Pre-operative stress in patients and the role of nurses in psychological preparation for spinal surgery

Introduction
Spondylosis causes pain and restricts everyday functioning. Surgical treatment contributes to experiencing stress, which negatively affects the course of procedure and recovery. The task of nursing and medical staff is to mentally prepare the patient for surgery. The aim of this study was to identify coping strategies used by patients to deal with pre-operative stress, and to determine their opinions and expectations regarding mental preparation for surgery by nurses.

Material and methods
A survey of 70 patients was conducted in the orthopedics department using the author’s (A.N.) survey questionnaire and COPE questionnaire. For statistical analysis, Shapiro-Wilk, Mann-Whitney U, Kruskal-Wallis tests, and Spearman’s correlation coefficient were employed, while p < 0.05 was considered statistically significant.

Results
According to the patients, preparation for surgery by nurses was sufficient. Nurses were expected to be professional, courteous, patient, skilled in observation, having manual dexterity, educated in pre- and post-operative management, and mentally supportive. The most frequently chosen strategies were active coping, planning, seeking instrumental and emotional support, and religious expression. There was no relationship between seeking instrumental support, denial, alcohol or substance use and expectations of nurses’ attitudes and behaviors as well as between alcohol or other substance use, denial, and expectations of nurses’ skills. Older people were more likely to choose the strategy of religious expression. Women were more likely to report seeking emotional and instrumental support, while men were more likely to report active coping and planning.

Conclusions
Patients demonstrate different ways of coping with stress before surgery, therefore it is important to evaluate them by professionals in order to reduce the experienced stress. Nurses actively participating in this evaluation should be aware of their important role and interventions taken in psychological preparation of the patient for surgery.