DISCUSSION: Using the Hospital anxiety and depression scale tool in measuring the anxiety and depression felt

by the patient during the perioperative phase in the institution of Saint Louis University Hospital of the Sacred Heart in Baguio City. This study aimed to explore the levels of anxiety and depression in pre-operative and post-operative surgical patients. The strengths of this study include the use of an internationally standardized tool to diagnose anxiety and depression which is the HADS and repeated assessments during hospitalization. The researchers came up with a result of 5 patients whose score for anxiety were 0-7 which is a normal range; 5 patients whose score were 8-10 which is a borderline risk; and 2 patients whose score were 11-21 which are at risk of anxiety. These may indicate that most health workers give appropriate interventions to control or even reduce anxiety of patients. According to Michael john Pritchard (2010) providing adequate support and accurate information before surgery is essential to reduce anxiety and improve patients outcome. Nurses should also consider the psychological aspects of patients during the perioperative phase that will greatly affect the condition of patient. Necessary support and letting the patient feel that there is this someone that is there for him or her helps in coping with his or her condition. In the depression scale, there were 8 patients whose score were 0-7 which is on the normal range; 1 patient whose score was 8-10 which is a borderline risk; and 3 patients whose score were 11-21 which are at risk of depression. These show that patients were minimally or not depressed in the surgery that they had or they will have. Being with the patient as a nurse may help to decrease the depression felt by the patient. John Lauerman (January 2000) points out the importance of communicating feelings of depression to medical professionals who may not be alert to symptoms, in order to have all possible causes of depression investigated. Shortly after surgery, depression can be attributed to pain, a sense of loss or another underlying cause. These results show a positive response to anxiety and depression however it cannot be denied that there are still patients who experience anxiety and depression so in order to lessen it, ways to help the patients cope with the situation must be applied. This may include ensuring that patients are well informed regarding the illness and surgical treatments. With this the patients may be able to predict and visualize what will happen thereby reducing their anxiety. Also according to Herrman 1997, Bjelland et al 2002, the ability to identify patients with psychological problems quickly and effectively would be of great benefit to patients and healthcare professionals by ensuring that patients at risk of anxiety are given the support they need to cope with surgery and make a quick and full recovery. Therefore assessment is very important not only physically but also psychologically so that appropriate interventions could be instigated to help the patients since anxiety and depression can come from different factors

such as financial, lack of knowledge, lack of support systems, role disturbance and others. It is also important to assess their ways of coping with similar situations so this implies that this is not a one-way process, the health worker and the patient must help each other so that positive results can be obtained. However, due to the small sample size, lack of time, lack of statistical power, inability to sort patients based on their gender, age, type of operation, presence of support system, and if they answered the questionnaire before or after the procedure, the generalizability of the results may be questioned.

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