established worldwide as a safe, effective operation for the treatment of coronary artery disease (CAD), it is an invasive procedure that often leaves patients feeling very anxious about the recovery process. The post-surgery phase should not only entail exercise intervention, but should also be paralleled with education and counselling to encourage patients to become responsible for the management of their own health and to achieve good functional capacity and quality of life (QoL). This prospective longitudinal study was aimed at achieving return to health and wellness in a group of CABG patients (n=18) with a mean age of 65 years. Four questionnaires were administered at the pre- and post-test, including Stone’s Heart Disease Risk Factor Questionnaire (1984), Paffenbarger Physical Activity Questionnaire (1978), Hawkes and Nowak Nutrition Knowledge Questionnaire (1998) and the Quality of Life Questionnaire. Morphological variables, biological and physiological fitness parameters, and health-related fitness were also assessed at the pre- and post-test. Prescribed exercise and lifestyle modifications were employed over twelve weeks, with emphasis on healthier nutrition and improved mental health. The level of significance was set at 5% (p ≤ 0.05) and 1% (p ≤ 0.0167). The findings in this study reflected significant improvements in heart disease risk, kilocalorie expenditure, nutrition knowledge, physical and mental QoL, waist circumference, body fat percentage, resting and recovery systolic blood pressure, aerobic endurance, flexibility, agility and dynamic balance, and lower-body strength. However, no significant changes were found in distance walked per day, body weight, body mass index, resting heart rate, resting diastolic blood pressure, blood cholesterol, maximum heart rate, maximum systolic and diastolic blood pressure, rating of perceived exertion, recovery heart rate, and recovery diastolic blood pressure. In addition, a deleterious change was found in blood glucose. Significant improvements were noted in the QoL and nutrition knowledge of this group of participants. The role limitations due to physical health reflected the most prominent improvement, indicating that the intervention positively influenced overall health, wellness, and activities of daily living. This study concluded that cardiac rehabilitation encompassing exercise intervention, nutrition guidelines, and psychosocial advice has been successful in improving the QoL of patients who have undergone CABG surgery.

The purpose of this study W8S to explore and describe the experience of waiting for coronary artery bypass graft (CABG) surgery from the perspective of the individual who h8s a prolonged wait for this surgery. A phenomenological approach was used to guide the study. Data were collected through 17 semi-structured, audio-taped interviews with 7 men and 2 women awaiting CABG surgery. Analysis occurred concurrently with data collection. It was found that there were three interrelated core facets of the experience: the illness, the prospective surgery, and the wait. Each facet held distinct meaning: the illness represented a loss of normalcy and a threat to life; the surgery, both an opportunity to regain normalcy and a threat; and the wait, a "no control" situation which enhanced the losses and threats of the other facets, engendered further losses, and delayed the expected gain from surgery. Within each facet, representative emotional reactions, and coping strategies were identified. The findings indicate that these clients require regular contact and that nursing care must address all three facets of the experience. / Applied Science, Faculty of / Nursing, School of / Graduate

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries. / School of Nursing

D.Litt. et Phil. (Psychology) / It is an accepted fact that the incidence of coronary heart disease has reached endemic proportions in South Africa. One of the fastest growing clinical populations in this domain is that of the coronary artery bypass patient. As a result the facilities catering to the biomedical needs of this population are amongst the most sophisticated in the world. However, facilities for the effective psychosocial rehabilitation of these patients are relatively scarce. When they are addressed they tend to focus essentially on secondary emotional factors impeding reintegration back into society. A sadly neglected psychosocial factor and independent risk factor is that of the Type A behaviour pattern. Extensive research in this area has not only found this behaviour pattern to be detrimental to effective rehabilitation but has also found it to be instrumental in the reocclusion of grafted blood vessels resulting in an elevated re-operation rate as well as putting these patients at risk for a potentially fatal coronary event. In an attempt to address this problem a rehabilitation group intervention program adapted for South African conditions was launched. This program was based on the Recurrent Coronary Prone Prevention Project intended for the treatment of post-myocardial infarct patients in San Francisco. Essentially the aim of the project was to ascertain whether this intervention could be applied effectively to the coronary artery bypass population and whether its duration could significantly shortened so as to be more economically viable given the limited economic resources characteristic of the health care services in this country. The modified programme was administered to a group of 13 post-coronary artery bypass graft patients at two local cardiac rehabilitation centres. A second group of 10 patients at these same centres served as a no-treatment waiting list control group, while simultaneously undergoing an aerobic exercise and cardiovascular counselling programme. Results of the study indicate the modified programme to be highly successful in modifying Type A behaviour and its components within the South African context in the post coronary artery bypass patient samples exposed to it. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. Thus it was- concluded that the modified programme has the potential to be an invaluable aid in the treatment of .this population in South Africa. Presently, however, this sample is being monitored longitudinally in order to ensure that the treatment benefits remain.