Many factors determine how well patients recover following cardiac surgery, but one of the least appreciated is the set of beliefs they hold regarding their illness. The understandings they take with them into the operating room strongly impact the extent of their recovery three months later.
That's the conclusion of a paper just published in the Journal of Psychosomatic Research.
A research team led by psychologist Meike Juergens of Philipps University in Marburg, Germany, surveyed 56 people who were set to undergo elective cardiac surgery: either coronary artery bypass grafting, a heart valve operation or a combination of the two.
As part of the survey, the heart patients filled out an Illness Perception Questionnaire. Among other things, it measured their beliefs regarding personal control ("The course of my heart condition depends on me"), their expected time frame ("My heart condition is likely to be permanent rather than temporary"), and their emotional response to the illness ("My heart condition makes me feel afraid").
The researchers returned to the patients three months after their surgery. They found "higher levels of physical functioning were associated with the pre-surgery belief that the heart disease would be of short duration and would not be related to serious consequences."
In contrast, "Patients who perceived their illness to have a chronic or cyclical time course and who perceived their illness to have severe consequences on their lives reported higher levels of disability, depressive symptoms and lower levels of physical functioning."
Given these findings, the researchers conclude that "it is important to identify maladaptive illness beliefs as early as possible" — that is, before the operation rather than after. Cognitive interventions such as counseling sessions need to take place as people are formulating their assumptions about their condition, rather than after they are firmly lodged in their minds.
Surgeons may resist this notion, but the researchers insist the evidence is clear: "The extent to which patients benefit from surgery depends only on the medical intervention, but also on the patients' view about their illness."
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