Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-14T01:26:44.291Z Has data issue: false hasContentIssue false

Peri-operative care in adults with congenital heart disease: room for improvement in after care

Published online by Cambridge University Press:  02 October 2012

Dounya Schoormans*
Affiliation:
Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
Ellen M. A. Smets
Affiliation:
Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
Ronald Zwart
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
Mirjam A. G. Sprangers
Affiliation:
Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
Tonny H. M. Veelenturg
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
Bas A. J. M. de Mol
Affiliation:
Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
Mark G. Hazekamp
Affiliation:
Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
Dave R. Koolbergen
Affiliation:
Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
Vladimir Sojak
Affiliation:
Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
Berto J. Bouma
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
Maarten Groenink
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
Matthijs S. M. Boekholdt
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
Ad P. C. M. Backx
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
Barbara J. M. Mulder
Affiliation:
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
*
Correspondence to: D. Schoormans, MPhil, Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands. Tel: +31(0)205668737; Fax: +31(0)205669104; E-mail: [email protected]

Abstract

Background

Patient satisfaction with care has received little attention within the field of congenital heart disease. Our objective was to examine patient satisfaction with the care received when undergoing open-heart surgery in order to identify the best and worst aspects of peri-operative care. Moreover, we examined whether having contact with a specialised nurse in addition to usual care is associated with higher patient satisfaction levels.

Methods

Patient satisfaction was measured by the Satisfaction with Hospital Care Questionnaire, evaluating nine aspects of care by answering individual items and giving overall grades. A top 10 of the best and worst items was selected. Linear regression analyses were used to examine the relationship between having contact with a specialised nurse and patient satisfaction (9 grades), independent of patient characteristics – sex, age, educational level, and health status.

Results

Data were available for 75 patients. Grades ranged from 6.74 for “discharge and after care” to 8.18 for “medical care”. In all, 21% of patients were dissatisfied with the clarity of the information about lifestyle adjustments given by the surgeon. However, patients who had contact with a specialised nurse were more satisfied with the provided information (B-coefficient is 0.497, p-value is 0.038), independent of patient characteristics.

Conclusions

Patients were satisfied with the received care, although there is room for improvement, especially in discharge and after care and the clarity of the information provided by the surgeon. This gap in care can be compensated for by specialised nurses, as patients who were counselled by a specialised nurse were more satisfied with the provided information.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Moons, P. Patient-reported outcomes in congenital cardiac disease: are they as good as you think they are? Cardiol Young 2010; 20 (Suppl. 3): 143148.CrossRefGoogle ScholarPubMed
2. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20–33 years follow-up. Eur Heart J 2003; 24: 673683.Google Scholar
3. Kamphuis, M, Ottenkamp, J, Vliegen, HW, et al. Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease. Heart 2002; 87: 356362.Google Scholar
4. Karsdorp, PA, Everaerd, W, Kindt, M, Mulder, BJ. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 2007; 32: 527541.Google Scholar
5. Schoormans, D, Mager, YL, Oort, FJ, Sprangers, MA, Mulder, BJ. New York Heart Association class assessment by cardiologists and outpatients with congenital cardiac disease: a head-to-head comparison of three patient-based versions. Cardiol Young 2012; 22: 2633.Google Scholar
6. Schoormans, D, Mulder, BJ, Sprangers, MA. Letter by Schoormans et al. regarding article “Recommendations for improving the quality of interdisciplinary care of grown-up with congenital heart disease (GUCH)”. Int J Cardiol 2011; 151: 121.Google Scholar
7. Linder-Pelz, SU. Toward a theory of patient satisfaction. Soc Sci Med 1982; 16: 577582.Google Scholar
8. Tomlin, MA, Gosney, K. Adult congenital heart care in a pediatric setting – a patient's perspective. J Cardiovasc Nurs 2011; 26: 329335.CrossRefGoogle Scholar
9. Moons, P, Pinxten, S, Dedroog, D, et al. Expectations and experiences of adolescents with congenital heart disease on being transferred from pediatric cardiology to an adult congenital heart disease program. J Adolesc Health 2009; 44: 316322.Google Scholar
10. Wray, J, Maynard, L. Specialist cardiac services: what do young people want? Cardiol Young 2008; 18: 569574.Google Scholar
11. Schoormans, D, Sprangers, MA, Pieper, PG, et al. The perspective of patients with congenital heart disease: does health care meet their needs? Congenit Heart Dis 2011; 6: 219227.Google Scholar
12. Acquadro, C, Berzon, R, Dubois, D, et al. Incorporating the patient's perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) Harmonization Group meeting at the Food and Drug Administration, February 16, 2001. Value Health 2003; 6: 522531.Google Scholar
13. Castaneda, A. Congenital heart disease: a surgical–historical perspective. Ann Thorac Surg 2005; 79: S2217S2220.Google Scholar
14. Moons, P, Bovijn, L, Budts, W, Belmans, A, Gewillig, M. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation 2010; 122: 22642272.Google Scholar
15. Giamberti, A, Chessa, M, Abella, R, et al. Morbidity and mortality risk factors in adults with congenital heart disease undergoing cardiac reoperations. Ann Thorac Surg 2009; 88: 12841289.Google Scholar
16. Verheugt, CL, Uiterwaal, CS, Grobbee, DE, Mulder, BJ. Long-term prognosis of congenital heart defects: a systematic review. Int J Cardiol 2008; 131: 2532.Google Scholar
17. Asilioglu, K, Celik, SS. The effect of preoperative education on anxiety of open cardiac surgery patients. Patient Educ Couns 2004; 53: 6570.Google Scholar
18. Contrada, RJ, Goyal, TM, Cather, C, Rafalson, L, Idler, EL, Krause, TJ. Psychosocial factors in outcomes of heart surgery: the impact of religious involvement and depressive symptoms. Health Psychol 2004; 23: 227238.Google Scholar
19. Cserep, Z, Balog, P, Szekely, J, et al. Psychosocial factors and major adverse cardiac and cerebrovascular events after cardiac surgery. Interact Cardiovasc Thorac Surg 2010; 11: 567572.Google Scholar
20. Mavros, MN, Athanasiou, S, Gkegkes, ID, Polyzos, KA, Peppas, G, Falagas, ME. Do psychological variables affect early surgical recovery? PLoS One 2011; 6: e20306.Google Scholar
21. Baumgartner, H, Bonhoeffer, P, De Groot, NM, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31: 29152957.Google Scholar
22. Moons, P, De Geest, S, Budts, W. Comprehensive care for adults with congenital heart disease: expanding roles for nurses. Eur J Cardiovasc Nurs 2002; 1: 2328.Google Scholar
23. Rickham, PP. Human experimentation. Code of ethics of the world medical association. Declaration of Helsinki. Br Med J 1964; 2: 177.Google Scholar
24. Ware, JE Jr, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473483.Google Scholar
25. Hendriks, AA, Vrielink, MR, Smets, EM, van Es, SQ, de Haes, JC. Improving the assessment of (in)patients’ satisfaction with hospital care. Med Care 2001; 39: 270283.Google Scholar
26. Kleefstra, SM, Kool, RB, Veldkamp, CM, et al. A core questionnaire for the assessment of patient satisfaction in academic hospitals in The Netherlands: development and first results in a nationwide study. Qual Saf Health Care 2010; 19: 16.Google Scholar
27. Hendriks, AA, Oort, FJ, Vrielink, MR, Smets, EM. Reliability and validity of the Satisfaction with Hospital Care Questionnaire. Int J Qual Health Care 2002; 14: 471482.CrossRefGoogle ScholarPubMed
28. Moons, P, Scholte op Reimer, W, De Geest, S, et al. Nurse specialists in adult congenital heart disease: the current status in Europe. Eur J Cardiovasc Nurs 2006; 5: 6067.Google Scholar
29. Moons, P, Engelfriet, P, Kaemmerer, H, Meijboom, FJ, Oechslin, E, Mulder, BJ. Delivery of care for adult patients with congenital heart disease in Europe: results from the Euro Heart Survey. Eur Heart J 2006; 27: 13241330.CrossRefGoogle ScholarPubMed
30. Pita-Fernandez, S, Farinas-Garrido, MP, Suarez-Fontaina, EM, et al. Satisfaction with treatment and prevalence of discomfort after external electrical cardioversion. J Cardiovasc Nurs 2005; 20: 4955.Google Scholar
31. Bleich, SN, Ozaltin, E, Murray, CK. How does satisfaction with the health-care system relate to patient experience? Bull World Health Organ 2009; 87: 271278.Google Scholar