Psychological preparation for medical procedures

Question 1

stressful medical procedures, categories

Answer 1

uncomfortable
diagnostic
oncology
gynaecological
intensive

Question 2

uncomfortable procedures

Answer 2

concern specific patient groups, cancer patients or children
large groups of patients, vaccinations, venepuncture, catheter insertion

Question 3

diagnostic procedures

Answer 3

upper GI endoscopy
MRI
bone marrow aspiration
pelvic exam
smear test
mammography

Question 4

oncology

Answer 4

cancer treatment

Question 5

gynaecological procedures

Answer 5

IVF
C-section
laparoscopic/lapaotomy procedures
hysterectomy

Question 6

intensive care

Answer 6

critical or life threatening conditions intubation

Question 7

psychological preparation needed

Answer 7

surgery can be perceived as a potential threat
results in increased levels of anxiety
may lead to increased risk of complications, pain and longer recovery

Question 8

preoperative anxiety

Answer 8

feeling exposed/loss of dignity
incision
losing consciousness
reliance on others
fear of not waking up
fear of being aware but not able to communicate

Question 9

postoperative anxiety

Answer 9

diagnosis nd prognosis
pain/loss of sensation
loss of mobility/function
disfigurement
surgical/anaesthetic harm
postoperative infection
what is happening at home/wokr

Question 10

what is anxiety

Answer 10

A sense of apprehension or doom,
accompanied by physiological reactions,
involving an uncertain or unspecified threat

Question 11

increased level of pre op anxiety has been shown to be related to negative consequences, affecting

Answer 11

anaesthesia
postoperative care and treatment
rehabilitation

Question 12

types of anxiety

Answer 12

cognitive
somatic
behaviour
state or trait

Question 13

cognitive anxiety

Answer 13

negative thoughts
worry
rumination

Question 14

somatic anxiety

Answer 14

autonomic arousal perception of physical symptoms of anxiety
increased HR,BP, muscle tension, sweating, nausea, trembling, dry mouth, dizziness

Question 15

behaviour

Answer 15

adaptive
maladaptive

Question 16

state or trait

Answer 16

some higher on trait anxiety

Question 17

risk factors for preoperative state anxiety

Answer 17

history of:
cancer
smoking
psychiatric disorders
negative future perception
moderate to intense depressive symptoms
high-trait anxiety
moderate to intense pain
medium surgery

female gender
more than 12 years of education
previous surgery reduced the risk

Question 18

more about cognitive anxiety

Answer 18

“what if?”
attentional bias towards threatening information
misinterpret benign physical sensations as evidence
biopsycho feedback loop that increases physical symptoms
worry about outcome and also everyday matters can be dispositional

Question 19

consequences of high anxiety

Answer 19

phobias, panic attacks, maladaptive, inability to process information
positive correlation between preoperative anxiety and postoperative pain
high pre op anxiety predicts poorer recovery outcomes
pre op anxiety can influence the intensity of post op pain and anaesthesia and analgesia requirement
anxiety may even increase post op morbidity and mortality

Question 20

how are patients helped to prepare

Answer 20

methods aim to increase feeling of control (informational, cognitive and behavioural) as well as reducing anxiety
information giving effectiveness depends on: type and level of information, anxiety level and coping style of patient

behavioural instruction
cognitive approaches
relaxation/imagery/hypnosis
focused discussion
modelling

Question 21

4 general types of intervention

Answer 21

procedural information
sensory information
coping information
modelling

Question 22

procedural information

Answer 22

giving objective information about the sequence of events, equipment used and timing of experiences

Question 23

sensory information

Answer 23

describing sensations that precede, accompany and follow the procedure

Question 24

coping infomration

Answer 24

teaching coping methods to minimise the experience of Naomi

Question 25

modelling

Answer 25

showing other persons undergoing the procedure without complications

Question 26

coping style and anxiety reduction

Answer 26

categorised into blunders and monitors divided into high and low information groups pulse rate measured pre and post information giving

Question 27

monitors

Answer 27

seek information less anxiety high information higher anxiety levels before information giving

Question 28

blunters

Answer 28

avoid information less anxiety low information lower anxiety levels before information giving

Question 29

relaxation

Answer 29

involve training in transferable skills reduce anxiety counter physical consequences of anxiety increase feeling of physical control psychological and physical benefits

Question 30

involving training in transferrable skills

Answer 30

progressive muscular relaxation meditation biofeedback guided imagery relaxation tapes

Question 31

what does cognitive behaviorual interventions involve

Answer 31

identifying problem thoughts giving rise to anxiety demonstrating link between thoughts and feelings looking at evidence for problems mthoughts replacing with more reality based thoughts

Question 32

effectiveness of cognitive behavioural interventions

Answer 32

compared with routine care controls no difference inc reported pain faster mobility and reduced pain medicatio n

Question 33

what is the most frequency used intervention in children n

Answer 33

modelling delivers procedural and sensory information in a different way and is an underutilised/underexplored form of intervention

Question 34

does psychological preparation work?

Answer 34

better prepared patients gave better post op outcomes

Question 35

psychological preparation may be beneficial for

Answer 35

post op pain behavioural recovery negative affect length of hospital stay quicker resumption of activities