Psychological interventions in the pre-surgical period

Information and its impact on satisfaction among surgical patients

This study investigates the association between patient characteristics, reported problems with obtaining information and global evaluations of care among surgical patients. Using data from a large scale study of hospital care, a factor analysis of 30 information-relevant items was conducted with data from a sample of 3602 surgical patients; and correlation and multiple regression analyses were conducted to identify the relationships among information, patient characteristics and global evaluations of care. Path analysis was also used to determine the extent to which perceived control mediates the information evaluation relationship. Four information factors were identified: surgical information, recovery information, general information and sensory information, and each was significantly related to global evaluations. Desire for involvement interacted with information received in determining patients' evaluations; and partial support was found for perceived control as a mediator of the information evaluation link. The data indicate that the relationship between information and evaluations of quality is generalizable across patients, conditions and hospitals; and should be defined more broadly to include that which is given by a variety of providers. to family, and about medications and home recovery. Desire for involvement and perceived control must also be considered in understanding the value and impact of information.

The efficacy of preparation for surgery and invasive medical procedures

In this article, we review published research evaluating the effectiveness of preparation interventions for adult patients undergoing surgery or invasive medical procedures. This review is meant to assist practitioners in selecting or designing an intervention. In general, preparation interventions have been shown to be effective across a range of health outcomes. However, the relative efficacy of different strategies has been difficult to assess, as has the contribution of several patient variables to outcome. Considering interventions used prior to surgery, there is not a clear demonstration of effectiveness, in part because large numbers of outcome variables have been used. In contrast, the preparation intervention literature using adult patients facing invasive medical procedures has shown the relative superiority of modeling procedures and coping strategies. In this review, we consider methodological weaknesses in previous research, and make suggestions for improving future research.

Psychosocial impact of cesarean section on the family: a literature review

This paper reviews the literature linking cesarean section with maternal, paternal and infant/child/familial psychosocial impact. Cesarean section is discussed as both major surgery, with concomitant physical and psychosocial ramifications, and as an increasingly and routinely utilized method of birthing. Also considered are factors associated with the current high cesarean birthrate, as well as socio-cultural based factors contributing to varying parental conceptualizations and expectations of birthing. Empirical research published during the past 14 years associates cesarean section with adverse maternal and paternal psychosocial outcome and with possible negative consequences for the infant/child. Weaknesses/flaws of psychosocial impact studies are discussed, including timing and location of data collection, sample bias, and the difficulties of analyzing vast arrays of complex variables. Enumeration of both physical/environmental variables and psychosocial/cultural variables of maternal psychosocial impact are included. A number of these variables form a profile of a woman at relatively high risk of adverse psychosocial outcome. This profile is useful in identification of approaches and strategies for the prevention of adverse psychosocial outcome as well as in the identification of women who might benefit from focused perinatal psychotherapeutic services. The importance of psychotherapeutic services for cesarean families, including local, national and international cesarean support networks, is discussed. Emphasis is given to the importance of increased awareness of psychosocial issues and of current research on the part of medical care providers and health policy experts.