Trajectory of psychological distress among cardiac surgery patients

Trajectory of psychological distress among cardiac surgery patients

Cardiac surgery patients commonly experience distress, manifested in anxiety, depression, and stress, with up to half reporting significant levels of these symptoms. This research aimed to identify factors associated with acute pre-surgical distress and the progression of early post-surgical distress, extending up to six months following hospital discharge. The mixed-methods research comprised four studies: a narrative literature review, a cross-sectional quantitative survey, a longitudinal quantitative survey, and a qualitative interview study. There were 71 elective CABG and/or cardiac valve surgery patients assessed utilising surveys and in-depth interviews. The narrative literature review identified several potential drivers of distress after cardiac surgery. Building on this, the novel survey data revealed large reductions in anxiety and stress among patients from pre-surgery to six months post-discharge; however, no such reductions were apparent for depression. Twelve individual difference characteristics emerged as predictors of pre-surgery distress, and only five – including higher remoteness of living – predicted greater magnitudes of change in distress over time. Participants in the qualitative interviews described deficiencies in communication from the operating hospital. Additionally, non-metropolitan participants expressed greater reliance on General Practitioners, emphasising the challenges of accessing care in rural areas. This research provides valuable insights into the nature of distress, offering several actionable implications for improving patient care, such as psychological screening during admission, an on-duty psychologist, and the provision of relevant education. By employing a complementary and varied methodology, this doctoral thesis significantly advances understanding of the psychological factors influencing distress in cardiac surgery patients, particularly non-metropolitan patients, uncovering novel predictors that can inform theory development, as well as providing actionable insights to improve patient care.

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