Psykosocial tilpasning hos hjertekirurgiske patienter I: Patienters og ægtefællers oplevelse af hjertesygdommen

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Abstract
Open heart surgery is accompanied by a high incidence of psychological complications. Systematic research covering patients' experiences is neccesary for clarification of pre-and postoperative emotional reactions. The present study focused on emotional and social aspects in 30 patients (20 men and 10 women) operated on for valvular heart disease or coronary artery disease. Nineteen of twenty-one spouses also participated in the investigation. Comprehensive interviews were conducted using a semi-structured questionnaire, and the patients were evaluated using the Bech-Rafaelsen melancholia scale and the Hamilton anxiety scale. The patients were examined five times, the last time six months after the operation. Their spouses were interviewed before the operation and six months later. In the present paper, the patients and methods are described in detail, as are results pertaining to the patients' and their families' reactions to the heart disease. Heart disease was followed by essential psychosocial changes and strain on the patient and the family but also appeared to mobilize resources. The patients reported emotional lability, nervousness, anxiety, and reduced self-esteem because of the enforced decrease in physical activity. Within couples, there was a tendency to conceal problems, but there was no indication of overprotection or guilt. The first symptoms of heart disease were often misinterpreted and/or related to other organs. Some patients initially attempted to deny having a heart disease but eventually developed a more realistic and information-seeking attitude.

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