Preoperative education and patient's anxiety

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TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION1

Background of the Study1

Significance of the Study2

Purpose of the Study2

Research Questions3

CHAPTER 2: LITERATURE REVIEW4

Anxiety4

Preoperative Anxiety5

Reducing Preoperative Anxiety8

Preoperative Education11

Physical Climate12

Psychological Climate14

Preoperative Education and Anxiety18

Summary20

REFERENCES21

CHAPTER 1: INTRODUCTION

Background of the Study

The notion of being admitted to the hospital for a surgery can result in causing anxiety for the patients. Due to certain types of surgery, patients spend their post operative period in ICU to allow the monitoring and management of nursing. Many patients have found ICU to be an alien environment and they have established links between the admissions to such environment and resulting in anxieties which some patients suffer. It has become increasingly important for nurse to use a patient centred approach which helps in providing information and education for the treatment they are receiving (Bird, Dickson, 2001, 639). Similarly, their relatives should also be provided information. It has been suggested that encouraging and empowering patients help in exerting a great responsibility and control for health care. The impact of pre operative information has been heavily debated by many researchers as they claim that the psychologically preparing the patients for operation can have a positive influence on the patients post operative conditions. The effects of nurses who undertake pre operative tests by providing pre operative information has been researched and documented by many researchers.

Fear and anxiety are prevalent in anticipation of surgery because of the association of surgery with pain, disfigurement, dependence and death (Giordano, 2006, 15). The extensiveness and uncertainty of the surgery and a diagnosis of cancer all contribute to the increased prevalence and intensity of preoperative anxiety experienced by patients (Blyth, March, Nicholas, 2005, 285). Cognitive anticipation of situational future harm is a crucial component of anxiety (Bradely, Mogg & Lee, 1997) which may lead to changes in thinking such as catastrophizing, changes in working memory capacity, altered concentration and problem solving skills, and interfering with patient's natural ability to cope with and lessen painful experiences (Bergner, 1989, S148). A number of studies have shown a relationship between anxiety and reported pain intensity and pain tolerance postoperatively, likely due to increased vigilance associated with the anxiety state (Arntz, Van, Meijboom, 1991, 547). Researchers also report that patients with higher levels of anxiety (Giordano, 2006, 15), or past experience with inadequate pain control (Danino, Chahraoui, 2005, 379) have higher levels of postoperative pain.

Significance of the Study

Studies indicate that many hospitalized patients do not expect to describe or communicate their pain experience to health professionals; rather they assume health care professionals will know when to treat their postoperative pain (Apfelbaum, Mehta, 2003, 534). A lack of patient resources such as preoperative information or unrealistic or unrealized expectations that health care providers have of patients negatively influences the patient's ability to carry out self-care tasks that are important to them. This is particularly important as postoperative reporting of pain has traditionally been under-reported to health professionals, resulting in under-treatment of postoperative pain (Bird, Dickson, 2001, 639).

Purpose of the Study

The purpose of the study is to ...