Should Doctors Know Their Patients’ Attachment Style? A Psychological Perspective and its Impact on Cardiac Surgery Outcomes

Abstract Objective: To increase our understanding of the psychological attachment styles in order to develop a preventative strategy that could potentially improve patients’ perioperative outcomes. Methods: A comprehensive literature search was performed utilizing major electronic databases. The search was done from inception to January 2019. All of the relevant papers have been extracted and critically appraised in this review. Results: Understanding the psychological aspects of patients is crucial for a satisfactory postoperative outcome. Depression and anxiety have been shown to increase both mortality and morbidity after coronary artery bypass graft surgery, independently of medical factors, although the behavioural and biological mechanisms are poorly understood. Psychosocial assessment is an important part of the pre-transplant evaluation process. The majority of individuals undergoing a transplant have significant psychosocial problems and can either be deferred or denied the transplant until these psychosocial issues are approached and managed. Psychological distress has been shown to affect long-term prognosis of cardiac patients and as a result, it should be addressed during follow-up of cardiac arrest survivors due to cardiac cause. Several studies have considered different approaches and analyses of different psychological attachments, and the understanding of such parameters perioperatively could possibly minimise perioperatively complications. Conclusion: Since psychological distress affects long-term prognosis of cardiac surgery patients, it should be addressed during follow-up of cardiac arrest survivors due to cardiac cause.

摘要：研究目的为加深对心理依恋类型的理解，以期开发可潜在改善患者围手术期结局的预防策略。研究方法：通过主流电子数据库开展全面文献检索，检索时限为数据库建库至2019年1月。本综述提取并严格评价了所有相关研究论文。研究结果：了解患者的心理特征对获得满意的术后结局至关重要。已有研究表明，抑郁与焦虑会独立于医疗因素，增加冠状动脉旁路移植术后患者的死亡率与并发症发生率，尽管其行为与生物学机制尚未阐明。社会心理评估是移植术前评估流程的重要组成部分。多数接受移植手术的患者存在显著的社会心理问题，需在解决并管控此类问题前暂缓或取消移植。心理困扰已被证实会影响心脏患者的长期预后，因此对于因心脏病因导致心搏骤停的幸存者，随访期间应关注其心理状态。多项研究探讨了不同心理依恋类型的评估方法与分析路径，对这类围手术期参数的理解或可最大限度降低围手术期并发症的发生风险。研究结论：鉴于心理困扰会影响心脏手术患者的长期预后，因此在对因心脏病因导致心搏骤停的幸存者开展随访时，应重视其心理干预与管理。