pre-surgery videotape may help reduce stress

May 21, 2000

Watching a videotape of the procedure they are about to undergo may help some patients cope with preoperative stress, according to a study.

Researchers from the University of Innsbruck in Austria created a 12-minute video presenting hip replacement surgery from the patient's perspective.

"By showing the process of surgery strictly from the patient's perspective, patients watching the film before their own operation have the opportunity to identify with the patient on the film, who successfully mastered this stressful and threatening situation," said lead author Stephan Doering, MD.

The video presents the experience of a 55-year-old man with osteoarthritis of the hip joint. A narrator explains each step as the patient is admitted to the hospital, is prepared for and undergoes surgery, and begins his recovery process.

One hundred patients scheduled for total hip replacement surgery at a hospital in Austria agreed to participate in the study. Doering and colleagues assigned roughly half to watch the video, and they compared them with the half of the patients that did not watch it.

Watching the videotape appeared to reduce anxiety and stress, the researchers found. The study results appear in the May/June 2000 issue of the journal Psychosomatic Medicine.

The day before surgery, both groups had roughly the same levels of anxiety, as measured by a standardized questionnaire. But on the morning of surgery, the anxiety levels of those who had not seen the video increased, while remaining constant among those who had seen the video on the previous evening.

Anxiety levels decreased for both groups just after the operation, but they stayed lower during the first few days after surgery in the group that had seen the video.

The researchers also found that the patients who had seen the video had lower quantities of a stress hormone called cortisol in their urine the night before surgery, as well as for two nights afterwards. In addition, more of the patients who didn't watch the video had blood pressure increases of above 15 percent during the operation.

Those who didn't watch the video also tended to need more pain medication. "We assume that this result is due to improved coping abilities," said Doering. "Prepared patients may be able to cope better with postoperative pain because they have a more concrete idea of and anticipate their early recovery after surgery."

But the researchers also noted that preparing for an operation by watching a videotape is not for everyone. It might not help individuals who prepare for a stressful experience over which they have no control--like an operation--by choosing not to think about it. "In patients who do not want to see the film, this kind of preparation before surgery might be maladaptive and therefore should not be used," said Doering.

Doering and colleagues also pointed out that their results may have been biased by the fact that those who saw the video did not watch it alone but rather watched it with a researcher. "More research is needed to separate the effects of the videotape itself from those provided by the personal attention of another person," said Doering.

This study was supported by the Jubilaeumsfond der Oesterreichischen Nationalbank.

Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.

Posted by the Center for the Advancement of Health . For information about the Center, call Petrina Chong, pchong@cfah.org, (202) 387-2829.
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Center for Advancing Health

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