Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

And When Patients Listen

The patients are often not listening to the surgeon when told what is wrong with their back (and/or neck). They are do not give their full attention when the surgical procedure is explained. And they are not listening when they are told about the results of completed surgery or the time and rehabilitation necessary for recovery.

They do not listen because they are anxious.

Medication may complicate their capacity for concentration. And most do not read the informed consent documents regarding the procedure being performed.

They do not ask questions, do not seek clarification and rarely admit that they do not understand what they have been told. Often they are embarrassed to do so, but equally often they do not know how to formulate the questions.

Importantly, they do not know terminology, do not understand even when presented with educational materials, and their mind wraps around dreading the procedure and expectancy of full recovery even when they have been told that there will be residual problems.

They are more likely to listen to their neighbor who had similar problems or medical advice from their attorney. They will gravitate toward surgeons whom they like since they cannot weigh whether a specific surgeon is skilled even if he has poor bedside manner.

I routinely ask patients to describe their impending or past spinal surgery, and consistently, they have an extremely poor understanding of what has occurred and/or what is planned.

It may well be that such understanding is not furthered by additional discussions with the surgeon since anxiety level may not decrease in his presence.

Quite often, the patient needs to discuss his/her understanding of procedures and outcome with a neutral third party before we even know how poorly they understand their condition.

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