Patient-Centered Cardiac Surgery: Psychosocial Challenges, Evidence-Based Interventions, and Future Horizons
Vasileios Leivaditis, Anastasios Sepetis, Francesk Mulita, Sofoklis Mitsos, Nikolaos G. Baikoussis, Efstratios Koletsis, Stelios F. Assimakopoulos, Andreas Maniatopoulos, Elias Liolis, Konstantinos G. Nikolakopoulos, Manfred Dahm, Nick Kontodimopoulos
Abstract
Background: Psychosocial factors such as anxiety, depression, and lack of social support are increasingly recognized as critical determinants of outcomes in cardiac surgery. Up to 32% of patients experience preoperative anxiety, and nearly 20% experience depression, both of which have been associated in observational studies with delayed recovery, increased complications, and higher mortality. Objective: This study aimed to review current evidence on psychosocial aspects of cardiac surgery and evaluate patient-centered care strategies that address these challenges. Methods: A narrative literature review was performed using PubMed, Scopus, and ScienceDirect, focusing on recently published studies. The search covered studies published between January 2009 and June 2024, yielding 76 eligible studies after screening and thematic synthesis. Search terms included patient-centered care, psychosocial factors, cardiac surgery, anxiety, depression, rehabilitation, and telemedicine. Eligible studies included randomized controlled trials, cohort studies, qualitative studies, and systematic reviews. Results: Key themes included preoperative psychological preparation, management of anxiety and depression, promotion of quality of life, effective communication strategies, and integration of psychosocial support into rehabilitation programs. Evidence shows that psychological and social interventions reduce reported pain by up to 33%, as reported in pooled randomized controlled trials and meta-analyses; shorten hospital stay; improve adherence to treatment; and enhance long-term quality of life. Emerging tools such as telemedicine and digital platforms further expand access to psychosocial care. Conclusions: Integrating psychosocial care into cardiac surgery is essential for achieving holistic outcomes. Patient-centered models that emphasize communication, shared decision-making, family involvement, and digital support improve not only survival but also recovery, well-being, and patient satisfaction. Redefining success in cardiac surgery requires attention to both clinical results and the broader human experience of illness and recovery.