Coping with stressful medical procedures

Stressful medical procedures range from highly stressful ones, such as major surgery and chemotherapy, to simple procedures such as immunizations and blood tests. Though such procedures vary greatly in the degree of physical intrusiveness, pain and discomfort they cause, the stress experienced by patients results not only from these physical factors but also from the subjective meaning of the procedure for the patient and his/her resources for coping (Scott et al., 2001; Wallace, 1985) (see ‘Abortion’; ‘Coronary heart disease: surgery’; ‘Chemotherapy’ and ‘Intimate examinations’). The physical aspects are interpreted within the subjective framework, which determines the extent of psychological reactions. Therefore, in order to understand how patients cope with these procedures and how to assist them in their effort, health care providers must understand both the objective and the subjective aspects of this experience. Undergoing a medical procedure entails coping with the procedure itself and coping with the accompanying negative feelings (mainly anxiety). Such feelings are related to the context in which the procedure is carried out, for example, cancer as highly anxiety-provoking (Schou et al., 2004), infertility as a low-control situation (Terry & Hynes, 1998), coronary artery bypass surgery or transplant surgery, which elicit fears due to the uncertainty involved (Heikkila et al., 1999; Jalowiec et al., 1994). Negative feelings also arise from discrepancies between prior expectancies or pre-existing imaginings and the actual procedure (e.g. the difference between the expectation and the reality of giving birth, see Katz, 1993; Slade et al., 1993).