Stressresponses arise when exposures to adverse life experiences outstrip protective psychosocial resources, leading to a failure of coping and adaptation – Lazarus RS. Stress and Emotion: A New Synthesis, 1st ed. London: Free Association Books; 1999
Preparing Patient for Unpleasant Medical Procedures (Personal and Professional Development -Year 3)
Overview
Preparing patients psychologically for surgery and other medical procedures is a vital aspect of medicine and has direct implications for their recovery. Research suggests a strong link between levels of anxiety and time taken to recover from surgery. This lecture will examine these issue and ask what psychologists can do to reduce the stress of medical procedures.
Objectives
· Identification of the need to provide psychological care for patients undergoing stressful medical procedures
· Outline factors that influence patient coping
· Describe the impact of anxiety on post-surgical recovery times
· Demonstrate practical skills in preparing patients for unpleasant investigative and therapeutic procedures.
Further reading
Johnston M and Wallace L. (eds) (1990) Stress and Medical Procedures Oxford: Oxford Medical Publications.
Ludwick-Rosenthal, R and Neufeld, R. (1988) Stress management during noxious medical procedures. Psychological Bulletin 104, 326-342.
GMC – Guidelines on Personal Beliefs and Medical Practice
Preparation for stressful medical procedures and person × treatment interactions
Emotional Impact of the Medical Examination for Child Sexual Abuse
Providing Children With Information About Forthcoming Medical Procedures: A Review and Synthesis
Behavioral Pediatrics: Research and Practice – Preparation for Surgery & Medical Procedures
UCSF Children’s Hospital – Emotional Aspects of a Bone Marrow Transplant
A feeling of being out of control pervades the litigation experience. Coping is a complex process in which regaining mastery is central. Clinical experience reveals that if physicians are shown strategies that they can apply “in their own way,” regaining mastery by their own efforts, they feel better about themselves. Ideally, the more rapidly this is achieved, the better because chronic stress can lead to further disability. Rapid restoration of emotional equilibrium is suggested as a way of reducing further risk because risk for an additional claim doubles for physicians who have a claim in the previous year.6
Useful coping strategies can be conceptualized in three categories7:
Social Support
As with any major life event, physicians need to share their feelings and reactions with someone who is trustworthy, understanding, and sensitive to their concerns during what is, for some, the most stressful period of their entire life.8 Legal counsel will advise not to talk about the details of the case to anyone. This is good legal advice, based on fears that the physician may say something that will potentially jeopardize the case. It is not, however, good psychological advice. Most of us can derive comfort confiding in an associate, legal counsel, our spouse, office staff, or a respected senior physician, all of whom can appreciate the concerns of legal counsel.
Restoring Mastery
The entire process challenges physicians’ feelings of mastery as it seeks to establish who was in control of, and therefore, responsible for, the events in question. Sued physicians often experience a “see-saw effect”: up one week and down another with alternating feelings of confidence and low self-esteem, of assurance and doubt. They may not be able to control the pace or even the outcome of their case, but engaging in activities that make them feel in better control of both their personal and professional lives and participating actively in their defense will help restore their sense of balance.
Changing the Meaning of the Event
The malpractice charge suggests that we are incompetent and, therefore, “bad doctors.” We need to change this perception and to develop inner peace and good feelings about ourselves. It helps to recognize that litigation is about compensation, not competence, that those who are sued are often the best in their field in working with the sick and high-risk patients, and that most physicians are eventually vindicated.
Physician Litigation Resource Centre – COPING WITH A MEDICAL MALPRACTICE SUIT
Successful treatment and continued care are not limited to purely medical factors. Ultimately, emotional well-being is the most important element for you to nurture. Having a good support system is essential to emotional health. This may include a network of close friends and family and/or a group that shares your religious beliefs.
It is also important to reduce stress and negative feelings. Instead, focus on maintaining a positive mindset, seeking new challenges and exploring new pursuits. The patient who engages in activities that bring enjoyment and satisfaction benefits most in life. This is particularly true during times of great difficulty. Positive influences produce inner strength and optimism. This enables a patient to cope successfully with challenging situations. My positive mindset has been essential to my emotional and physical well-being.
Early Intervention – Positive Outcome: Experiences of a Melanoma Patient
Surgical Patients Need Us: Psychological Preparation Improves Outcomes
Distress, coping, and blogging : comparing new MySpace users by their intention to blog
The psychological precipitants of transient postpartum depression: A review
“Rob the average man of his life illusion, and you rob him of his happiness at the same stroke…” Herik Ibsen
… The psychological side to injury and healing is paramount to physical rehabilitation and imperative to the art of practicing “good” medicine. What, then, does it mean to “experience” physical disability on the emotional level? How does one traverse the experience to arrive on the other side, not O.K. with the event but O.K. with oneself? This article provides a general overview of the psychological “experience” of physical disability, from encountering disillusionment, through the work of adaptation, to treatment considerations focusing on positive emotional recovery. … The article aims to signify the importance of psychological factors in healing and recovery while challenging the practitioner-reader to evaluate his or her own perceptions of, tolerances for, and attention to the “human drama” of emotion.
The “Psychological Emergency” Of New Onset Physical Disability And Deformity
Behavior-Cognitive Protocol to Reduce Anxiety during a Magnetic Resonance Examination
Hope: An Emotion and a Vital Coping Resource Against Despair (note – has list of citations at the back including lots of relevant papers by the author)
Contributions of leisure to coping with daily hassles in university students’ lives
Stress and Emotion: A New Synthesis
Emerald FullText Article : A comprehensive system for leader evaluation and development – References – (whole paper)
Impact of traumatic events on coping strategies and their effectiveness among Kurdish children
The measurement of coping in achievement situations: an international comparison
A CRITICAL SURVEY OF COPING INSTRUMENTS
Emotional Competency – Coping (Responding to Loss)
See also http://www.emotionalcompetency.com/, http://www.coping.org/, Google: repression-sensitization in coping with threatening information
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