PREOPERATIVE REHEARSAL OF ACTIVE COPING IMAGERY INFLUENCES SUBJECTIVE AND HORMONAL RESPONSES TO ABDOMINAL-SURGERY

被引:60
作者
MANYANDE, A
BERG, S
GETTINS, D
STANFORD, SC
MAZHERO, S
MARKS, DF
SALMON, P
机构
[1] UNIV LIVERPOOL, DEPT CLIN PSYCHOL, LIVERPOOL L69 3BX, MERSEYSIDE, ENGLAND
[2] UCL, DEPT PSYCHOL, LONDON, ENGLAND
[3] UCL, DEPT PHARMACOL, LONDON, ENGLAND
[4] ST MARKS HOSP, DEPT ANAESTHET, LONDON EC1V 2PS, ENGLAND
[5] MIDDLESEX UNIV, SCH PSYCHOL, LONDON, MIDDX, ENGLAND
来源
PSYCHOSOMATIC MEDICINE | 1995年 / 57卷 / 02期
关键词
SURGERY; PREPARATION; ENDOCRINE RESPONSES; STRESS; IMAGERY;
D O I
10.1097/00006842-199503000-00010
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Existing evidence suggests that preoperative psychological preparation that is designed to reduce anxiety may sensitize cortisol and adrenaline responses to surgery. In a controlled trial of abdominal surgery patients, we therefore tested the effects of a preoperative preparation that used guided imagery, not to reduce anxiety, but to increase patients' feelings of being able to cope with surgical stress; 26 imagery patients were compared with 25 controls who received, instead, background information about the hospital. State-anxiety was similar in each group, but imagery patients experienced less postoperative pain than did the controls, were less distressed by it, felt that they coped with it better, and requested less analgesia, Hormone levels measured in peripheral venous blood did not differ on the afternoon of admission, before preparation. Cortisol levels were, however, lower in imagery patients than in controls immediately before and after surgery. Noradrenaline levels were greater on these occasions in imagery patients than controls. The results are interpreted in relation to two theories. One states that preoperative ''worry'' reduces surgical stress. The other concerns the influence of active and passive coping on endocrine responses to stress.
引用
收藏
页码:177 / 182
页数:6
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