September 9, 1998
Media Contact: Mario Aguilera, (619) 534-7572, [email protected]
INFORMATION VIDEOS SPEED RECOVERY OF BYPASS PATIENTS ACCORDING TO STUDY BY UCSD PSYCHOLOGISTS
Patients who viewed videotapes explaining how they would feel after coronary bypass surgery generally recovered more quickly from their procedures, resulting in shorter stays in intensive care and in the hospital.
According to two studies conducted by psychologists at the University of California, San Diego, patients who viewed the tapes felt better prepared to participate in such activities as walking, deep breathing and coughing needed to speed their recovery. Moreover, they felt more confident that they could help speed their recovery.
"Information is a form of control," said Heike I. M. Mahler, research psychologist at UCSD and co-author of the studies with UCSD psychology professor James Kulik.
"If patients can visualize the recovery period, if they can better imagine themselves in the situation, then when the time comes, they may be better prepared to get up and walk and do the things they need to do to speed their recovery."
With per diem hospital costs escalating and more than 300,000 bypass surgeries performed yearly in the United States alone, Mahler added that such an intervention also may represent a significant savings in health-care costs.
"We would expect that some of these results might translate to other types of major surgery as well," she said. "We would expect that if such information were provided to heart/valve patients, or lung patients, or other kinds of major surgery patients, then we might see some of the same beneficial effects."
In all, some 288 patients at Scripps Memorial Hospital and the San Diego Veterans Affairs Medical Center, both in La Jolla, Calif., participated in the two studies, published in the Annals of Behavioral Medicine and Mind/Body Medicine. The first study included 30 female patients at Scripps undergoing cardiac bypass for the first time; the second involved 258 male bypass patients at both Scripps and the VA Medical Center.
Interestingly, the impact of viewing the 40-minute tapes on recovery time seemed to be more profound at the VA Medical Center, a government-funded teaching hospital, than at Scripps, a private hospital that performs most surgeries under pre-paid reimbursement contracts.
For example, bypass patients at the VA Medical Center who did not view the experimental tapes had an average length of stay of about 10 1/2 days, compared to nearly 7 3/4 days for those who did view the tapes. By contrast, patients who did not see the tapes at Scripps stayed in the hospital roughly 5 1/2 days, compared to about 5 1/3 days for those who viewed the tapes.
"We believe that at hospitals where postoperative stays are already at the bare minimum, it may not be possible for the tapes to reduce stays any further," said Mahler, also a professor of psychology at California State University, San Marcos. "However, the tapes may also have more subtle benefits. For example, patients who view such tapes may require less nursing staff time devoted to teaching or encouragement to perform recovery behaviors."
Videos used in the studies not only included information about the procedure patients would experience, they also featured interviews with patients who described their experiences and sensations at select days following their surgery.
In one video, patients were uniformly inspiring and upbeat about their experiences; by contrast, a second video portrayed patients going through some difficulty during recovery, although ultimately coping and succeeding.
Though the researchers expected the so-called "coping tape" to be more effective for recovery, both tapes achieved about the same results.
"It may be that the differences between the tapes are too subtle to reliably affect clinical outcomes such as length of postoperative stays," Mahler said.
Nevertheless, both tapes appeared to work by raising the patients' self-efficacy, or the feeling that they have a role to play in their own recovery.
"These studies suggest that if people have information about both the sensory and psychological effects of surgery, this information may well raise their beliefs that they can do something to speed their recovery from surgery," said Mahler. "And this seems to be a critical factor."
Both studies were supported by grants from the American Heart Association and the National Heart, Lung, and Blood Institute.
# # #
RSS