OJMP  Vol.3 No.3 , April 2014
Surgery and Caregiving: Loneliness of the Patients and Those Who Care for Them
ABSTRACT
This research, conducted on patients and caregivers, examined the qualitative aspects of their loneliness. Patients were divided into those who were approached before they had surgery, and those post operatively. We collected information about their tumors, which were either benign or malignant. The patients’ loneliness was compared to their caregivers who were either intimate partners or “others”, i.e. family members and friends. The loneliness questionnaire, has already been extensively utilized in previous studies, and was used to explore the various aspects of loneliness of those groups. Significant differences in subscale scores were found in patients pre and post surgery, with those who have already had surgery scoring higher. Additionally, those who were cared for by a partner scored lower on the loneliness subscales than those attended to by “other”. Interestingly, the only significant difference in the caregiver group was between men and women, in line with the socialization process of the genders, which makes women more open and vocal about their feelings and needs.

Cite this paper
Rokach, A. , Miller, Y. , Shick, S. , Abu, R. and Matot, I. (2014) Surgery and Caregiving: Loneliness of the Patients and Those Who Care for Them. Open Journal of Medical Psychology, 3, 222-234. doi: 10.4236/ojmp.2014.33024.
References
[1]   Hartsfield, J. and Clopton, J.R. (1985) Reducing Presurgical Anxiety: A Possible Visitor Effect. Social Science and Medicine, 20, 529-533. http://dx.doi.org/10.1016/0277-9536(85)90369-7

[2]   Rollins, J.A. (2004) Evidence-Based Hospital Design Improves Health Care Outcomes for Patients, Families and Staff. Pediatric Nursing, 30, 338-339.

[3]   Hughes, B.M. (2001) Psychology, Hospitalization and Some Thoughts on Medical Training. European Journal of Psychotherapy & Counselling, 4, 7-26. http://dx.doi.org/10.1080/13642530110040109

[4]   Hallstrom, I. and Elander, G. (2007) Families’ Needs When a Child Is Long-Term Ill: A Literature Review with Reference to Nursing Research. International Journal of Nursing Practice, 13, 193-200. http://dx.doi.org/10.1111/j.1440-172X.2007.00625.x

[5]   Paul, F. and Rattray, J. (2008) Short-and Long-Term Impact of Critical Illness Relatives: Literature Review. Journal of Advanced Nursing, 62, 276-292.
http://dx.doi.org/10.1111/j.1440-172X.2007.00625.x

[6]   Rokach, A. and Matalon, R. (2007) “Tails”—A Fairy Tale on Furry Tails: A 15-Year Theatre Experience for Hospitalized Children Created by Health Professionals. Paediatric Child Health, 12, 301-304.

[7]   Williams, A. M. and Irurita, V. F. (2005) Enhancing the Therapeutic Potential of Hospital Environment by Increasing the Personal Control and Emotional Comfort of Hospitalized Patients. Applied Nursing Research, 18, 22-28. http://dx.doi.org/10.1016/j.apnr.2004.11.001

[8]   Attree, M. (2001) Patients’ and Relatives’ Experiences and Perspectives of “Good” and “Not so Good” Quality Care. Journal of Advanced Nursing, 33, 456-466.
http://dx.doi.org/10.1046/j.1365-2648.2001.01689.x

[9]   Thomas, L.H. and Bond, S. (1996) Measuring Patients’ Satisfaction with Nursing: 1990-1994. Journal of Advanced Nursing, 23, 747-756. http://dx.doi.org/10.1111/j.1365-2648.1996.tb00047.x

[10]   Rokach, A. and Sha’ked, A. (2013) Together and Lonely: Loneliness in Intimate Relationships—Causes and Coping. Nova Pub, NY.

[11]   Barker, R., Wright, B. and Gonick, M. (1946) Adjustment to Physical Handicap and Illness: A Survey of the Social Psychology of Physique and Disability. Social Science Research Council, New York. http://dx.doi.org/10.1037/11780-000

[12]   Rokach, B. and Rokach, A. (2013) Medicine, Radiology, Hospitalization, and Loneliness. In: Rokach, A., Ed., Loneliness Updated: Recent Research on Loneliness and How It Affects our Life (pp. 270-283). Routledge, Abingdon.

[13]   Montgomery, G.H. and Bovbjerg, D.H. (2004) Presugery Distress and Specific Response Expectancies Predict Postsurgery Outcomes in Surgery Patients Confronting Breast Cancer. Health Psychology, 23, 381-387. http://dx.doi.org/10.1037/0278-6133.23.4.381

[14]   Batner, N.H., Nielson, W.R., Munk, S., Kwiatkowska, C.K. and Gelb, A.W. (1990) Preoperative Anxiety: Detection and Contributing Factors. Canadian Journal of Anaesthesiology, 27, 444-447.
http://dx.doi.org/10.1007/BF03005624

[15]   Moerman, N. (1996) Psychological Aspects of Anesthesia. CIP-DATA Koninklijke Bibliotheek, Haag.

[16]   McCleane, G.J. and Cooper, R. (1990) The Nature of Preoperative Anxiety. Anaesthesia, 45, 153-155. http://dx.doi.org/10.1111/j.1365-2044.1990.tb14285.x

[17]   Shevde, K. and Panagopoulos, G. (1990) A Survey of 800 Patients’ Knowledge, Attitudes, and Concerns Regarding Anesthesia. Anesthesia & Analgesia, 73, 190-198.

[18]   Mackenzie, J.W. (1989) Daycase Anaesthesia and Anxiety. A Study of Anxiety Profiles amongst Patients Attending a Day Bed Unit. Anaesthesia, 44, 679-682. http://dx.doi.org/10.1111/j.1365-2044.1989.tb11349.x

[19]   Craig, K.D. (1989) Emotional Aspects of Pain. In: Wall, P.D. and Melzack, R., Eds., The Textbook of Pain (2nd Ed., pp. 220-230), Churchill Livingstone, London.

[20]   Mindus, P. (1987) Pain and Sedation: Some Psychiatric Aspects. Acta Anaesthesiologica of Scandinavia, 32, S88, 7-12.

[21]   Edell-Gustafson, U.M. and Hetta, J.E. (1999) Anxiety, Depression and Sleep in Male Patients Undergoing Coronary Artery Bypass Surgery. Scandinavian Journal of Caring Sciences, 13, 137-143.

[22]   Kagan, I. and Bar-Tal, Y. (2008) The Effect of Preoperative Uncertainty and Anxiety on Short-Term Recovery after Elective Arthroplasty. Journal of Clinical Nursing, 17, 576-583.
http://dx.doi.org/10.1111/j.1365-2702.2007.01968.x

[23]   Mitchell, M. (2009) General Anaesthesia and Day-Case Patient Anxiety. Journal of Advanced Nursing, 66, 1059-1071. http://dx.doi.org/10.1111/j.1365-2648.2010.05266.x

[24]   Majasaari, H., Paavilainen, E. and Astedt-Kurki, P. (2007) The Visible and Invisible Family: Nurses’ Perceptions of Counselling in Day Surgical Nursing. Journal of Advanced Perioperative Care, 3, 11-19.

[25]   Kiecolt-Glaser, J.K., Glaser, R., Gravenstein, S., Malarky, W.B. and Sheridan, J. (1996) Chronic Stress Alters the Immune Response to Influenza Virus Vaccine in Older Adults. Proceedings of the National Academy of Sciences of the United States of America, 93, 3043-3047.
http://dx.doi.org/10.1073/pnas.93.7.3043

[26]   Contrada, R.J., Leventhal, E.A. and Anderson, J.R. (1994) Psychological Preparation for Surgery: Marshaling Individual and Social Resources to Optimize Self-Regulation. In: Maes, S., Leventhal, H. and Johnson, M., Eds., International Review of Health Psychology, Wiley, New York, 219-266.

[27]   Devine, D.E. (1992) Effects of Psychoeducational Care for Adultsurgical Patients: A Meta-Analysis of 191 Studies. Patient Education and Counseling, 19, 129-142. http://dx.doi.org/10.1016/0738-3991(92)90193-M

[28]   Marucha, P.T., Kiecolt-Glaser, J.K. and Favagehi, M. (1998) Mucosal Wound Healing Is Impaired by Examination Stress. Psychosomatic Medicine, 60, 362-365.

[29]   Padgette, D.A., Marucha, P.T. and Sheridan, J.F. (1998) Restraint Stress Slows Cutaneous Wound Healing in Mice. Brain, Behavior & Immunity, 12, 64-73. http://dx.doi.org/10.1006/brbi.1997.0512

[30]   Salomaki, T.E., Leppaleuoto, J., Laitinen, J.O., Vuolteenaho, O. and Nuutinen, L.S. (1993) Epidural Versus Intravenous Fentanyl for Reducing Hormonal, Metabolic, and Physiologic Responses after Thoractomy. Anesthesiology, 79, 672-679.
http://dx.doi.org/10.1097/00000542-199310000-00007

[31]   Kiecolt-Glaser, J.K., Page, G.G., Marucha, P.T., MacCullum, R.C. and Glaser, R. (1998) Psychological Influences on Surgical Recovery: Perspectives from Psychoneuroimmunology. American Psychologist, 53, 1209-1218. http://dx.doi.org/10.1037/0003-066X.53.11.1209

[32]   Johnson, M. (1988) Impending Surgery. In: Fisher, S. and Reason, J., Eds., Handbook of Life Stress, Cognition and Health, Wiley, New York, 79-100.

[33]   Pond, R.S., Brey, J. and DeWall, C.N. (2011) Denying the Need to Belong: How Social exclusion Impairs Human Functioning and How People Can Protect against It. In: Bevinn, S.J., Ed., Psychology of loneliness, Nova Science Publishers, New York, 107-122.

[34]   Shaver, P. and Buhrmester, D. (1983) Loneliness, Sex Role Orientation and Group Life: Social Needs Perspective. In: Baulus, P.B., Ed., Basic Group Processes, Springer-Verlag, New York, 259-288.

[35]   Olds, J. and Schwartz, R.S. (2009) The Lonely American: Drifting Apart in the Twenty-First Century. Beacon Press, Boston.

[36]   Cacioppo, J.T. and Patrick, W. (2008) Loneliness: Human Nature and the Need for Social Connection. W.W. Norton, New York.

[37]   Hawkley, L.C., Thisted, R.A., Masi, C.M. and Cacioppo, J.T. (2010) Loneliness Predicts Increased Blood Pressure: 5-Year Cross-Lagged Analyses in Middle-Aged and Older Adults. Psychology and Aging, 25, 132-141. http://dx.doi.org/10.1037/a0017805

[38]   Heinrich, L.M. and Gullone, E. (2006) The Clinical Significance of Loneliness: A Literature Review. Clinical Psychology Review, 26, 695-718. http://dx.doi.org/10.1016/j.cpr.2006.04.002

[39]   McWhirter, B.T. (1990) Loneliness: A Review of Current Literature with Implications for Counselling and Research. Journal of Counselling and Development, 68, 417-422.
http://dx.doi.org/10.1002/j.1556-6676.1990.tb02521.x

[40]   Booth, R., Bartlett, D. and Bohnsock, J. (1992) An Examination of the Relationship between Happiness, Loneliness, and Shy Men in College Students. Journal of College Student Development, 33, 157-162.

[41]   Riggio, R.E., Watring, K.P. and Throckmorton, B. (1993) Social Skills, Social Support, and Psychosocial Adjustment. Personality and Individual Differences, 15, 275-280.
http://dx.doi.org/10.1016/0191-8869(93)90217-Q

[42]   Rokach, A. and Brock, H. (1997) Loneliness: A Multidimensional Experience. Psychology: A Journal of Human Behaviour, 34, 1-9.

[43]   Dwyer, T.F. (2011) Family Caregiving across the Lifespan. Family Therapy Magazine, 10, 18-21.

[44]   Novotney, A. (2009) Help for Caregivers. Monitor on Psychology, 41, 61-63.

[45]   Rainer, J.P. and McMurry, P.E. (2002) Caregiving at the End of Life. Journal of Clinical Psychology, 58, 1421-1431.

[46]   Chentsova-Dutton, Y., Shucter, S., Hutchin, S., Strause, L., Burns, K., Dunn, L., Miller, M. and Zisook, S. (2002) Depression and Grief Reactions in Hospice Caregivers: From Pre-Death to 1 Year Afterwards. Journal of Affective Disorders, 69, 53-60.
http://dx.doi.org/10.1016/S0165-0327(00)00368-2

[47]   Pagnini, F., Rossi, G., Lunetta, C., Banfi, P., Castelnuovo, G., Corbo, M. and Molinari, E. (2010) Burden, Depression, and Anxiety in Caregivers of People with Amyotrophic Lateral Sclerosis. Psychology, Health & Medicine, 15, 685-693.
http://dx.doi.org/10.1080/13548506.2010.507773

[48]   Chio, A., Gauthier, A., Calvo, A., Ghiglione, P. and Mutani, R. (2005) Caregiver Burden and Patients’ Perception of Being a Burden in ALS. Neurology, 64, 1780-1782.
http://dx.doi.org/10.1212/01.WNL.0000162034.06268.37

[49]   Gauthier, A., Vignola, A., Calvo, A., Cavallo, E., Moglia, C. and Chio, A. (2007) A Longitudinal Study on Quality of Life and Depression in ALS Patient-Caregiver Couples. Neurology, 68, 923-926.
http://dx.doi.org/10.1212/01.wnl.0000257093.53430.a8

[50]   Goldstein, L.H., Atkins, L., Landau, S., Brown, R. and Leigh, P.N. (2006) Predictors of Psychological Distress in Carers of People with Amyotrophic Lateral Sclerosis: A Longitudinal Study. Psychological Medicine, 36, 865-875.
http://dx.doi.org/10.1017/S0033291706007124

[51]   O’connor, E.J., McCabe, M.P. and Firth, L. (2008) The Impact of Neurological Illness on Marital Relationships. Journal of Sex and Marital Therapy, 34, 115-132.
http://dx.doi.org/10.1080/00926230701636189

[52]   Chio, A., Gauthier, A., Montuschi, A., Calvo, A., Di Vito, N., Ghiglione, P. and Mutani, R. (2004) A Cross Sectional Study on Determinants of Quality of Life in ALS. Journal of Neurological Neurosurgery and Psychiatry, 75, 1597-1601.
http://dx.doi.org/10.1136/jnnp.2003.033100

[53]   Cobb, A.K. and Hamera, E. (1986) Illness Experience in a Chronic Disease—ALS. Social Science and Medicine, 23, 641-650. http://dx.doi.org/10.1016/0277-9536(86)90111-5

[54]   Rokach, A. (1988) The Experience of Loneliness: A Tri-Level Model. The Journal of Psychology: Interdisciplinary and Applied, 122, 531-544. http://dx.doi.org/10.1080/00223980.1988.9915528

[55]   Rowe, M.A. (1996) The Impact of Internal and External Resources on Functional Outcome in Chronic Illness. Research in Nursing & Health, 19, 485-497. http://dx.doi.org/10.1002/(SICI)1098-240X(199612)19:6<485::AID-NUR4>3.0.CO;2-K

[56]   Rattray, M., Johnston, J.A. and Wildsmith, W. (2005) Predictors of Emotional Outcomes of Intensive Care. Anesthesia, 60, 1085-1092. http://dx.doi.org/10.1111/j.1365-2044.2005.04336.x

[57]   Mishel, M.H. (1997) Uncertainty in Acute Illness. Annual Review of Nursing Research, 15, 57-80.

[58]   Raps, C.S., Peterson, C., Jonas, M. and Seligman, M.E.P. (1982) Patient Behavior in Hospitals: Helplessness, Reactance, or Both? Journal of Personality and Social Psychology, 42, 1036-1041. http://dx.doi.org/10.1037/0022-3514.42.6.1036

[59]   Seeman, M. and Seeman, T.E. (1983) Health Behavior and Personal Autonomy: A Longitudinal Study of the Sense of Control in Illness. Journal of Health and Social Behavior, 24, 144-160.
http://dx.doi.org/10.2307/2136641

[60]   William, A.M., Dawson, S. and Kristjanson, L.J. (2008) Exploring the Relationship between Personal Control and the Hospital Environment. Journal of Clinical Nursing, 17, 1601-1609.
http://dx.doi.org/10.1111/j.1365-2702.2007.02188.x

[61]   Gardner, T.F., Nnadozie, M.U., Davis, B.A. and Kirk, S. (2005) Patient Anxiety and Patient Satisfaction in Hospital-Based and Freestanding Ambulatory Surgery Centers. Journal of Nursing Care Quality, 20, 238-243. http://dx.doi.org/10.1097/00001786-200507000-00008

[62]   Rosen, S., Svensson, M. and Nilsson, U. (2008) Calm or Not Calm: The Question of Anxiety in the Perianesthesia Patient. Journal of Peri-Anesthesia Nursing, 23, 237-246.
http://dx.doi.org/10.1016/j.jopan.2008.05.002

[63]   Elkins, G., Rajab, M.S., Marcus, J. and Staniunas, R. (2004) Prevalence of Anxiety among Patients Undergoing Colorectal Surgery. Psychological Reports, 95, 657-658.
http://dx.doi.org/10.2466/pr0.95.2.657-658

[64]   Dunkel-Schetter, C. (1984) Social Support and Cancer: Findings Based on Patient Interviews and Their Implications. Journal of Social Issues, 40, 77-98.
http://dx.doi.org/10.1111/j.1540-4560.1984.tb01108.x

[65]   Revenson, T.A., Wollman, A. and Felton, B.J. (1983) Social Supports as Stress Buffers for Adult Cancer Patients. Psychosomatic Medicine, 45, 321-331.

[66]   Bloom, J.R. and Spiegel, D. (1984) The Relationship of Two Dimensions of Social Support to the Psychological Well-Being and Social Functioning of Women with Advanced Breast Cancer. Social Science and Medicine, 19, 831-837.
http://dx.doi.org/10.1016/0277-9536(84)90400-3

[67]   De Haes, J.C.J.M. and Van Knipperberg, F.C.E. (1985) The Quality of Life of Cancer Patients: A Review of the Literature. Social Science and Medicine, 20, 809-817.
http://dx.doi.org/10.1016/0277-9536(85)90335-1

[68]   Phillips, D. (1996) Medical Professional Dominance and Client Dissatisfaction: A Study of Doctor-Patient Interaction and Reported Dissatisfaction with Medical Care among Female Patients at Four Hospitals in Trinidad and Tobago. Social Science & Medicine, 42, 1419-1425.
http://dx.doi.org/10.1016/0277-9536(95)00290-1

[69]   Polimeni, A. and Moore, S. (2002) Insight into Women’s Experiences of Hospital Stays: Perceived Control, Powerlessness and Satisfaction. Behaviour Change, 19, 52-64.
http://dx.doi.org/10.1375/bech.19.1.52

[70]   Baker, C.F. (1984) Sensory Overload and Noise in the ICU: Sources of Environmental Stress. Critical Care Quarterly, 6, 66-80.

[71]   Rokach, A. and Parvini, M. (2011) Experience of Adults and Children in Hospitals. Early Child Development and Care, 181, 707-715.
http://dx.doi.org/10.1080/03004430.2010.483115

[72]   Singer, B.A. (1983) Psychosocial Trauma, Defense Strategies and Treatment Considerations in Cancer Patients and Their Families. The American Journal of Family Therapy, 11, 15-22.
http://dx.doi.org/10.1080/01926188308250131

[73]   Kawachi, I. and Berkman, L. (2001) Social Ties and Mental Health. Journal of Urban Health, 78, 458-467. http://dx.doi.org/10.1093/jurban/78.3.458

[74]   Wittenberg-Lyles, E., Demiris, G., Oliver, D.P. and Burt, S. (2011) Reciprocal Suffering: Caregiver Concerns during Hospice Care. Journal of Pain and Symptom Management, 41, 383-393.
http://dx.doi.org/10.1016/j.jpainsymman.2010.04.026

[75]   Rokach, A., Findler, L., Chin, J., Lev, S. and Kollender, Y. (2013) Cancer Patients, Their Caregivers, and Coping with Loneliness. Psychology, Health & Medicine, 18, 135-144.
http://dx.doi.org/10.1080/13548506.2012.689839

[76]   Rokach, A. and Brock, H. (1998) Coping with Loneliness. The Journal of Psychology: Interdisciplinary and Applied, 132, 107-127.
http://dx.doi.org/10.1080/00223989809599269

[77]   Rokach, A., Orzeck, T., Moya, M. and Exposito, F. (2001) Loneliness in North America and Spain. Social Behaviour and Personality: An International Journal, 29, 477-489.
http://dx.doi.org/10.2224/sbp.2001.29.5.477

[78]   Riches, G. (2002) The Loss of Children: Thinking the Unthinkable. In: Mason, C., Ed., .Journeys into Palliative Care: Roots and Reflection, Jessica Kingsley Publishers, London, 135-153.

[79]   Croog, S.H., Baume, R.M. and Nalbandian, J. (1995) Pre-Surgery Psychological Characteristics, Pain Response, and Activities Impairment in Female Patients with Repeated Periodontal Surgery. Journal of Psychosomatic Research, 39, 39-51.
http://dx.doi.org/10.1016/0022-3999(94)00089-N

[80]   Korporaal, M., van Groenou, M.I.B. and van Tilburg, T.G. (2008) Effects of Own and Spousal Disability on Loneliness among Older Adults. Journal of Aging and Health, 20, 306-325.
http://dx.doi.org/10.1177/0898264308315431

 
 
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