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Psychophysiological preparation for surgery: Teaching the Freeman Preparation Program for improved patient outcomes

Shelley C. (Skibinski) Freeman, University of Nebraska - Lincoln


This research focuses on assessing the effectiveness of the Freeman Preparation Program (FPP), a treatment designed by the author, in preparing patients psychologically for surgery. This paper discusses two studies comparing the FPP, listening to relaxing music, and a no treatment control measuring various psychological and physiological factors before, during, and after surgery. The FPP focuses on the differences between the psychological (cognitive) and the physiological arousal component of preoperative anxiety and the contribution each makes to the surgery experience. The FPP includes a variety of instruction including relaxation and imagery aimed at training patients to maximally reduce their physiological arousal at the start of anesthesia. Music selected by the patient as being relaxing provided an appropriate comparison to this treatment, since prior research suggests it may reduce psychological anxiety but may increase physiological arousal (Dainow, 1977; for review see Hodges, 1980). This paper presents the results from Study 1, which included the FPP and Music Condition (MC), and Study 2, which included the FPP, MC, and a Control Condition (CC). The research hypothesis was that the FPP patients would have lower anxiety, lower physiological arousal at the start of anesthesia, and reduced postoperative pain than the MC or CC. In addition, this project used new electromyography (EMG) technology designed to detect physiological arousal during general anesthesia by monitoring facial muscles used to express pain and distress. The research did support the hypothesis that the FPP patients would have reduced physiological arousal at the start and throughout surgery and reduced pain after surgery than those in the MC or CC. Neither the FPP nor the MC reduced self-reported anxiety before surgery in either Study 1 or Study 2. Patients in the FPP tended to have greater confidence in their medical providers before surgery and reported improvements on several psychological factors. Implications for patient well being and for awareness during anesthesia are discussed. ^

Subject Area

Psychology, Clinical

Recommended Citation

Freeman, Shelley C. (Skibinski), "Psychophysiological preparation for surgery: Teaching the Freeman Preparation Program for improved patient outcomes" (2005). ETD collection for University of Nebraska - Lincoln. AAI3167458.