Psychological Preparation for Cardiac Surgery

Abstract

Purpose of Review To review the current state of preoperative psychological preparation to improve outcomes after cardiac surgery. Recent Findings Preoperative psychosocial factors are associated with short- and long-term outcomes after cardiac surgery. There are several approaches to optimize patients’ preoperative psychological status with promising effects on postoperative outcomes (e.g., less complications, improved quality of life). Preoperative psychological preparation often aims to improve patients’ knowledge or social support and to modify and optimize expectations and illness beliefs. Summary Preoperative psychological preparation is gaining importance for cardiac surgery. However, patients’ psychological status still does not get as much attention as it deserves. Preoperative psychological preparation seems to have positive effects on postoperative outcomes. Since overall evidence is still weak, further studies are warranted to understand which intervention works best for whom and why.

Predictors of health-related quality of life after cardiac surgery: a systematic review

“…Individually focused lifestyle and therapeutic interventions have shown effectiveness in weight and BMI reduction [ 38 ], decreasing alcohol consumption [ 39 ], psychological preparation (including depression and anxiety) [ 40 ] and smoking cessation [ 41 ]. Given that BMI [ 42 ], alcohol use [ 43 ], depression and anxiety [ 44 ] and smoking [ 45 ] have also been identified to be associated with many in-hospital post-operative complications, strategies to encourage their reduction are likely to have beneficial impacts on improving overall morbidity and general recovery.…”

Effect of Psychological Intervention on Pelvic Floor Function and Psychological Outcomes After Hysterectomy

“…Professional psychological intervention would reduce patient's psychological distress and help them cope with life stressors. Besides, psychological intervention could benefit patients in different ways, such as improving their knowledge regarding the postoperative complications, providing professional advices about rehabilitation training, and reducing their psychological distress and concerns ( 20 , 47 , 48 ). Therefore, the combination of disease-directed therapy with psychotherapy should be recommended, which may confer additional and positive functional outcomes.…”

Baseline depressive symptoms, personal control, and concern moderate the effects of preoperative psychological interventions: the randomized controlled PSY-HEART trial

“…Coronary artery bypass grafting (CABG) is an established treatment option for patients with advanced coronary artery disease that has been thoroughly studied over several decades (Hawkes et al, 2006 ). However, it is still unknown why a substantial number of patients faces problems in the recovery process and does not benefit as much from the surgery as surgeons would predict (Blumenthal et al, 2003 ; Burg et al, 2003 ; Hawkes & Mortensen, 2006 ; Hawkes et al, 2006 ; Salzmann, Euteneuer, et al, 2020 ; Salzmann, Salzmann-Djufri, et al, 2020 ). Patients’ recovery after surgery is not explained by medical factors alone; recovery seems to be a multidimensional phenomenon in which physical, psychological, and social factors play important roles as well (Auer et al, 2016 ; Hawkes et al, 2006 ; Sadeghi et al, 2017 ).…”

“…Patients’ recovery after surgery is not explained by medical factors alone; recovery seems to be a multidimensional phenomenon in which physical, psychological, and social factors play important roles as well (Auer et al, 2016 ; Hawkes et al, 2006 ; Sadeghi et al, 2017 ). Growing evidence suggests the importance of psychological preparation for improving post-surgery physical outcomes and psychological outcomes (i.e., quality of life, disability, pain, morbidity, length of hospital stay) (Auer et al, 2017 ; Levett & Grimmett, 2019 ; Salzmann, Euteneuer, et al, 2020 ; Salzmann, Salzmann-Djufri, et al, 2020 ; Wynter-Blyth & Moorthy, 2017 ). A better understanding of whether and when psychological interventions affect specific outcomes may help design even more powerful interventions and make better predictions of which patients will benefit from which psychological intervention.…”