Events leading to the treatment of coronary artery disease: implications for nursing care.
The selection of a particular treatment for CAD was found to be related to the severity of illness, patients who were more severely disabled by angina elected surgical treatment after vessel blockage was documented by angiography. Differential access to treatments was not described by study subjects and therefore cannot be evaluated as a contributing factor to the selection of treatment. Although most subjects participated in a therapeutic pharmacologic regimen, few patients in either group employed dietary or exercise programs to ameliorate CAD. Most patients received information about CAD and about surgery as a treatment option. This educational communication was directed by the cardiologist for a large majority of patients. Nurses were cited as information sources for surgical subjects only. In retrospect, more than half of the surgical subjects indicated a need for additional information. The decision regarding which type of treatment to have was made autonomously by most subjects, unlike the usual decision-making styles of families of surgical patients. A significantly greater proportion of surgical patients identified their family as a source of support during the elected treatment. Both groups described family changes specific to the illness and selected treatment.