Medical procedures vary greatly as to the extent of intrusiveness and complexity. Despite this even the simplest procedures can generate high levels of anxiety in patients. Unfamiliar surroundings and smells, strange people speaking in jargon and lack of understanding as to what is happening and why are just some of the reasons people feel under stress.
Some medical procedures require little more than offering a tablet. Some are painful, some intimate, some difficult and lengthy. Many will leave the patient with little or no control over what is happening to them. As patients, the way we cope with such situations depends on a variety of factors. Previous experience and knowledge can make a big difference, although in some situations a little knowledge is almost as bad as too much. Generally though our age, gender and the social and cultural context to which we are familiar has a big influence over how well we are prepared to take action in order to reduce anxiety.
Some early studies into the needs and expectations of patients were simple but interesting. Typically both patients and health professionals were asked to rank a list of things felt to be most or least important to patients during a stay in hospital. It was quickly discovered that the priority lists for patients were in stark contrast to those assumed by health professionals. A lot has been learned since then, most notably the fact that the patient’s perspectives should have priority when it comes to helping them cope with anxiety in the order and the speed they require.
Helping patients cope with the anxiety of medical procedures is a two-way street. The health professional needs to know the type of information that is necessary and that will be of benefit, but they need to tailor this to the needs and capabilities of the individual. For the benefit of the argument let’s assume the patient is about to undergo some surgical procedure, although it could just as well be a course of radiotherapy or say ECT for depression. Five broadly overlapping types of information will be of benefit. The first of these is simple factual information about the procedure(s) and what will happen. The second is how this will make the person feel in terms of their senses. For example, they may want to know that it is perfectly normal to feel sick following anesthetic. The third relates to any particular emotions that may be evoked and the fourth a time frame for recovery. Although not strictly related to the procedure it is important for the patient to know how long they may be out of action as a result of their condition.
With all of these issues, effective communication is the key to helping reduce anxiety. Not all patients like to ask questions and not all know what questions to ask. It shouldn’t be assumed that silence equates to satisfaction. Neither should it be assumed that having imparted information it has been remembered or understood. Even the most relaxed and intelligent person can find themselves overwhelmed with information and terminology. As much as information can help to reduce anxiety it must be remembered that anxiety also serves to block information. For this reason, time, careful use of language and checking that information is understood are essential skills for caregivers in helping patients cope with anxiety.
Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.