Meeri Koivula

Fear and anxiety in patients at different time-points in the coronary artery bypass process

The purpose of this study was to examine fear and anxiety of coronary artery bypass patients at different time-points in the coronary artery bypass process and changes between different time-points. Patients (n = 171) from one university hospital completed questionnaires while awaiting surgery at home, in hospital the evening before surgery and 3 months later. The Bypass Grafting Fear scale was developed to measure fear. Anxiety was measured using state-trait-anxiety inventory and HAD. The highest levels of fear and anxiety were measured in the waiting period to coronary artery bypass grafting (CABG). Compared with the waiting period, fear and anxiety levels dropped in hospital and 3 months later. Female gender was related to change in fear and HAD anxiety. Marital status and vocational education were related to changes in STATE-A. Age under 55 years was related to higher TRAIT-A especially in the recovery period. These findings warrant concern for fear and anxiety in patients awaiting CABG, especially women and patients who do not have partner relationship.

Fear and in-hospital social support for coronary artery bypass grafting patients on the day before surgery

The purpose of this study was to ascertain the amount of in-hospital social support received by coronary artery bypass grafting patients and the impact of this support on their feelings of fear and anxiety. As adapted from Kahns theory, social support was understood as emotional, informational and tangible support. The bypass grafting fear scale was developed to measure the fear, and the hospital anxiety and depression scale and the state anxiety inventory were used to measure the anxiety. Data were collected pre-operatively with a questionnaire from in-patients (N=193) and analysed using logistic regression analysis and one-way ANOVA. The majority of patients received plenty of social support from nurses and a great deal of multiprofessional counselling. When the amount of social support was high, patients experienced lower levels of fear and anxiety. It is concluded that social support from nurses can effectively reduce pre-operative fear and anxiety, but that the amount of support should be high.

Family dynamics of families with cancer in Finland

The purpose of this study was to describe family dynamics of families with cancer on the basis of Barnhills framework for healthy family systems. The sample consisted of families in which one member had cancer. Both the patients (n = 96) and their relatives (n = 96) participated in the study (n = 192). The data for the study were collected using the Family Dynamics Questionnaire and the Family Dynamics Measure. The results indicated that the cancer of a single family member did not impair family functioning, but that family dynamics were considered quite good. There were no statistically significant differences between cancer patients and relatives on any of the family dynamics dimensions. However, an examination of sociodemographic characteristics did reveal some differences. Older relatives reported more enmeshment and rigidity than did younger relatives, whereas the latter reported more role conflict than older relatives. Older patients reported more rigidity than younger patients. Relatives who were men reported more enmeshment than women, whereas women reported more role conflict. Relatives of two-member families reported more rigidity than relatives with a larger family. Patients who reported a serious illness in the family described more mutuality, better flexibility, and clearer communication than patients who did not report such an illness. Also, relatives who mentioned a serious illness reported more mutuality and flexibility.

Predictors of depressive symptoms among coronary heart disease patients: A cross-sectional study nine years after coronary artery bypass grafting

OBJECTIVE This study sought to identify the incidence of depression and its associations with demographic, lifestyle, perceived health, symptoms, treatment, and social support variables in patients 9 years after a coronary artery bypass graft. METHODS The questionnaire was mailed to 152 surviving patients who had undergone a coronary artery bypass graft 9 years earlier, and who had been respondents in an earlier study. Depressive symptoms were measured using the Zung Self-Rating Depression Scale, and social support was measured using Social Support from the Network Scale. Descriptive statistics and the linear regression method were used for analysis. RESULTS Depressive symptoms were reported by one fourth of the patients. The predictors for depressive symptoms included gender, perceived health, cardiac ischemic symptoms at rest, and emotional social support, which explained 24% of the variance. Controlling for gender revealed that the predictors for women and men were different. CONCLUSIONS Depression is more difficult to predict in men than in women.

Predictors of fear and anxiety nine years after coronary artery bypass grafting

AIM This paper is a report of a study to identify (i) associations between fear and anxiety with variables of demography, symptoms, treatment and perceived health, (ii) associations between fear, anxiety, depression and social support and (iii) predictors of fear and anxiety nine years after coronary artery bypass grafting. BACKGROUND Earlier research shows that anxiety and fear are common, but there is a lack of knowledge about the long-term (>five years) situation of people after coronary artery bypass grafting. METHOD A convenience sample (n = 170) was formed of patients who had undergone coronary artery bypass grafting (n = 723) in one university hospital in 2007, nine years after surgery, by postal questionnaire. The questionnaire was sent to 152 surviving patients, and 114 responded (75%). RESULTS Fear had a connection to female sex, age under 65 years, more chest pain, hospitalization and poor perceived health. Anxiety had a connection to age under 65 years, living alone, more chest pain and poor perceived health. Social support had a low negative correlation with anxiety. Age under 65 years and chest pain explained 28% of the variance in fear. Age under 65 years and depressive symptoms explained 51-57% of the variance in anxiety. CONCLUSION Anxiety in people with coronary heart disease can be alleviated by developing social support from peers and professionals. Those aged under 65 years should be recognized as at greater risk of a predictor of long-term fear and anxiety after coronary artery bypass grafting.

Research utilisation among nursing teachers in Finland: A national survey

Evidence-based nursing practices using the latest knowledge require nursing education and further education based on the latest research findings. Anyhow, research utilisation by nursing teachers is poorly known. The aim of this study was to assess research utilisation by nursing teachers and connections of teachers background, further education and research activity variables to research utilisation on nursing education. A descriptive, cross-sectional survey design was used. A structured questionnaire specifically designed for this study which focused on research utilisation by nursing teachers were used. Data were collected from all nursing schools in Finland using a survey via the Internet. Participating nursing teachers totaled 339, with a response rate of 46%. The mean age of teachers was 51years and most had masters degrees, although 12% had a licentiate or PhD. Most nursing teachers had taken further education, were members of research and development teams and had publications. Research utilisation in nursing teaching was connected to teachers age, nursing diploma, academic degree, work experience, official title, further education, research and development activities and publication activity. Conclusion is that nursing teachers with doctoral degrees make better use of research on nursing education than those with masters degrees.