Effects of preoperative psychological care on postoperative recovery : an exploratory experiment
The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital.
This study was based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups.
Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery.
This process was performed by use of the following steps:
1 The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety.
2. The nurse explored further to find out what was causing the anxiety and what was needed to relieve it.
3. The nurse listened carefully to the patient.
4. The nurse gave an opportunity for expression of individuality.
5. The nurse showed friendliness and reassured the patient.
6. the nurse gave instruction about deep breathing, turning and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety.
The findings of this study are as follows:
1. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following:
a. Length of stay in the hospital 60.7%(31 cases)
b. Condition unimproved or worse 58.8%(30 cases)
c. Postoperative pain and discomfort 56.8%(29 cases)
2. The results of the study regarding the four hypothesis wre as follows:
a. Preoperative psychological care did not reduce the number of analgesics needled during the 48 hour period following surgery.
b. Preoperative psychological care did not reduce the postoperative incidence of vomiting.
c. Preoperative psychological care had no influence on voiding ability following surgery.
d. Preoperative psychological care significantly reduced the number of postoperative days in the hospital.
The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization(improving rate of healing). This study has domonstrated further that the relief of anxiety(emotional distress) is part of the nurses' professional role. In order to be sure psychological care is given it is important to make a nursing care plain which includes a plan for the psychological care needed by the patients. As this care is given it can be checked off by each nurse just as medication and treatment are checked after they are give.