TAIWANESE PATIENTS CONCERNS AND COPING STRATEGIES - TRANSITION TO CARDIAC-SURGERY

OBJECTIVE: To explore patients' concerns during the admission transiti on to cardiac surgery. DESIGN: A descriptive qualitative design. SETTI NG: Four hospitals in northern Taiwan, Republic of China. PATIENTS: A purposive sample consisting of 40 adult patients (20 men and 20 women) who planned to have cardiac surgery. Age range was 20 to 70 years (me an 50.1 years). OUTCOME MEASURES: The types, levels, components, copin g strategies, context, and conceptual framework of patients' concerns. INTERVENTION: Data were collected through semistructured interviews, and then analyzed using qualitative content analysis. RESULTS: Ninety percent of subjects (N = 36) reported two types of concerns: certain ( 80%) and uncertain (10%). Their certain concerns reflected three level s of concerns: ''Caring about'' or ''Thinking about'' (52%); ''Worryin g about'' or ''Being afraid of'' (43%); and ''Experiencing a mortal fe ar of'' (30%), ordered from the weakest to the strongest. The componen ts of patients' concerns were the process of recovery; hospital experi ences, including maintaining daily activities, pain at admission, and expectant discomforts and disabilities in the intensive care unit; dea th; unfinished responsibilities and life goals, significant persons, a nd places; financial needs; and poor quality of care. Strategies devel oped to manage their concerns included (1) The use of person-focused e ffort (both cognitive and psychomotor), (2) Seeking help from others, including family members, friends, other patients, and health professi onals, and (3) Turning to metaphysical power. The context for the phen omenon of Taiwanese subjects' concerns concerning cardiac surgery duri ng the admission transition were ''Being a person,'' resuming normalit y and empowerment of self. CONCLUSION: The types, levels, components, and coping strategies of patients' concerns during the admission trans ition to cardiac surgery were discovered and delineated. The backgroun d context and conceptual framework for the phenomenon also were develo ped from the data analysis to describe and depict this phenomenon.