Predictors of Psychological Distress among Post-Operative Cardiac Patients: A Narrative Review

Abstract

Following surgery, over 50% of cardiac surgery patients report anxiety, stress and/or depression, with at least 10% meeting clinical diagnoses, which can persist for more than a year. Psychological distress predicts post-surgery health outcomes for cardiac patients. Therefore, post-operative distress represents a critical recovery challenge affecting both physical and psychological health. Despite some research identifying key personal, social, and health service correlates of patient distress, a review or synthesis of this evidence remains unavailable. Understanding these factors can facilitate the identification of high-risk patients, develop tailored support resources and interventions to support optimum recovery. This narrative review synthesises evidence from 39 studies that investigate personal, social, and health service predictors of post-surgery psychological distress among cardiac patients. The following factors predicted lower post-operative distress: participation in pre-operative education, cardiac rehabilitation, having a partner, happier marriages, increased physical activity, and greater social interaction. Conversely, increased pain and functional impairment predicted greater distress. The role of age, and sex in predicting distress is inconclusive. Understanding several factors is limited by the inability to carry out experimental manipulations for ethical reasons (e.g., pain). Future research would profit from addressing key methodological limitations and exploring the role of self-efficacy, pre-operative distress, and pre-operative physical activity. It is recommended that cardiac patients be educated pre-surgery and attend cardiac rehabilitation to decrease distress.

Assessing the validity and reliability of the 10-item Persian version of the perceived stress scale in post-surgery patients

“…The fear of the unknown, loss of control, and potential risk of harm all contribute to this anxiety-inducing situation (3,4). Several studies demonstrated that physical stress, psychological stress, stress due to hospitalization, self-care stress, and spiritual stress are the main sources of stress experienced by patients who are candidates for various surgery that result in enhancing the risk of complications, morbidity, and mortality (5)(6)(7)(8)(9)(10)(11). A situation is stressful when it is perceived by a person as threatening and uncontrollable and that person does not have the necessary resources to face the situation (12).…”