Anxiety During Stressful Medical Procedures Flashcards
What is anxiety?
- Unpleasant feeling or emotion
- Associated with:
- Threatening situations OR
- Thoughts of threatening situations
What does anxiety provoke?
Range of physiological, emotional and cognitive symptoms
What are the main examples of medical procedures that cause anxiety?
- surgery
- chemotherapy
- radiotherapy
- diagnostic tests (endoscopy)
- predictive tests (genetic testing)
Different procedures cause…
different stresses
What are the main types of stress associated with medical procedures?
- Procedural stress
- Outcome stress
What are patients anxious about?
- Anaesthesia/being unconscious
- Fear of waking during surgery
- Pain (e.g. post-operative)
- Life threatening procedures
- Post-operative outcome
- Possibility of disfigurement
- Threat of severe illness
- Outcome of test results
- Unfamiliarity of surroundings
- The ward environment
- Surrounded by machines
- Physical reaction
- Loss of independence
- Being away from home (children, job, obligations)
Why do medical procedures cause anxiety?
Medical procedures are inherently threatening as they involve a huge amount of UNCERTAINITY
Describe anxiety before and after medical procedures
- Most surgical patients experience high anxiety when they are admitted to the hospital
- Anxiety remains quite high before and after the operation
What is more likely in patients with pre-operative anxiety?
- Experience more pain post-operatively
- Use more analgesic
- Stay in the hospital longer
- Experience more complications
- Anxiety and depression after surgery
What three areas does patient anxiety impact on?
- Communication
- Adherence
- Pain management
What are the main methods used to help patients with anxiety surrounding medical procedures?
- Procedural information
- Behavioural instruction
- Cognitive coping
- Sensory information
- Modelling
- Counselling
What is procedural information?
- Giving patients information about the procedures they will undergo
- This involves patients being formed:
- When the procedure will happen and where they will be
- E.g. they might be told about the possibility of a catheter and waking up in a recovery room
What is the main way to minimise anxiety?
What is sensory information?
- Giving patients information about sensations they will experience
- E.g. They might be told that premedication will not necessarily make them feel drowsy; how it will feel when the anaesthetics are given
- What do you tell the patients before you but the needle in?
What is cognitive coping?
- Encouraging more adaptive/helpful thoughts (‘cognitions’)
- Teaching methods of reinterpreting apparent threats in a more positive light, using distraction or other techniques that has been previously useful in anxiety provoking situations and using these before and after surgery
What is behavioural instruction?
Teaching techniques such as breathing, coughing exercises, and relaxation or how to turn over in bed
What are the main OTHER areas that can help patients with anxiety about a medical procedure?
- Modelling (e.g. showing videos of similar patients
- Particularly used with children
- Contains a lot of procedural information
- Emotion focused or psychotherapeutic discussion
- There’s a lot of variation
- Can be one to one or with other patients
- Relaxation
- Hypnosis
What can psychological preparation for a medical procedure impact?
- post-ioperative pain
- behavioural recovery
- negative affect (anxiety and distress)
- length of hospital stay
Describe an experiment regarding social support for patients going in for an operation and the outcomes of the experiment
- Patients placed in a room with another post-operative patient were:
- Less anxious post-op
- more ambulatory post-op
- released more quickly
What are the three methods used to prepare anxious patients for non-surgical medical procedures?
- Relaxation training
- Systemic desensitisation
- Information provision
What is a monitor coping style?
copes by seeking out detailed information
What is a blunter coping style?
copes by avoidance to minimise the situation
How can catering to coping style impact on anxiety?
Catering to the cognitive style of the patient usually results in a more positive outcome
How does psychological preparation impact recovery?
PROMOTES RECOVERY
- reduces stress –> decreases SNS arousal –> improves patients immune response
- Reduce frequency and extent of maladaptive behaviours that an unprepared patient can engage in
