Patients’ pre- and postoperative expectations as predictors of clinical outcomes six months after cardiac surgery

ABSTRACT

The aim of this study was to investigate not only preoperative expectations (as shown previously), but also postoperative expectations of patients predict clinical outcomes six months after cardiac surgery. Furthermore, the study sought to examine illness behavior as a possible pathway through which expectations may affect postoperative well-being. Seventy patients scheduled for cardiac surgery were examined one day before surgery, ~7–10 days after surgery, and six months after surgery. Regression analyses indicated that disability at follow-up (primary outcome) was significantly predicted by postoperative (β = −.342, p = .008), but not by preoperative expectations (β = −.213, p = .069). Similar results were found for the secondary outcomes, i.e. quality of life and depressive symptoms. A bootstrapped mediation analysis showed that although both postoperative expectations and illness behavior had significant unique effects on disability, there was no significant mediation effect. While previous studies have mainly focused on patients’ preoperative expectations, the present is the first to emphasize the predictive value of patients’ expectations a few days after surgery, pointing to the potential of interventions targeting postoperative expectations. However, given the non-significant results of the mediation analysis, it remains unclear how exactly patients’ expectations affect clinical outcomes in cardiac surgery.

KEYWORDS:

• Expectation
• cardiac surgery
• illness perception
• illness behavior
• disability

Acknowledgments

We are very grateful to our master students who contributed to the study: Muna Al-Mukadam, Sabine Böhringer, Sabrina Herweg, Theresa Horst, and Janine Menke.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committees for medical research of the Philipps-University of Marburg and the Justus-Liebig University of Giessen.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplemental data for this article can be accessed here.

Notes

1. In the supplement, a tables displays at which points in time the respective questionnaires were used.

Additional information

Funding

The study received no funding.