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Abstract：
Open-heart surgery (OHS) is common in late life and is expected to improve functioning despite aging of OHS patients. Few studies have explored the influence of both psychosocial strength factors, metal health, and pre- and peri-OHS medical factors, including cardiac indices, on post-OHS functioning. This study explores the role of character strengths (e.g., hope and spirituality) in post-OHS activities of daily living (ADL) and instrumental ADL (IADL), along with cardiac indices used by all cardio-thoracic surgeons, after controlling for self-reported pre-OHS depression, quality of life indicators, and non-cardiac medical comorbidities. Three waves of interview data and cardiac/surgical indices in the Society of Thoracic Surgeon (STS) national database were collected for a cohort of 481 patients (age = 62 +, female 42%). Multiple linear regression was used to identify pre-OHS predictors of post-OHS functional status. ADL and IADL statuses after OHS were better among those who pursued pre-OHS positive spiritual/religious coping than those who did not. Outcomes were poorer for those reporting poor pre-OHS, higher numbers of medical comorbidities, and use of more post-OHS prayer for coping. Perfusion time, a proxy for surgical complexity, was associated with poor IADL only. Pre-OHS positive spiritual coping, a common coping means used among cardiac patients in medical crises, could have played a positive role in better post-OHS functional status during the post-OHS recovery month. Cardiac health providers should pay more attention to patient-centered character strengths and coping and non-cardiac conditions. More nuanced interdisciplinary research is necessary to identify mechanisms underlying these associations.
摘要：
心脏直视手术（OHS）在晚年很常见，尽管OHS患者衰老，但有望改善功能。很少有研究探讨这两种心理社会力量因素的影响，金属健康，以及OHS前后的医疗因素，包括心脏指数,OHS后的运作。这项研究探讨了性格优势的作用(例如，希望和灵性)在OHS后日常生活活动(ADL)和工具性ADL(IADL)中，以及所有心胸外科医生使用的心脏指数，在控制了自我报告的OHS前抑郁症后，生活质量指标，和非心脏疾病。针对481例患者（年龄=62岁，女性42%）。多元线性回归用于确定OHS前OHS后功能状态的预测因子。OHS后的ADL和IADL状态在那些追求OHS前积极的精神/宗教应对的人中比那些没有的人更好。对于那些报告OHS前不良的人来说，结果较差，更多的医疗合并症，并使用更多的OHS后祈祷来应对。灌注时间,手术复杂性的代表，仅与不良的IADL有关。OHS前积极的精神应对，心脏病患者在医疗危机中常用的一种应对手段，在OHS恢复后的一个月中，可能对OHS后功能状态的改善起到了积极作用。心脏健康提供者应更加注意以患者为中心的性格优势以及应对和非心脏疾病。需要进行更细致的跨学科研究，以确定这些关联的潜在机制。
