[The preparation for elective interventions--the spectrum and dissemination of somatic and psychological measures in Germany].
BACKGROUND
The positive effects of preoperative preparation on postoperative recovery in patients undergoing elective surgery have been demonstrated. On that account, we surveyed the practice procedures of preoperative preparation for elective surgery patients at German hospitals.


METHODS
During November 1994, we sent 1500 questionnaires to the directors of anaesthesiology departments in Germany. A total of 590 questionnaires (39.3%) were completed and returned. The participating hospitals range in size from 20 to 2600 beds (mean = 364; s = 334,97), totalling together more than 1.7 million surgical operations per year.


RESULTS
The surveyed hospitals used one or more of the following procedures for pre-operative preparation: 573 (98.6%) of the replying hospitals used medical anxiolysis, 415 (71.3%) applied preoperative respiratory therapy. Furthermore, 222 (38.5%) of the studied hospitals trained their patients in postoperative relevant behaviour (respiratory therapy n = 167; physiotherapy n = 63 and patient-controlled analgesia n = 41). 74 (13%) offered psychological counselling, 29 (5%) made use of other psychological techniques (muscle relaxation; autogenic training, biofeedback) and 26 (4%) used other preparatory methods like video tapes (n = 13), music (n = 5), acupuncture (n = 4).


CONCLUSIONS
Nearly all hospitals prepared their patients for surgery with a pre-op visit and anxiolytic medications. Further preparatory methods in most surveyed hospitals are only used on a case-by-case basis. At present psychological methods of preoperative preparation are not routinely used in clinical practice in Germany.


CONCLUSIONS
Existing possibilities for optimising preoperative preparation in patients undergoing elective surgery are not used regularly. Preoperative preparation needs to be improved, especially in patients undergoing major surgery. Standardisation of management procedures and integration of several professional groups and regular application of known procedures for preoperative preparation may lead to cost-saving optimisation of the duration of hospital stay.
Roth-Isigkeit
A
A
Klinik für Anästhesiologie, Medizinische Universität zu Lübeck.
Schwarzenberger
J
J
Brechmann
J
J
Gehring
H
H
Klotz
K F
KF
Schmucker
P
P
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D017558:Elective Surgical Procedures / Q000379:methods* / Q000523:psychology* / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D011300:Preoperative Care / Q000379:methods* / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D014151:Anti-Anxiety Agents
Vorbereitung auf elektive Eingriffe--Spektrum und Verbreitung somatischer und psychologischer Massnahmen in Deutschland.