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Title: A psychological investigation into the experience of surgery
Author: Pick, Bernice Caroline
ISNI:       0000 0001 3489 8486
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 2002
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The stress response, a complex multi-factorial survival mechanism is elicited by surgery. The factors of the stress response include psychological variables, anxiety, mood, coping and sense of control and physiological variables, activation of the adrenocortical system to increase peripheral levels of cortisol and catecholamines, cardiovascular and metabolic changes. The relationships between these factors are generally unknown. Nor is it clear that the stress response remains the same over the period of the hospitalisation, surgery and recovery. The general aim of the studies reported here was to investigate any relationships between the factors of the stress response to surgery within the context of the patients lives. The Response to Surgery Questionnaire was developed to assess subjective responses to surgery identifying four subjective coping response styles, 'optimistic / vigilant', pessimistic / negative', 'anger' and 'faith in others'. This questionnaire was used with other established measures to assess the psychological factors of the stress response and the recovery from surgery. Interactions between the catecholamines and some of the psychological variables emerged. Overall the findings indicate a complex interactive response to pain and stress. Subjective anticipation of the event influences the subsequent experience and recall. Anticipation, experience and recall are elaborated by anxiety. Subjective perception of the event emerged as important to recovery and was related to factors beyond the immediate scope of the hospitalisation and surgery. Recovery was influenced by environmental, ward versus home, sociological factors and subtle failures in communication between patients and professional staff. Interactions between physiological and psychological variables emerged. There were clear associations between catecholamines, treatment failure and postoperative fatigue. The evidence indicated future research and the importance of including subjective perspective and sociological factors is emphasised.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Stress