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Psychological prehabilitation: the patients' perspective

Prehabilitation is a collection of methods that aims to improve outcomes in surgery by optimising the patient’s condition prior to their operation. Increasing surgical wait time has led to calls for a change in the perception of waiting lists to seeing them as ‘preparation lists’. Preparation is multifactorial, and one aspect of it is psychological prehabilitation.

Authors:

  • Dr Hugh Tulloch, CT3, Medway NHS Foundation Trust
  • Dr Samantha Black, RCoA Patient Information Lead
  • Dr Caroline Pocknall, Consultant Anaesthetist, Ashford and St Peter’s Hospitals NHS Foundation Trust
  • Dr Caroline Ellis, CT2, Ashford and St Peter’s Hospitals NHS Foundation Trust

Prehabilitation is a collection of methods that aims to improve outcomes in surgery by optimising the patient’s condition prior to their operation.1,2 Increasing surgical wait time has led to calls for a change in the perception of waiting lists to seeing them as ‘preparation lists’. Preparation is multifactorial, and one aspect of it is psychological prehabilitation.3 Research into psychological prehabiliation has identified modifiable characteristics in patients and shown that targeted interventions can improve their experience and surgical outcomes.1,4

One such modifiable characteristic is preoperative anxiety, which has been shown to be linked to increase in postoperative pain and increased length of stay.2,4 The first Sprint National Anaesthesia Project (SNAP-1) indicated that, for patients, anxiety was the worst part of having an operation.5 While high-quality evidence is missing from the literature, a 2016 Cochrane meta-analysis did identify improvements in surgical outcomes as a result of psychological interventions.4

RCoA response to the Autumn Statement

We welcome the government’s commitment to publish a comprehensive long-term workforce plan for the NHS, including independently verified forecasts for the number of doctors, nurses and other professionals that will be needed over the next 5, 10 and 15 years.