Technological and medical advances are increasing which means a growing number of adults are having surgical performances, usually older, higher risk, disabled and debilitated (Abreu, 2018;McCann et al., 2019). Open-heart surgery emerges when conservative ways of treatment are no longer a viable resource, it leads to acute stress, and it is associated with morbidity and mortality related to the underlying disease, surgical technical procedures and other factors (Abreu, 2018;McCann et al., 2019). Relying on evidence found through the years, we should not discuss whether implementing a pre-operative intervention in patients waiting for open-heart surgery is necessary, but rather how to implement it, making it more accessible to all (Ettema et al., 2014;McCann et al., 2019).Open-heart surgery patients are getting older; therefore, caring is increasingly more complex due to comorbid disease, frailty and psychosocial concerns (Abreu, 2018;McCann et al., 2019). It is estimated that in the next few years, the ageing of population will affect the perioperative patient care, and the number of surgical procedures will rise and consequently surgery waiting times (Abreu, 2018).
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