Presurgical stress: Nursing and psychological interventions

Feelings of ambivalence, melancholy, despair and fear are usual psychological reactions prior to a surgical intervention. Αim: the main aim of this review is a comprehensive presentation of pre-operative anxiety as well as the analysis of the effectiveness of relevant nursing and psychological interventions. A secondary aim was to highlight the role of the nurse in treating pre-operative anxiety. Method: A search in Greek and international databases (IATROTEK, PubMed, CINAHL) was conducted. The search strategy combined the following key word: preoperative anxiety, nursing, psychological support. Initially, 123 articles were identified (general articles, clinical studies, reviews, and meta-analysis) and after adjustments for duplicate results, the final material of this review were 38 selected articles published during the last decade. Results: Many studies demonstrate the usefulness of preoperative preparation through specialized information and social support interventions in relation to post-surgery adaptation process. The use of methods and strategies that enable the individual to reduce stress and handle the highly-stressing dimensions of the impending surgery have also been proposed. Finally, various psychotherapeutic interventions and other specialized techniques of crisis management as measures to address both the pre-operative anxiety and stress brought about by the disease have also successfully been implemented. Conclusions: The preoperative clinical care must include the systematic treatment of pre-operative anxiety through specialized information. However, behavioral or cognitive interventions that facilitate self-control appear to be more effective and have significant influence on the patient’s postoperative course. Training and education of nurses should be sufficient and part of their continuing education.

Keywords: Pre-surgical stress, nursing, psychological support