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Psychological preparation for invasive medical and dental procedures

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Abstract

Psychological preparation for invasive medical and dental procedures has been based on the rationale that high levels of preprocedural fear are detrimental to patients' subsequent adaptation. After a brief survey of the theoretical and empirical evidence pertaining to this rationale, the major psychological approaches designed to alleviate preprocedural concern and enhance recovery are discussed. Outcome studies that have employed informative, psychotherapeutic, modeling, behavioral, cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated. Although the research suggests that each of these approaches can be effective, such serious methodological problems as heterogeneity of sample characteristics, limited range of outcome measures, and lack of manipulation checks prevent definitive conclusions. Legal-ethical concerns and the issue of cost effectiveness are also considered. Suggestions are made for future research and theory development.

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References

  • Abram, H. S. (1969). Psychotherapy in renal failure.Curr. Psychiat. Ther. 9: 86–92.

    Google Scholar 

  • Aiken, L. H., and Henrichs, T. F. (1971). Systematic relaxation as a nursing intervention technique with open heart surgery patients.Nurs. Res. 20: 212–217.

    Google Scholar 

  • Andrew, J. M. (1970). Recovery from surgery, with and without preparatory instruction, for three coping styles.J. Personal. Soc. Psychol. 40: 264–271.

    Google Scholar 

  • Auerbach, S. M. (1973). Trait-state anxiety and adjustment to surgery.J. Consult. Clin. Psychol. 40: 264–271.

    Google Scholar 

  • Auerbach, S. M., Kendall, P. C., Cuttler, H. F., and Levitt, N. R. (1976). Anxiety, locus of control, type of preparatory information, and adjustment to dental surgery.J. Consult. Clin. Psychol. 44: 809–818.

    Google Scholar 

  • Baldwin, D. C. (1966). An investigation of psychological and behavioral responses to dental extraction in children.J. Dent. Res. 45: 1637–1651.

    Google Scholar 

  • Bandura, A. (1977).Social Learning Theory, Prentice-Hall, Englewood Cliffs, N.J.

    Google Scholar 

  • Bernstein, N. R. (1976).Emotional Care of the Facially Burned and Disfigured, Little, Brown, Boston.

    Google Scholar 

  • Bonilla, K. B., Quigley, W. F., and Bowers, W. F. (1961). Experiences with hypnosis on a surgical service.Milit. Med. 126: 364–370.

    Google Scholar 

  • Boyd, I., Yeager, M., and McMillan, M. (1973). Personality styles in the postoperative course.Psychosom. Med. 35: 23–40.

    Google Scholar 

  • Carnevali, D. L. (1966). Preoperative anxiety.Am. J. Nurs. 66: 1536–1538.

    Google Scholar 

  • Cassell, S. (1965). Effect of brief puppet therapy upon the emotional responses of children undergoing cardiac catheterization.J. Consult. Clin. Psychol. 29: 1–8.

    Google Scholar 

  • Chapman, J. S. (1970). Effects of different nursing approaches on psychological and physiological responses.Nurs. Res. Rep. 5: 1–7.

    Google Scholar 

  • Cohen, F., and Lazarus, R. S. (1973). Active coping processes, coping dispositions, and recovery from surgery.Psychosom. Med. 35: 375–389.

    Google Scholar 

  • Corah, N. L. (1973). Effect of perceived control on stress reduction in pedodontic patients.J. Dent. Res. 52: 1261–1264.

    Google Scholar 

  • Corah, N. L., Bissell, G. D., and Illig, S. J. (1978). Effect of perceived control on stress reduction in adult dental patients.J. Dent. Res. 57: 74–76.

    Google Scholar 

  • Corah, N. L., Gale, E. N., and Illig, S. J. (1979). Psychological stress reduction during dental procedures.J. Dent. Res. 58: 1347–1351.

    Google Scholar 

  • Dimsdale, J. E., and Moss, J. (1980). Short-term catecholamine response to psychological stress.Psychosom. Med. 42: 493–497.

    Google Scholar 

  • Doberneck, R. C., Griffen, W., Papermaster, A. A., Bonello, F., and Wangensteen, O. H. (1959). Hypnosis as an adjunct to surgical therapy.Surgery 46: 299–304.

    Google Scholar 

  • Drew, F. L., Moriarty, R. W., and Shapiro, A. P. (1968). An approach to the measurement of the pain and anxiety responses of surgical patients.Psychosom. Med. 30: 826–837.

    Google Scholar 

  • Dumas, R. G., and Johnson, B. A. (1972). Research in nursing practice: A review of five clinical experiments.Int. J. Nurs. Stud. 9: 137–149.

    Google Scholar 

  • Dumas, R. G., and Leonard, R. C. (1963). The effect of nursing on the incidence of postoperative vomiting.Nurs. Res. 12: 12–15.

    Google Scholar 

  • Egbert, L. D., Battit, G. D., Turndorf, H., and Beecher, H. K. (1963). The value of the preoperative visit by an anesthetist.JAMA 185: 553–555.

    Google Scholar 

  • Egbert, L. D., Battit, G. D., Welch, C. E., and Bartlett, M. K. (1964). Reduction of postoperative pain by encouragement and instruction of patients.N. Engl. J. Med. 270: 825–827.

    Google Scholar 

  • Ferguson, B. F. (1979). Preparing young children for hospitalization: A comparison of two methods.Pediatrics 64: 656–664.

    Google Scholar 

  • Field, P. B. (1974). Effects of tape-recorded hypnotic preparation for surgery.Int. J. Clin. Exp. Hypnos. 22: 54–61.

    Google Scholar 

  • Finesilver, C. (1978). Preparation of adult patients for cardiac catheterization and coronary cineangiography.Int. J. Nurs. Stud. 15: 211–221.

    Google Scholar 

  • Flaherty, G. G., and Fitzpatrick, J. J. (1978). Relaxation technique to increase comfort level of postoperative patients: A preliminary study.Nurs. Res. 27: 352–355.

    Google Scholar 

  • Fortin, F., and Kirouac, S. (1976). A randomized controlled trial of preoperative patient education.Int. J. Nurs. Stud. 13: 11–24.

    Google Scholar 

  • Fredericks, L. E. (1978). Teaching of hypnosis in the overall approach to the surgical patient.Am. J. Clin. Hypnos. 20: 175–183.

    Google Scholar 

  • Ghose, L. J., Giddon, D. B., Shiere, F. R., and Fogels, H. R. (1969). Evaluation of sibling support.J. Dent. Child. 36: 35–49.

    Google Scholar 

  • Graham, L. E., and Conley, E. M. (1971). Evaluation of anxiety and fear in adult surgical patients.Nurs. Res. 20: 113–122.

    Google Scholar 

  • Greene, W. A., Conron, G., Schalch, D. S., and Schreiner, B. F. (1970). Psychologic correlates of growth hormone and adrenal secretory responses of patients undergoing cardiac catheterization.Psychosom. Med. 32: 599–614.

    Google Scholar 

  • Healy, K. M. (1968). Does preoperative instruction make a difference?Am. J. Nurs. 68: 62–67.

    Google Scholar 

  • Hedberg, A. G., and Schlong, A. (1973). Eliminating fainting by school children during mass inoculation clinics.Nurs. Res. 22: 352–353.

    Google Scholar 

  • Herbertt, R. M., and Innes, J. M. (1979). Familiarization and preparatory information in the reduction of anxiety in child dental patients.J. Dent. Child. 46: 319–323.

    Google Scholar 

  • Hilgard, E. R., and Hilgard, J. R. (1975).Hypnosis in the Relief of Pain, Kaufman, Los Altos, Calif.

    Google Scholar 

  • Janis, I. L. (1958).Psychological Stress: Psychoanalytic and Behavioral Studies of Surgical Patients, Wiley, New York.

    Google Scholar 

  • Janis, I. L., and Mann, L. (1977).Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment, Macmillan, New York.

    Google Scholar 

  • Johnson, J. E. (1966). The influence of purposeful nurse-patient interaction on the patient's postoperative course. InExploring Progress in Medical-Surgical Nursing Practice, American Nurses' Association, New York.

    Google Scholar 

  • Johnson, J. E. (1975). Stress reduction through sensation information. In Sarason, E. G., and Spielberger, C. D. (eds.),Stress and Anxiety, Vol. 2, Wiley, New York.

    Google Scholar 

  • Johnson, J. E., and Leventhal, H. (1974). Effects of accurate expectations and behavioral instructions on reactions during a noxious medical examination.J. Personal. Soc. Psychol. 29: 710–718.

    Google Scholar 

  • Johnson, J. E., Morrisey, J. F., and Leventhal, H. (1973). Psychological preparation for an endoscopic examination.Gastrointest. Endosc. 19: 180–182.

    Google Scholar 

  • Kaplan De-Nour, A. (1970). Psychotherapy with patients on chronic haemodialysis.Br. J. Psychiat. 116: 207–215.

    Google Scholar 

  • Kendall, P. C., Williams, L., Pechacek, T. F., Graham, L. E., Sisslak, C., and Herzoff, N. (1979). Cognitive-behavioral and patient education interventions in cardiac catheterization procedures: The Palo Alto Medical Psychology Project.J. Consul. Clin. Psychol. 47: 49–58.

    Google Scholar 

  • Kessler, H. W. (1977). Preoperative education and the informed patient.J. Leg. Med. 5: 46–47.

    Google Scholar 

  • Kinney, M. R. (1977). Effects of preoperative teaching upon patients with differing modes of response to threatening stimuli.Int. J. Nurs. Stud. 14: 49–59.

    Google Scholar 

  • Klorman, R. Hilpert, P., Michael, R., LaGana, C., and Sveen, C. (1980). Effects of coping and mastery modeling on experienced and inexperienced pedodontic patients' disruptiveness.Behav. Ther. 11: 156–168.

    Google Scholar 

  • Kohlenberg, R., Greenberg, D., Reymore, L., and Hass, G. (1972). Behavior modification and the management of mentally retarded dental patients.J. Dent. Child. 39: 61–66.

    Google Scholar 

  • Kolouch, F. T. (1962). Role of suggestion in surgical convalescence.Arch. Surg. 85: 304–315.

    Google Scholar 

  • Kornfeld, D. S., Heller, S. S., Frank, D. A., and Moskowitz, R. (1974). Personality and psychological factors in postcardiotomy delirium.Arch. Gen. Psychiat. 31: 249–253.

    Google Scholar 

  • Langer, E. J., Janis, I. E., and Wolfer, J. A. (1975). Reduction of psychological stress in surgical patients.J. Exp. Soc. Psychol. 11: 155–165.

    Google Scholar 

  • Layne, O. L., and Yudofsky, S. C. (1971). Postoperative psychosis in cardiotomy patients: The role of organic and psychiatric factors.N. Engl. J. Med. 284: 518–520.

    Google Scholar 

  • Lazarus, H. R., and Hagens, J. H. (1968). Prevention of psychosis following open heart surgery.Am. J. Psychiat. 124: 1190–1195.

    Google Scholar 

  • Leigh, J. M., Walker, J., and Janaganathan, P. (1977). Effect of preoperative anesthetic visit on anxiety.Br. Med. J. 2: 987–989.

    Google Scholar 

  • Lewis, M. S., Gottesman, D., and Gutstein, S. (1979). The course and duration of crisis.J. Consult. Clin. Psychol. 47: 128–134.

    Google Scholar 

  • Ley, P. (1977). Psychological studies of doctor-patient communication. In Rachman, S. (ed.),Contributions to Medical Psychology, Vol. 1, Pergamon Press, New York.

    Google Scholar 

  • Lindeman, C. A., (1972). Nursing intervention with the pre-surgical patient.Nurs. Res. 21: 196–209.

    Google Scholar 

  • Lindeman, C. A., and Aernam, B. V. (1971). Nursing intervention with the presurgical patient: The effects of structured and unstructured preoperative teaching.Nurs. Res. 20: 319–332.

    Google Scholar 

  • Lindeman, C. A., and Stetzer, S. L. (1973). Effect of preoperative visits by operating room nurses.Nurs. Res. 22: 4–16.

    Google Scholar 

  • Loomis, W. G. (1970). Management of children's emotional reactions to severe body damage (burns).Clin. Pediat. 9: 362–367.

    Google Scholar 

  • Ludlam, L. E. (1978).Informed Consent, American Hospital Association, Chicago.

    Google Scholar 

  • Machen, J. B., and Johnson, R. (1974). Desensitization, model learning, and the dental behavior of children.J. Dent. Res. 53: 83–87.

    Google Scholar 

  • Martin, J. B., Shaw, M. A., and Taylor, P. P. (1977). The influence of prior surgical experience on the child's behavior at the initial dental visit.J. Dent. Child. 44: 443–447.

    Google Scholar 

  • McAmmond, D. M., Davidson, P. O., and Kovitz, D. M. (1971). A comparison of the effects of hypnosis and relaxation training on stress reactions in a dental situation.Am. J. Clin. Hypnos. 13: 233–242.

    Google Scholar 

  • Meichenbaum, D. (1977).Cognitive Behavior Modification, Plenum, New York.

    Google Scholar 

  • Melamed, B. G., and Siegel, L. J. (1975). Reduction of anxiety in children facing hospitalization and surgery by use of filmed modeling.J. Consult. Clin. Psychol. 43: 511–521.

    Google Scholar 

  • Melamed, B. G., Hawes, R. R., Heiby, E., and Glick, J. (1975a). Use of filmed modeling to reduce uncooperative behavior of children during dental treatment.J. Dent. Res. 54: 979–801.

    Google Scholar 

  • Melamed, B. G., Weinstein, D., Hawes, R., and Katin-Borland, M. (1975b). Reduction of fear-related dental management problems with use of filmed modeling.J. Am. Dent. Assoc. 90: 822–826.

    Google Scholar 

  • Melamed, B. G., Meyer, R., Gee, C., and Soule, L. (1976). The influence of time and type of preparation on children's adjustment to hospitalization.J. Pediat. Psychol. 1: 31–37.

    Google Scholar 

  • Melamed, B. G., Yurcheson, R., Fleece, L., Hutcherson, S., and Hawes, R. (1978). Effects of filmed modeling on the reduction of anxiety-related behaviors in individuals varying in level of previous experience in the stress situation.J. Consult. Clin. Psychol. 46: 1357–1467.

    Google Scholar 

  • Miller, S. P., and Shada, E. A. (1978). Preoperative information and recovery of open-heart surgery patients.Heart Lung 7: 487–493.

    Google Scholar 

  • Molinaro, J. R. (1978). The social fate of children disfigured by burns.Am. J. Psychiat. 135: 979–980.

    Google Scholar 

  • Newton, J. R., and Reading, A. E. (1977). The effects of psychological preparation on pain at intrauterine device insertion.Contraception 16: 523–532.

    Google Scholar 

  • Peterson, L., and Ridley-Johnson, R. (1980). Pediatric hospital response to survey on prehospital preparation for children.J. Pediat. Psychol. 5: 1–7.

    Google Scholar 

  • Peterson, L., and Shigetomi, C. (1981). The use of coping techniques to minimize anxiety in hospitalized children.Behav. Ther. 12: 1–14.

    Google Scholar 

  • Rayder, M. (1979). Problem: A new nurse asks why preoperative teaching isn't done. Three answers from experience.Am. J. Nurs. 10: 1992–1995.

    Google Scholar 

  • Ryan, D. (1975). A questionnaire survey of preoperative fears.Br. J. Clin. Pract. 29: 3–6.

    Google Scholar 

  • Schmitt, F. E., and Wooldridge, P. J. (1973). Psychological preparation of surgical patients.Nurs. Res. 22: 108–116.

    Google Scholar 

  • Shipley, R. H., Butt, J. H., Horwitz, B., and Farbry, J. E. (1978). Preparation for a stressful medical procedure: Effect of stimulus pre-exposure and coping style.J. Consult. Clin. Psychol. 46: 499–507.

    Google Scholar 

  • Shipley, R. H., Butt, J. H., and Horwitz, E. A. (1979). Preparation to re-experience a stressful medical examination: Effect of repetitious videotape exposure and coping style.J. Consult. Clin. Psychol. 47: 485–492.

    Google Scholar 

  • Siegel, L. J., and Peterson, L. (1980). Stress reduction in young dental patients through coping skills and sensory information.J. Consult. Clin. Psychol. 48: 785–787.

    Google Scholar 

  • Siegel, L. J., and Peterson, L. (1981). Maintenance effects of coping skills and sensory information on young children's response to repeated dental procedures.Behav. Ther. 12: 530–535.

    Google Scholar 

  • Sime, A. M. (1976). Relationship of preoperative fear, type of coping, and information received about surgery to recovery from surgery.J. Personal. Soc. Psvchol. 34: 716–724.

    Google Scholar 

  • Streltzer, J., and Leigh, H. (1978). Psychological preparation for surgery: The usefulness of a preoperative psychotherapeutic interview.Hawaii Med. J. 37: 139–142.

    Google Scholar 

  • Surman, O. S., Hackett, T. P., Silverberg, E. L., and Behrendt, D. M. (1974). Usefulness of psychiatric intervention in patients undergoing cardiac surgery.Arch. Gen. Psychiat. 30: 830–835.

    Google Scholar 

  • Titchener, J. L., Zwerling, I., Gottschalk, L. A., Levine, M., Silver, H., Cowett, A., Cohen, S., and Culbertson, W. (1957). Consequences of surgical illness and treatment.A.M.A. Arch. Neurol. Psychiat. 77: 623–634.

    Google Scholar 

  • Venham, L. L. (1977). T.V. helps young patients relax.Dent. Survey. 53: 98.

    Google Scholar 

  • Vernon, D. T. W. (1973). Use of modeling to modify children's responses to a natural potentially stressful situation.J. Appl. Psychol. 58: 351–356.

    Google Scholar 

  • Vernon, D. T. W., and Bigelow, D. W. (1974). Effect of information about a potentially stressful situation on responses to stress impact.J. Personal. Soc. Psychol. 29: 50–59.

    Google Scholar 

  • Vernon, D. T. W., Foley, J. M., Sipowicz, R. R., and Schulman, J. L. (1965).The Psychological Responses of Children to Hospitalization and Illness. Charles C. Thomas, Springfield, Ill.

    Google Scholar 

  • Visintainer, M. A., and Wolfer, J. A. (1975). Psychological preparation for surgical pediatric patients: The effect on children's and parents' stress responses and adjustment.Pediatrics 56: 187–202.

    Google Scholar 

  • Wakeman, R. J., and Kaplan, J. Z. (1978). An experimental study of hypnosis in painful burns.Am. J. Clin. Hypnos. 21: 3–12.

    Google Scholar 

  • Weiler, S. M. C. (1968). Postoperative patients evaluate preoperative instructions.Am. J. Nurs. 68: 1465–1467.

    Google Scholar 

  • White, W. C., Akers, J., Green, J., and Yates, D. (1974). Use of imitation in the treatment of dental phobia in early childhood: A preliminary report.J. Dent. Child. 41: 106–110.

    Google Scholar 

  • Williams, J. G., Jones, J. R., Workhoven, M. N., and Williams, B. (1975). The psychological control of preoperative anxiety.Psychophysiology 12: 50–54.

    Google Scholar 

  • Williams, P. D. (1980). Preparation of school-age children for surgery: A program in preventive pediatrics-Philippines.Int. J. Nurs. Stud. 17: 107–119.

    Google Scholar 

  • Wilson, J. F. (1981). Behavioral preparation for surgery: Benefit or harm?J. Behav. Med. 4: 79–102.

    Google Scholar 

  • Wolfer, J. A. (1973). Definition and assessment of surgical patients' welfare and recovery.Nurs. Res. 22: 394–401.

    Google Scholar 

  • Wolfer, J. A., and Davis, C. E. (1970). Assessment of surgical patients' preoperative emotional condition and postoperative welfare.Nurs. Res. 19: 402–414.

    Google Scholar 

  • Wolfer, J. A., and Visintainer, M. A. (1975). Pediatric surgical patients' and parents' stress responses and adjustment.Nurs. Res. 24: 244–255.

    Google Scholar 

  • Wolfer, J. A., and Visintainer, M. A. (1979). Pre-hospital psychological preparation for tonsillectomy patients: Effects on children's and parents' adjustment.Pediatrics 64: 646–655.

    Google Scholar 

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  1. Memphis State University, 38111, Memphis, Tennessee

    Karen O. Anderson

  2. 6005 Park Avenue, Suite 903, 38119, Memphis, Tennessee

    Frank T. Masur III

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Private Practice, Memphis, Tennessee.

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Anderson, K.O., Masur, F.T. Psychological preparation for invasive medical and dental procedures. J Behav Med 6, 1–40 (1983). https://doi.org/10.1007/BF00845274

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