Table 1 presented the frequency and percentage of the types of major sur geries in the experimental and control

group. The results yielded a total of eig hty (80) respondents, forty (40) respondents from the control group and the othe r forty (40) from the experimental group. A total of twenty- seven (27) responde nts or thirty four percent (33.75%) underwent open cholecystectomy. From this, t he control group had eighteen (18) respondents or forty-five percent (45%) while the experimental group had nine (9) respondents or twenty three percent (22.5%) . Laparoscopic cholecystectomy had a total of eleven (11) respondents or thirte en point seventy-five percent (13.75%). This was also divided into the control g roup with five (5) respondents or twelve point five percent (12.5%) for the expe rimental group six (6) respondents or fifteen percent (15%). The total mastecto my respondents was seventeen (17) or twenty-one point (21.13%) wherein, eight ( 8) respondents or twenty percent (20%) were under the control group and nine (9) respondents or twenty-two point five percent (22.5%) were in the experimental g roup. Total abdominal hysterectomy with salphingo oopherectomy had a total of t hirteen (13) respondents or sixteen point twenty-five percent (16.25%) with the control group composed of four (4) respondents or ten percent (10%) and the exp erimental group composed of nine (9) respondents or twenty-two point five percen t (22.5%). In Hysterectomy the total respondents was twelve (12) or fifteen perc ent (15%) of which five (5) or twelve point five percent (12.5%) were under the control group and (7) respondents or seventeen point five percent (17.5%) were i n the experimental group. This denoted that most of the respondents in this study were Open Cholecystectom y pre operative patients, while the least number of respondents were Hysterectom y pre operative patients. Most of the hospitals the data were gathered were public or local hospitals whic h offered open cholecystectomy compared to the other surgeries. Considering the prevalence of cholecystectomy in the surgical ward, the open or traditional meth od is still the most practical choice financially since it costs it much lower t han that of laparoscopic cholecystectomy. Although the hospital stay was longer and the surgical process and incision or scar more pronounced, it yielded more r espondents because of its availability and affordability. For the more complex c ases of cholecystitis or diseases that require cholecystectomy such as in ruptur es, infections or multiple stones, open cholecystectomy is oftentimes preferred by physicians themselves. The frequency of mastectomy respondents ranked second and can be attributed to the percentage of patients requiring surgery and the nu mber of patients afflicted with breast malignancies in comparison with the preva lence of the other diseases requiring the abovementioned surgeries. Relatively, the frequency of patients who are diagnosed with the breast or chest malignancie s are fewer since its symptoms are less pronounced or are usually ignored by pat ients compared to the cholecystectomy candidates who seek medical attention beca use of the more acute and alarming symptoms such as pain. Mastectomy patients wh o require and prefer the surgical method is a factor since the cost of treatment is greater compared to other methods which are conservative such as radiation o r chemotherapy. Mastectomy is also the last resort of most physicians if and whe n other conservative methods are ineffective or when malignancies are too pronou nced. Hysterectomy and Total abdominal hysterectomy with salphingo oopherectomy , both common gynecological or reproductive surgeries are offered in all the hos pitals this study was affiliated in, although cost wise the latter is more expen sive and complicated it is also the most frequently done amongst the two. It can be attributed to the overall incidence of uterine or female reproductive malign ancies that are already widespread, complicated and untreatable except via surge ry. All the female reproductive parts are removed to prevent complications, prov ide relief and as a practical choice to avoid future malignancies in the other f emale organs. Surgeons and patients therefore opt for Total abdominal hysterect omy with salphingo oopherectomy to prevent another gynecological surgery in the upcoming years. On the other hand laparoscopic cholecystectomy frequency was att ributed to accessibility and availability, relative to the institutions included in this study. It had the least number of respondents because most of the hospi tals that offered laparoscopic cholecystectomy were private facilities and only

a minority of public hospitals that are tertiary or are specialty departments si nce it is more recent and advanced compared to open cholecystectomy. The accessi bility can be considered as a factor since the hospitals offering laparoscopic c holecystectomy are outnumbered by the hospitals that do not. Affordability matte red since generally, laparoscopic cholecystectomy is more expensive than its cou nterpart surgery, open cholecystectomy since it utilizes newer technology and re quires specialization from the surgeon. Surgeons would also recommend this surge ry for the uncomplicated cases requiring cholecystectomy, for patients particula r of the duration of hospital stay and over all invasiveness of the procedure. P atients would also opt for this because of the faster surgical duration and less er incision scar. Open cholecystectomy patients yielded the greatest number of respondents and can be attributed to the financial aspects of the general populace as supported by Brekalu, et al (2011), Varek (2009) and Limion (2000). Approximately only 50,00 0 Filipinos are diagnosed with gallstones annually and a great percentage of the m could only afford the less expensive surgical treatment which is open cholecys tectomy and only 33% of the population can afford private medical care with heal th maintenance organizations. In addition cost treatment showed that open cholec ystectomy was 8% less expensive than laparoscopic cholecystectomy. Aside from th is, the estimated number of local or government hospitals offering open cholecys tectomy is higher than those with a more advanced method such as the laparoscopi c cholecystectomy which is usually performed in private institutions and in a fe w government hospitals. However in American hospitals laparoscopic cholecystect omy is the surgery of choice due to its advantages in decreased hospital stay, d ecreased invasiveness and scars, decreased risks and complications and faster re covery time of clients. For the gynecological surgeries according to the Philipp ine Cancer Society-Manila (2009), Laudico (2009) and Caurado (2007), breast canc er or malignancies was most common among women in developed countries and is als o the leading female cancer or malignancy with a surgery rate of 97% for mastect omy or modified radical mastectomy. Thus giving mastectomy a higher frequency c ompared to hysterectomy or Total abdominal hysterectomy with salphingo oopherect omy. In addition Domingo and Dy Echo (2009) added that Cervical cancer or malign ancy remains the second most common malignancy or anomaly in the country and in recent ratings only 11.6% were eligible for surgery due to factors such as finan cial constraints and inaccessibility to medical care. Saini (2002) argued that h ysterectomy is the most common gynecologic operation performed in the United Sta tes and Verna and Hwang (2010) cited Total abdominal hysterectomy with salphing o oopherectomy as usually performed for prophylaxis or late stage gynecological malignancy. Thus the most common surgery is Open Cholecystectomy and is attributed to its gr eater availability and affordability compared to laparoscopic cholecystectomy. H owever common or simple it may be perceived it is still a major and invasive sur gery which causes anxiety to the patients and poses risks and complications. Lap aroscopic cholecystectomy in the Philippine setting is on the other hand the lea st preferred or conducted due to the same factors regardless of its benefits and advantages. It can be summed that patients for both operations still require ad amant assessment for anxiety and other aspects that may and will affect post ope rative outcomes. The three surgeries are often than not cancer related also requ ires the same recommendations with emphasis on psychological and emotional facet s due to the high probability of depression and financial constraints due to the cost of treatment and prolonged infirmity.