Erwartungs-Optimierung bei Patienten vor der Herzoperation: Eine randomisiert-kontrollierte Studie zur Wirksamkeit einer präoperativen psychologischen Intervention auf die Erwartungen herzchirurgischer Patienten

Präoperative Erwartungen stellen einen wichtigen psychologischen Prädiktor der Genesung und des Behandlungsergebnises bei Patienten nach der Herzoperation dar. Weiterhin konnte bereits bei anderen Behandlungsformen gezeigt werden, dass sich die Erwartungen der Patienten mittels psychologischer Inter...

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Bibliographic Details
Main Author: Laferton, Johannes Andreas Christoph
Contributors: Rief, Winfried (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2014
Online Access:PDF Full Text
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Patients‘ expectations have been identified as a major psychological predictor of course and outcome following cardiac surgery procedures. In addition, patients’ expectations have been shown to be modifiable through psychological interventions. However, few studies have tried to specifically change different aspects of patients’ expectations prior to cardiac surgery. This dissertation had two main purposes. First, a brief psychological intervention was developed in order to optimize different aspects of preoperative expectations in cardiac surgery patients (study I). The effect of the intervention on change in expectations was compared to a standard medical care condition and an active control condition in N = 90 patients undergoing coronary artery bypass graft surgery (study III). The brief psychological intervention was able to optimize patients’ preoperative expectations. Patients developed higher expectations of personal control, more realistic expectations of disease duration and partially lower disability expectations. The beneficial effect of the intervention was predominant in patients with low to moderate disability. Second, the associations of different aspects of patients’ expectations among each other as well as the associations of patients’ expectations with other preoperative characteristics were investigated in N = 63 patients before coronary artery bypass graft surgery (study II). Interestingly, patients’ disability expectations were unrelated to patients’ actual surgery related risk factors. Patients’ disability expectations were associated with patients’ expectations of treatment control and patients’ self rated disability. Expectations about personal control, however, were not associated with patients’ disability expectations. In conclusion, this dissertation provides first evidence that a brief psychological intervention can optimize patients’ expectations prior to cardiac surgery. Further, it identifies factors possibly influencing preoperative expectations in cardiac surgery patients. Whether the optimized expectations will lead to benefits in terms of patients health has to be answered after collecting the follow up data of the ongoing trial.