A comparative study of the effects of environment on preoperative anxiety and pain levels and postoperative outcomes in an outpatient population

Surgery is commonly regarded as a psychologically stressful experience that requires appraisal and coping responses. Stress occurs when a situation has been appraised as demanding and as having the potential to exceed coping resources. The objective condition of the hospital environment is important since it influences the primary and secondary appraisals processes. The act of appraisal, in tur n, determines the patient's coping ability, which ultimately influences recovery. Studies in the medical and psychological literatures have suggested that an aversive hospital environment may increase anxiety and negatively influence health outcomes. Additional research has found that increased preoperative anxiety is associated with poor postoperative behavioral and clinical recovery. The research problem addressed in this dissertation is whether there is a difference in preoperative anxiety and pain and postoperative outcomes between neurological and orthopedic surgery outpatients who are assigned to a private room versus a ward-style unit. The variables used to answer this question are preoperative anxiety and pain levels and postoperative narcotics usage, length of time hospitalized, and infection rate. Gender will be considered in the analysis to determine if there is a difference in how men and women cope with the two different hospital environments. Depending upon the outcome, this research may alter thinking concerning the design of outpatient preoperative/postoperative areas and/or healthcare strategies to enhance person-environment compatibility in an outpatient surgery setting.