Psychometric testing of the Cardiac Symptom Survey, and prediction of outcomes over the first three months after coronary artery bypass graft surgery.

摘要

Symptom management is important in the recovery of postoperative coronary artery bypass graft (CABG) patients, yet no tool was found in the literature that has been psychometrically tested to measure the symptom experience in this population. Phase one of this study was methodologic, and tested psychometric components of the Cardiac Symptom Survey (CSS). The CSS assesses three components (perception of symptoms, evaluation of symptoms and response to symptoms) of the symptom experience of postoperative CABG patients. Phase two used a longitudinal, exploratory design, and described the symptom experience during the first three months postoperatively, and determined the degree to which selected patient characteristic variables and symptom experience variables predicted selected outcomes. Data were collected at baseline, 2 weeks, 6 weeks, and 3 months, with a convenience sample of 90.; Content validity (using an expert panel), construct validity (using factor analysis and contrasted groups techniques), stability, and internal consistency were all demonstrated. Psychometric testing documented satisfactory reliability and validity of the CSS in this sample.; In the prediction of symptoms (physical and psychologic) at each time point, hierarchical regression revealed women were significantly more likely to have higher physical symptom ratings than men at 3 months. Higher baseline physical symptom ratings were predictive of higher 3 month physical symptom ratings. Increasing age and higher baseline psychologic symptom ratings were predictive of higher psychologic symptom ratings at each time point.; Better physical functioning at 3 months was predicted by lower 2 week physical symptom ratings. Better psychosocial functioning at 3 months was predicted by higher baseline psychosocial functioning and lower 2 week psychologic symptom ratings.; Using logistic regression, higher 2 week physical symptom ratings predicted the occurrence of a cardiac disease-related postoperative problem. Higher 2 week physical and psychologic symptom ratings combined predicted the occurrence of an impaired recovery-related postoperative problem.; Limitations, conclusions, implications for practice, and recommendations for future research were presented.