Psychological preparation for medical procedures Flashcards

1
Q

stressful medical procedures, categories

A

uncomfortable
diagnostic
oncology
gynaecological
intensive

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2
Q

uncomfortable procedures

A

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

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3
Q

diagnostic procedures

A

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

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4
Q

oncology

A

cancer treatment

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5
Q

gynaecological procedures

A

IVF
C-section
laparoscopic/lapaotomy procedures
hysterectomy

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6
Q

intensive care

A

critical or life threatening conditions intubation

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7
Q

psychological preparation needed

A

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

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8
Q

preoperative anxiety

A

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

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9
Q

postoperative anxiety

A

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

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10
Q

what is anxiety

A

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

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11
Q

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

A

anaesthesia
postoperative care and treatment
rehabilitation

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12
Q

types of anxiety

A

cognitive
somatic
behaviour
state or trait

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13
Q

cognitive anxiety

A

negative thoughts
worry
rumination

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14
Q

somatic anxiety

A

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

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15
Q

behaviour

A

adaptive
maladaptive

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16
Q

state or trait

A

some higher on trait anxiety

17
Q

risk factors for preoperative state anxiety

A

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

18
Q

more about cognitive anxiety

A

“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

19
Q

consequences of high anxiety

A

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

20
Q

how are patients helped to prepare

A

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

21
Q

4 general types of intervention

A

procedural information
sensory information
coping information
modelling

22
Q

procedural information

A

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

23
Q

sensory information

A

describing sensations that precede, accompany and follow the procedure

24
Q

coping infomration

A

teaching coping methods to minimise the experience of Naomi

25
Q

modelling

A

showing other persons undergoing the procedure without complications

26
Q

coping style and anxiety reduction

A

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

27
Q

monitors

A

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

28
Q

blunters

A

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

29
Q

relaxation

A

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

30
Q

involving training in transferrable skills

A

progressive muscular relaxation
meditation
biofeedback
guided imagery
relaxation tapes

31
Q

what does cognitive behaviorual interventions involve

A

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

32
Q

effectiveness of cognitive behavioural interventions

A

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

33
Q

what is the most frequency used intervention in children n

A

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

34
Q

does psychological preparation work?

A

better prepared patients gave better post op outcomes

35
Q

psychological preparation may be beneficial for

A

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