AND PERIOPERATVE STATES OF ANXIETY WITH OPERATIONS ON
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
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%).