Mitchell, MJ 'Psychological preparation for patients undergoing day surgery' , Ambulatory Surgery .

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Abstract

Surgical and anaesthetic intervention associated with day surgery over the last 10 years has greatly improved although the position of psychological preparation has remained virtually unchanged [Ridgeway V, Mathews A. Brit J Clin Psychol 1982;21(4):271–80; Salmon P. Clin Psychol Rev 1992;12(7):681–704; Jarrett PEM. Surgery 1997;15(4):94–6]. Information provision, an essential component of anxiety management, has recently been highlighted as a considerable problem for day surgery patients [Mitchell MJ. Ambul Surg 1999a;7(2):65–73; Mitchell MJ. Ambul Surg 1999b;7(2):75–100]. Contemporary evidence has suggested that the ability to cope with a stressful event can be improved if the preparatory information is matched with the individual’s coping style, i.e. provision is made for patients with a desire for maximum levels of information (vigilant coper) and for patients with a desire for minimal levels of information (avoidant coper) [Krohne HW, Slangen K, Kleemann PP. Psychol Health 1996;11(3):315–30]. A convenience sample of 120 patients undergoing non life-threatening, gynaecological laparoscopic day surgery was contacted prior to surgery and randomly assigned into two groups. Group I received an extended information booklet, group II a simple booklet and all received a coping style questionnaire. Immediately prior to surgery patients with a desire for maximum levels of information (vigilant copers) who had received the simple information were more anxious than the vigilant copers who had received the extended information (0.013, P≤5%). Irrespective of coping style, participants who received the simple information contacted their general practitioner more than participants who had received the extended information (0.008, P≤1%). Incorporation of the results into day surgery nursing practices are discussed and a new, pioneering anxiety management plan providing explicit guidance is outlined.

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