Enhancing the efficacy of heart surgery by optimizing patients' preoperative expectations

TY - JOUR

T1 - Enhancing the efficacy of heart surgery by optimizing patients' preoperative expectations

T2 - Study protocol of a randomized controlled trial

AU - Laferton, Johannes A C

AU - Shedden Mora, Meike

AU - Auer, Charlotte J

AU - Moosdorf, Rainer

AU - Rief, Winfried

N1 - Copyright © 2013 Mosby, Inc. All rights reserved.

PY - 2013/1

Y1 - 2013/1

N2 - In coronary heart disease (CHD) and heart surgery, there is sound evidence for the relationship between patients' expectations and treatment outcome, especially for outcome variables such as disability and quality of life. In addition, patients' expectations have been shown to be modifiable through psychological interventions. Therefore, targeting patients' expectations might offer a promising opportunity to enhance heart surgery outcome. However, few studies have tried to actively change patients' expectations before surgery. The purpose of this clinical trial is to optimize patients' outcome expectations before undergoing coronary artery bypass graft surgery (CABG) through a brief psychoeducational program. The present article describes the study protocol and reports preliminary data on feasibility. Using a randomized controlled design, 180 patients who are scheduled to undergo elective CABG are randomly assigned to either (1) standard medical care (SMC) alone, (2) to an additional expectation manipulation intervention during the 2 weeks before surgery, and (3) to an additional attention-control group ("supportive therapy"). The main goal is to test (a) whether expectation manipulation intervention can optimize patients' expectations and (b) whether optimized expectations lead to enhanced surgery efficacy. The primary outcome variable is illness-related disability 6 months after surgery, whereas secondary outcome variables will be quality of life, return to work, physical activity, and medical outcome variables. First, feasibility data of 36 patients show that the patients appreciated the additional psychological intervention before CABG. Satisfaction of those who received psychological interventions was very high.

AB - In coronary heart disease (CHD) and heart surgery, there is sound evidence for the relationship between patients' expectations and treatment outcome, especially for outcome variables such as disability and quality of life. In addition, patients' expectations have been shown to be modifiable through psychological interventions. Therefore, targeting patients' expectations might offer a promising opportunity to enhance heart surgery outcome. However, few studies have tried to actively change patients' expectations before surgery. The purpose of this clinical trial is to optimize patients' outcome expectations before undergoing coronary artery bypass graft surgery (CABG) through a brief psychoeducational program. The present article describes the study protocol and reports preliminary data on feasibility. Using a randomized controlled design, 180 patients who are scheduled to undergo elective CABG are randomly assigned to either (1) standard medical care (SMC) alone, (2) to an additional expectation manipulation intervention during the 2 weeks before surgery, and (3) to an additional attention-control group ("supportive therapy"). The main goal is to test (a) whether expectation manipulation intervention can optimize patients' expectations and (b) whether optimized expectations lead to enhanced surgery efficacy. The primary outcome variable is illness-related disability 6 months after surgery, whereas secondary outcome variables will be quality of life, return to work, physical activity, and medical outcome variables. First, feasibility data of 36 patients show that the patients appreciated the additional psychological intervention before CABG. Satisfaction of those who received psychological interventions was very high.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cardiac Surgical Procedures

KW - Coronary Artery Bypass

KW - Coronary Disease

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Postoperative Complications

KW - Preoperative Care

KW - Quality of Life

KW - Return to Work

KW - Self-Help Groups

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1016/j.ahj.2012.10.007

DO - 10.1016/j.ahj.2012.10.007

M3 - SCORING: Journal article

C2 - 23237127

VL - 165

SP - 1

EP - 7

JO - AM HEART J

JF - AM HEART J

SN - 0002-8703

IS - 1

ER -