Medical scientific information

Children's Hospital, Department of Cardiology, Linz, Austria

For the past several decades, pre- and postoperative psychological treatment has been offered to patients in the United States, especially to children, whenever they have had to undergo difficult medical interventions. Such care reduces overall anxiety and enables patients to cope with distress and pain after operations. The research project has introduced new information to the European scientific environment, which has not been up-to-date in this respect, as well as innovation in a completely different way of differentiating preoperative preparation in meeting the demands of science. No comparable studies have been carried out to date in the German-speaking countries.
The goal of the project was to minimize anxiety and psychological distress in children preparatory to undergoing open-heart surgery. According to models contained in recent research, young patients from three to fourteen years of age were offered differentiated psychological preparatory treatment (role-play, cognitive learning program, techniques of coping) while considering sociodemographic, personality and medical variables. The patients' families were also involved in the process of psychological preparation.
Anxiety as a state and as a personality variable was measured by means of the State-Trait Anxiety Inventory for Children (STAIC, Spielberger, 1983) before and after psychological preparation. After their opeations and before they were released from the hospital, the children were evaluated by their physicians, nurses, and parents by means of a modified questionnaire on behavior. The patients' verbal and nonverbal expressions with regard to anxiety and fear, their readiness to cooperate during required medical treatments as well as the observations of additional behavioral factors- such as rejecting food, sleeping disorders, over attachment, etc.- were also included in the evaluation. The children also rated themselves with respect to these factors. A psychologist was at the hospital to help the children and their parents during the hospital stay.
Salomon's study in 1992 confirms a reduction of costs for long-term therapeutical interventions among young heart patients and their families when psychological care is offered from the time the need for an operation becomes apparent. The preparation and treatment methods used in this project have been implemented in the Department of Cardiology at the Children's Hospital in Linz for general long-term application.
A highly significant reduction (at the 1 % level) of state as welI as trait anxiety levels was measured in patients as a result of differentiated psychological methods preparatory to cardiovascular surgery. Physicians, nurses, parents and patients alike confirm independently of one another the effectiveness of psychological assistance. The variance in the patients' readiness to cooperate during medical treatments was marked most by a parent staying constantly at the hospital (26,1%), followed by a pleasant atmosphere in the patient ward (17,9%), psychological assistance (18,9%), and good cooperation between medical treatment and psychological care (23,9%).

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