Anxiety, depression and perceived control in patients having coronary artery bypass grafts

TITLE: Anxiety, depression and perceived control in patients having coronary artery bypass grafts. AIM: This paper is a report of a study to determine (1) the course of anxiety, depression and perceptions of control, and (2) the influence of perceptions of control, in patients undergoing coronary artery bypass grafts before surgery, after surgery in hospital and 2 weeks after discharge. BACKGROUND: Anxiety and depression are common in patients undergoing coronary artery bypass graft surgery patients and predictive of worse outcomes. Few researchers have examined the influence of perceived control on these emotional states in the acute surgical period. METHODS: A prospective, descriptive design was used with a convenience sample of patients having coronary grafts (n = 155). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale and perceptions of control over their cardiac illness by the Control Attitudes Scale before surgery, after surgery during hospitalization and 2 weeks after hospital discharge. The data were collected in 2005. RESULTS: Patients had low levels of anxiety at each timepoint; however, borderline or clinically significant levels were common before surgery (38.7%) and after discharge. (38.6%). Depression levels were low, but increased over time (F = 27.03, P < 0.001). Patients had low to moderate perceptions of control over their illness before surgery, which increased over time (F = 25.51, P < 0.001). Those with stronger perceptions of control were less anxious or depressed at all times and those who were more anxious or depressed before surgery continued to be so afterwards. CONCLUSION: Routine assessment of anxiety, depression and perceptions of control are justified to identify patients at risk and to intervene to promote control perceptions.