Older cardiac surgery patients' experiences with a pre-surgery nursing consultation and the influence on their self-management: A qualitative study.

Self-management support for pre-hospital patients is urgently needed to bridge the gap between hospital and home. An example of a self-management supporting intervention is PREDOCS (PREvention of Decline in Older Cardiac Surgery patients). However, patients' experiences with this nursing consultation remain unclear. Therefore this study aims to explore experiences of older cardiac surgery patients with a pre-surgery nursing consultation and the influence on their self-management prior to cardiac surgery. A generic qualitative study was conducted using fifteen semi-structured interviews with older cardiac surgery patients selected through purposive sampling. Interviews were thematically analysed. Patients' experiences and the influence on their self-management were divided into two main themes: (1) Taking a role in preparation for open cardiac surgery. Through the entire process of preparation for surgery, patients showed an active or a more avoiding style of preparation. (2) Emotional management. After the PREDOCS consultation, patients mentioned different effects of the consultation in managing their emotions. On the one hand, too detailed information negatively affected their fear, on the other hand, the nurse increased patients' trust. Findings suggest that PREDOCS is not aligned with individual patients' style of preparation. Therefore, PREDOCS needs a more tailored approach taking into account patients' coping styles, anxiety level, need for information and current level and readiness for self-management, to support all patients' self-management. Moreover, the importance of tailored interventions to support self-management should be considered when developing similar interventions for larger scale deployment, as well as the consideration that nurses should be key-figures in supporting patients' self-management.