Patient Anxiety during Medical Stress

Question 1

What is anxiety?

Answer 1

Unpleasant feeling or emotion associated with threatening situations or thoughts of threatening situations. Includes a range of physiological, emotional and cognitive symptoms

Question 2

Explain why medical procedures cause anxiety?

Answer 2

• They are inherently threatening as they involve a huge amount of uncertainty.
• Different procedures cause different stress for example, procedural or outcome stress.

Question 3

List some examples of what patients are anxious about?

Answer 3

• Anaesthesia/being unconscious,
• Fear of waking during surgery,
• Pain,
• Life threatening procedures,
• Possibility of disfigurement,
• Threat of severe illness,
• Outcome of test results,
• Ward environment,
• Physical restriction,
• Loss of independence.

Question 4

Describe the impact of pre-operative anxiety

Answer 4

These patients are more likely to;

• experience pain post-operatively,
• Use more analgesic,
• Stay in hospital longer,
• Experience more complications,
• Experience anxiety and depression after surgery.

Question 5

Describe the psychological influences on surgical recovery

Answer 5

Communication - Less likely to understand information they are told.
Adherence - Less likely to comply to coughing breathing exercises and getting out of bed to improve mobility.
Pain Management - anxiety can influence type and amount of anaesthetic

Question 6

How can we help patient anxiety?

Answer 6

• Increase sense of control via providing procedural info, sensory info, behavioural instructions, cognitive coping or via other techniques.
• Psychological preparation

Question 7

Discuss how psychological preparation affects outcomes

Answer 7

• It may reduce post operative pain after surgery,

- Reduce length of stay in hospital

Question 8

Describe the benefits of providing procedural information

Answer 8

• Beneficial for length of stay,

- Beneficial for negative affect

Question 9

Describe the effects of providing sensory information to patients

Answer 9

• This method is always combined with others.
• It is beneficial for length of stay,
• Beneficial for negative affect,
• No clear evidence for post operative pain

Question 10

Describe the effects of behavioural instruction

Answer 10

• Beneficial for length of stay,
• Greatest potential for behavioural recovery outcomes,
• NO evidence for post-operative

Question 11

Describe the effects of cognitive interventions on patients

Answer 11

Small number of studies and therefore no clear evidence on any outcome.

Question 12

Describe the effects of relaxation techniques on patients

Answer 12

• Beneficial effect on post operative pain,

- Beneficial effect on ‘-ve affect’ when combined with other techniques

Question 13

Describe the effects of emotion focused interventions

Answer 13

Small number of studies but has potential benefit for post-op pain when combined with other techniques.

Question 14

What are the results when a patients shares a room with another post-op patient whos had the same or different surgery

Answer 14

• They are less anxious post-op,
• Released more quickly,
• More ambulatory post-op

Question 15

Describe preparation for non-surgical procedures which reduce anxiety

Answer 15

• Relaxation training,
• Systematic Desensitization,
• Information provision

Question 16

Describe the difference between monitors and blunters

Answer 16

Monitors - Cope by seeking out detailed info.

Blunters - Cope by using avoidance to minimise situation