The effect of therapist and spouse assisted emotive imagery on post-surgical pain and adjustment

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Virginia Polytechnic Institute and State University

The psychological well-being of surgical patients is important to the smoothness of recovery. Effective psychological preparation which reduces pre- and post-surgical anxiety should reduce the patient's perception of pain and reduce the stress associated with hospitalization. Within the context of total patient care, there is also concern for the effect the spouse has on the patient. Techniques to improve the care of patients must be both appropriate and feasible given the shortage of staff in hospitals. This reality underscores the need to involve the patient and spouse as active participants in the health care system.

The efficacy of teaching surgical patients a cognitive coping strategy designed to distance the patient from the stressful situation was examined in this study. It was hypothesized that regular utilization of self-generated emotive imagery should decrease the patients' state of anxiety and attenuate the pain experience. The second hypothesis examined whether actively involving the patient's spouse in the emotive imagery treatment would enhance the effects of the coping strategy.

Twenty-four married, male patients who were scheduled for their first laminectomy were contacted the afternoon prior to surgery. They were divided into three groups (attention-placebo, therapist-assisted intervention, and spouse-assisted intervention) of eight which were matched for type of surgery, surgeon, and duration of back pain. Two treatment sessions were conducted; the first, pre-surgically, was done under the direction of the experimenter; the second, post-surgically, under the direction of either experimenter or spouse.

Using state anxiety, self-report pain measures, behavioral pain measures, and several medication indices as dependent measures, analyses of variance comparing the three groups were performed. No significant main effects or interactions that supported the use of emotive imagery as a presurgical intervention on the utilization of the spouse as a partner in the intervention were found. Reasons for this outcome were explored and suggestions for further research were made. A model for clinical intervention was also suggested.