Welchen Nutzen hat psychologische Operationsvorbereitung?

Eine Metaanalyse der Literatur zur psychologischen Operationsvorbereitung Erwachsener
  • M. Johnston
  • C. Vögele
Part of the Jahrbuch der medizinischen Psychologie book series (MEDPSYCHOL, volume 7)


Der Nutzen psychologischer Operationsvorbereitung wird heute kaum noch in Frage gestellt. Es ist jedoch wichtig zu bestimmen, in welchen Indikatoren postoperativer Erholung eine Verbesserung durch psychologische Operationsvorbereitung angestrebt wird und ob alle Interventionsverfahren dabei gleich effektiv sind. In der vorliegenden Übersicht wird deshalb der Effekt psychologischer Operationsvorbereitung vor dem Hintergrund der verwendeten Erfolgskriterien analysiert. Insgesamt betrachtet kann aus den Ergebnissen dieser Analyse der Schluß gezogen werden, daß ein signifikanter Effekt psychologischer Operationsvorbereitung in den meisten Erholungsparametern nachzuweisen ist. Prozedurinformation und Verhaltensinstruktionen scheinen dabei die erfolgreichsten Interventionsverfahren zu sein.


There is now substantial agreement that psychological preparation for surgery is beneficial to patients. It is important, however, to establish which aspects of recovery can be improved by psychological preparation and whether all forms of preparation are equally effective. In this chapter, therefore, the success of psychological preparation in adult patients is reviewed in terms of outcome rather than input. It is concluded that significant benefits can be obtained on all of the major outcome variables that have been explored. Information concerning the procedure and behavioural instruction seem to be the most effective interventions for improving postoperative recovery.


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  1. Anderson EA (1987) Preoperative preparation for cardiac surgery facilitates recovery, reduces psychological distress, and reduces the incidence of acute postoperative hypertension J Consult Clin Psychol 55:513–520PubMedCrossRefGoogle Scholar
  2. Anderson KO, Masur FT (1983) Psychological preparation for invasive medical and dental procedures. J Behav Med 6:1–40PubMedCrossRefGoogle Scholar
  3. Andrew JM (1979) Recovery from surgery, with and without preparatory instruction, for three coping styles. J Pers Soc Psychol 15:223–226Google Scholar
  4. Bafford DC (1977) Progressive relaxation as a nursing intervention: a method of controlling pain for open-heart surgery patients. Commun Nurs Res 8:284–290PubMedGoogle Scholar
  5. Boore J (1978) Prescription for Recovery. Royal College of Nursing, LondonGoogle Scholar
  6. Burton MV, Parker RW (1988) A randomized controlled trial of preoperative psychological preparation for mastectomy: A preliminary report. In: Watson M, Greer S, Thomas C (eds) Psychosocial Oncology. Pergamon, Oxford, pp 133–158Google Scholar
  7. Ceccio CM (1984) Postoperative pain relief through relaxation in elderly patients with fractured hips. Ortho Nurs 3:11–19CrossRefGoogle Scholar
  8. Chapman JS (1970) Effects of different nursing approaches upon psychological and pysiological responses of patients. Nurs Res 19:189–190CrossRefGoogle Scholar
  9. Christopherson B, Pfeiffer C (1980) Varying the timing of information to alter preoperative anxiety and postoperative recovery in cardiac surgery patients. Heart Lung 9:854–861PubMedGoogle Scholar
  10. Dumas RG, Johnson BA (1972) Research in nursing practice: a rewiew of five clinical experiments. Nurs Stud 9:137–149CrossRefGoogle Scholar
  11. Egbert LD, Battit GE, Welch CE, Bartlett MK (1964) Reduction of postoperative pain by encouragement and instruction of patients. N Engl J Med 270:825–827PubMedCrossRefGoogle Scholar
  12. Felton G, Huss K, Payne EA, Srsic K (1976) Preoperative nursing intervention with the patient for surgery: outcomes of three alternative approaches. Int J Nurs Stud 13:83–96PubMedCrossRefGoogle Scholar
  13. Field PB (1974) Effects of tape-recorded hypnotic preparation for surgery. Int J Clin Exp Hypn 12:54–61CrossRefGoogle Scholar
  14. Flaherty GG, Fitzpatrick JJ (1978) Relaxation technique to increase comfort level of postoperative patients: a preliminary study. Nurs Res 27:352–355PubMedCrossRefGoogle Scholar
  15. Fortin F, Kirouac S (1976) A randomized controlled trial of preoperative patient education. Int J Nurs Stud 13:11–24PubMedCrossRefGoogle Scholar
  16. Gaskey NJ (1987) Evaluation of the effect of a pre-operative anesthesia videotape. Am Assoc Nurs Anesth 55:431–345Google Scholar
  17. Gil KM (1984) Coping effectively with invasive medical procedures: a descriptive model. Clin Psychol Rev 4:339–362CrossRefGoogle Scholar
  18. Hayward J (1975) Information — A prescription against pain. The study of nursing care project reports, ser 2/5. Royal College of Nursing, LondonGoogle Scholar
  19. Hedges LV (1989) Metaanalysis of related research. In: Schneiderman N, Weiss SM, Kaufmann PG (eds) Handbook of research methods in cardiovascular behavioral medicine. Plenum, New York, pp 647–663Google Scholar
  20. Ho KH, Hashish I, Salmon P, Freeman R, Harvey W (1988) Reduction of post-operative swelling by a placebo effect. J Psychosom Res 32:197–205PubMedCrossRefGoogle Scholar
  21. Holden-Lund C (1988) Effects of relaxation with guided imagery on surgical stress and wound healing. Res Nurs Health 11:235–244PubMedCrossRefGoogle Scholar
  22. Janis IL (1958) Psychological stress: Psychoanalytical and behavioral studies of surgical patients. Wiley, New YorkCrossRefGoogle Scholar
  23. Johnson JE (1984) Psychological interventions and coping with surgery. In: Baum A, Taylor SE, Singer JE (eds) Handbook of psychology and health, vol IV. Erlbaum, Hillsdale NJ, pp 167–188Google Scholar
  24. Johnson JE, Leventhal H, Dabbs JM (1971) Contributions of emotional and instrumental response processes in adaptation to surgery. J Pers Soc Psychol 20:55–64PubMedCrossRefGoogle Scholar
  25. Johnson JE, Rice VH, Fuller SS, Endress MP (1978a) Sensory information, instruction in a coping strategy, and recovery from surgery. Res Nurs Health 1:4–17PubMedCrossRefGoogle Scholar
  26. Johnson JE, Fuller SS, Endress MP, Rice VH (1978b) Altering patients’ responses to surgery: An extension and replication. Res Nurs Health 1:111–121PubMedCrossRefGoogle Scholar
  27. Johnston M (1978) Assessing recovery from surgery. (Paper presented at the British Psychological Society Annual Conference)Google Scholar
  28. Johnston M (1984) Dimensions of recovery from surgery. Int Rev Appl Psychol 33:505–520CrossRefGoogle Scholar
  29. Johnston M (1986) Preoperative emotional states and postoperative recovery. Adv. Psychosom Med 15:1–22PubMedGoogle Scholar
  30. Johnston M (1988) Impending surgery. In: Fisher S, Reason J (eds) Handbook of life stress, cognition and health. Wiley, London, pp 79–100Google Scholar
  31. Johnston M, Lee-Jones M (1979) Evaluating the care of post-surgical patients in the community hospital. In: Oborne DJ, Gruneburg MM, Eiser JR (eds) Research in psychology and medicine. Academic Press, London, pp 353–369Google Scholar
  32. Kendall PC, Epps J (1990) Medical treatments. In: Johnston M, Wallace LM (eds) Stress and medical procedures. Oxford Univ Press, Oxford, pp 99–119Google Scholar
  33. Kendall PC, Watson D (1981) Psychological preparation for stressful medical procedures. In: Bradley L, Prokop C (eds) Medical psychology: Contributions to behavioral medicine. Academic Press, New York, pp 198–221Google Scholar
  34. Kincey J, Saltmore S (1990) Surgical treatments. In: Johnston M, Wallace LM (eds) Stress and medical procedures. Oxford Univ Press, Oxford, pp 120–137Google Scholar
  35. King NJ, Murphy GC (1983) Preparing patients for aversive medical procedures. NZ Nurs J 76:9–11Google Scholar
  36. Kulik JA, Mahler HIM (1987) Effects of preoperative room-mate assignment on preoperative anxiety and recovery from coronary bypass surgery. Health Psychol 6:525–543PubMedCrossRefGoogle Scholar
  37. Langer EJ, Janis IL, Wolfer JA (1975) Reduction of psychological stress in surgical patients. J Exp Soc Psychol 11:155–165CrossRefGoogle Scholar
  38. Lawlis GF, Selby D, Hinnant D, McCoy CE (1985) Reduction of postoperative pain parameters by presurgical relaxation instructions for spinal pain patients. Spine 10:649–651PubMedCrossRefGoogle Scholar
  39. Leigh JM, Walker J, Janaganathan P (1977) Effect of preoperative anaesthetic visit on anxiety. Br Med J 2: 987–989PubMedCrossRefGoogle Scholar
  40. Levesque L, Grenier R, Kirouac S, Reidy M (1984) Evaluation of a presurgical group program given at two different times. Res Nurs Health 7:227–236PubMedCrossRefGoogle Scholar
  41. Ley P (1977) Psychological studies of doctor-patient communication. In: Rachman SJ (ed) Contributions to medical psychology, vol 1. Pergamon, Oxford, pp 9–42Google Scholar
  42. Lindeman CA (1972) Nursing intervention with the presurgical patient. Nurs Res 21:196–209PubMedGoogle Scholar
  43. Lindeman CA, Aernam B van (1971) Nursing intervention with the presurgical patient. The effects of structured and unstructured preoperative teaching. Nurs Res 20:319–332PubMedGoogle Scholar
  44. Lindeman CA, Stetzer SL (1973) Effect of preoperative visits by operating room nurses. Nurs Res 22:4–16PubMedGoogle Scholar
  45. Lobb ML, Shannon MC, Recer SL, Allen JB (1984) A behavioral technique for recovery from the psychological trauma of hysterectomy. Percept Mot Skills 59:677–678PubMedCrossRefGoogle Scholar
  46. Ludwick-Rosenthal R, Neufeld WJ (1988) Stress management during noxious medical procedures: an evaluation review of outcome studies. Psychol Bull 104:326–342PubMedCrossRefGoogle Scholar
  47. Martelli MF, Auerbach SM, Alexander J, Mercuri LG (1987) Stress management in the health care setting: matching interventions with patient coping styles. J Consul Clin Psychol 55:201–207CrossRefGoogle Scholar
  48. Mathews A, Ridgeway V (1984) Psychological preparation for surgery. In: Steptoe A, Mathews A (eds) Health care and human behaviour. Academic Press, London, pp 321–259Google Scholar
  49. Mumford E, Schlesinger HJ, Glass GV (1982) The effects of psychological intervention on recovery from surgery and heart attacks. An analysis of the literature. Am J Public Health 72:141:151Google Scholar
  50. Newman S (1984) Anxiety, hospitalization, and surgery. In: Fitzpatrick R, Hinton J, Newman S, Scambler G, Thompson J (eds) The experience of illness. Tavistock, London New York, pp 133–153Google Scholar
  51. Oakley G (1988) The use of an information booklet to reduce the anxiety of hospitalization for elderly patients. (Unpublished BSc thesis)Google Scholar
  52. Perri KD, Perri MG (1979) Use of relaxation training to reduce pain following vaginal hysterectomy. Percept Mot Skills 48:478PubMedCrossRefGoogle Scholar
  53. Pickett C, Clum GA (1982) Comparative treatment strategies and their interaction with locus of control in the reduction of postsurgical pain and anxiety. J Consul Clin Psychol 50:439–441CrossRefGoogle Scholar
  54. Postlethwhaite R, Stirling G, Peck CL (1986) Stress inoculation for acute pain: a clinical trial. J Behav Med 9:219–227CrossRefGoogle Scholar
  55. Pruitt SD, Elliot CH (1990) Paediatric procedures. In: Johnston M, Wallace LM (eds) Stress and medical procedures. Oxford Univ Press, Oxford, pp 157–170Google Scholar
  56. Reading A (1979) The short term effects of psychological preparation for surgery. Soc Sci Med 13:641–654Google Scholar
  57. Reading AE (1982) The effects of psychological preparation on pain and recovery after minor gynaecological surgery: a preliminary report. J Clin Psychol 58:504–512CrossRefGoogle Scholar
  58. Rice VH, Johnston JE (1984) Preadmission self-instruction booklets, postadmission exercice performance and teaching time. Nurs Res 33:147–151PubMedCrossRefGoogle Scholar
  59. Ridgeway V, Mathews A (1982) Psychological preparation for surgery: a comparison of methods. Br J Clin Psychol 21:271–280PubMedCrossRefGoogle Scholar
  60. Rogers M, Reich P (1986) Psychological intervention with surgical patients: evaluation outcome. Adv Psychosom Med 15:23–50PubMedGoogle Scholar
  61. Saile H, Burgmeier R, Schmidt LR (1988) A metaanalysis of studies on psychological preparation of children facing medical procedures. Psychol Health 2:107–132CrossRefGoogle Scholar
  62. Schmitt FE, Woolridge PJ (1973) Psychological preparation of surgical patients. Nurs Res 22:108–116PubMedCrossRefGoogle Scholar
  63. Schultheis K, Peterson L, Selby V (1987) Preparation for stressful medical procedures and person x treatment interactions. Clin Psychol Rev 7:329–352CrossRefGoogle Scholar
  64. Scott LE, Clum G A (1984) Examining the interaction effects of coping style and brief interventions in the treatment of postsurgical pain. Pain 20:279–291PubMedCrossRefGoogle Scholar
  65. Shipley RH, Butt JH, Horowitz B (1979) Preparation to re-experience a stressful medical examination: effect of repetitious videotape exposure and coping style. J Consult Clin Psychol 47:485–492PubMedCrossRefGoogle Scholar
  66. Surman OS, Hackett TP, Silverberg EL, Behrendt DM (1974) Usefulness of psychiatric intervention in patients undergoing cardiac surgery. Arch Gen Psychiatry 30:830–835PubMedCrossRefGoogle Scholar
  67. Vernon DT, Bigelow DA (1974) Effect of information about a potentially stressful situation on responses to stress impact. J Pers Soc Psychol 29:50–59PubMedCrossRefGoogle Scholar
  68. Vögele C (1988) Perioperativer Streß. Eine psychophysiologische Untersuchung zu prä- und postoperativen Reaktionen chirurgischer Patienten. Lang, Frankfurt am MainGoogle Scholar
  69. Voshall B (1980) The effects of preoperative teaching on postoperative pain. Top Clin Nurs 2:39–43PubMedGoogle Scholar
  70. Wallace LM (1984a) Psychological preparation for gynaecological surgery. In: Broome AK, Wallace LM (eds) Psychology and gynaecological problems. Tavistock, London, pp 161–188Google Scholar
  71. Wallace LM (1984b) Psychological preparation as a method of reducing the stress of surgery. J Hum Stress 10:62–79CrossRefGoogle Scholar
  72. Wallace LM (1986) Communication variables in the design of pre-surgical preparatory information. Br J Clin Psychol 25:111–118PubMedCrossRefGoogle Scholar
  73. Watson D, Pennebaker JW (1989) Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychol Rev 96:234–254PubMedCrossRefGoogle Scholar
  74. Weinman J, Johnston M (1988) Stressful medical procedures: an analysis of the effects of psychological interventions and of the stressfulness of the procedures. In: Maes S, Defares B, Sarason IG, Spielberger CD (eds) Topics in health psychology. Wiley, Chichester, pp 205–217Google Scholar
  75. Weis OF, Weintraub M, Sriwtanakul K, Lasagna L (1983) Reduction of anxiety and postoperative analgesic requirements by audiovisual instruction. Lancet 1:43–44PubMedCrossRefGoogle Scholar
  76. Wells JK, Howard GS, Nowlin WF, Vargas MJ (1986) Presurgical anxiety and postsurgical pain and adjustment: effects of a stress inoculation procedure. J Consult Clin Psychol 54:831–835PubMedCrossRefGoogle Scholar
  77. Wells N (1982) The effect of relaxation on postoperative muscle tension and pain. Nurs Res 31:236–238PubMedCrossRefGoogle Scholar
  78. Wilson JF (1981) Behavioral preparation for surgery: benefit or harm? J Behav Med 4:79–102PubMedCrossRefGoogle Scholar
  79. Wilson-Barnett J (1984) Interventions to alleviate patients’ stress: a review. J Psychosom Res 28:63–72PubMedCrossRefGoogle Scholar
  80. Wilson-Barnett J (1990) Diagnostic procedures. In: Johnston M, Wallace LM (eds) Stress and medical procedures. Oxford Univ Press, Oxford, pp 83–98Google Scholar
  81. Ziemer MM (1983) Effects of information on postsurgical coping. Nurs Res 32:282–287PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • M. Johnston
  • C. Vögele

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