primary goal of all forms of therapy is not just prolonging life, but improving the quality of life, has forced analysis of what constitutes quality of life, a concept whose structure pervades all walks of life and eludes definition. Global well being, happiness, morale, vitality, fullness of social life, and satisfaction must be integrated and assessed for the effects of the disease and the therapy, in the context of specific personality traits, attitudes to life, family situation, and socio-economic and political freedom. A growing inter est in research on this subject has led to a clearer understanding of the components which come to determine quality of a patient's life, and how they can be measured in a reproducible manner so that valid comparisons can be made. Keeping these recommendations of analysing quality of life within the context of patients who have undergone open heart surgery, it seemed appro priate to me to separate the influence of various forms of open heart surgery into five aspects of life which can comprehensively reflect the quality of life outcome of the operation. These five 'components' are (1) Physiological state, which summarises the traditionally reported incidence of operative mortality and morbidity, objectively and subjectively measured physical ca pacity, and the residual symptoms, treatment and long-term survival. (2) Intellectual functioning relates to the psychoneurolgocial deficit in memory, reasoning or judgement because of cerebral microembolism and hypo perfusion during cardiopulmonary bypass.

Klappentext

The technical evolution of cardiac surgery in the last decades has been rewarded with long-term survival with few complications. A matching improvement in the quality of this survival as subjectively felt by the patient has now become most important to assess the justification of surgery. This book is the summary of the proceedings of an international symposium which addressed the growing demand in this facet of cardiac surgery. For the first time quality of life after valve replacement, coronary bypass, surgery for congenital heart disease, and heart transplantation has been extensively analyzed in terms of the physiological state, intellectual functioning, emotional state, performance of social roles and general satisfaction. The patient's well-being has become the focus of a joint effort of cardiologists, surgeons, general practitioners, psychologists, sociologists and occupational physicians, for all of whom this book offers a guide to the improvement of our patients' `Quality of life after open heart surgery'.

Inhalt
Preface. Foreword. Part One: Quality of Life after Heart Valve Replacement. A. Physiological State. B. Intellectual Functioning. C. Emotional State. D. General Satisfaction. Part Two: Quality of Life after Coronary Bypass Surgery. A. Physiolocial State. B. Intellectual Functioning. C. Emotional State. D. Performance of Social Soles. E. Summary: Quality of Life after Coronary Bypass Surgery. Part Three: Quality of Life after Surgical Correction of Congenital Heart Disease. A. Physiological State. B. Intellectual Functioning. C. Emotional State. D. Performance of Social Roles. E. General Satisfaction. F. Summary: Quality of Life after Surgical Correction of Congenital Heart Disease. Part Four: Quality of Life after Heart Transplantation. A. Physiological State. B. Intellectual Functioning. C. Emotional State. D. Performance of Social Roles. E. General Satisfaction. F. Summary: Quality of Life after Heart Transplantation. Index.