W 11 Psychosocial problems of hospitalisation Flashcards
Psychosocial Aspects of Hospitalisation: Physical Environment (5):
- spend whole day in the hospital building
- remain in one place
- patients are likely to be anxious
- more sensitive
- more readily disturbed by changes
Psychosocial Aspects of Hospitalisation: Social Environment (7):
- individual privacy is intruded on in a way which might be found intolerable in normal life
- hospital environment is frequently seen to be drab (colorless), clinically impersonal and cold by patients
- patients are confined to bed and allow a large number of strange people to observe, move and quite often cause pain to various parts of their bodies
- personal space is constantly invaded as part of the daily routine
- daily routine is very likely to be different from life at home and may require considerable adjustment
- normally ppl can come and go as they please, but in hospital they are likely to be totally dependent on others for most basic functions such as washing and feeding
- they are restricted to one place, surrounded by new sights, sounds and smells and above all by totally new people
personal space -
amount of space necessary for optimal social behaviour
Hospitalization f/ patients involves the following social changes (3):
• Invasion of privacy
• Loss of independence and individualism
• Reduced opportunities for social contact
Rachman and Philips (2005): study on hospitalization and its effect on patients. Manifestations of distress (5):
• Fear
• Increased irritability
• Loss of interest in the outside world
• Unhappiness
• Preoccupation with one’s body processes
reasons for that unwillingness to ask for information (5):
• fear of ridicule or reprisal
• feeling that nothing would be done
• not wanting to cause trouble
• not knowing how to complain
• a feeling that complaining or requesting more information was inappropriate behaviour
Ley et al, (2007) where three wards of patients were
assessed in terms of communication satisfaction study:
• Ward 1 – Extra visit every 10 days to discuss medical progress, clarify information, environment, food etc. => 80% satisfied with communication.
• Ward 2 – Extra visit every 10 days to discuss environment, food etc. => 80% satisfied with communication.
• Word 3 – No extra visits. => 48% satisfied with communication
Examples of Stressful Medical Procedures in hospital
• Endoscopy
• Barium X-Rays
• Cardiac catheterization
These procedures could cause serious psychological effect not only because they are 1) uncomfortable and 2) sometimes physically distressing but also 3) carry the threat of uncovering a serious medical condition.
Patients w/ higher pre-surgical levels of stress:
- adverse psychological reactions post-surgically
- more likely to show poorer physical recovery
- will require more analgesia
- will show more post-surgical complications
- tend to recover more slowly with delays in discharge
Psychological Interventions with stressful Medical Conditions (5):
- Psychological Support: These interventions allow the patients to talk, discuss and come to terms with their fears and concerns about the medical event and any associated issue (e.g., short and long term effects of surgery).
- Information Provision: Psychoeducation providing sensory and procedural information.
- Skills training intervention: Learning specific behaviour that will help them cope with specific medical procedures and for helping postoperative recovery (ex: training on breathing and in other aspects of bodily control).
- Modelling: following patients to see on film or videotape other patients undergoing similar investigative procedures treatment or surgery. This is especially helpful in preparing children for surgery.
- Cognitive Behavioural Interventions: Identification of Negative automatic thoughts and thought challenging and modification.
