Stress of Surgery can be Reduced (PART-I)    
  Vijai P. Sharma, Ph.D

Stress of an illness or injury requiring surgery can have a critical impact on the emotional state of a person.  The surgery and post-operative pain may also produce additional major stress.  Patient education and preparation prior to the surgery and psychological support after surgery can significantly reduce the stress level for patients and their families.  

Education and preparation is necessary because most surgical consent forms are highly technical and beyond comprehension for most people.  Sixty percent people don't even bother to read them.  Most of us just sign on the dotted line, and after signing, we are scared even more.  Stress is so high at that time that even when surgical information is presented in simple words, patients only remember 30 to 50% of it.  

Hospitalization before or after surgery has become short and infrequent, thanks to managed care system.  More than half of all surgical procedures are done at the outpatient level.  Patients are often admitted and discharged the same day even with major operations.  Surgeons and members of the hospital staff don't get an opportunity to sit down with their patients, listen to their inner most fears, reassure them or give them the  guidance they need.  

A survey done by American Medical Association reveals that only 31% of the patients feel that physicians spend enough time with their patients.  The average amount of time a general practitioner spends with a patient is 7 minutes.  Most doctors interrupt their patients within the first 18 seconds of the description of their symptoms.  

Why not employ therapists who are trained to listen?  They can fill in the gap.  Therapists with some coaching can guide patients at their own pace, level of understanding and readiness.  Thus, patients and their families may experience less stress and uncertainty.  
Studies have shown that patients' worries about surgeries are often not addressed.  The three most common worries reported by patients facing surgery: 1. How much pain will I experience after surgery? 2. What if the surgeon makes a mistake?  3. Will I survive the surgery?  These worries can result in significant distress.  The ensuing depression and anxiety can negatively influence recovery.  

Psychological support after surgery is required because psychological stress can weaken the healing process.  For instance, research has shown that people who experience more everyday life stresses had a more difficult recovery from surgery.  In another study, researchers found that the wounds of women who were highly stressed took about nine days longer to heal than those who were less stressed.  
Ongoing psychological support during the recovery period can help to manage the stress that patients and families experience while adjusting to post-surgery life changes.  Psychological support also helps patients to manage their pain better.  

More than half of surgical patients are offered inadequate pain control measures after surgery.  This negatively influences their healing and recovery.  Patients who are provided adequate pain management become more active, heal faster, experience less distress, and feel more satisfied with the entire surgical process.  

Each year, 50 million surgeries are performed in our country.  More than 200 studies with thousands of patients have shown that psychological preparation before, and psychological support after the surgery provide the following benefits: reduced distress before and after surgery; reduced need for pain medications; less post-operative complications; faster recovery; higher level of daily functioning and faster return to work.  
Eighty percent of the surgeries in our country are not sudden, unexpected or unplanned.  These surgeries are scheduled ahead of time.  There is 
plenty of time for psychological preparation, if we just put our will behind it.      

Such psychological services are safe and can save hundreds of millions of dollars in medical cost.  Where are you dear health cost managers?  Are you listening?         

   In a future article, I will discuss how you can reduce the surgery-related stress for yourself or of your family member.    


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