Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review

Ji, Wentao; Sang, Chao; Zhang, Xiaoting; Zhu, Kehua; Bo, Lulong

doi:10.3390/ijerph191912162

Cited by 22 publications

(16 citation statements)

References 128 publications

(161 reference statements)

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“…It is known that anxiety is more likely to precede depression through a causal link, suggesting that this is facilitated by the anxiety response style. 22 It can be argued that parturients with greater pre-operative anxiety possess certain personality traits that result in a defective stress response, 23 predisposing them to PND, among other post-operative complications such as increased post-operative analgesia usage and poor patient satisfaction, 24 and may even arguably influence the parturient’s preference for anesthesia modality for CD. 25 …”

Section: Discussionmentioning

confidence: 99%

Investigating Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Validation Cohort Study

Tan,

Sultana,

Chow

et al. 2024

NDT

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Purpose This study aimed to validate a proposed association model previously published to determine the clinical relevance of pre-operative determinants in the development of PND after Cesarean delivery (CD). Patients and Methods Parturients undergoing elective CD under neuraxial anesthesia were recruited for a prospective cohort study between Oct 2021 and Oct 2022 at KK Women’s and Children’s Hospital, Singapore. Predelivery pain, psychological and mechanical temporal summation, and demographic data were recorded. A follow-up survey was conducted at 6 to 10 weeks after CD. The primary outcome was the incidence of PND, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10. Results A total of 180 patients were recruited for validation. PND 6 to 10 weeks post-delivery occurred in 18.9% of recruited parturients. Multivariate regression analyses showed that higher pre-operative CSI scores (p=0.0156), higher anxiety levels about upcoming surgery (p=0.0429), increased pre-operative pain scores on movement (p=0.0110), and higher pre-operative HADS subscale scores on anxiety (p=0.0041) were independently associated with the development of PND weeks post-CD. Lower anticipation of pain medication needs (p=0.0038) was independently associated with the development of PND post-CD. The area under curve (AUC) of this multivariable model (training cohort), internal cross validation (training cohort) and external cross validation (validation cohort) were 0.818 (95% CI, 0.746 to 0.889), 0.785 (95% CI, 0.707 to 0.864) and 0.604 (95% CI, 0.497 to 0.710) respectively. Conclusion The proposed model performed well in a local population. Further refinement is necessary to test the proposed model in populations with social and cultural differences.

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Section: Discussionmentioning

confidence: 99%

Investigating Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Validation Cohort Study

Tan,

Sultana,

Chow

et al. 2024

NDT

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“…This prospective study is unique in that it evaluated multiple dimensions of postoperative pain after orbital fracture repairs using a validated survey tool. Pain after surgery is a complex, subjective and emotional experience with important affective and psychometric dimensions [11]. Alleviating postoperative pain is important in improving patient satisfaction after surgery and perceptions of surgical outcome [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Postoperative Pain and Satisfaction After Orbital Fracture Repair

Harold Lee

2024

JOAR

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Objective: To correlate clinical outcomes in postoperative pain managed with opioid medications after orbital fracture repairs. Methods: A prospective observational study of all patients who underwent orbital fracture repairs and postoperative pain managed with hydrocodone-acetaminophen, oxycodone-acetaminophen or tramadol for three days was performed. Collected data included numerical pain rating scores, type of fractures, patient satisfaction, side effects and non-medicinal interventions. International Pain Outcomes (IPO) questionnaire was completed at postoperative week one visit. Results: Twenty-nine patients who underwent orbital fracture repairs and completed the IPO questionnaire reported having taken an average of 74.8 +/- 36.6 Morphine Milligram Equivalent (MME) in the first week after the surgery from 102.5 +/- 10.0 MME of total opioids prescribed (Table 1). The amount of opioids used was not related to patient satisfaction or pain relief (p>0.05). Smoking status showed a moderate correlation and linear association with total MME taken by patients (spearman correlation coefficient 0.34, p=0.051). Although patients reported 69.4 +/- 24.9% overall pain relief and 9 out of 10 (median, IQR 5-10) scores in satisfaction with the pain regimen, 27.8% of patients reported needing more pain medication. This group reported higher levels of anxiety and lower satisfaction scores (p<0.001). They reported having taken more opioids than those who did not report the need for additional pain medications (p=0.07). Conclusion: Postoperative pain is managed with less than the prescribed amount of opioids after orbital fracture repairs in most patients. Anxious patients who had more opioids than average in the postoperative period expressed low satisfaction.

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“…Formal mobile-based cognitive behavioral therapy interventions still require greater and longer patient engagement and often mental health professional support [ 22 ]. In addition, cognitive behavioral therapy is most often used to address trait anxiety or mental disorder symptomatology by dealing with maladaptive thoughts and behaviors over time [ 23 ], rather than the more transient nature of PSA, which is a psychological state directly related to the stressor [ 24 ]. Thus, virtual reality (VR) may be optimally suited to address PSA because it requires less time commitment and may be undergone at any point in the weeks leading up to surgery, providing greater flexibility.…”

Section: Introductionmentioning

confidence: 99%

An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial

El-Gabalawy,

Sommer,

Hebbard

et al. 2024

JMIR Res Protoc

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Background Preoperative state anxiety (PSA) is distress and anxiety directly associated with perioperative events. PSA is associated with negative postoperative outcomes such as longer hospital length of stay, increased pain and opioid use, and higher rates of rehospitalization. Psychological prehabilitation, such as education, exposure to hospital environments, and relaxation strategies, has been shown to mitigate PSA; however, there are limited skilled personnel to deliver such interventions in clinical practice. Immersive virtual reality (VR) has the potential for greater accessibility and enhanced integration into an immersive and interactive experience. VR is rarely used in the preoperative setting, but similar forms of stress inoculation training involving exposure to stressful events have improved psychological preparation in contexts such as military deployment. Objective This study seeks to develop and investigate a targeted PSA intervention in patients undergoing oncological surgery using a single preoperative VR exposure. The primary objectives are to (1) develop a novel VR program for patients undergoing oncological surgery with general anesthesia; (2) assess the feasibility, including acceptability, of a single exposure to this intervention; (3) assess the feasibility, including acceptability, of outcome measures of PSA; and (4) use these results to refine the VR content and outcome measures for a larger trial. A secondary objective is to preliminarily assess the clinical utility of the intervention for PSA. Methods This study comprises 3 phases. Phase 1 (completed) involved the development of a VR prototype targeting PSA, using multidisciplinary iterative input. Phase 2 (data collection completed) involves examining the feasibility aspects of the VR intervention. This randomized feasibility trial involves assessing the novel VR preoperative intervention compared to a VR control (ie, nature trek) condition and a treatment-as-usual group among patients undergoing breast cancer surgery. Phase 3 will involve refining the prototype based on feasibility findings and input from people with lived experience for a future clinical trial, using focus groups with participants from phase 2. Results This study was funded in March 2019. Phase 1 was completed in April 2020. Phase 2 data collection was completed in January 2024 and data analysis is ongoing. Focus groups were completed in February 2024. Both the feasibility study and focus groups will contribute to further refinement of the initial VR prototype (phase 3), with the final simulation to be completed by mid-2024. Conclusions The findings from this work will contribute to the limited body of research examining feasible and broadly accessible interventions for PSA. Knowledge gained from this research will contribute to the final development of a novel VR intervention to be tested in a large population of patients with cancer before surgery in a randomized clinical trial. Trial Registration ClinicalTrials.gov NCT04544618; https://www.clinicaltrials.gov/study/NCT04544618 International Registered Report Identifier (IRRID) DERR1-10.2196/55692

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Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review

Cited by 22 publications

References 128 publications

Investigating Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Validation Cohort Study

Investigating Factors Associated with the Development of Postnatal Depression After Cesarean Delivery: A Validation Cohort Study

Evaluation of Postoperative Pain and Satisfaction After Orbital Fracture Repair

An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial

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