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Do psychological variables affect early surgical recovery?

Mavros MN, Athanasiou S, Gkegkes ID, Polyzos KA, Peppas G, Falagas ME - PLoS ONE (2011)

Bottom Line: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet.We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome.Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece.

ABSTRACT

Background: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery.

Methods: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes.

Results: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview) also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger.

Conclusion: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

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Related in: MedlinePlus

Flow diagram for reviewed studies.
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pone-0020306-g001: Flow diagram for reviewed studies.

Mentions: A total of 16 studies were eligible for inclusion in the present review (Figure 1). Thirteen studies were observational (comparing two groups with different psychological status) and 5 were interventional (comparing the study group, which received the psychological intervention, with a control group); two of the studies had both an observational and an interventional design (in one study, the authors both assessed the volunteers' preoperative psychological status and applied an intervention [17]; in the other study they asked the volunteers to visit the clinic twice and performed two separate analyses [22]). In seven studies there was some degree of blinding, 4 of the interventional studies were randomized and 6 studies did not report any blinding or randomization. The median quality of the interventional studies was 2. Most of the studies were prospective in design (exception: [21]) and performed multivariate analyses (exceptions: [16], [23], [25], [27]).


Do psychological variables affect early surgical recovery?

Mavros MN, Athanasiou S, Gkegkes ID, Polyzos KA, Peppas G, Falagas ME - PLoS ONE (2011)

Flow diagram for reviewed studies.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3102096&req=5

pone-0020306-g001: Flow diagram for reviewed studies.
Mentions: A total of 16 studies were eligible for inclusion in the present review (Figure 1). Thirteen studies were observational (comparing two groups with different psychological status) and 5 were interventional (comparing the study group, which received the psychological intervention, with a control group); two of the studies had both an observational and an interventional design (in one study, the authors both assessed the volunteers' preoperative psychological status and applied an intervention [17]; in the other study they asked the volunteers to visit the clinic twice and performed two separate analyses [22]). In seven studies there was some degree of blinding, 4 of the interventional studies were randomized and 6 studies did not report any blinding or randomization. The median quality of the interventional studies was 2. Most of the studies were prospective in design (exception: [21]) and performed multivariate analyses (exceptions: [16], [23], [25], [27]).

Bottom Line: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet.We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome.Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece.

ABSTRACT

Background: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery.

Methods: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes.

Results: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview) also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger.

Conclusion: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

Show MeSH
Related in: MedlinePlus