Modifying a generic postoperative recovery profile instrument to an instrument specifically targeting coronary artery bypass grafting

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Cardiovascular disease is the main cause of death worldwide 1 and is usually caused by a general arteriosclerosis. The treatment includes lifestyle changes, pharmacological therapy to control risk factors such as hypertension, hyperlipidaemia and diabetes, and symptomatic treatment of chest pain with nitrates. When the pharmacological therapy is insufficient and there is an increased risk of a heart attack, coronary artery bypass grafting (CABG) may be considered to restore the normal blood supply to the heart muscle. After a CABG, patients may experience a wide range of postoperative symptoms during their way back to everyday life. Knowledge of the range and duration of these symptoms is a prerequisite for providing patient‐centred care in accordance with the nurses’ core competences 2. In‐depth knowledge of the recovery process is also of vital importance when evaluating interventions aimed at improving the quality and evidence‐based nursing practice. However, we found no specific instrument covering the whole range and duration of postoperative symptoms related to this procedure.
CABG is a major surgical procedure with the risk of potential complications, such as myocardial infarction, stroke, gastrointestinal bleeding and renal failure. The perioperative mortality is 1.5% 3. During the procedure, the patients are intubated and the heart is bypassed by a heart–lung machine. The sternum is opened. The vascular grafts are taken from the saphenous veins or the radial arteries, meaning that the patients usually have surgical wounds on chests as well as on legs or arms. After an isolated CABG, patients are usually discharged from the hospital within 10 days 4.
It is essential that nurses are able to inform the patients of which symptoms they may experience after CABG, as well as what they can and should do themselves to improve the outcome and reduce the risk of complications 5. However, Dunckley et al. 6 reported that patients lacked information about the normal recovery after CABG, which symptoms they could expect as part of the normal healing process and which may be associated with a potentially serious complication. This is of concern, not least because the patients are at home during most of the recovery process.

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