Psychological preparation for patients undergoing day surgery

Surgical and anaesthetic intervention associated with day surgery over the last 10 years has greatly improved although the position of psychological preparation has remained virtually unchanged [Ridgeway V, Mathews A. Brit J Clin Psychol 1982;21(4):271–80; Salmon P. Clin Psychol Rev 1992;12(7):681–704; Jarrett PEM. Surgery 1997;15(4):94–6]. Information provision, an essential component of anxiety management, has recently been highlighted as a considerable problem for day surgery patients [Mitchell MJ. Ambul Surg 1999a;7(2):65–73; Mitchell MJ. Ambul Surg 1999b;7(2):75–100]. Contemporary evidence has suggested that the ability to cope with a stressful event can be improved if the preparatory information is matched with the individual’s coping style, i.e. provision is made for patients with a desire for maximum levels of information (vigilant coper) and for patients with a desire for minimal levels of information (avoidant coper) [Krohne HW, Slangen K, Kleemann PP. Psychol Health 1996;11(3):315–30]. A convenience sample of 120 patients undergoing non life-threatening, gynaecological laparoscopic day surgery was contacted prior to surgery and randomly assigned into two groups. Group I received an extended information booklet, group II a simple booklet and all received a coping style questionnaire. Immediately prior to surgery patients with a desire for maximum levels of information (vigilant copers) who had received the simple information were more anxious than the vigilant copers who had received the extended information (0.013, P≤5%). Irrespective of coping style, participants who received the simple information contacted their general practitioner more than participants who had received the extended information (0.008, P≤1%). Incorporation of the results into day surgery nursing practices are discussed and a new, pioneering anxiety management plan providing explicit guidance is outlined