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Impact of Acceptance-Based Nursing Intervention on Postsurgical Recovery: Preliminary Findings

Published online by Cambridge University Press:  10 January 2013

María Dolores Fernández ,
Carmen Luciano  and
Sonsoles Valdivia-Salas
María Dolores Fernández
Affiliation:
Hospital Torrecárdenas (Spain)
Carmen Luciano
Affiliation:
Universidad de Almería (Spain)
Sonsoles Valdivia-Salas*
Affiliation:
Universidad de Zaragoza (Spain)
*
Corresponding concerning this article should be addressed to Sonsoles Valdivia-Salas. Departamento de Psicología y Sociología, Universidad de Zaragoza. Campus Ciudad Escolar, Teruel 44003 (Spain). Phone: +34 978 645343. Fax: +34 978 618103. E-mail: sonsoval@unizar.es - sonvaldivia@gmail.com
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Abstract

Research has shown that teaching individuals to experience pain and anxiety as inevitable products of the actions they freely and responsibly undertake yields healthier reactions to suffering. This preliminary study assesses whether a brief acceptancebased psychological intervention along with the usual presurgical protocol for a laparoscopic cholecystectomy will produce healthier reactions to postsurgical pain, and will reduce anxiety, duration of postsurgical hospitalization, and demand of analgesics. After admission, screening, and consent procedures, we assessed pain and anxiety. Patients in the experimental condition (n = 6) then received a brief acceptance-based nursing intervention addressing the individual meaning of surgery, and including a metaphor and defusion practice, along with routine care. Patients in the control condition (n = 7) received routine care only. Twenty-four hr following the intervention, surgery took place. Pain, anxiety, and patients' demand for analgesics were assessed 24 hr or 48 hr after surgery. All six experimental patients, as compared to three of seven control patients, demanded fewer analgesics and left the hospital within 24 hr or 48 hr from surgery even in the presence of frequent and/or intense pain. Anxiety slightly decreased in the experimental patients. The brief acceptance-based intervention was effective in improving postsurgical recovery. These preliminary findings support the potential of this type of intervention as a cost-effective strategy to be implemented in the sanitary context.

Se ha demostrado que enseñar a los individuos a experimentar el dolor y la ansiedad como productos inevitables de las acciones que ellos, libre y responsablemente, deciden emprender, produce menos sufrimiento. El estudio se llevó a cabo en un hospital. Este estudio, preliminar, examina los efectos de un protocolo breve basado en la aceptación en la mejora de la recuperación postquirúrgica tras una colecistectomía laparoscópica, entendida como: reacciones más saludables al dolor y reducción de la ansiedad, duración de hospitalización y demanda de analgésicos. Una vez completada la admisión, selección de participantes, y obtención del consentimiento, se tomaron medidas de dolor y ansiedad. Los pacientes experimentales (n = 6) recibieron entonces el protocolo, que incluía la evaluación del significado individual de la cirugía, una metáfora y práctica de defusion, junto con los cuidados rutinarios preoperatorios. Los pacientes controles (n = 7) recibieron cuidados rutinarios preoperatorios solamente. La cirugía se llevó a cabo veinticuatro horas tras la implementación del protocolo. Pasadas 24 o 48 horas desde la cirugía, se tomó una segunda medida de dolor, ansiedad y demanda de analgésicos. El protocolo implementado mejoró sensiblemente el postoperatorio de los pacientes experimentales: todos, en comparación con tres de los siete controles, demandaron menos analgésicos, recibieron el alta a las 24 o 48 horas tras la cirugía, y puntuaron más bajo en ansiedad. Estos resultados preliminares apoyan el potencial de este tipo de intervenciones para ser implementadas en el contexto sanitario.

Keywords

postsurgical recoveryacceptanceanxietypaincholecystectomyrecuperación postquirúrgicaaceptaciónansiedaddolorcolecistectomía
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 15 , Issue 3 , November 2012 , pp. 1361 - 1370
Copyright
Copyright © Cambridge University Press 2012

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