The relationships among quality of life, uncertainty, and hope for 21 patients and their spouses before bypass surgery were examined in this study. The instruments used included: Ferrans' and Powers' Quality of Life Index, Mishel's Uncertainty in Illness Scale, and the Herth Hope Index. Greater uncertainty was associated with lower quality of life and hope scores for patients and spouses. Spouses were more uncertain about the patients' cardiac disease and had higher quality of life scores than the patients. Female patients had more uncertainty about their disease. Patients with poor left ventricle function had lower quality of life. Implications for practice include the need to incorporate the spouse into the plan of care. Also, the presence of uncertainty in the waiting period for surgery for both patients and their spouses, and its negative association with quality of life, reinforces the importance of pre-admission intervention with this population.