Effects of Pre-operative Psychological Status on Post-operative Recovery: A Prospective Study.

BACKGROUND: Often in clinical practice, a spectrum of outcomes from surgery may be observed ranging from a quick and comfortable recovery to a recovery punctuated by persistent pain and decreased quality of life. While there has been a fast pace of advances made in the field of operative surgery, surgeons seldom pay attention to factors such as the psychological profile of a patient that can affect recovery from surgery.

OBJECTIVE: To study the effects of pre-operative psychological profile on post-operative recovery in terms of pain, return to work and quality of life.

MATERIALS AND METHODS: Consecutive patients undergoing laparoscopic surgeries at Sagar Hospitals, Jayanagar, were recruited. All patients were assessed for psychological status using the screening for illness behaviour questionnaire (SIBQ) and pain catastrophizing scale (PCS). Following surgery, they were followed up for a period of 3 months-on post-operative day 1, post-operative day 7, 1 month and 3 months from the date of surgery. Post-operative pain was measured using the visual analogue scale (Wong-Baker's), return to work was documented in days and quality of life was measured using the Short Form-36 version 2 (SF-36v2) Health Survey. The Pearson's correlation coefficients were used to compare variables with continuous data and Chi-square and Fisher's tests were used to test categorical data for significance.

RESULTS: In a total of 98 patients recruited, 50 patients had a complete follow-up of 3 months. Significant correlations existed between the pre-operative markers and markers of recovery. The Chi-square test and Fisher's exact tests showed significant differences in the scores of pre-operative markers between the groups of patients who developed chronic pain and those who did not. Difference in scores with regard to quality of life was also noted.

CONCLUSION: Psychological status does play a role in post-operative recovery. This result opens up scope for counselling patients towards a healthy and comfortable recovery from surgery.