Postoperative Survival Process of Patients who Underwent Coronary Artery Bypass Grafting Miwako Funayama Doctoral Candidate, The Japanese Red Cross College of Nursing Key words: survival process, post coronary artery bypass grafting, critical care Abstract The purpose of this study was to observe the postoperative survival process of the eight patients-seven males and one female-who underwent coronary artery bypass grafting (CABG). After CABG, most of the patients went through life-threatening experiences. Qualitative inductive design was utilized in explaining and describing postoperative survival process. For collecting data, participant observation and semi-structured interview were used. For data analyses, constant comparative method based on Grounded Theory Approach was adopted. It turned out that survival process was observed between the 4th day and the 7th after the operation, after which period the patients were able to "manage their own life". It also turned out that postoperative survival process consisted of five consecutive phases,-a) "being-in-the-dark condition", b) "beginning to feel alive", c) "feeling his or her life not to be under complete control", d) "gradually getting out of the previous c -phase and trying his or her own ability" and e) "having his or her life under control". These five phases arose in accordance with the enhancement of a) "the degree of physical movement", b) "the degree of controlling his or her life-supporting functions", and c) "the degree of arousal of vitality". In proportion to the recovery of the three "dimensions" mentioned above, we could observe the five phases consecutively surfacing. This study shows that postoperative survival process owes much to the patients' willingness to recover. Consequently it seems to be of utmost importance to encourage the patients to be self-reliant and self-subsistent.
Black, P., McKenna, D.P. (1997): A concept analysis of the sensoristrain experienced by intensibe care patients, Intensive and Critical Care Nursing, 13, 209-215. Camp, P.E. (1996): Having faith; Experiencing coronary artery bypass grafting, Journal of Cardiovascular Nursing, 10(3), 55-64. Compton, P (1991): Critical illness and intensive care; What is mearns to the client, Critical Care Nurse, 11(1), 50-56. Fareed, A. (1996): The experience of reassurance; patiens' perspective, Journal of Advanced Nursing, 23, 272-279. Granberg, A., Engberb, I.B., Lundberg, D.
(1996): Intensive Care Syndrome: A literature review, Intensive and Critical Care Nursing, 12, 173-182. Hawthorne, M.H. (1994): Gender difference in recovery after coronary artery surgery, IMAGE: Journal of Nursing Scholarship, 26 (1), 75-80. Laitinen, H. (1996): Patients' experience of confusion in the intensive care unit following cardiac surgery, Intensive and Critical Care Nursing, 12, 79-83. Holland, C., Cason, C.L., Prater, L.R. (1997): Patients' recollections of criticalcare, Dimension of Critical Care Nursing, 16(3), 132-141. Hudak, G.R., Gallo, B.M., Morton, P.G. (1997): Critical care nursing (7), LIPPINCOTT', Philadelphia, PA. Hudson, G.R. (1993): Empathy and technology in the coronary care unit, Intensive and Critical Care Nursing, 9, 55-61. Keller, C. (1991): Seeking normalcy; The experience of coronary artery bypass surgery, Research in Nursing & Health, 14, 173-178. Salyer, J., Stuart, B.J. (1985): Nurse-patient interaction in the intensive care unit, Heart & Lung, 14(1), 20-24. Strauss, A.L., Corbin, J. (1990): Basics of qualitative research CA. (2), SAGE, San Francisco, Tess, M.M. (1991): Acute confusional states in critically ill patients: A review, Journal of Neurosciense Nursing, 23(6), 398-401. Tucker, L.A. (1993): Post-pump delitium, Intensive and Critical Care Nursing, 9, 269-273.