BSS: Psychological prep for investigations and surgery Flashcards
Why is psychological preparation needed?
-Perceived as potential threat
-Increased anxiety > longer recovery, complications
What may patients feel anxious about?
-Anxiety about the procedure
-Anxiety about later
What is anxiety?
-As well as the different types?
-A sense of apprehension or doom, accompanied by physiological reactions, involving an uncertain
or unspecified threat.
- Cognitive : negative thoughts “what if”
- Somatic: manifestation of physical symptoms of anxiety e.g. increased HR
- Behavioural: adaptive/maldaptive
- State or trait :
What is the difference between anxiety and stress?
Stress= under pressure
Anxiety= feeling worries
What are the consequences of anxiety?
-High or low levels = not very helpful
-Moderate levels =driver to perform better , little bit Is good.
What are the consequences of high anxiety?
-phobias
-panic attacks
-inability to process information
-affects pain perception
-poorer recovery outcomes
How can patients be helped to prepare?
-Aim to increase feeling of control as well as reducing anxiety
- Information giving -effectiveness depends on:
> type/level of info
> Anxiety level and coping style of patient - Behavioural instructions
- Cognitive approaches
- Relaxation
- Focussed discussion
- Modelling
Studies have investigated how type and level of information and coping style of patient can influence levels of anxiety and the relationship between these variables? Discuss this… Using
1. monitors+ blunters
2. seekers and avoiders
Anxiety depends on information level and coping style
- Monitors = less anxiety with high information Blunters = less anxiety low information
- Less anxiety and pain in:
Seekers given sensory information
Avoiders given minimal information
What are the 2 types of information you can give?
What type of info has research suggested you should be given if you are:
1. more anxious
2. less anxious
*Information giving to reduce anxiety
1. Sensory information
2. Procedural or combination
>More of an effect on really anxious people big reduction
Information giving:
Cognitive-behavioural interventions ?
Is it effective?
- Identify problem thoughts giving rise to anxiety
- Demonstrate link between thoughts & feelings
- Look at evidence for problem thoughts
- Replace with more reality based thoughts
>No difference in reported pain but faster mobility & reduced pain medication
Information giving:
Relaxation, imagery,hypnosis
Relaxation Techniques:
* Involve training in transferable skills:
oProgressive muscular relaxation
o Meditation
o Biofeedback
oRelaxation tapes
* Reduce anxiety
Information giving:
Guided imagery
Vivid mental images produce similar (but reduced) physiological responses
* Can include positive suggestions for coping & control
Less postoperative pain Less distressed by pain Felt coped better Requested less analgesia Cortisol levels lower
Information giving:
Hypnosis
- Putting patients into a trance, which may be induced by suggestion or visual imagery, and making them focus on inner experiences
-State of Hyper-sugestability
> Increased relaxation and easier sleep
> Symptom alleviation
Information giving:
Focussed discussion
- Psychological support
- Opportunity to discuss specific worries
- Can be useful when combined with other techniques
>Most anxious patients benefit
