Physiological, Psychological and Autonomic Responses to Pre-Operative Instructions for Patients Undergoing Cardiac Surgery

Huey-Ling Liou；Yann-Fen C. Chao；Terry B.J. Kuo；Hsing I Chen

pre-operative instruction ； cardiac surgery ； heart rate variability ； perceived stress ； perceived helpfulness

The Chinese Journal of Physiology

51卷5期（2008 / 10 / 01）

317 - 323

英文

Several studies have reported that the experience may induce emotional reactions before and after surgery. Various Studies have demonstrated that effective pre-operative information reduces stress and anxiety levels. However, little is known about the effect of pre-operative instruction on autonomic responses as measured by heart rate variability (HRV) before cardiac surgery. Ninety-one patients were randomly assigned to video-tape viewing and teaching booklet group. Electrocardiogram was monitored before and after pre-operative instruction. HRV was analyzed with spectral analysis of frequency domains of heart rate and categorized into low and high frequency (LF and HF). After pre-operative instruction, subjects completed a score of perceived stress and helpfulness. In this study, we found that pre-operative instruction with video-tape was similarly effective as teaching booklets on patients' perceived stress, perceived helpfulness and recovery outcomes. The decrease in HF% and increase in LF/HF ratio of HRV indicate a change in sympathovagal balance toward a lower parasympathetic activity after pre-operative instruction in subjects of both groups. However, the perceived helpfulness of pre-operative instruction may often be associated with a relatively less sympathetic activity. Further studies are needed to determine the optimal timing to enhance the positive effects on the sympathovagal balance after pre-operative instruction.

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