Taiwanese patients' concerns and coping strategies: Transition to cardiac surgery☆

OBJECTIVE: To explore patients' concerns during the admission transition to cardiac surgery.

DESIGN: A descriptive qualitative design.

SETTING: 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 (mean 50.1 years).

OUTCOME MEASURES: The types, levels, components, coping 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 levels of concerns: “Caring about” or “Thinking about” (52%); “Worrying about” or “Being afraid of” (43%); and “Experiencing a mortal fear of” (30%), ordered from the weakest to the strongest. The components of patients' concerns were the process of recovery; hospital experiences, including maintaining daily activities, pain at admission, and expectant discomforts and disabilities in the intensive care unit; death; unfinished responsibilities and life goals, significant persons, and places; financial needs; and poor quality of care. Strategies developed to manage their concerns included (1) The use of person-focused effort (both cognitive and psychomotor), (2) Seeking help from others, including family members, friends, other patients, and health professionals, and (3) Turning to metaphysical power. The context for the phenomenon of Taiwanese subjects' concerns concerning cardiac surgery during the admission transition were “Being a person,” resuming normality, and empowerment of self.

CONCLUSION: The types, levels, components, and coping strategies of patients' concerns during the admission transition to cardiac surgery were discovered and delineated. The background context and conceptual framework for the phenomenon also were developed from the data analysis to describe and depict this phenomenon.