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Behavioral preparation for surgery: benefit or harm?
Wilson JF
Journal of Behavioral Medicine 1981 Mar;4(1):79-102
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Elective surgery patients were prepared for surgery with training in muscle relaxation or with information about sensations they would experience. Relaxation reduced hospital stay, pain, and medication for pain and increased strength, energy, and postoperative epinephrine levels. Information reduced hospital stay. Personality variables (denial, fear, aggressiveness) were associated with recovery and influenced patients' responses to preparation. Less frightened patients benefited more from relaxation than did very frightened patients. Nonaggressive patients reacted to information with decreased hospital stay along with increased pain, medication, and epinephrine. Aggressive patients responded to information with decreased hospital stay along with decreased pain, medication, and epinephrine. Patients using denial were not harmed by preparation. A catharsis/moderation model is proposed to explain the benefits of relaxation. This study suggests that behavioral preparation benefits even frightened, aggressive, or denying elective surgical patients.

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