Psychological status and the role of coping style after coronary artery bypass graft surgery. Results of a prospective study

The results of a prospective study in patients who underwent a first corona ry artery bypass graft operation are presented. The goals of this project c onsisted in assessing the psychological changes during the first year after surgery. For that purpose, 330 consecutive patients were recruited. They w ere assessed by means of several psychological scales before and on three o ccasions after surgery. These scales were: the Heart Patients' Psychologica l Questionnaire (HPPQ), the State-Trait Anxiety Scale (STAI), the Symptom C heck List (SCL-90), the Maastricht Questionnaire (MQ) and the Marlowe Crown e Desirability Scale. Furthermore, the study focused on the differential in fluence of three coping styles. The data demonstrate a clear overall improv ement in psychological status over the first year, more specifically during the first 6 months after CABG. Patients were less anxious, less depressed, less exhausted and experienced more subjective well-being. However, almost 30% of all patients did not experience that average favourable evolution. The final psychological end-state was predicted by psychological variables, measured pre-operatively (somatic complaints, hostility and dysphoria) and short-term post-operatively (anxiety). No single medical variable could pr edict patients' psychological end-state. Finally, the most favourable chang e was made by patients who display the sensitising coping style, resulting in lower anxiety and depression. Health care providers, physicians as well as nursing staff and psychologists, should therefore use psychodiagnostic t ools in order to identify patients at risk for negative psychological outco me. Appropriate therapeutic interventions may consequently be developed and evaluated in future research.