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Abstract
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Background and Aims Nosocomephobia, a type of PTSD, is an extreme fear of hospitals. Hospital phobia is usually caused by a traumatic hospital experience. If untreated, nosocomephobia can hinder medical care. There is little research on how nosocomephobia affects elective surgery and how acupuncture can help patients cope with it. Using the transactional model of stress and coping, this qualitative case study examines acupuncture’s role in nosocomephobia patients‘ elective surgery appraisal process.
Methods Individual interviews were conducted with participants to inquire about their nosocomephobia and prior hospital experiences. Six reviewers coded the interview transcripts line-by-line. Reviewers labeled meaningful words, phrases, and sentences and produced over 600 codes. All reviewers discuss and identify themes by grouping similar codes and resolving discrepancies. A thematic analysis was used to develop final themes for this study. The coding process was conducted in Dedoose.
Results Sophie had avascular necrosis in both hips and suffered PTSD from a previous traumatic event. Intraoperative acupuncture calmed her hospital anxiety, allowing her to have both hips replaced. Olivia has PTSD and a hospital phobia since age 12. Acupuncture reduced her anxiety about a total knee arthroscopy. Thematic analysis showed how nosocomephobia impacted patients‘ views of surgery and distinguished between their unique fear rationale. The transactional model of stress and coping illustrated patients‘ appraisal process from surgery (stressor) to coping (acupuncture) to reappraisal (mental state).
A theoretical map of the appraisal process
Major themes co-occurance
A summary of major themes and related subthemes
Conclusions Compared to other hospital visits, surgery can be stressful. Acupuncture is a safe, non-invasive way for nosocomephobia patients to manage preoperative anxiety and undergo elective surgery.