Anxiety and fear in patients with short waiting times before coronary artery bypass surgery – a qualitative study
Abstract
Aims and objectives To obtain qualitative information on fears and anxieties of coronary artery bypass grafting patients with short waiting periods (up to a maximum of four weeks) before surgery. Background Coronary artery bypass grafting is a standard procedure in cardiac surgery. However, many patients suffer significant anxiety and fear before the operation. Preoperative anxiety and fear correlate with adverse outcomes, but there is a lack of data on the emotional stressors for patients with short waiting periods as applicable in Germany. This knowledge would be a prerequisite for the development of in-hospital interventions to reduce patients' anxieties and fears. Design An exploratory study was chosen to learn about patients' anxieties and fears. Method The day before coronary artery bypass grafting, 24 patients were examined with respect to their emotional experience using semi-structured interviews. The results were categorised by inductive content analysis. Results The overall waiting time for coronary artery bypass grafting was 6 ± 6 days. According to the analysis, the patients' statements were grouped in 'fears', 'negation of fears' and 'other emotional and physical conditions'. The interviews could cover all categories simultaneously. Eighteen patients mentioned fears, and most of them referred to specific issues. However, 16 of the 18 patients also named nonspecific fears and uncertainties. Fifteen patients negated fear. Twenty-three patients described their emot…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Waiting for planned cardiac surgery may cause uncertainty, psychological distress, anger, or disappointment and negatively impact quality of life.
“Waiting for planned cardiac surgery may cause uncertainty, psychological distress, anger, or disappointment and negatively impacting the patient's quality of life (AL-Hassan et al., 2014;Carr et al., 2017;Feuchtinger et al., 2014;McCormick et al., 2006;Teo et al., 1998).”
From Postponement of elective cardiac surgery: A prospective observational analysis of anxiety, depression, social support and clinical complications. (2023) · cites this paper as Feuchtinger et al., 2014
Duration of waiting time may influence patients' psychological outcome.
“In addition, the duration of the waiting time may also influence the patients' psychological outcome (Feuchtinger et al., 2014).”
From Postponement of elective cardiac surgery: A prospective observational analysis of anxiety, depression, social support and clinical complications. (2023) · cites this paper as Feuchtinger et al., 2014
Cited by
Sorted by citations
Psychological Preparation for Cardiac Surgery
Salzmann, S., Salzmann-Djufri, M., Wilhelm, M., & Euteneuer, F. (2020) · Current Cardiology Reports · doi:10.1007/s11886-020-01424-9 · Cited by 72 · see citing works
Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis
Correa-Rodríguez, M., Ejheisheh, M. A., Suleiman-Martos, N., Membrive-Jiménez, M. J., Velando-Soriano, A., Schmidt-Riovalle, J., & Gómez-Urquiza, J. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9040909 · Cited by 55 · see citing works
“, [46] Germany First-time CABG Cross-sectional n = 24 37.”
Preoperative concerns of patients undergoing general surgery
Cheng, J. Y. J., Wong, B. W. Z., Chin, Y. H., Ong, Z. H., Ng, C. H., Tham, H. Y., Samarasekera, D. D., Devi, M. K., & Chong, C. S. (2020) · Patient Education and Counseling · doi:10.1016/j.pec.2020.11.010 · Cited by 48 · see citing works
Heilmann, C., Stotz, U., Burbaum, C., Feuchtinger, J., Leonhart, R., Siepe, M., Beyersdorf, F., & Fritzsche, K. (2016) · Journal of Clinical Nursing · doi:10.1111/jocn.13055 · Cited by 29 · see citing works
Self-citationChuang, M., Tung, H.-H., Clinciu, D., Huang, J.-S., Iqbal, U., Chang, C.-J., Su, I.-C., Lai, F., & Li, Y.-C. (2016) · Comput. Methods Programs Biomed. · doi:10.1016/j.cmpb.2016.05.003 · Cited by 28 · see citing works
Palmer, P. K., Wehrmeyer, K., Florian, M. P., Raison, C. L., Idler, E. L., & Mascaro, J. S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260921 · Cited by 26 · see citing works
“qualitative studies that tallied stressor mentions; our data likely reflect participants’ more frequent recall of stressors when responding to survey prompts compared to more open-ended inquiries [49].”
BackgroundResultHanita, Z. N., Khatijah, L., Kamaruzzaman, S., Karuthan, C., & Mokhtar, R. A. R. (2022) · BMC Nursing · doi:10.1186/s12912-022-00814-4 · Cited by 26 · see citing works
“Another study revealed preoperative anxiety to be higher among CABG patients in comparison to patients hospitalised for other procedures and the general public [2].”
BackgroundResultLingehall, H. C., Smulter, N., Olofsson, B., & Lindahl, E. (2015) · BMC Nursing · doi:10.1186/s12912-015-0069-7 · Cited by 22
“These events come with a strong encroachment on the person’s body and integrity [5-7].”
BackgroundClarke, S. T., Murphy, B. M., Rogerson, M., Grande, M. R. L., Hester, R., & Jackson, A. C. (2024) · Heart and Mind · doi:10.4103/hm.hm-d-23-00046 · Cited by 20 · see citing works
Risk factors for anxiety and depression in the preoperative period of cardiac surgery
Gomes, E., Galvão, P. C. D. C., Santos, K. D. D., & Bezerra, S. M. M. D. S. (2019) · Enfermería Global · doi:10.6018/eglobal.18.2.322041 · Cited by 16
Höppchen, I., Kulnik, S., Meschtscherjakov, A., Niebauer, J., Pfannerstill, F., Smeddinck, J., Strumegger, E., Young, F., & Wurhofer, D. (2024) · Conference on Designing Interactive Systems · doi:10.1145/3643834.3661633 · Cited by 13 · see citing works
“Previous research indicated that patients’ ability to process and remember information during this phase is reduced due to emotional challenges and their CVD [24].”
BackgroundSupervised prehabilitation in patients scheduled for spinal surgery – a scoping review
Gränicher, P., Reicherzer, L., Wanivenhaus, F., Farshad, M., Spörri, J., Wirz, M., & Scherr, J. (2025) · European Spine Journal · doi:10.1007/s00586-025-08710-6 · Cited by 10 · see citing works
“During waiting times before surgery, the symptoms and disabilities often continue to increase and induce loss of muscle mass, cardiopulmonary deconditioning, pulmonary complications, and psychological distress [11, 12].”
Yamikan, H., Ahiskali, G., Demirel, A., & Kütükcü, E. (2024) · Heart & lung : the journal of critical care · doi:10.1016/j.hrtlng.2024.09.007 · Cited by 10 · see citing works
Lang, X., Huang, S.-F., Wang, Q., Feng, D., Xiao, Y.-R., Li, M., Guo, Z.-R., & Zhou, Q. (2022) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-022-01779-w · Cited by 9
“Although heart surgery has been concerned as a life-threatening event for patients and associated with a strong encroachment on the person’s body and integrity [8, 9], most clinical studies have only focused on postoperative complications instead of their subjective symptoms.”
BackgroundYıldırım, M., Akbal, S., & Turkoglu, M. (2023) · Applied Nursing Research · doi:10.1016/j.apnr.2023.151687 · Cited by 10 · see citing works
Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review
Olsen, D. B., Pedersen, P. U., & Nørgaard, M. W. (2023) · JBI Evidence Synthesis · doi:10.11124/jbies-22-00265 · Cited by 9 · see citing works
The effect of training on coronary artery bypass graft surgery patients.
Olgun, Ş., & Ozsaker, E. (2022) · Nursing Critical Care · doi:10.1111/nicc.12876 · Cited by 7 · see citing works
The relationship between pain beliefs and anxiety levels in patients undergoing urologic surgery
Alan, H., & Kurt, H. (2022) · Bangladesh Journal of Medical Science · doi:10.3329/bjms.v21i2.58058 · Cited by 7 · see citing works
Auer, C., Kube, T., Laferton, J., Salzmann, S., Shedden-Mora, M., Rief, W., & Moosdorf, R. (2016) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000358 · Cited by 6 · see citing works
Meng, S., Guo, Q.-X., Tong, G.-X., Shen, Y., Tong, X.-S., Gu, J., & Li, X.-L. (2022) · Angiology · doi:10.1177/00033197221098278 · Cited by 5
Kankaya, E., & Bilik, Ö. (2019) · Clinical and Experimental Health Sciences · doi:10.33808/clinexphealthsci.599805 · Cited by 5 · see citing works
“Other studies conducted in the field support the results the current study, emphasizing pain, sense of discomfort and fear of death as the most frequently encountered causes of preoperative anxiety (45).”
ResultSchooley, B. L., Nicolas-Rocca, T. S., & Burkhard, R. J. (2019) · Health Systems · doi:10.1080/20476965.2019.1663974 · Cited by 5 · see citing works
“Fear of medical procedures has been associated with negative outcomes of the procedure, although the extent of this e ff ect is not well measured or understood (Feuchtinger et al., 2014).”
BackgroundWu, E., Broström, A., & Mårtensson, J. (2019) · Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000530 · Cited by 5 · see citing works
Spindler, H., Thorup, C. B., Nøhr, D., & Andreasen, J. J. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16818 · Cited by 4 · see citing works
Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review protocol.
Olsen, D. B., Pedersen, P. U., & Noergaard, M. W. (2020) · JBI Evidence Synthesis · doi:10.11124/jbies-20-00012 · Cited by 4
The relationship between the perception of surgical fear and nursing satisfaction
Soydaş, D., Orğan, E. M., Findik, U. Y., & Işıklı, A. G. (2022) · Journal of Perioperative Practice · doi:10.1177/17504589221137983 · Cited by 3 · see citing works
“Preoperative fear levels lead to adverse outcomes and adversely affect patients’ learning, participation in interventions, cooperation skills and postoperative recovery processes (Aksoy 2021, Aşçı 2019, Feuchtinger et al 2014).”
BackgroundA Bibliometric Analysis of hypertension and anxiety from 2004 to 2022
Liu, S.-Q., Ji, X., Liang, H.-Y., Zhao, S.-H., Yang, F.-Y., Tang, Y., & Shi, S. (2025) · Medicine · doi:10.1097/md.0000000000041859 · Cited by 2 · see citing works
“[72] Patients with coronary artery disease are more prone to anxiety as well as depression and other adverse emotions before [73,74] and after PCI surgery.”
Clinical experience with medical hypnosis as an adjunctive therapy in heart surgery
Tigges-Limmer, K., Brocks, Y., Winkler, Y., Stock-Gissendanner, S., & Gummert, J. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1356392 · Cited by 2 · see citing works
Benevides, L. M. B., da Silva, L. D. F., Silva, G. C. E., & Farias, M. S. (2020) · Revista de Pesquisa : Cuidado é Fundamental Online · doi:10.9789/2175-5361.rpcfo.v12.8496 · Cited by 2 · see citing works
The Relationship Between Surgical Fear and Sleep Before Open-heart Surgery: A Descriptive Approach.
Gacaner, S., & Dönmez, Y. C. (2026) · Journal of Perianesthesia Nursing · doi:10.1016/j.jopan.2026.04.001 · Cited by 1 · see citing works
Olsen, D. B., Højskov, I. E., & Missel, M. (2025) · Nursing Research and Practice · doi:10.1155/nrp/3139277 · Cited by 1 · see citing works
“Factors such as the nature of illness, patient characteristics, and their sense of time can all shape how they experience this waiting period [9, 24].”
InfluentialHaider, S., Elshatoury, M., Elfghi, M., & Tawfick, W. (2026) · Pakistan Heart Journal · doi:10.47144/phj.v59i3.3139
“(Figure 3) [18,26,27,37– 39 Published by Pakistan Cardiac Society Vascular Complications: Three studies reported 30-day vascular complications.”
InfluentialÇolak, S., Balel, Y., & Keldal, G. (2026) · Archives of Current Medical Research · doi:10.47482/acmr.1668433
RELATIONSHIP OF PATIENTS’ ANXIETY LEVELS PRIOR TO OPEN HEART SURGERY WITH POSTOPERATIVE SYMPTOMS
Yaman, Ö., & Aygin, D. (2022) · Sakarya Üniversitesi Holistik Sağlık Dergisi · doi:10.54803/sauhsd.1103950
PACIENTŲ PATIRIAMAS NERIMAS PRIEŠOPERACINIU LAIKOTARPIU
Blaževičiūtė, T., Gedrimė, L., Brasaitė, I., Rapolienė, L., & Razbadauskas, A. (2017) · doi:10.5200/sm-hs.2017.102
“Keletas kitų tyrimų taip pat tyrė priešoperacinio nerimo priežastis ir jų metu buvo nustatyta, kad respondentai nerimauja prieš operaciją dėl: baimės numirti, skausmo, kurį gali pajusti operacijos metu, komplikacijų po operacijos, pooperacinio skausmo, artimųjų gerovės [17, 16, 4, 11].”
Background
- Authors
- Feuchtinger, J., Burbaum, C., Heilmann, C., Imbery, C., Siepe, M., Stotz, U., Fritzsche, K., & Beyersdorf, F.
- Affiliations
- University Medical Center Freiburg (DE)
- University of Freiburg (DE)
- Universitäts-Herzzentrum Freiburg-Bad Krozingen (DE)
- Corresponding author
- Feuchtinger, Johanna
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2013-12-27
- Volume
- 23
- Issue
- 13-14
- Pages
- 1900-1907
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W2154095604
- Cited by
- 41
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Albert-Ludwigs-Universität Freiburg
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- preoperative anxiety, preoperative fear, coronary artery bypass grafting, patient emotions, uncertainty, frustration, somatic symptoms, cardiac surgery patients
- MeSH terms
- Adaptation, Psychological, Aged, Anxiety, Coronary Artery Bypass, Fear, Female, Germany, Humans, Interviews as Topic, Male, Middle Aged, Surveys and Questionnaires, Waiting Lists
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review