A biopsychological network approach to variables contributing to preoperative quality of life in patients undergoing cardiac surgery
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Springer Nature
Abstract
Quality of life (QoL) in cardiac surgery patients is increasingly recognized as a critical outcome,
influenced by biopsychosocial variables. This study aims to explore the associations between
preoperative QoL and various psychological and biomedical variables in patients undergoing cardiac
surgery. The study includes cross-sectional baseline data from 204 cardiac surgery patients in two
distinct cardiac surgery samples: Data collection for the PSY-HEART I trial (coronary artery bypass
grafting) was conducted from 2011 to 2015, while data for the ValvEx (valvular surgery) trial were
collected between 2020 and 2022. We assessed psychological variables, such as illness beliefs and
expectations, alongside biomedical variables, including body mass index, EuroSCORE II, and C-reactive
protein levels. Data analysis involved partial correlation Gaussian Graphical Models (GGM) and Directed
Acyclic Graphs (DAGs) to identify key nodes and pathways affecting QoL. The resulting GGM was
estimated to be rather sparse (38 of 136 possible edges were present) and the case-drop bootstrap
node stability estimates ranged from sufficient (CS-Coefficient Bridge Expected Influence = 0.28) to
good (CS-Coefficient Expected Influence = 0.51). Our analyses revealed strong associations between
psychological variables and preoperative QoL, with current and expected illness-related disability
being central to the network. Medical variables showed weaker connections to QoL. The DAG
indicated that expected disability influenced current disability and preoperative QoL, suggesting that
preoperative expectations may be crucial for postoperative outcomes. This study underscores the
importance of psychological variables, particularly illness perceptions and expectations, in determining
QoL in cardiac surgery patients. Targeting these variables through preoperative interventions may
enhance postoperative recovery and QoL, advocating for a biopsychosocial approach in cardiac surgery
care.
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Except where otherwised noted, this item's license is described as Attribution 4.0 International
