Stress Prior to Surgery: A Thesis

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It is important to note that the relationship between pain and anxiety is reciprocal. Painful experiences may lead to anxiety (e.g., "Something must be wrong... Increased anxiety will lead to accentuated perception of pain, which further increases the anxiety level. Obviously, potentially traumatic experiences may result unless there is some intervention in this pain-anxiety cycle. Narcotics may be helpful, but psychological interventions are quite appropriate in this regard. (King, 1991, p. 129)

5. Defining Criteria: Describe how you would know if the concept were present in a situation.

Listening to the patient and watching physical cues, such as increases pulse of BP, increased pallor, as well as listening to the patient when he or she has concerns about procedural or context questions.

6. Antecedents: Identify antecedents that you would expect to find in biological, psychological and/or social systems

Precious personal or secondary bad experiences with surgical procedures, recovery times or even fatal events are all antecedents to "stress prior to surgery," though these issues are not absolutely self-evident and no prior experience with surgery in a primary or secondary sense may be just as likely to be antecedent to "stress prior to surgery."

7. Consequences: Note those consequences to an individual/group experiencing the concept you've identified

Heightened physical response, increasing surgical complications, pain and pain anxiety as well as difficult recovery room wake up and lengthened recovery due in part to anxiety physical response as well as possible decreased immune function, are all possible outcomes of unresolved, "stress prior to surgery." (Devito, 1994, p. 27)

8. Application to Nursing: note the model, related, border and contrary to cases certain amount of stress prior to surgery is normal, and may serve a useful purpose of helping the patient heighten his or her response to physical cues for recovery, yet it is also clear that heightened and out of control stress prior to surgery has extreme physical and psychological consequences.
It is the nurse's responsibility to recognize and intervene when such is the case. Prevention is essential to successful resolution of concept as well as the development of normal or even heightened recovery. (Lewis, 1998, p. 26) (Ben-Zur, Rappaport, Ammar & Uretzky, 2000, p. 201) (Mcmurray, 1998, p. 14)


Ben-Zur, H., Rappaport, B., Ammar, R., & Uretzky, G. (2000). Coping Strategies, Life Style Changes and Pessimism after Open-Heart Surgery. Health and Social Work, 25(3), 201.

Bradley, E.L. (1994). A Patient's Guide to Surgery. Philadelphia: University of Pennsylvania Press.

Devito, P.L. (1994, July). The Immune System vs. Stress. USA Today (Society for the Advancement of Education), 123, 27.

Guided Imagery Speeds Surgical Recovery. (1996, October). USA Today (Society for the Advancement of Education), 125, 8.

King, P.E. (1991). Communication, Anxiety, and the Management of Postoperative Pain. Health Communication, 3(2), 127-138.

Lewis, C. (1998, November). Sizing Up Surgery. FDA Consumer, 32, 26.

Mahler, H.I., Kulik, J.A., & Hill, M.R. (1993). A Preliminary Report on the Effects of Videotape Preparations for Coronary Artery Bypass Surgery on Anxiety and Self-Efficacy: a Simulation and Validation with College Students. Basic and Applied Social Psychology, 14(4), 437-454.

Mcmurray, D.L. (1998). Psychological, Social and Medical Factors Affecting Rehabilitation Following Coronary Bypass Surgery. The Journal of Rehabilitation, 64(1), 14.


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