Holistic Needs and Coping Among Preoperative Patients in a Government Teriary Hospital in Metro Manila, Philippines

Abstract

This study seeks to understand the holistic needs of the preoperative patients in terms of informational, physical, psychological, social, spiritual, level of independence and environment and their relationships to the coping level of the preoperative patients as an aspect of holistic nursing. It also examines the profile of the patient participants as it relates to their coping level. The study runs on the conceptual framework that the holistic needs are related to the coping needs of the preoperative patients. In the same manner, the framework is also applied in looking into the demographic profile of the patients and its relationship to coping. The level of coping serves as an indicator as to the wholeness of the person yielding better patient recovery and outcome. The study utilized the descriptive correlational design done in the medical, surgical, and gynecology wards of a government tertiary hospital located in Metro Manila, Philippines. The researcher considered 43 preoperative patients who underwent operation in a few days following the survey in the given wards. The survey among the preoperative patients were based using the following tools, namely, The Amsterdam Preoperative Anxiety and Informational Scale (APAIS), Quality of Life Tool (QOLT) and Brief COPE. Where applicable, the necessary permissions on the use of the said tools were sought from the authors. The results of the study show that the level of independence is the top priority need of the patient undergoing surgery. This is followed by the spiritual need showing that spirituality is a vital factor in the quality of life of the respondents. The physical need comes in next which is undoubtedly an important aspect when one is under the challenges of an illness. Meanwhile, preoperative patients greatly need to know the information about anesthesia more than about the surgical procedure. Consequently, they worried more on the anesthesia than on the procedure but think less about these. In terms of coping, physical, social relationship and spirituality coping were the top means used by the patients. The results also show that among the holistic needs of the preoperative patients and the existing coping mechanisms for the specific holistic need, only social relationship need has significant correlation with social coping mechanism. The correlation is negative, that is as the coping level increases, the holistic needs decreases. As for the demographic profile of the respondents, the results show significant relationships between the eight groups of demographic profile and the six categories of coping mechanism with varying dependencies among profile. Spiritual, environment and level of independence coping mechanisms show as the common top three coping mechanisms with highest association except for the category of income where the third significant association is with social coping mechanism. Based on the foregoing, the study concludes that there exist significant relationships between the holistic needs and coping among preoperative patients. Moreover, significant relationships exist in terms of the presented demographic profile and coping mechanisms. Knowing the importance of the holistic needs of the patients during this situation is a great leap among the healthcare providers, patients and their family members in choosing the type of care and arriving at the most appropriate approach needed to hurdle the health situation. This study contributes to the nursing literature in the Philippines on holistic nursing and coping responses during surgical procedures.