Preparation For Unpleasnt Procedres

Question 1

What are the 6 most important factors to patients during colonoscopy?

Answer 1

1. Decency treated with respect.
2. Clear instructions.
3. Staff attitudes treat me as an individual
4. Detailed information.- knowing what to expect.
5. Results provide a timely manner.
6. Pain control.

Question 2

How can we approach preparation for a procedure?

Answer 2

• communication
  +coping skill - distraction or guided imagery
• Relaxation
  + hypnosis

Question 3

What can influence pain?

Answer 3

Anxiety makes people experience more strongly, but pain makes people anxious

The meaning of pain - if people believe pain indicates a problem, pain is perceived as being worse

Information provided to the patient has potential to directly influence the degree of physical pain

Question 4

What are the ways of presenting information to patients?

Answer 4

Follow up from other staff eg nurses
Written material
Video
Internet

Question 5

What are the advantages and disadvantages of providing written material to patients?

Answer 5

+ increased patient knowledge
+ reduces pt anxiety
+ allows pt to refer back to

• may be complex or conflicting
• may need clarification by staff
• too much medical language
• small typeface or long sentences
• not personalised (generic)

Question 6

What types of info do patients want to know?

Answer 6

What will happen?( procedural)
Experience of procedure ( sensory)
What is expected of the patient? (Behavioural.)
Outcomes - what will happen as a result

Question 7

What is a Nocebo?

Answer 7

Is the native equivalent of a placebo?
The information provided to patients may change the situation that’s being described
If patients expect an negative outcome that outcome becomes more likely

It may therefore not be the patient’s interest to exhaustively list, all the potential negative outcomes .

Question 8

What do we need to consider when gaining informed consent?

Answer 8

There is small risk of …

Need for considerable preparation before telling the patient about possible risks
* emphasise the positive first first
* make clear the probabilities of a negative outcome
*pt may not understand the probability of risk
8 can compare it with the risk of every day events

Question 9

What is health literacy?

Answer 9

Health literacy is the capacity to obtain process and understand basic health information

Question 10

What are the 2 approaches of patient information requests?

Answer 10

Information seeking vs avoidance

Seeking = “ was extremely helpful because she drew very detailed sketches of what the procedure would involve and talked me through”

Avoidance = “ well as regard to the operation I didn’t want to know anything”

Question 11

What is the hazards information?

Answer 11

~ Information to graphic, e.g. coloured pictures
~ too much information about possible complications
~ bombarded with information
~ daunting and terrifying

Question 12

What are the 2 common coping styles?

Answer 12

Internal vs external control

Question 13

What do we need to communicate with the patient about?

Answer 13

+ Information
- what’s going on?
- What they need to do
+ reassurance
- All about the procedure
- That they are doing okay
+ maintenance of atmosphere
- Avoidance of high, fear words such as knife, or blade or needle
- Background chat can be okay and reassuring