Sense of coherence: quality of life before and after coronary artery bypass surgery - a longitudinal study

The attention to patient outcome has nowadays extended from morbidity and m ortality to an aspect of patients' benefits in terms of quality of life. On e factor crucial for quality of life is coping capacity, in this study repr esented by the sense of coherence concept. Physical status and emotional st ate (often measured by comprehensive instruments not always suitable for cl inical use) are also additionally used to reflect quality of life. The purp ose was therefore to study sense of coherence and emotional state as indire ct measures of quality of life in relation to coronary artery bypass grafti ng surgery. One hundred and eleven patients were studied by a developed que stionnaire on five occasions in relation to the surgery: the week before th e angiography, the day before surgery and then at 3, 6, and 12 months post- operatively. The main findings were: (1) The sense of coherence was changed (more than +/- 10%) from before to 1 year after surgery in 41% of the pati ents, which is contrary to the theory of sense of coherence as a stable per sonality characteristic in adults. (2) Experience of depressed mood, stress , and anxiety decreased significantly from before to after surgery. (3) Ben eficial outcome with regard to sense of coherence was significantly related to less experience of loneliness, depressed mood, stress and anxiety, and to less experience of chest pain 1 year after surgery. In conclusion, sense of coherence and emotional state variables, are suggested to be valuable a s measurements of quality of life in relation to coronary artery bypass gra fting surgery.