Defense Date

2018

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Related Sciences

First Advisor

Tony Gentry

Second Advisor

Al Copolillo

Third Advisor

Diane Dodd-McCue

Abstract

This study investigated the impact of open heart surgery (Coronary Artery Bypass Graft, Heart Valve Replacement, or Left Ventricular Assist Device placement) on cognition, functional performance, and mood in the three months following surgery. The Montreal Cognitive Assessment (MoCA), Kettle Test (KT), Physical Self Maintenance Scale (PSMS), and Hospital Anxiety and Depression Scale (HD) measured global cognition, functional cognition, functional performance, and mood states, respectively.

Thirteen male participants (ages 38 – 75) completed assessments at four time points -- when they were scheduled for surgery, within one week prior to surgery, before hospital discharge after surgery, and three months after surgery. ANOVA analyses were conducted on overall raw mean scores taken at these time points. Correlational analysis compared changes in cognition and functional performance of daily activities for this group. Effect size estimations and power analyses were conducted to estimate sample sizes needed for adequately powered subsequent study. Two measures (KT and PSMS) were adequately powered at 95% for the study sample. Functional cognition as measured by the KT improved significantly after surgery and surpassed baseline within three months after surgery. Functional performance as measured by the PSMS declined significantly after surgery but returned to baseline within three months after surgery. Global cognition as measured by the MoCA did not change, was not correlated with other measures, and was below norms at all time points. Mood states as measured by the HADS did not change and were above norms at all time points.

This study had a small sample, only male participants, and one pooled group that did not allow for group comparisons. Two measures were self-reported, which may have impacted results due to responses biases. Despite these limitations, this is one of the first studies to track and compare both cognitive and functional performance changes over time. As such, this study may help practitioners and researchers improve and prioritize assessment and treatment options for individuals with cognitive and functional performance deficits after open heart surgery.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-7-2018

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