Coping strategies in anxious surgical patients

Abstract

BackgroundAnaesthesia and surgery provoke preoperative anxiety and stress. Patients try to regain control of their emotions by using coping efforts. Coping may be more effective if supported by specific strategies or external utilities. This study is the first to analyse coping strategies in a large population of patients with high preoperative anxiety.MethodsWe assessed preoperative anxiety and coping preferences in a consecutive sample of 3087 surgical patients using validated scales (Amsterdam Preoperative Anxiety and Information Scale/Visual Analogue Scale). In the subsample of patients with high preoperative anxiety, patients’ dispositional coping style was determined and patients’ coping efforts were studied by having patients rate their agreement with 9 different coping efforts on a four point Likert scale. Statistical analysis included correlational analysis between dispositional coping styles, coping efforts and other variables such as sociodemographic data. Statistical significance was considered for p < 0.05.ResultsThe final analysis included 1205 patients with high preoperative anxiety. According to the initial self-assessment, about two thirds of the patients believed that information would help them to cope with their anxiety (“monitors”); the remainder declined further education/information and reported self-distraction to be most helpful to cope with anxiety (“blunters”). There was no significant difference between these two groups in anxiety scores.Educational conversation was the coping effort rated highest in monitors whereas calming conversation was the coping effort rated highest in blunters. Coping follows no demographic rules but is influenced by the level of education. Anxiolytic Medication showed no reliable correlation to monitoring and blunting disposition. Both groups showed an exactly identical agreement with this coping effort.Demand for medical anxiolysis, blunting or the desire for more conversation may indicate increased anxiety. The use of the internet was independent of the anxiety level and the demand of information.ConclusionConversation with medical staff proved to be the most popular coping strategy. Acknowledgment of the division between information-seeking and blunting-like personalities is central to supporting the patient’s individual coping efforts. Internet access may be the easiest way to support coping today.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1492-5) contains supplementary material, which is available to authorized users.

Ansiedad en el paciente prequirúrgico: un problema que nos afecta a todos

“…Durante la sesión de intervención, se aportó información adicional y se potenciaron las estrategias de afrontamiento, con el propósito de brindar un mejor manejo de la ansiedad antes de la cirugía. Aunque no fue un objetivo de este trabajo evaluar la utilidad de las intervenciones, se encontró que esta intervención permite ampliar la información recibida por los pacientes, con un aparente impacto favorable 3,[11][12][13] .…”

Validation of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

“…However, patients with high information requirements or confrontation coping style still had higher anxiety levels [7,9]. The explanation could be confrontation tended to focus on health-related threatening situations and paying close attention to details, which was an anxiety-provoking way to deal with uncontrollable stressors [23]. Furthermore, the monitoring style was an independent predictor of postoperative pain [24].…”

Évaluation de la communication thérapeutique pour améliorer l’accueil du patient au bloc opératoire: étude d’impact

“…26 Récemment, dans une étude réalisée chez 1 205 patients ayant un haut degré d'anxiété préopératoire, évaluée par échelle visuelle analogique (EVA) et par score APAIS (Amsterdam Preoperative Anxiety and Information Scale), l'approche la plus appréciée par les patients pour réduire celle-ci était la communication avec le personnel soignant. 27 En 2004, l'effet sur l'anxiété préopératoire et la satisfaction des patients d'un programme d'enseignement des anesthésistes sur la communication basé sur des vidéos commentées de visites préanesthésiques et sur des jeux de rôles a été évalué. 28 La durée de ce programme d'enseignement était de vingt heures et a montré une amélioration de la satisfaction des patients concernant la visite préopératoire ainsi qu'une diminution de l'anxiété concernant certains aspects spécifiques de l'anesthésie ou de la chirurgie.…”