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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 1998 January-February;64(1-2):21-7
Assessment of psychological characteristics during presurgical phase in patients with mental retardation
Cavaliere F. 2, Cormaci S. 1, Cormaci M. 1, Mongelli V. 1, Buono S. 1
1 IRCCS «Oasi Maria SS» - Troina (EN), Servizio di Anestesia e Rianimazione, Servizio di Psicologia;
2 Università Cattolica del Sacro Cuore - Roma, Istituto di Anestesia e Rianimazione
Objectives. To make easier the psychological evaluation of patients affected by Mental Retardation and scheduled for general anesthesia.
Design. A form prepared by the Psychological Service of the IRCCS “Oasi Maria SS” in collaboration with the Service of Anesthesia was evaluated prospectively. The form is addressed to relatives and psychologists; the interviewed person is firstly asked for a short description of patient’s personality and for any suggestion useful to patient’s management; secondly it is requested to assign a score from 1 (never present) to 5 (always present) to 44 items concerning adaptive capacities (divided into body scheme, spoken language, receptive language, mimic-gestural language, temporal orientation, memory), emotional and social fields (including sensibility, dependence, and social behaviors), problematic and stereotyped behaviors.
Setting. A medical and psychological Institute aimed at the study of Mental Retardation.
Patients. Twenty-five patients affected by Mental Retardation and scheduled for general and dental surgery.
Results. The form supplied a great deal of information and suggestions for patient management. Subjects that did not cooperate with the anesthetist presented lower scores about the ability to use mimic-gestural language (p<0.05) and higher scores about the presence of anxiety or fear caused by the sight of syringes or blood (p<0.05) and about behaviors of flight, isolation, or aggression caused by fear (p<0.05). By contrast, patients presenting mild or moderate degrees of Mental Retardation differentiated from patients with serious degree of Mental Retardation about body scheme (p<0.001), spoken language (p<0.05), receptive language (p<0.001), temporal orientation (p<0.001) and memory (p<0.001).
Conclusions. The form was very useful to plan patient management. These data suggest that the lack of cooperation by some patients affected by Mental Retardation is related to fear, anxiety, and incapacity to communicate rather than to the degree of Mental Retardation.