Thorac Cardiovasc Surg 2014; 62 - OP7
DOI: 10.1055/s-0034-1367087

Short-term intervention to reduce anxiety before artery coronary bypass surgery - A randomised controlled study

C. Heilmann 1, K. Fritzsche 2, F. Beyersdorf 1, R. Leonhart 3, C. Imbery 4, S. Starke 1, G. Bigot 1, J. Feuchtinger 5, M. Siepe 1
  • 1Universitäts-Herzzentrum Freiburg - Bad Krozingen, Klinik für Herz- und Gefäßchirurgie, Freiburg, Germany
  • 2Universitätsklinikum Freiburg, Abt. für Psychosomatische Medizin und Psychotherapie, Freiburg, Germany
  • 3Albert-Ludwigs-Universität Freiburg, Institut für Psychologie, Freiburg, Germany
  • 4Universitäts-Herzzentrum Freiburg - Bad Krozingen, Bad Krozingen, Germany
  • 5Universitätsklinikum Freiburg, Stabsstelle Qualität und Entwicklung in der Pflege, Freiburg, Germany

Objectives: Anxiety is experienced by most patients who face CABG. Patients with high preoperative anxiety suffer more often postoperative adverse events. According to a recent survey, 62% of cardiosurgical patients would appreciate preoperative psychosocial support. Therefore, we tested an anxiety-reducing intervention that is applicable to CABG patients even in the evening before surgery.

Methods: We included 253 adult patients (208 male, 45 female) who were admitted for planned CABG. Following the preoperative information by surgeon and anaesthetist and after giving informed consent, patients were randomized to intervention (n = 139) or control (n = 114). They completed the STOA questionnaire (State-Trait Operation Anxiety) and a visual analog scale for current anxiety (T0). State anxiety (STOA-S, 10 items) describes cognitive and affective components of situational anxiety, trait anxiety depends on the personality. The intervention consisted of a 30 minute dialog with a trained nurse containing information on surgery and postoperative care and emotional support with respect to the specific anxieties of the patient. Control patients received usual information only. The primary endpoint was state anxiety (STOA-S, anxiety scale) after the intervention at the evening before surgery (T1). Secondary end points were time on intensive care unit (ICU), in-hospital mortality and postoperative need for analgetics and antiphlogistics on day 5 postop (T2).

Results: There were no differences between intervention and control group with regard to anxiety or clinical and demographic data at T0.

The intervention resulted in significantly different changes between the groups at T1. Values for cognitive anxiety fell from 10.4 at T0 to 9.1 at T1 in the intervention group and from 11.1 to 10.5 in the control group (p = 0.008 between groups for difference T0-T1). Affective anxiety changed from 10.0 at T0 to 8.4 after intervention and from 10.0 to 10.1 in control patients (p = 0.004). Anxiety scale values sank from 3.5 to 2.8 in the intervention group and from 3.7 to 3.4 in the control group (p = 0.004 between groups T0-T1). A strong influence of trait anxiety was found.

The groups did not differ in time on ICU, in-hospital mortality and postoperative need for medication at T2.

Conclusion: Medical information and professional emotional support, both focussing on the patients' specific concerns, can help to reduce preoperative situational fear even at the evening before CABG.