Topic 15: psychosocial aspects of hospitalization

Question 1

What is the recent trend of hospitalization?

Answer 1

• Increasing tendency for hospital treatments for any and all problems other than psychiatric

Question 2

Explain the hospitalization experience for doctors and patients

Answer 2

• Doctors: aim of work based around detecting patient problems and selecting appropriate treatment = patient is there and all facilities present = good experience
• Patients: more complicated than staff as limitations in hospital life = psychosocial disruption = may be severe to need psychiatric help

Question 3

Explain the psychological effects of hospitalization

Answer 3

• Range of lengths of stays in hospital = experiences vary = difficult to generalize impact of hospitalization
  FACTORS EFFECTING:
• Physical environment
• Social environment

Question 4

Describe the factor of physical environment

Answer 4

• Big change to their homes
• Very few studies investigating physical environment on patient conditions
• More knowledge of spatial needs of animals in zoos = die if too much/little space
• Architect building hospitals guided by people not hospitalized = designers or hospital personnel not patients
• Changing of environment = likely to cause anxiety + more sensitivity

Question 5

Describe the factor of social environment

Answer 5

• Privacy intruded compared to normal life = confined to bed = large number of strangers in each other’s space
• Compared to sense of personal space in outside world invaded in hospitalization = staff in and put moving you + touching you
• Routine predetermined = big adjustment
• Study shows home-treated less psychosocial distress than hospitalized = defined routine decide for self + own environment + not dependant on others for basic functions = feel in control

Question 6

What causes psychological reactions as a result of hospitalization?

Answer 6

• Due to social changes:
  1) Invasion of privacy
  2) Loss of independence + individualism
  3) Reduced social contact

Question 7

Describe psychological reactions as a result of hospitalization

Answer 7

• Study carried out by Rachman + Philips = 5 types of distress
  1) Fear
  2) Increased irritability
  3) Loss of interest in outside world
  4) Unhappiness
  5) Preoccupied with own body processes
• Anxiety is related to uncertainty concerning nature of condition
• Study also suggests need for social reassurance from family + professionals

Question 8

Describe the communication aspect of hospitalization

Answer 8

• Patients dissatisfied despite rating technical skills highly
• 40-50% criticize communication aspect
• Studies where professionals feel they put extra effort to communicate however patients still critical = gap in communication
• May be due to unwillingness of patients to ask for info

Question 9

Why may patients be unwilling to ask doctors for information?

Answer 9

• Fear of ridicule
• Feeling would be done
• Not want to cause trouble
• Feeling that complaining or asking info is inappropriate behavior

Question 10

Describe the studies about the communication aspect of hospitalization

Answer 10

• Studies show good explanations of what admission entails reduce patient anxiety for painful + distressing treatments that can uncover serious conditions e.g. endoscopy + cardiac catheterization + barium x-ray
• Study by Ley = 3 wards communication satisfaction assessed
  1) Extra visits every 10 days + discuss medical progress/clarify info + complaints about environment/food
  2) Extra visits every 10 days + discuss complaints about environment/food
  3) No extra visits
• RESULTS:
  1) 80% satisfied
  2) 41% satisfied
  3) 48% satisfied

Question 11

Describe the psychological effect of surgery

Answer 11

• Depending on procedure + condition + likely outcome
• Also depends on patient expectations + coping style
• Patient reaction to the procedure can influence outcome + recovery
• Patients with high pre-surgical stress = adverse psychological reactions post-surgery = poor recovery

Question 12

5 types of psychological interventions

Answer 12

1) Psychological support = discuss fears + come to terms with issue
2) Provide information = sensory or procedural info
3) Skills training = stress coping techniques
4) Modelling = films of other similar patient
5) Cognitive behavior techniques = identify how emotion making you feel + challenge